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 ecalta Package Leaflet for language en - JSON Representation

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  "timestamp" : "2023-06-27T10:09:22Z",
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          "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\" xml:lang=\"en\" lang=\"en\"><a name=\"Composition_composition-en-d1ac9f4f2138f35170941f82d23b13ed\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Composition composition-en-d1ac9f4f2138f35170941f82d23b13ed</b></p><a name=\"composition-en-d1ac9f4f2138f35170941f82d23b13ed\"> </a><a name=\"hccomposition-en-d1ac9f4f2138f35170941f82d23b13ed\"> </a><a name=\"composition-en-d1ac9f4f2138f35170941f82d23b13ed-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/1/07/416/002</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 - ecalta</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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        "title" : "TEST PURPOSES ONLY - ecalta",
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                  "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p>What is in this leaflet:</p><ol type=\"1\"><li>What ECALTA is and what it is used for</li><li>What you need to know before you or your child use ECALTA</li><li>How to use ECALTA</li><li>Possible side effects</li><li>How to store ECALTA</li><li>Contents of the pack and other information</li></ol></div>"
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              {
                "title" : "1. What ecalta is and what it is used for",
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                  "text" : "1. What ecalta is and what it is used for"
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                  "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p>ECALTA contains the active substance anidulafungin and is prescribed in adults and in paediatric patients aged 1 month to less than 18 years to treat a type of fungal infection of the blood or other internal organs called invasive candidiasis. The infection is caused by fungal cells (yeasts) called Candida.</p><p>ECALTA belongs to a group of medicines called echinocandins. These medicines are used to treat serious fungal infections.</p><p>ECALTA prevents normal development of fungal cell walls. In the presence of ECALTA, fungal cells have incomplete or defective cell walls, making them fragile or unable to grow.</p></div>"
                }
              },
              {
                "title" : "2. What you need to know before you take ecalta",
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                  "text" : "2. What you need to know before you take ecalta"
                },
                "text" : {
                  "status" : "additional",
                  "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p>Do not use ECALTA</p><ul><li>if you are allergic to anidulafungin, other echinocandins (e.g. caspofungin acetate), or any of the other ingredients of this medicine (listed in section 6).</li></ul><p>Warnings and precautions</p><p>Talk to your doctor or pharmacist or nurse before using ECALTA.</p><p>Your doctor may decide to monitor you</p><ul><li>for liver function more closely if you develop liver problems during your treatment</li><li>if you are given anaesthetics during your treatment with ECALTA</li><li>for signs of an allergic reaction such as itching, wheezing, blotchy skin</li><li>for signs of an infusion related reaction which could include a rash, hives, itching, redness</li><li>for shortness of breath/breathing difficulties, dizziness or lightheadedness</li></ul><p>Children and adolescents</p><p>ECALTA should not be given to patients under 1 month of age.</p><p>Other medicines and ECALTA</p><p>Tell your doctor or pharmacist if you or your child are taking, have recently taken or might take any other medicines.</p><p>Pregnancy and breast-feeding</p><p>The effect of ECALTA in pregnant women is not known. Therefore, ECALTA is not recommended during pregnancy. Effective contraception should be used in women of childbearing age. Contact your doctor immediately if you become pregnant while taking ECALTA.</p><p>The effect of ECALTA in breast-feeding women is not known. Ask your doctor or pharmacist for advice before taking ECALTA while breast-feeding.</p><p>Ask your doctor or pharmacist for advice before taking any medicines.</p><p>ECALTA contains fructose</p><p>This medicine contains 119 mg fructose (a type of sugar) in each vial. If you have been told by your doctor that you have an intolerance to some sugars, contact your doctor before taking this medicinal product.</p><p>If you (or your child) have hereditary fructose intolerance (HFI), a rare genetic disorder, you (or your child) must not receive this medicine. Patients with HFI cannot break down fructose in this medicine, which may cause serious side effects.</p><p>You must tell your doctor before receiving this medicine if you (or your child) have HFI or if your child can no longer take sweet foods or drinks because they feel sick, vomit or get unpleasant effects such as bloating, stomach cramps or diarrhoea.</p><p>ECALTA contains sodium</p><p>This medicine contains less than 1 mmol sodium (23 mg) per vial, that is to say essentially sodium-free .</p></div>"
                }
              },
              {
                "title" : "3. How to take ecalta",
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                  "text" : "3. How to take ecalta"
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                "text" : {
                  "status" : "additional",
                  "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p>ECALTA will always be prepared and given to you or your child by a doctor or a healthcare professional (there is more information about the method of preparation at the end of the leaflet in the section for medical and healthcare professionals only).</p><p>For use in adults, the treatment starts with 200 mg on the first day (loading dose). This will be followed by a daily dose of 100 mg (maintenance dose).</p><p>For use in children and adolescents (age from 1 month to less than 18 years), the treatment starts with 3.0 mg/kg (not to exceed 200 mg) on the first day (loading dose). This will be followed by a daily dose of 1.5 mg/kg (not to exceed 100 mg) (maintenance dose). The dose that is given depends on the patient s weight.</p><p>ECALTA should be given to you once a day, by slow infusion (a drip) into your vein. For adults, this will take at least 1.5 hours for the maintenance dose and 3 hours for the loading dose. For children and adolescents, the infusion may take less time depending on the patient s weight.</p><p>Your doctor will determine the duration of your treatment and how much ECALTA you will receive each day and will monitor your response and condition.</p><p>In general, your treatment should continue for at least 14 days after the last day Candida was found in your blood.</p><p>If you receive more ECALTA than you should</p><p>If you are concerned that you may have been given too much ECALTA, tell your doctor or another healthcare professional immediately.</p><p>If you forgot to use ECALTA</p><p>As you will be given this medicine under close medical supervision, it is unlikely that a dose would be missed. However tell your doctor or pharmacist if you think that a dose has been forgotten.</p><p>You should not be given a double dose by doctor.</p><p>If you stop using ECALTA</p><p>You should not experience any effects from ECALTA if your doctor stops ECALTA treatment.</p><p>Your doctor may prescribe another medicine following your treatment with ECALTA to continue treating your fungal infection or prevent it from returning.</p><p>If your original symptoms come back, tell your doctor or another healthcare professional immediately.</p><p>If you have any further questions on the use of this medicine, ask your doctor, or pharmacist or nurse.</p></div>"
                }
              },
              {
                "title" : "4. Possible side effects",
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                  "text" : "4. Possible side effects"
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                  "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p>Like all medicines, this medicine can cause side effects, although not everybody gets them. Some of these side effects will be noted by your doctor while monitoring your response and condition.</p><p>Life-threatening allergic reactions that might include difficulty breathing with wheezing or worsening of an existing rash have been rarely reported during administration of ECALTA.</p><p>Serious side effects tell your doctor or another healthcare professional immediately should any of the following occur:</p><ul><li>Convulsion (seizure)</li><li>Flushing</li><li>Rash, pruritis (itching)</li><li>Hot flush</li><li>Hives</li><li>Sudden contraction of the muscles around the airways resulting in wheezing or coughing</li><li>Difficulty of breathing</li></ul><p>Other side effects</p><p>Very common side effects (may affect more than 1 in 10 people) are:</p><ul><li>Low blood potassium (hypokalaemia)</li><li>Diarrhoea</li><li>Nausea</li></ul><p>Common side effects (may affect up to 1 in 10 people) are:</p><ul><li>Convulsion (seizure)</li><li>Headache</li><li>Vomiting</li><li>Changes in blood tests of liver function</li><li>Rash, pruritis (itching)</li><li>Changes in blood tests of kidney function</li><li>Abnormal flow of bile from the gallbladder into the intestine (cholestasis)</li><li>High blood sugar</li><li>High blood pressure</li><li>Low blood pressure</li><li>Sudden contraction of the muscles around the airways resulting in wheezing or coughing</li><li>Difficulty of breathing</li></ul><p>Uncommon side effects (may affect up to 1 in 100 people) are:</p><ul><li>Disorder of blood clotting system</li><li>Flushing</li><li>Hot flush</li><li>Stomach pain</li><li>Hives</li><li>Pain at injection site</li></ul><p>Not known (frequency cannot be estimated from the available data) are:</p><ul><li>Life-threatening allergic reactions</li></ul><p>Reporting of side effects<br/>If you get any side effects, talk to your doctor or, pharmacist or nurse. 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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                "title" : "5. How to store ecalta",
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                  "div" : "<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 label. The expiry date refers to the last day of that month.</p><p>Store in a refrigerator (2 C 8 C).</p><p>The reconstituted solution may be stored up to 25 C for up to 24 hours. The infusion solution may be stored at 25 C (room temperature) for 48 hours (do not freeze) and should be administered at 25 C (room temperature) within 48 hours.</p><p>Do not throw away any medicines via wastewater or household waste.</p></div>"
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                  "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p>What ECALTA contains</p><ul><li>The active substance is anidulafungin. Each vial of powder contains 100 mg anidulafungin.</li><li>The other ingredients are: fructose (see section 2 ECALTA contains fructose ), mannitol, polysorbate 80, tartaric acid, sodium hydroxide (for pH-adjustment) (see section 2 ECALTA contains sodium ), hydrochloric acid (for pH-adjustment)</li></ul><p>What ECALTA looks like and contents of the pack</p><p>ECALTA is supplied as a box containing 1 vial of 100 mg powder for concentrate for solution for infusion.</p><p>The powder is white to off-white.</p><p>Marketing Authorisation Holder</p><p>Pfizer Europe MA EEIG, Boulevard de la Plaine 17, 1050 Bruxelles, Belgium</p><p>Manufacturer</p><p>Pfizer Manufacturing Belgium NV, Rijksweg 12, 2870 Puurs-Sint-Amands, Belgium</p><p>For any information about this medicine, please contact the local representative of the Marketing Authorisation Holder:</p><p>Belgi /Belgique/Belgien Luxembourg/Luxemburg Pfizer NV/SA T l/Tel: +32 (0)2 554 62 Lietuva Pfizer Luxembourg SARL<br/>filialas Lietuvoje Tel. +3705 2514<br/>,<br/>.: +359 2 970 4Magyarorsz g Pfizer Kft. Tel. + 36 1 488 37 esk republika Pfizer, spol. s r.o. Tel: +420-283-004-Malta Vivian Corporation Ltd. Tel : +356 21344Danmark Pfizer ApS Tlf: +45 44 20 11 Nederland Pfizer bv Tel: +31 (0)800 63 34 Deutschland PFIZER PHARMA GmbH Tel: +49 (0)30 550055-51Norge Pfizer AS Tlf: +47 67 52 61 Eesti Pfizer Luxembourg SARL Eesti filiaal Tel: +372 666 7 sterreich Pfizer Corporation Austria Ges.m.b.H. Tel: +43 (0)1 521 15-0</p><p>Pfizer A.E. .: +30 210 6785 Polska Pfizer Polska Sp. z o.o., Tel.: +48 22 335 61 Espa a Pfizer, S.L. Tel: +34 91 490 99 Portugal Laborat rios Pfizer, Lda. Tel: + 351 214 235 France Pfizer<br/>T l: +33 (0)1 58 07 34 Rom nia Pfizer Rom nia S.R.L Tel: +40 (0)21 207 28 Hrvatska Pfizer Croatia d.o.o. Tel: + 385 1 3908 Slovenija Pfizer Luxembourg SARL Pfizer, podru nica za svetovanje s podro ja farmacevtske dejavnosti, Ljubljana Tel: + 386 (0)152 11 Ireland Pfizer Healthcare Ireland Tel: 1800 633 363 (toll free) Tel: +44 (0)1304 616Slovensk republika Pfizer Luxembourg SARL, organiza n zlo ka Tel: +421-2-3355 5 sland Icepharma hf.,<br/>S mi: + 354 540 8Suomi/Finland Pfizer Oy Puh/Tel: +358(0)9 43 00 Italia Pfizer S.r.l. Tel: +39 06 33 18 Sverige Pfizer AB Tel: +46 (0)8 5505 2K<br/>Pfizer . . (Cyprus Branch)<br/>: +357 22 817United Kingdom (Northern Ireland) Pfizer Limited Tel: +44 (0)1304 616Latvija Pfizer Luxembourg SARL Fili le Latvij<br/>Tel: +371 670 35 This leaflet was last revised in {MM/YYYY}.</p><p>Detailed information on this medicine is available on the European Medicines Agency web site:</p></div>"
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                "part" : "nan",
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                    {
                      "system" : "https://spor.ema.europa.eu/lists/220000000000",
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                      "display" : "Strength part"
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                  ]
                }
              },
              {
                "part" : "nan",
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                    {
                      "system" : "https://spor.ema.europa.eu/lists/220000000000",
                      "code" : "220000000005",
                      "display" : "Pharmaceutical dose form part"
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                  ]
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              }
            ],
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                    {
                      "system" : "urn:iso:std:iso:3166",
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                      "display" : "EU"
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                  "coding" : [
                    {
                      "system" : "urn:iso:std:iso:3166",
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                      "display" : "EU"
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                  ]
                },
                "language" : {
                  "coding" : [
                    {
                      "system" : "urn:ietf:bcp:47",
                      "code" : "en",
                      "display" : "en"
                    }
                  ]
                }
              }
            ]
          }
        ]
      }
    }
  ]
}