Gravitate Health FHIR Implementation Guide
0.1.0 - CI Build
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
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<div xmlns="http://www.w3.org/1999/xhtml"><p>What is in this leaflet</p><ol type="1"><li>What Repatha is and what it is used for</li><li>What you need to know before you use Repatha</li><li>How to use Repatha</li><li>Possible side effects</li><li>How to store Repatha</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>What Repatha is and how it works</p><p>Repatha is a medicine that lowers levels of bad cholesterol, a type of fat, in the blood.</p><p>Repatha contains the active substance evolocumab, a monoclonal antibody (a type of specialised protein designed to attach to a target substance in the body). Evolocumab is designed to attach to a substance called PCSK9 that affects the liver s ability to take in cholesterol. By attaching to, and mopping up PCSK9, the medicine increases the amount of cholesterol entering the liver and so lowers the level of cholesterol in the blood.</p><p>What Repatha is used for</p><p>Repatha is used in addition to your cholesterol lowering diet if you are:</p><ul><li>an adult with a high cholesterol level in your blood (primary hypercholesterolaemia [heterozygous familial and non-familial] or mixed dyslipidaemia). It is given:</li></ul><ul><li>together with a statin or other cholesterol lowering medication, if the maximum dose of a statin does not lower levels of cholesterol sufficiently.</li><li>alone or together with other cholesterol lowering medications when statins do not work well or cannot be used.</li></ul><ul><li>a child aged 10 years and older with a high cholesterol level in your blood because of a condition that runs in your family (heterozygous familial hypercholesterolaemia or HeFH). It is given alone or together with other cholesterol lowering treatments</li><li>an adult or a child aged 10 years and older with a high cholesterol level in your blood because of a condition that runs in your family (homozygous familial hypercholesterolaemia or HoFH). It is given together with other cholesterol lowering treatments</li><li>an adult with a high cholesterol level in your blood and established atherosclerotic cardiovascular disease (a history of heart attack, stroke or blood vessel problems). It is given:</li></ul><ul><li>together with a statin or other cholesterol lowering medication, if the maximum dose of a statin does not lower levels of cholesterol sufficiently.</li><li>alone or together with other cholesterol lowering medications when statins do not work well or cannot be used.</li></ul><p>Repatha is used in patients who cannot control their cholesterol levels with a cholesterol lowering diet alone. You should stay on your cholesterol lowering diet while taking this medicine. Repatha can help prevent heart attack, stroke, and certain heart procedures to restore blood flow to the heart due to a build-up of fatty deposits in your arteries (also known as atherosclerotic cardiovascular disease).</p></div>
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<div xmlns="http://www.w3.org/1999/xhtml"><p>Do not use Repatha if you are allergic to evolocumab or any of the other ingredients of this medicine (listed in section 6).</p><p>Warnings and precautions</p><p>Talk to your doctor, pharmacist or nurse before using Repatha if you have liver disease.</p><p>The needle cover of the glass pre-filled syringe is made from dry natural rubber (a derivative of latex), which may cause severe allergic reactions.</p><p>In order to improve the traceability of this medicine, your doctor or pharmacist should record the name and the lot number of the product you have been given in your patient file. You may also wish to make a note of these details in case you are asked for this information in the future.</p><p>Children and adolescents</p><p>The use of Repatha has been studied in children 10 years of age and older being treated for heterozygous or homozygous familial hypercholesterolaemia.</p><p>The use of Repatha has not been studied in children under 10 years of age.</p><p>Other medicines and Repatha</p><p>Tell your doctor or pharmacist if you are taking, have recently taken or might take any other medicines.</p><p>Pregnancy and breast-feeding</p><p>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>Repatha has not been tested in pregnant women. It is not known if Repatha will harm your unborn baby.</p><p>It is not known whether Repatha is found in breast milk.</p><p>It is important to tell your doctor if you are breast-feeding or plan to do so. Your doctor will then help you decide whether to stop breast-feeding, or whether to stop taking Repatha, considering the benefit of breast-feeding to the baby and the benefit of Repatha to the mother.</p><p>Driving and using machines</p><p>Repatha has no or negligible influence on the ability to drive and use machines.</p><p>Repatha contains sodium</p><p>This medicine contains less than 1 mmol sodium (23 mg) per dose, that is to say essentially sodium- free .</p></div>
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<div xmlns="http://www.w3.org/1999/xhtml"><p>Always use this medicine exactly as your doctor has told you. Check with your doctor if you are not sure.</p><p>The recommended dose depends on the underlying condition:</p><ul><li>for adults with primary hypercholesterolaemia and mixed dyslipidaemia the dose is either 140 mg every two weeks or 420 mg once monthly.</li><li>for children aged 10 years or older with heterozygous familial hypercholesterolaemia the dose is either 140 mg every two weeks or 420 mg once monthly.</li><li>for adults or children aged 10 years or older with homozygous familial hypercholesterolaemia the recommended starting dose is 420 mg once monthly. After 12 weeks your doctor may decide to increase the dose to 420 mg every two weeks. If you also receive apheresis, a procedure similar to dialysis where cholesterol and other fats are removed from the blood, your doctor may decide to start you on a dose of 420 mg every two weeks to coincide with your apheresis treatment.</li><li>for adults with established atherosclerotic cardiovascular disease (a history of heart attack, stroke or blood vessel problems) the dose is either 140 mg every two weeks or 420 mg once monthly.</li></ul><p>Repatha is given as an injection under the skin (subcutaneous).</p><p>If your doctor prescribes a dose of 420 mg you must use three pre-filled syringes because each pre-filled syringe only contains 140 mg of medicine. After reaching room temperature, all injections should be given within a 30 minute period.</p><p>If your doctor decides that you or a caregiver can give the injections of Repatha, you or your caregiver should receive training on how to prepare and inject Repatha correctly. Do not try to inject Repatha until you have been shown how to do it by your doctor or nurse.</p><p>See the detailed Instructions for Use at the end of this leaflet for instructions about how to store, prepare, and give your Repatha injections at home.</p><p>Before starting Repatha, you should be on a diet to lower your cholesterol. You should keep on this cholesterol lowering diet while taking Repatha.</p><p>If your doctor has prescribed Repatha along with another cholesterol lowering medicine, follow your doctor s instructions on how to take these medicines together. In this case, please read the dosage instructions in the package leaflet of that particular medicine as well.</p><p>If you use more Repatha than you should</p><p>Contact your doctor or pharmacist immediately.</p><p>If you forget to take Repatha</p><p>Take Repatha as soon as you can after the missed dose. Then, contact your doctor who will tell you when you should schedule your next dose, and follow the new schedule exactly as your doctor has told you.</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>Common (may affect up to 1 in 10 people)</p><ul><li>Flu (high temperature, sore throat, runny nose, cough and chills)</li><li>Common cold, such as runny nose, sore throat or sinus infections (nasopharyngitis or upper respiratory tract infections)</li><li>Feeling sick (nausea)</li><li>Back pain</li><li>Joint pain (arthralgia)</li><li>Muscle pain</li><li>Injection site reactions, such as bruising, redness, bleeding, pain or swelling</li><li>Allergic reactions including rash</li><li>Headache</li></ul><p>Uncommon (may affect up to 1 in 100 people)</p><ul><li>Hives, red itchy bumps on your skin (urticaria)</li><li>Flu-like symptoms</li></ul><p>Rare (may affect up to 1 in 1,000 people)</p><ul><li>Swelling of the face, mouth, tongue, or throat (angioedema)</li></ul><p>Reporting of side effects</p><p>If you get any side effects, talk to your doctor, 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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<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 and carton after EXP. The expiry date refers to the last day of that month.</p><p>Store in a refrigerator (2 C 8 C). Do not freeze. Store in the original carton in order to protect from light.</p><p>Your pre-filled syringe may be left outside the refrigerator to reach room temperature (up to 25 C) before injection. This will make the injection more comfortable. After removal from the refrigerator, Repatha may be stored at room temperature (up to 25 C) in the original carton and must be used within 1 month.</p><p>Do not use this medicine if you notice it is discoloured or contains large lumps, flakes or coloured particles.</p><p>Do not throw away any medicines via wastewater or household waste.</p><p>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 Repatha contains</p><ul><li>The active substance is evolocumab. Each pre-filled syringe contains 140 mg of evolocumab in 1 mL of solution.</li><li>The other ingredients are proline, glacial acetic acid, polysorbate 80, sodium hydroxide, water for injections.</li></ul><p>What Repatha looks like and contents of the pack</p><p>Repatha is a solution which is clear to opalescent, colourless to yellowish, and practically free from particles.</p><p>Each pack contains one single use pre-filled syringe.</p><p>Marketing Authorisation Holder and Manufacturer Amgen Europe B.V. Minervum 74817 ZK Breda The Netherlands</p><p>Marketing Authorisation Holder Amgen Europe B.V. Minervum 74817 ZK Breda The Netherlands</p><p>Manufacturer Amgen Technology (Ireland) Unlimited Company Pottery Road Dun Laoghaire Co Dublin Ireland</p><p>Manufacturer Amgen NV Telecomlaan 5-7 1831 Diegem Belgium</p><p>For any information about this medicine, please contact the local representative of the Marketing Authorisation Holder:</p><p>Belgi /Belgique/Belgien s.a. Amgen n.v. Tel/T l: +32 (0)2 7752Lietuva Amgen Switzerland AG Vilniaus filialas Tel: +370 5 219 7</p><p>.: +359 (0)2 424 7Luxembourg/Luxemburg s.a. Amgen Belgique/Belgien Tel/T l: +32 (0)2 7752 esk republika Amgen s.r.o. Tel: +420 221 773 Magyarorsz g Amgen Kft. Tel.: +36 1 35 44 Danmark Amgen, filial af Amgen AB, Sverige Tlf: +45 39617Malta Amgen B.V. The Netherlands Tel: +31 (0)76 5732Deutschland AMGEN GmbH Tel.: +49 89 1490Nederland Amgen B.V. Tel: +31 (0)76 5732Eesti Amgen Switzerland AG Vilniaus filialas Tel: +372 586 09Norge Amgen AB Tel: +47 23308<br/>Amgen . . . .: +30 210 3447 sterreich Amgen GmbH Tel: +43 (0)1 50 Espa a Amgen S.A. Tel: +34 93 600 18 Polska Amgen Biotechnologia Sp. z o.o. Tel.: +48 22 581 3France Amgen S.A.S. T l: +33 (0)9 69 363 Portugal Amgen Biofarmac utica, Lda. Tel: +351 21 422 06 Hrvatska Amgen d.o.o. Tel: +385 (0)1 562 57 Rom nia Amgen Rom nia SRL Tel: +4021 527 3Ireland Amgen Ireland Limited Tel: +353 1 8527Slovenija AMGEN zdravila d.o.o. Tel: +386 (0)1 585 1 sland Vistor hf. S mi: +354 535 7Slovensk republika Amgen Slovakia s.r.o. Tel: +421 2 321 114 Italia Amgen S.r.l. Tel: +39 02 6241Suomi/Finland Amgen AB, sivuliike Suomessa/Amgen AB, filial i Finland Puh/Tel: +358 (0)9 54900K<br/>C.A. Papaellinas Ltd .: +357 22741 Sverige Amgen AB Tel: +46 (0)8 6951Latvija Amgen Switzerland AG R gas fili le Tel: +371 257 25United Kingdom (Northern Ireland) Amgen Limited Tel: +44 (0)1223 420This 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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IG © 2021+ Gravitate Health Project. Package hl7.eu.fhir.ghepi#0.1.0 based on FHIR 5.0.0. Generated 2024-10-14
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QA Report
The Gravitate Health project has received funding from the IMI 2 Joint Undertaking under grant agreement No 945334.
This joint undertaking receives support from the EU H2020 research and innovation programme and EFPIA.
