Gravitate Health FHIR Implementation Guide
0.1.0 - CI Build

Gravitate Health FHIR Implementation Guide, published by Gravitate Health Project. This guide is not an authorized publication; it is the continuous build for version 0.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/joofio/test-epi-composition/ and changes regularly. See the Directory of published versions

: ePI document Bundle for vipidia Package Leaflet for language en - XML Representation

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          <div xmlns="http://www.w3.org/1999/xhtml" xml:lang="en" lang="en"><a name="Composition_composition-en-d0b40c63b26d00d8cd281b17148dcf97"> </a><p class="res-header-id"><b>Generated Narrative: Composition composition-en-d0b40c63b26d00d8cd281b17148dcf97</b></p><a name="composition-en-d0b40c63b26d00d8cd281b17148dcf97"> </a><a name="hccomposition-en-d0b40c63b26d00d8cd281b17148dcf97"> </a><a name="composition-en-d0b40c63b26d00d8cd281b17148dcf97-en-US"> </a><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px">Language: en</p><p style="margin-bottom: 0px">Profile: <a href="https://build.fhir.org/ig/HL7/emedicinal-product-info/StructureDefinition-Composition-uv-epi.html">Composition (ePI)</a></p></div><p><b>identifier</b>: <code>http://ema.europa.eu/identifier</code>/EU/1/13/844/001-030</p><p><b>status</b>: Final</p><p><b>type</b>: <span title="Codes:{https://spor.ema.europa.eu/rmswi/ 100000155538}">Package Leaflet</span></p><p><b>category</b>: <span title="Codes:{http://hl7.eu/fhir/ig/gravitate-health/CodeSystem/epicategory-cs R}">Raw</span></p><p><b>date</b>: 2022-02-16 13:28:17+0000</p><p><b>author</b>: <a href="Organization-mah-ema.html">Organization ACME industry</a></p><p><b>title</b>: TEST PURPOSES ONLY - vipidia</p><h3>Attesters</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Mode</b></td><td><b>Time</b></td></tr><tr><td style="display: none">*</td><td><span title="Codes:{http://hl7.org/fhir/composition-attestation-mode official}">Official</span></td><td>2022-02-16 13:28:17+0000</td></tr></table></div>
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              <div xmlns="http://www.w3.org/1999/xhtml"><p>What is in this leaflet</p><ol type="1"><li>What Vipidia is and what it is used for</li><li>What you need to know before you take Vipidia</li><li>How to take Vipidia</li><li>Possible side effects</li><li>How to store Vipidia</li><li>Contents of the pack and other information</li></ol></div>
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              <div xmlns="http://www.w3.org/1999/xhtml"><p>Vipidia contains the active substance alogliptin which belongs to a group of medicines called DPP-4 inhibitors (dipeptidyl peptidase-4 inhibitors) which are oral anti-diabetics . It is used to lower blood sugar levels in adults with type 2 diabetes. Type 2 diabetes is also called non-insulin-dependent diabetes mellitus or NIDDM.</p><p>Vipidia works to increase the levels of insulin in the body after a meal and decrease the amount of sugar in the body. It must be taken together with other anti-diabetic medicines, which your doctor will have prescribed for you, such as sulphonylureas (e.g. glipizide, tolbutamide, glibenclamide), metformin and/or thiazolidinediones (e.g. pioglitazone) and metformin and/or insulin.</p><p>Vipidia is taken when your blood sugar cannot be adequately controlled by diet, exercise and one or more of these other oral anti-diabetic medicines. It is important that you continue to take your other anti-diabetic medicine, and continue to follow the advice on diet and exercise that your nurse or doctor has given you.</p></div>
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              <div xmlns="http://www.w3.org/1999/xhtml"><p>Do not take Vipidia</p><ul><li>if you are allergic to alogliptin or any of the other ingredients of this medicine (listed in section 6)</li><li>if you have had a serious allergic reaction to any other similar medicines that you take to control your blood sugar. Symptoms of a serious allergic reaction may include; rash, raised red patches on your skin (hives), swelling of the face, lips, tongue, and throat that may cause difficulty in breathing or swallowing. Additional symptoms may include general itching and feeling of heat especially affecting the scalp, mouth, throat, palms of hands and soles of feet (Stevens-Johnson syndrome).</li></ul><p>Warnings and precautions<br/>Talk to your doctor or pharmacist before taking Vipidia:</p><ul><li>if you have type 1 diabetes (your body does not produce insulin)</li><li>if you have diabetic ketoacidosis (a complication of diabetes that occurs when the body is unable to breakdown glucose because there is not enough insulin). Symptoms include excessive thirst, frequent urination, loss of appetite, nausea or vomiting and rapid weight loss</li><li>if you are taking an anti-diabetic medicine known as sulphonylurea (e.g. glipizide, tolbutamide, glibenclamide) or insulin. Your doctor may want to reduce your dose of sulphonylurea or insulin when you take any of them together with Vipidia in order to avoid too low blood sugar (hypoglycaemia)</li><li>if you have kidney disease, you can still take this medicine but your doctor may reduce the dose</li><li>if you have liver disease</li><li>if you suffer from heart failure</li><li>if you are taking insulin or an anti-diabetic medicine, your doctor may want to reduce your dose of the other anti-diabetic medicine or insulin when you take either of them together with Vipidia in order to avoid low blood sugar</li><li>if you have or have had a disease of the pancreas</li></ul><p>Contact your doctor if you encounter blistering of the skin, as it may be a sign for a condition called bullous pemphigoid. Your doctor may ask you to stop alogliptin.</p><p>Children and adolescents<br/>Vipidia is not recommended for children and adolescents under 18 years due to lack of efficacy in these patients.</p><p>Other medicines and Vipidia Tell your doctor or pharmacist if you are taking, have recently taken or might take any other medicines.</p><p>Pregnancy and breast-feeding<br/>If you are pregnant or breast-feeding, think you may be pregnant or are planning to have a baby, ask your doctor or pharmacist for advice before taking this medicine.</p><p>There is no experience of using Vipidia in pregnant women or during breast-feeding. Vipidia should not be used during pregnancy or breast-feeding. Your doctor will help you to decide whether to continue breast-feeding or to continue using Vipidia.</p><p>Driving and using machines Vipidia is not known to affect your ability to drive and use machines. Taking Vipidia in combination with other anti-diabetic medicines called sulphonylureas, insulin or combination therapy with thiazolidinedione plus metformin can cause too low blood sugar levels (hypoglycaemia), which may affect your ability to drive and use machines.</p><p>Vipidia contains sodium This medicine contains less than 1 mmol sodium (23 mg) per tablet, that is to say essentially sodium- free .</p></div>
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              <div xmlns="http://www.w3.org/1999/xhtml"><p>Always take this medicine exactly as your doctor or pharmacist has told you. Check with your doctor or pharmacist if you are not sure.</p><p>Your doctor will prescribe Vipidia together with one or more other medicines to control your blood sugar levels. Your doctor will tell you if you need to change the amount of other medicines you take.</p><p>The recommended dose of Vipidia is 25 mg once a day. Patients with kidney disease If you have kidney disease your doctor may prescribe you a reduced dose. This may be 12.5 mg or 6.25 mg once a day, depending on the severity of your kidney disease.</p><p>Patients with liver disease If you have mildly or moderately reduced liver function, the recommended dose of Vipidia is 25 mg once a day. This medicine is not recommended for patients with severely reduced liver function due to the lack of data in these patients.</p><p>Swallow your tablet(s) whole with water. You can take this medicine with or without food.</p><p>If you take more Vipidia than you should If you take more tablets than you should, or if someone else or a child takes your medicine, contact or go to your nearest emergency centre straight away. Take this leaflet or some tablets with you so that your doctor knows exactly what you have taken.</p><p>If you forget to take Vipidia If you forget to take a dose, take it as soon as you remember it. Do not take a double dose to make up for a forgotten dose.</p><p>If you stop taking Vipidia Do not stop taking Vipidia without consulting your doctor first. Your blood sugar levels may increase when you stop taking Vipidia.</p><p>If you have any further questions on the use of this medicine, ask your doctor or pharmacist.</p></div>
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              <div xmlns="http://www.w3.org/1999/xhtml"><p>Like all medicines, this medicine can cause side effects, although not everybody gets them.</p><p>STOP taking Vipidia and contact a doctor immediately if you notice any of the following serious side effects:</p><p>Not known (frequency cannot be estimated from the available data):</p><ul><li>An allergic reaction. The symptoms may include: a rash, hives, swallowing or breathing problems, swelling of your lips, face, throat or tongue and feeling faint.</li><li>A severe allergic reaction: skin lesions or spots on your skin that can progress to a sore surrounded by pale or red rings, blistering and/or peeling of the skin possibly with symptoms such as itching, fever, overall ill feeling, achy joints, vision problems, burning, painful or itchy eyes and mouth sores (Stevens-Johnson syndrome and Erythema multiforme).</li><li>Severe and persistent pain in the abdomen (stomach area) which might reach through to your back, as well as nausea and vomiting, as it could be a sign of an inflamed pancreas (pancreatitis).</li></ul><p>You should also discuss with your doctor if you experience the following side effects:</p><p>Common (may affect up to 1 in 10 people):</p><ul><li>Symptoms of low blood sugar (hypoglycaemia) may occur when Vipidia is taken in combination with insulin or sulphonylureas (e.g. glipizide, tolbutamide, glibenclamide). Symptoms may include: trembling, sweating, anxiety, blurred vision, tingling lips, paleness, mood change or feeling confused. Your blood sugar could fall below the normal level, but can be increased again by taking sugar. It is recommended that you carry some sugar lumps, sweets, biscuits or sugary fruit juice.</li><li>Cold like symptoms such as sore throat, stuffy or blocked nose.</li><li>Rash</li><li>Itchy skin</li><li>Headache</li><li>Stomach ache</li><li>Diarrhoea</li><li>Indigestion, heartburn.</li></ul><p>Not known:</p><ul><li>Liver problems such as nausea or vomiting, stomach pain, unusual or unexplained tiredness, loss of appetite, dark urine or yellowing of your skin or the whites of your eyes.</li><li>Inflammation of the connective tissue within the kidneys (interstitial nephritis).</li><li>Blistering of the skin (bullous pemphigoid).</li></ul><p>Reporting of side effects If you get any side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet. You can also report side effects directly via the national reporting system listed in Appendix V. By reporting side effects you can help provide more information on the safety of this medicine.</p></div>
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              <div xmlns="http://www.w3.org/1999/xhtml"><p>Keep this medicine out of the sight and reach of children.</p><p>Do not use this medicine after the expiry date which is stated on the carton and blister after EXP. The expiry date refers to the last day of that month.</p><p>This medicinal product does not require any special storage conditions.</p><p>Do not throw away any medicines via wastewater or household waste. Ask your pharmacist how to throw away medicines you no longer use. These measures will help protect the environment.</p></div>
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              <div xmlns="http://www.w3.org/1999/xhtml"><p>What Vipidia contains</p><ul><li>The active substance is alogliptin.<br/>Each 25 mg tablet contains alogliptin benzoate equivalent to 25 mg alogliptin,</li><li>The other ingredients are: mannitol, microcrystalline cellulose, hydroxypropylcellulose, croscarmellose sodium, magnesium stearate, hypromellose, titanium dioxide (E171), red iron oxide (E172), macrogol 8000, shellac and black iron oxide (E172). Each 12.5 mg tablet contains alogliptin benzoate equivalent to 12.5 mg alogliptin</li><li>The other ingredients are: mannitol, microcrystalline cellulose, hydroxypropylcellulose, croscarmellose sodium, magnesium stearate, hypromellose, titanium dioxide (E171), yellow iron oxide (E172), macrogol 8000, shellac and black iron oxide (E172). Each 6.25 mg tablet contains alogliptin benzoate equivalent to 6.25 mg alogliptin</li><li>The other ingredients are: mannitol, microcrystalline cellulose, hydroxypropylcellulose, croscarmellose sodium, magnesium stearate, hypromellose, titanium dioxide (E171), red iron oxide (E172), macrogol 8000, shellac and black iron oxide (E172).</li></ul><p>What Vipidia looks like and contents of the pack</p><ul><li>Vipidia 25 mg film-coated tablets (tablets) are light red, oval (approximately 9.1 mm long by 5.1 mm wide), biconvex, film-coated tablets, with TAK and ALG-25 printed in grey ink on one side.</li><li>Vipidia 12.5 mg film-coated tablets (tablets) are yellow, oval (approximately 9.1 mm long by 5.1 mm wide), biconvex, film-coated tablets, with TAK and ALG-12.5 printed in grey ink on one side.</li><li>Vipidia 6.25 mg film-coated tablets (tablets) are light pink, oval (approximately 9.1 mm long by 5.1 mm wide), biconvex, film-coated tablets, with TAK and ALG-6.25 on printed in grey ink on one side.</li></ul><p>Vipidia is available in blister packs containing 10, 14, 28, 30, 56, 60, 84, 90, 98 or 100 tablets.</p><p>Not all pack sizes may be marketed.</p><p>Marketing Authorisation Holder Takeda Pharma A/S Delta Park 2665 Vallensbaek Strand Denmark</p><p>Manufacturer Takeda Ireland Limited Bray Business Park Kilruddery Co. Wicklow Ireland</p><p>For any information about this medicine, please contact the local representative of the Marketing Authorisation Holder:</p><p>Belgi /Belgique/Belgien Takeda Belgium NV T l/Tel: +32 2 464 06 <a href="mailto:medinfoEMEA@takeda.com">medinfoEMEA@takeda.com</a></p><p>Lietuva Takeda UAB Tel: +370 521 09 <a href="mailto:medinfoEMEA@takeda.com">medinfoEMEA@takeda.com</a></p><p>.: +359 2 958 27 <a href="mailto:medinfoEMEA@takeda.com">medinfoEMEA@takeda.com</a></p><p>Luxembourg/Luxemburg Takeda Belgium NV T l/Tel: +32 2 464 06 <a href="mailto:medinfoEMEA@takeda.com">medinfoEMEA@takeda.com</a><br/>esk republika Takeda Pharmaceuticals Czech Republic s.r.o. Tel: +420 234 722 <a href="mailto:medinfoEMEA@takeda.com">medinfoEMEA@takeda.com</a></p><p>Magyarorsz g Takeda Pharma Kft. Tel.: +36 1 270 <a href="mailto:7medinfoEMEA@takeda.com">7medinfoEMEA@takeda.com</a> Danmark Takeda Pharma A/S Tlf: +45 46 77 10 <a href="mailto:medinfoEMEA@takeda.com">medinfoEMEA@takeda.com</a></p><p>Malta Takeda HELLAS S.A. Tel: +30 210 <a href="mailto:6387medinfoEMEA@takeda.com">6387medinfoEMEA@takeda.com</a></p><p>Deutschland Takeda GmbH Tel: +49 (0)800 825 <a href="mailto:3medinfoEMEA@takeda.com">3medinfoEMEA@takeda.com</a></p><p>Nederland Takeda Nederland B.V. Tel: +31 20 203 <a href="mailto:5medinfoEMEA@takeda.com">5medinfoEMEA@takeda.com</a></p><p>Eesti Takeda Pharma AS Tel: +372 6177 <a href="mailto:medinfoEMEA@takeda.com">medinfoEMEA@takeda.com</a></p><p>Norge Takeda AS Tlf: +47 800 800 <a href="mailto:medinfoEMEA@takeda.com">medinfoEMEA@takeda.com</a></p><p>Takeda . . : +30 210 <a href="mailto:6387medinfoEMEA@takeda.com">6387medinfoEMEA@takeda.com</a><br/>sterreich Takeda Pharma Ges.m.b.H. Tel: +43 (0) 800-20 80 <a href="mailto:medinfoEMEA@takeda.com">medinfoEMEA@takeda.com</a></p><p>Espa a Laboratorios Menarini, S.A. Tel: +34 934 628 <a href="mailto:info@menarini.es">info@menarini.es</a></p><p>Polska Takeda Pharma Sp. z o.o. Tel.: <a href="mailto:+48223062medinfoEMEA@takeda.com">+48223062medinfoEMEA@takeda.com</a></p><p>France Takeda France SAS T l: + 33 1 40 67 33 <a href="mailto:medinfoEMEA@takeda.com">medinfoEMEA@takeda.com</a></p><p>Portugal Tecnimede - Sociedade T cnico-Medicinal, S.A Tel: +351 21 041 41 <a href="mailto:dmed.fv@tecnimede.pt">dmed.fv@tecnimede.pt</a></p><p>Hrvatska Takeda Pharmaceuticals Croatia d.o.o Tel: +385 1 377 88 <a href="mailto:medinfoEMEA@takeda.com">medinfoEMEA@takeda.com</a></p><p>Rom nia Takeda Pharmaceuticals SRL Tel: +40 21 335 03 <a href="mailto:medinfoEMEA@takeda.com">medinfoEMEA@takeda.com</a></p><p>Ireland Takeda Products Ireland Ltd Tel: 1800 937 <a href="mailto:medinfoEMEA@takeda.com">medinfoEMEA@takeda.com</a></p><p>Slovenija Takeda Pharmaceuticals farmacevtska dru ba d.o.o. Tel: +386 (0) 59 082 <a href="mailto:medinfoEMEA@takeda.com">medinfoEMEA@takeda.com</a></p><p>sland Vistor hf. S mi: +354 535 <a href="mailto:7medinfoEMEA@takeda.com">7medinfoEMEA@takeda.com</a></p><p>Slovensk republika Takeda Pharmaceuticals Slovakia s.r.o. Tel: +421 (2) 20 602 <a href="mailto:medinfoEMEA@takeda.com">medinfoEMEA@takeda.com</a></p><p>Italia Takeda Italia S.p.A. Tel: +39 06 <a href="mailto:502medinfoEMEA@takeda.com">502medinfoEMEA@takeda.com</a></p><p>Suomi/Finland Takeda Oy Puh/Tel: 0800 774 <a href="mailto:medinfoEMEA@takeda.com">medinfoEMEA@takeda.com</a></p><p>Takeda . . : +30 210 <a href="mailto:6387medinfoEMEA@takeda.com">6387medinfoEMEA@takeda.com</a></p><p>Sverige Takeda Pharma AB Tel: 020 795 <a href="mailto:medinfoEMEA@takeda.com">medinfoEMEA@takeda.com</a></p><p>Latvija Takeda Latvia SIA Tel: +371 <a href="mailto:67840medinfoEMEA@takeda.com">67840medinfoEMEA@takeda.com</a> United Kingdom (Northern Ireland) Takeda UK Ltd Tel: +44 (0) 2830 640 <a href="mailto:medinfoEMEA@takeda.com">medinfoEMEA@takeda.com</a></p><p>This leaflet was last revised in</p><p>Other sources of information</p><p>Detailed information on this medicine is available on the European Medicines Agency web site:</p></div>
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          <div xmlns="http://www.w3.org/1999/xhtml"><a name="MedicinalProductDefinition_mpd0b40c63b26d00d8cd281b17148dcf97"> </a><p class="res-header-id"><b>Generated Narrative: MedicinalProductDefinition mpd0b40c63b26d00d8cd281b17148dcf97</b></p><a name="mpd0b40c63b26d00d8cd281b17148dcf97"> </a><a name="hcmpd0b40c63b26d00d8cd281b17148dcf97"> </a><a name="mpd0b40c63b26d00d8cd281b17148dcf97-en-US"> </a><p><b>identifier</b>: <code>http://ema.europa.eu/identifier</code>/EU/1/13/844/001-030</p><p><b>type</b>: <span title="Codes:{http://hl7.org/fhir/medicinal-product-type MedicinalProduct}">Medicinal Product</span></p><p><b>domain</b>: <span title="Codes:{http://hl7.org/fhir/medicinal-product-domain Human}">Human use</span></p><p><b>status</b>: <span title="Codes:{http://hl7.org/fhir/publication-status active}">active</span></p><p><b>legalStatusOfSupply</b>: <span title="Codes:{https://spor.ema.europa.eu/rmswi 100000072084}">Medicinal product subject to medical prescription</span></p><blockquote><p><b>name</b></p><p><b>productName</b>: Vipidia 6.25 mg film-coated tablets</p><p><b>type</b>: <span title="Codes:{https://spor.ema.europa.eu/lists/220000000000 220000000001}">Full name</span></p><blockquote><p><b>part</b></p><p><b>part</b>: nan</p><p><b>type</b>: <span title="Codes:{https://spor.ema.europa.eu/lists/220000000000 220000000002}">Invented name part</span></p></blockquote><blockquote><p><b>part</b></p><p><b>part</b>: nan</p><p><b>type</b>: <span title="Codes:{https://spor.ema.europa.eu/lists/220000000000 220000000003}">Scientific name part</span></p></blockquote><blockquote><p><b>part</b></p><p><b>part</b>: nan</p><p><b>type</b>: <span title="Codes:{https://spor.ema.europa.eu/lists/220000000000 220000000004}">Strength part</span></p></blockquote><blockquote><p><b>part</b></p><p><b>part</b>: nan</p><p><b>type</b>: <span title="Codes:{https://spor.ema.europa.eu/lists/220000000000 220000000005}">Pharmaceutical dose form part</span></p></blockquote><h3>Usages</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Country</b></td><td><b>Jurisdiction</b></td><td><b>Language</b></td></tr><tr><td style="display: none">*</td><td><span title="Codes:{urn:iso:std:iso:3166 EU}">EU</span></td><td><span title="Codes:{urn:iso:std:iso:3166 EU}">EU</span></td><td><span title="Codes:{urn:ietf:bcp:47 en}">en</span></td></tr></table></blockquote></div>
        </text>
        <identifier>
          <system value="http://ema.europa.eu/identifier"/>
          <value value="EU/1/13/844/001-030"/>
        </identifier>
        <type>
          <coding>
            <system value="http://hl7.org/fhir/medicinal-product-type"/>
            <code value="MedicinalProduct"/>
            <display value="Medicinal Product"/>
          </coding>
        </type>
        <domain>
          <coding>
            <system value="http://hl7.org/fhir/medicinal-product-domain"/>
            <code value="Human"/>
            <display value="Human use"/>
          </coding>
        </domain>
        <status>
          <coding>
            <system value="http://hl7.org/fhir/publication-status"/>
            <code value="active"/>
            <display value="active"/>
          </coding>
        </status>
        <legalStatusOfSupply>
          <coding>
            <system value="https://spor.ema.europa.eu/rmswi"/>
            <code value="100000072084"/>
            <display
                     value="Medicinal product subject to medical prescription"/>
          </coding>
        </legalStatusOfSupply>
        <name>
          <productName value="Vipidia 6.25 mg film-coated tablets"/>
          <type>
            <coding>
              <system value="https://spor.ema.europa.eu/lists/220000000000"/>
              <code value="220000000001"/>
              <display value="Full name"/>
            </coding>
          </type>
          <part>
            <part value="nan"/>
            <type>
              <coding>
                <system
                        value="https://spor.ema.europa.eu/lists/220000000000"/>
                <code value="220000000002"/>
                <display value="Invented name part"/>
              </coding>
            </type>
          </part>
          <part>
            <part value="nan"/>
            <type>
              <coding>
                <system
                        value="https://spor.ema.europa.eu/lists/220000000000"/>
                <code value="220000000003"/>
                <display value="Scientific name part"/>
              </coding>
            </type>
          </part>
          <part>
            <part value="nan"/>
            <type>
              <coding>
                <system
                        value="https://spor.ema.europa.eu/lists/220000000000"/>
                <code value="220000000004"/>
                <display value="Strength part"/>
              </coding>
            </type>
          </part>
          <part>
            <part value="nan"/>
            <type>
              <coding>
                <system
                        value="https://spor.ema.europa.eu/lists/220000000000"/>
                <code value="220000000005"/>
                <display value="Pharmaceutical dose form part"/>
              </coding>
            </type>
          </part>
          <usage>
            <country>
              <coding>
                <system value="urn:iso:std:iso:3166"/>
                <code value="EU"/>
                <display value="EU"/>
              </coding>
            </country>
            <jurisdiction>
              <coding>
                <system value="urn:iso:std:iso:3166"/>
                <code value="EU"/>
                <display value="EU"/>
              </coding>
            </jurisdiction>
            <language>
              <coding>
                <system value="urn:ietf:bcp:47"/>
                <code value="en"/>
                <display value="en"/>
              </coding>
            </language>
          </usage>
        </name>
      </MedicinalProductDefinition>
    </resource>
  </entry>
</Bundle>