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 Pemetrexed Pfizer is and what it is used for</li><li>What you need to know before you use Pemetrexed Pfizer</li><li>How to use Pemetrexed Pfizer</li><li>Possible side effects</li><li>How to store Pemetrexed Pfizer</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>Pemetrexed Pfizer is a medicine used in the treatment of cancer.</p><p>Pemetrexed Pfizer is given in combination with cisplatin, another anti-cancer medicine, as treatment for malignant pleural mesothelioma, a form of cancer that affects the lining of the lung, to patients who have not received prior chemotherapy.</p><p>Pemetrexed Pfizer is also given in combination with cisplatin for the initial treatment of patients with advanced stage of lung cancer.</p><p>Pemetrexed Pfizer can be prescribed to you if you have lung cancer at an advanced stage if your disease has responded to treatment or it remains largely unchanged after initial chemotherapy.</p><p>Pemetrexed Pfizer is also a treatment for patients with advanced stage of lung cancer whose disease has progressed after other initial chemotherapy has been used.</p></div>
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<div xmlns="http://www.w3.org/1999/xhtml"><p>Do not use Pemetrexed Pfizer</p><ul><li>if you are allergic (hypersensitive) to pemetrexed or any of the other ingredients of this medicine (listed in section 6).</li><li></li></ul><h2 id="if-you-are-breast-feeding-you-must-discontinue-breast-feeding-during-treatment-with-pemetrexed-pfizer">if you are breast-feeding; you must discontinue breast-feeding during treatment with Pemetrexed Pfizer.</h2><p>if you have recently received or are about to receive a vaccine against yellow fever.</p><p>Warnings and precautions</p><p>Talk to your doctor or hospital pharmacist before receiving Pemetrexed Pfizer.</p><p>If you currently have or have previously had problems with your kidneys, talk to your doctor or hospital pharmacist as you may not be able to receive Pemetrexed Pfizer. Before each infusion you will have samples of your blood taken to evaluate if you have sufficient kidney and liver function and to check that you have enough blood cells to receive Pemetrexed Pfizer. Your doctor may decide to change the dose or delay treating you depending on your general condition and if your blood cell counts are too low. If you are also receiving cisplatin, your doctor will make sure that you are properly hydrated and receive appropriate treatment before and after receiving cisplatin to prevent vomiting.</p><p>If you have had or are going to have radiation therapy, please tell your doctor, as there may be an early or late radiation reaction with Pemetrexed Pfizer.</p><p>If you have been recently vaccinated, please tell your doctor, as this can possibly cause bad effects with Pemetrexed Pfizer.</p><p>If you have heart disease or a history of heart disease, please tell your doctor.</p><p>If you have an accumulation of fluid around your lungs, your doctor may decide to remove the fluid before giving you Pemetrexed Pfizer.</p><p>Children and adolescents This medicine should not be used in children or adolescents, since there is no experience with this medicine in children and adolescents under 18 years of age.</p><p>Other medicines and Pemetrexed Pfizer Please tell your doctor if you are taking any medicine for pain or inflammation (swelling), such as medicines called nonsteroidal anti-inflammatory drugs (NSAIDs), including medicines purchased without a doctor s prescription (such as ibuprofen). There are many sorts of NSAIDs with different durations of activity. Based on the planned date of your infusion of pemetrexed and/or on the status of your kidney function, your doctor needs to advise you on which medicines you can take and when you can take them. If you are unsure, ask your doctor or pharmacist if any of your medicines are NSAIDs.</p><p>Please tell your doctor or hospital pharmacist if you are taking or have recently taken any other medicines, including medicines obtained without a prescription.</p><p>Pregnancy If you are pregnant, think you may be pregnant or are planning to have a baby, tell your doctor. The use of pemetrexed should be avoided during pregnancy. Your doctor will discuss with you the potential risk of taking pemetrexed during pregnancy. Women must use effective contraception during treatment with pemetrexed and for 6 months after receiving the last dose.</p><p>Breast-feeding If you are breast-feeding, tell your doctor.<br/>Breast-feeding must be discontinued during treatment with pemetrexed.</p><p>Fertility Men are advised not to father a child during and up to 3 months following treatment with pemetrexed and should therefore use effective contraception during treatment with pemetrexed and for up to 3 months afterwards. If you would like to father a child during the treatment or in the 3 months following receipt of treatment, seek advice from your doctor or pharmacist. Pemetrexed Pfizer can affect your ability to have children. Talk to your doctor to seek advice about sperm storage before starting your therapy.</p><p>Driving and using machines Pemetrexed Pfizer may make you feel tired. Be careful when driving a car or using machines.</p><p>Pemetrexed Pfizer contains sodium</p><p>Pemetrexed Pfizer 100 mg powder for concentrate for solution for infusion This medicine contains less than 1 mmol sodium (23 mg) per vial, that is to say essentially sodium- free .</p><p>Pemetrexed Pfizer 500 mg powder for concentrate for solution for infusion This medicine contains 54 mg sodium (main component of cooking/table salt) in each vial. This is equivalent to 2.7 % of the recommended maximum daily dietary intake of sodium for an adult.</p><p>Pemetrexed Pfizer 1,000 mg powder for concentrate for solution for infusion<br/>This medicine contains 108 mg sodium (main component of cooking/table salt) in each vial. This is equivalent to 5.4 % of the recommended maximum daily dietary intake of sodium for an adult.</p></div>
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<div xmlns="http://www.w3.org/1999/xhtml"><p>The dose of Pemetrexed Pfizer is 500 milligrams for every square metre of your body s surface area. Your height and weight are measured to work out the surface area of your body. Your doctor will use this body surface area to work out the right dose for you. This dose may be adjusted, or treatment may be delayed depending on your blood cell counts and on your general condition. A hospital pharmacist, nurse or doctor will have mixed the Pemetrexed Pfizer powder with sodium chloride 9 mg/ml (0.9 %) solution for injection before it is given to you.</p><p>You will always receive Pemetrexed Pfizer by infusion into one of your veins. The infusion will last approximately 10 minutes.</p><p>When using Pemetrexed Pfizer in combination with cisplatin: The doctor or hospital pharmacist will work out the dose you need based on your height and weight. Cisplatin is also given by infusion into one of your veins, and is given approximately 30 minutes after the infusion of Pemetrexed Pfizer has finished. The infusion of cisplatin will last approximately 2 hours.</p><p>You should usually receive your infusion once every 3 weeks.</p><p>Additional medicines: Corticosteroids: your doctor will prescribe you steroid tablets (equivalent to 4 milligram of dexamethasone twice a day) that you will need to take on the day before, on the day of, and the day after Pemetrexed Pfizer treatment. This medicine is given to you to reduce the frequency and severity of skin reactions that you may experience during your anti-cancer treatment.</p><p>Vitamin supplementation: your doctor will prescribe you oral folic acid (vitamin) or a multivitamin containing folic acid (350 to 1,000 micrograms) that you must take once a day while you are taking Pemetrexed Pfizer. You must take at least 5 doses during the seven days before the first dose of Pemetrexed Pfizer. You must continue taking the folic acid for 21 days after the last dose of Pemetrexed Pfizer. You will also receive an injection of vitamin B12 (1,000 micrograms) in the week before administration of Pemetrexed Pfizer and then approximately every 9 weeks (corresponding to 3 courses of Pemetrexed Pfizer treatment). Vitamin B12 and folic acid are given to you to reduce the possible toxic effects of the anti-cancer treatment.</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>You must contact your doctor immediately if you notice any of the following:</p><p>Fever or infection (respectively, common or very common): if you have a temperature of 38 C or greater, sweating or other signs of infection (since you might have fewer white blood cells than normal which is very common). Infection (sepsis) may be severe and could lead to death.</p><p>If you start feeling chest pain (common) or having a fast heart rate (uncommon).</p><p>If you have pain, redness, swelling or sores in your mouth (very common).</p><p>Allergic reaction: if you develop skin rash (very common) / burning or prickling sensation (common), or fever (common). Rarely, skin reactions may be severe and could lead to death. Contact your doctor if you get a severe rash, or itching, or blistering (Stevens-Johnson syndrome or toxic epidermal necrolysis).</p><p>If you experience tiredness, feeling faint, becoming easily breathless or if you look pale (since you might have less haemoglobin than normal which is very common).</p><p>If you experience bleeding from the gums, nose or mouth or any bleeding that would not stop, reddish or pinkish urine, unexpected bruising (since you might have less platelets than normal which is common).</p><p>If you experience sudden breathlessness, intense chest pain or cough with bloody sputum (uncommon) (may indicate a blood clot in the blood vessels of the lungs).</p><p>Side effects with pemetrexed may include:</p><p>Very common (may affect more than 1 in 10 people) Infection Pharyngitis (a sore throat) Low number of neutrophil granulocytes (a type of white blood cell) Low white blood cells Low haemoglobin level<br/>Pain, redness, swelling or sores in your mouth Loss of appetite Vomiting Diarrhoea<br/>Nausea Skin rash Flaking skin Abnormal blood tests showing reduced functionality of kidneys<br/>Fatigue (tiredness)</p><p>Common (may affect up to 1 in 10 people) Blood infection Fever with low number of neutrophil granulocytes (a type of white blood cell) Low platelet count Allergic reaction Loss of body fluids Taste change Damage to the motor nerves which may cause muscle weakness and atrophy (wasting) primary in the arms and legs) Damage to the sensory nerves that may cause loss of sensation, burning pain and unsteady gait Dizziness Inflammation or swelling of the conjunctiva (the membrane that lines the eyelids and covers the white of the eye Dry eye Watery eyes Dryness of the conjunctiva (the membrane that lines the eyelids and covers the white of the eye) and cornea (the clear layer in front of the iris and pupil). Swelling of the eyelids Eye disorder with dryness, tearing, irritation, and/or pain Cardiac Failure (Condition that affects the pumping power of your heart muscles) Irregular heart rhythm Indigestion Constipation Abdominal pain Liver: increases in the chemicals in the blood made by the liver<br/>Increased skin pigmentation Itchy skin Rash on the body where each mark resembles a bullseye Hair loss Hives Kidney stop working Reduced functionality of kidney<br/>Fever Pain Excess fluid in body tissue, causing swelling Chest pain Inflammation and ulceration of the mucous membranes lining the digestive tract</p><p>Uncommon (may affect up to 1 in 100 people) Reduction in the number of red, white blood cells and platelets Stroke Type of stroke when an artery to the brain is blocked Bleeding inside the skull Angina (Chest pain caused by reduced blood flow to the heart) Heart attack Narrowing or blockage of the coronary arteries Increased heart rhythm Deficient blood distribution to the limbs Blockage in one of the pulmonary arteries in your lungs Inflammation and scarring of the lining of the lungs with breathing problems Passage of bright red blood from the anus Bleeding in the gastrointestinal tract Ruptured bowel Inflammation of the lining of the oesophagus Inflammation of the lining of the large bowel, which may be accompanied by intestinal or rectal bleeding (seen only in combination with cisplatin) Inflammation, edema, erythema, and erosion of the mucosal surface of the esophagus caused by radiation therapy Inflammation of the lung caused by radiation therapy</p><p>Rare (may affect up to 1 in 1,000 people) Destruction of red blood cells Anaphylactic shock (severe allergic reaction) Inflammatory condition of the liver Redness of the skin Skin rash that develops throughout a previously irradiated area</p><p>Very rare (affect up to 1 of 10 000 people) Infections of skin and soft tissues Stevens-Johnson syndrome (a type of severe skin and mucous membranes reaction that may be life threatening) Toxic epidermal necrolysis (a type of severe skin reaction that may be life threatening) Autoimmune disorder that results in skin rashes and blistering on the legs, arms, and abdomen Inflammation of the skin characterized by the presence of bullae which are filled with fluid Skin fragility, blisters and erosions and skin scarring Redness, pain and swelling mainly of the lower limbs Inflammation of the skin and fat beneath the skin (pseudocellulitis) Inflammation of the skin (dermatitis) Skin to become inflamed, itchy, red, cracked, and rough Intensely itchy spots</p><p>Not known (frequency cannot be estimated from the available data) Form of diabetes primarily due to pathology of the kidney Disorder of the kidneys involving the death of tubular epithelial cells that form the renal tubules</p><p>You might have any of these symptoms and/or conditions. You must tell your doctor as soon as possible when you start experiencing any of these side effects.</p><p>If you are concerned about any side effects, talk to your doctor.</p><p>Reporting of side effects If you get any side effects, talk to your doctor. 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 vial label after EXP. The expiry date refers to the last day of that month.</p><p>This medicine does not require any special storage conditions.</p><p>Reconstituted and infusion solution: The product should be used immediately. When prepared as directed, chemical and physical in-use stability of reconstituted and infusion solutions of pemetrexed were demonstrated for 24 hours at refrigerated temperature (2 C to 8 C).</p><p>The reconstituted solution is clear and ranges in colour from colourless to yellow or green-yellow without adversely affecting product quality. Parenteral medicines must be inspected visually for particulate matter and discolouration prior to administration. If particulate matter is observed, do not administer.</p><p>This medicine is for single use only; any unused solution must be disposed of in accordance with local requirements.</p></div>
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<div xmlns="http://www.w3.org/1999/xhtml"><p>What Pemetrexed Pfizer contains</p><p>The active substance is pemetrexed.</p><p>Pemetrexed Pfizer 100 mg powder for concentrate for solution for infusion: Each vial contains 100 milligrams of pemetrexed (as pemetrexed disodium hemipentahydrate).</p><p>Pemetrexed Pfizer 500 mg powder for concentrate for solution for infusion: Each vial contains 500 milligrams of pemetrexed (as pemetrexed disodium hemipentahydrate).</p><p>Pemetrexed Pfizer 1,000 mg powder for concentrate for solution for infusion: Each vial contains 1,000 milligrams of pemetrexed (as pemetrexed disodium hemipentahydrate).</p><p>After reconstitution as directed, the solution contains 25 mg/ml of pemetrexed. Further dilution by a healthcare provider is required prior to administration.</p><p>The other ingredients are mannitol (E421), hydrochloric acid (for pH adjustment) and sodium hydroxide (for pH adjustment). Refer to section 2 Pemetrexed Pfizer contains sodium .</p><p>What Pemetrexed Pfizer looks like and contents of the pack</p><p>Pemetrexed Pfizer is a powder for concentrate for solution for infusion in a glass vial. It is a white to either light yellow or green-yellow lyophilised powder.</p><p>Each pack contains one vial of 100 mg, 500 mg or 1,000 mg pemetrexed as (pemetrexed disodium hemipentahydrate).</p><p>Marketing Authorisation Holder Pfizer Europe MA EEIG Boulevard de la Plaine 1050 Bruxelles Belgium</p><p>Manufacturer Pfizer Service Company BV Hoge Wei 1930 Zaventem Belgium</p><p>For any information about this medicine, please contact the local representative of the Marketing Authorisation Holder:</p><p>BE Pfizer SA/NV T l/Tel: +32 2 554 62 LT Pfizer Luxembourg SARL filialas Lietuvoje Tel. + 370 52 51 4BG ,<br/>.: +359 2 970 4LU Pfizer SA/NV T l/Tel: +32 2 554 62 CZ Pfizer, spol. s r.o. Tel: +420-283-004-HU Pfizer Kft. Tel: + 36 1 488 37 DK Pfizer ApS Tlf: + 45 44 20 11 MT Drugsales Ltd<br/>Tel.: + 356 21 419 070/1/2</p><p>DE<br/>PFIZER PHARMA GmbH<br/>Tel: +49 (0)30 550055-51NL Pfizer bv Tel: +31 (0) 800 63 34 EE Pfizer Luxembourg SARL Eesti filiaal Tel: +372 666 7NO Pfizer AS Tlf: +47 67 52 61 EL Pfizer A.E. .: +30 210 6785 AT Pfizer Corporation Austria Ges.m.b.H. Tel: +43 (0)1 521 15-0</p><p>ES Pfizer, S.L. Tel: +34 91 490 99 PL Pfizer Polska Sp. z o.o. Tel: +48 22 335 61 FR Pfizer T l: + 33 (0)1 58 07 34 PT Laborat rios Pfizer, Lda. Tel: + 351 21 423 55 HR Pfizer Croatia d.o.o. Tel: +385 1 3908 RO Pfizer Rom nia S.R.L. Tel: +40 (0)21 207 28 IE Pfizer Healthcare Ireland<br/>Tel: 1800 633 363 (toll free) +44 (0) 1304 616SI Pfizer Luxembourg SARL Pfizer, podru nica za svetovanje s podro ja farmacevtske dejavnosti, Ljubljana Tel: +386 (0)1 52 11 IS Icepharma hf. S mi: +354 540 8SK Pfizer Luxembourg SARL, organiza n zlo ka Tel: +421 2 3355 5IT Pfizer S.r.l.<br/>Tel: +39 06 33 18 FI Pfizer Oy Puh/Tel: +358 (0)9 430 CY<br/>Pfizer . . (Cyprus Branch) .: +357 22817SE Pfizer AB Tel: +46 (0)8 550 520 LV Pfizer Luxembourg SARL fili le Latvij<br/>Tel.: + 371 670 35 UK (Northern Ireland) Pfizer Limited Tel: + 44 (0) 1304 616This leaflet was last revised in month YYYY.</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_mpe0aa2bfe700a8fcff3620d6e0a596f13"> </a><p class="res-header-id"><b>Generated Narrative: MedicinalProductDefinition mpe0aa2bfe700a8fcff3620d6e0a596f13</b></p><a name="mpe0aa2bfe700a8fcff3620d6e0a596f13"> </a><a name="hcmpe0aa2bfe700a8fcff3620d6e0a596f13"> </a><a name="mpe0aa2bfe700a8fcff3620d6e0a596f13-en-US"> </a><p><b>identifier</b>: <code>http://ema.europa.eu/identifier</code>/EU/1/15/1057/001</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>: Pemetrexed Pfizer 100 mg powder for concentrate for solution for infusion</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/1/15/1057/001"/>
</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="Pemetrexed Pfizer 100 mg powder for concentrate for solution for infusion"/>
<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>
IG © 2021+ Gravitate Health Project. Package hl7.eu.fhir.ghepi#0.1.0 based on FHIR 5.0.0. Generated 2024-10-14
Links: Table of Contents |
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.
