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 Dovprela is and what it is used for</li><li>What you need to know before you take Dovprela</li><li>How to take Dovprela</li><li>Possible side effects</li><li>How to store Dovprela</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>Dovprela contains the active substance pretomanid, a type of antibiotic. Antibiotics are medicines used to kill bacteria that cause diseases.</p><p>Dovprela is used in combination with two other medicines called linezolid and bedaquiline to treat tuberculosis that affects the lungs, when the disease has become resistant to many other antibiotics:</p><ul><li>extensively drug resistant tuberculosis or</li><li>treatment-intolerant or multidrug-resistant tuberculosis It is used in adults 18 years and over.</li></ul></div>
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<div xmlns="http://www.w3.org/1999/xhtml"><p>Do not take Dovprela</p><ul><li>if you are allergic to pretomanid, antibiotics of the group called nitroimidazoles, or any of the other ingredients of this medicine (listed in section 6)</li></ul><p>Since pretomanid must be used in combination with other medicines against tuberculosis linezolid and bedaquiline please make sure that you read the Do not take section of the package leaflets for these medicines as well. If you are unsure of any information in the package leaflets, please contact your doctor or pharmacist.</p><p>Warnings and precautions</p><p>Talk to your doctor, pharmacist or nurse before taking Dovprela if you:</p><ul><li><p>have reduced liver function</p></li><li><p>drink alcohol on a regular basis</p></li><li><p>have reduced kidney function</p></li><li><p>have or have had disturbances of the heart rhythm, or if someone in your family has a heart rhythm problem</p></li><li><p>have heart failure</p></li><li><p>have or have had an underactive thyroid</p></li><li><p>have reduced blood levels of calcium, magnesium or potassium</p></li></ul><p>Liver damage There is a risk of liver damage when you are treated with Dovprela, linezolid and bedaquiline. Your doctor will therefore monitor you for signs of liver damage and take blood samples before the start of treatment and regularly during treatment. Tell your doctor if you experience symptoms such as:</p><ul><li>fatigue</li><li>lack or loss of appetite</li><li>nausea</li><li>yellowing of the skin and eyes</li><li>dark urine</li><li>abdominal pain The doctor will adjust your treatment if your liver is affected.</li></ul><p>Reduced number of blood cells Treatment with Dovprela, linezolid and bedaquiline can severely reduce the number of blood cells, such as blood platelets, red blood cells and white blood cells called neutrophils. Contact your doctor immediately about any signs of bruising, bleeding or infections. Your doctor will monitor complete blood counts before the start of treatment and regularly during treatment. The doctor will adjust your treatment if your blood cell count is reduced.</p><p>Nerve disorders in hands, feet or eyes Nerve disorders in hands, feet or eyes may occur during treatment. Contact your doctor if you have visual problems, or numbness, tingling or burning in your hands or feet during treatment. Your doctor will adjust your treatment in these cases. If visual problems occur contact a doctor for a prompt eye examination.</p><p>Increased blood level of lactic acid A disorder of blood over-acidification called lactic acidosis may occur during treatment. Contact your doctor if you have recurrent nausea or vomiting. Your doctor may adjust your treatment in these cases.</p><p>Heart problems A certain heartbeat abnormality known as QT prolongation may occur during treatment. Your doctor will therefore perform an ECG before the start of treatment and regularly during treatment. Your treatment will be adjusted if heartbeat abnormalities occur. In addition, potassium, calcium and magnesium levels will be monitored and corrected if abnormal.</p><p>The safety and efficacy of Dovprela has not been studied in combination with medicines other than linezolid and bedaquiline and therefore it should not be used as part of any other treatment combination.</p><p>Children and adolescents</p><p>This medicine is not recommended for children and adolescents under 18 years. This is because it has not been studied in this age group.</p><p>Other medicines and Dovprela</p><p>Tell your doctor or pharmacist if you are taking, have recently taken, or might take any other medicines, including herbal therapies. These may affect the way Dovprela works or increase the risk of side effects.</p><p>Avoid treatment with Dovprela and any of the following medicines at the same time. These may lower the effect of Dovprela so your treatment may not work; therefore, inform your doctor immediately about these:</p><ul><li>rifampicin, rifamycin, rifapentine, rifabutin: other medicines to treat tuberculosis or certain other infections</li><li>efavirenz, etravirine: medicines to treat HIV infection</li><li>carbamazepine, phenytoin: medicines to treat epilepsy and certain pain conditions</li><li>St John s wort: a herbal medicine to treat depression and anxiety</li></ul><p>You should also avoid the use of medicines that may have a damaging effect on your liver (other than bedaquiline and linezolid). Talk to you doctor who will be able to tell you which medicines this applies to.</p><p>Inform your doctor if you are using:</p><ul><li>methotrexate: a medicine to treat severe joint inflammation, cancer and the skin disease psoriasis</li><li>benzylpenicillin, ciprofloxacin: medicines to treat bacterial infections</li><li>indomethacin: a medicine to treat pain and inflammation</li><li>ritonavir: a medicine to treat HIV infection</li></ul><p>Dovprela with alcohol</p><p>Avoid drinking alcohol while being treated with Dovprela since this increases the risk of serious liver damage.</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><ul><li>Pregnancy Very limited knowledge exists about the use of Dovprela during pregnancy. Therefore, Dovprela is used during pregnancy only if the benefit to the patient outweighs the potential risk to the foetus. Your doctor will decide whether you should be treated with Dovprela.</li><li>Breast-feeding It is not known if pretomanid is passed into human milk. Your doctor has to decide if you should discontinue breast-feeding or avoid treatment with Dovprela.</li></ul><p>Driving and using machines</p><p>You may feel dizzy after taking Dovprela or you may experience problems with your vision. Do not drive or operate machinery if this happens.</p><p>Dovprela contains lactose and sodium</p><p>If you have been told by your doctor that you have an intolerance to some sugars, contact your doctor before taking this medicine. 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>Dovprela is used in combination with linezolid and bedaquiline. Please also read the package leaflets from these medicines. If you have any questions ask your doctor or pharmacist.</p><p>The recommended dose is</p><ul><li>Dovprela: 1 tablet once daily</li><li>linezolid: 600 mg daily</li><li>bedaquiline: 400 mg once daily for 2 weeks, followed by 200 mg 3 times per week (with at least 48 hours between doses). For example you may take bedaquiline on Monday, Wednesday and Friday every week from week 3 onwards.</li></ul><p>Method of use Take Dovprela at the same time as linezolid and bedaquiline. Swallow the tablets with a glass of water and take them with food. The tablets are taken under direct observation of a healthcare professional or in accordance with local practice.</p><p>Duration of use The duration of treatment with the combination Dovprela, linezolid and bedaquiline is 26 weeks. Your doctor may decide to expand this period or to interrupt dosing to ensure that the treatment is safe and effective for you.</p><p>If you take more Dovprela than you should</p><p>Contact your doctor straight away and take the medicine pack with you.</p><p>If you forget to take Dovprela</p><p>Do not take a double dose to make up for a forgotten dose.</p><p>Any missed dose of pretomanid and bedaquiline is recommended to be made up at the end of treatment. Doses of linezolid missed due to linezolid adverse reactions are not recommended to be made up. Talk to your doctor or pharmacist if you have missed a dose and you are not sure what to do.</p><p>If you stop taking Dovprela</p><p>Do not stop taking Dovprela or its combination medicines linezolid or bedaquiline without your doctor s permission. Skipping doses or not completing the full course of therapy may make treatment ineffective and your tuberculosis could get worse. In addition, this would increase the chance that bacteria become resistant to these medicines.</p><p>If you have any further questions on the use of this medicine, ask your doctor, pharmacist or nurse.</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>When Dovprela is used together with linezolid and bedaquiline the following side effects have been reported:</p><p>Contact your doctor immediately if you experience any of the following:</p><p>Very common (may affect more than 1 in 10 people)</p><ul><li>reduced number of red blood cells Possible signs are feeling tired, weakness, shortness of breath, loss of consciousness and increased thirst.</li><li>increased blood levels of liver enzymes called transaminase such as ALT, AST Tell your doctor if you experience symptoms such as fatigue, lack or loss of appetite, nausea, yellowing of the skin and eyes, dark urine or abdominal pain.</li></ul><p>Common (may affect up to 1 in 10 people)</p><ul><li>reduced number of white blood cells or platelets Possible signs are bruising, bleeding or infections.</li><li>increased blood levels of a liver enzyme called gamma GT (indicating how well your liver is working)</li><li>increased blood level of lactic acid Contact your doctor if you have recurrent nausea or vomiting.</li></ul><p>Other side effects may occur with following frequencies: Very common (may affect more than 1 in 10 people)</p><ul><li>nausea, vomiting, indigestion</li><li>acne,</li><li>decreased appetite</li><li>nerve problems in the hands or feet, such as pain, burning, abnormal sensation or numbness</li></ul><p>Common (may affect up to 1 in 10 people)</p><ul><li>fungal (including candida, yeast, fungi) infection in the mouth or throat, which appears as white patches</li><li>sleeping difficulties</li><li>fatigue</li><li>taste disturbance</li><li>dizziness</li><li>headache</li><li>muscle spasm, muscle and skeleton pain, such as joint pain, back pain, muscle pain</li><li>diarrhoea, constipation</li><li>inflammation of stomach lining, pancreas inflammation</li><li>reflux of stomach juices in the oesophagus</li><li>abdominal pain</li><li>hair loss, dry skin, itching skin, rash</li><li>irritation or pain of the eye, dry eye, vision problems</li><li>optic nerve damage and/or inflammation with swellings and visual disturbances</li><li>abnormal electrical activity of the heart (prolonged electrocardiogram QT interval)</li><li>increased blood levels:</li></ul><ul><li>amylase</li><li></li></ul><p>bilirubin, which is the yellow breakdown substance of the blood pigment</p><ul><li>lipase</li><li>alkaline phosphatase</li><li></li></ul><p>creatinine</p><ul><li>creatine phosphokinase</li><li>urea</li></ul><ul><li>decreased blood sugar level</li><li>decreased magnesium blood level</li></ul><p>Uncommon (may affect up to 1 in 100 people)</p><ul><li><p>fungal infection</p></li><li><p>too much fluid loss, reduced body fluid volume</p></li><li><p>anxiety, depression</p></li><li><p>enlarged liver</p></li><li><p>yellowing of the skin, internal organs and/or the whites of the eyes (jaundice)</p></li><li><p>eye lens disorder</p></li><li><p>worsening ability to focus clearly on close objects</p></li><li><p>eye itching, eye swelling</p></li><li><p>optic disc swelling (leading to loss of vision)</p></li><li><p>deafness</p></li><li><p>feeling of increased heartbeat</p></li><li><p>increased heartbeat</p></li><li><p>low blood pressure</p></li><li><p>cough, nosebleed</p></li><li><p>feeling bloated</p></li><li><p>burning tongue, enlargement of the small, nipple-like structures on the upper surface of the tongue</p></li><li><p>eczema, excessive skin pigmentation</p></li><li><p>inability to have or maintain an erection</p></li><li><p>womb bleeding at irregular intervals, particularly between the expected menstrual periods</p></li><li><p>feeling unwell</p></li><li><p>abnormal presence of the protein albumin in the urine</p></li><li><p>vomiting blood</p></li><li><p>decreased elimination of the muscle tissue breakdown product creatinine through kidneys</p></li><li><p>lack of white and red blood cells, and blood platelets</p></li><li><p>decreased calcium blood level</p></li><li><p>increased blood levels:</p></li></ul><ul><li>creatine phosphokinase isoenzyme (MB)</li><li>uric acid</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 carton, bottle or blister after EXP . The expiry date refers to the last day of that month.</p><p>This medicine does not require any special temperature storage conditions.</p><p>Any unused medicinal product or waste material should be disposed of in accordance with local requirements.</p></div>
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<div xmlns="http://www.w3.org/1999/xhtml"><p>What Dovprela contains</p><ul><li>The active substance is pretomanid. Each tablet contains 200 mg pretomanid.</li><li>The other ingredients are lactose monohydrate, microcrystalline cellulose, sodium starch glycolate, magnesium stearate, silica colloidal, sodium lauryl sulphate, povidone.</li></ul><p>What Dovprela looks like and contents of the pack</p><p>Dovprela is a white to off-white oval tablet with M debossed on one side and P200 on the other side. Tablet dimensions: 18 9 mm.</p><p>The tablets are provided in: Blister packs containing 14, 14 1, 182 or 182 1 tablets Plastic bottles containing 26 tablets</p><p>Not all pack sizes may be marketed.</p><p>Marketing Authorisation Holder</p><p>Mylan IRE Healthcare Limited<br/>Unit 35/36 Grange Parade Baldoyle Industrial Estate Dublin Ireland</p><p>Manufacturer</p><p>Mylan Hungary Kft.<br/>H-2900, Kom rom Mylan utca 1 Hungary</p><p>Rottapharm Limited, Damastown Industrial Park,<br/>Mulhuddart, Dublin 15,<br/>D15 XDIreland</p><p>For any information about this medicine, please contact the local representative of the Marketing Authorisation Holder:</p><p>Belgi /Belgique/Belgien Mylan bvba/sprl T l/Tel: + 32 (0)2 658 61 Lietuva Mylan Healthcare UAB Tel: +370 5 205 1</p><p>: +359 2 44 55 Luxembourg/Luxemburg Mylan bvba/sprl T l/Tel: + 32 (0)2 658 61 (Belgique/Belgien)</p><p>esk republika Viatris CZ s.r.o. Tel: + 420 222 004 Magyarorsz g Mylan EPD Kft Tel: + 36 1 465 2Danmark Viatris ApS Tlf: +45 28 11 69 Malta V.J. Salomone Pharma Ltd Tel: + 356 21 22 01 Deutschland Viatris Healthcare GmbH Tel: +49 800 0700 Nederland Mylan BV Tel: +31 (0)20 426 3Eesti BGP Products Switzerland GmbH Eesti filiaal<br/>Tel: + 372 6363 Norge Viatris AS Tlf: + 47 66 75 33<br/>Viatris Hellas Ltd<br/>: +30 2100 100 sterreich Arcana Arzneimittel GmbH Tel: +43 1 416 2Espa a Viatris Pharmaceuticals, S.L.U. Tel: + 34 900 102 Polska Mylan Healthcare Sp. z o.o. Tel: + 48 22 546 64 France Viatris Sant</p><p>T l : +33 1 40 80 15 Portugal Viatris Healthcare, Lda<br/>Tel: + 351 21 412 72 Hrvatska Viatris Hrvatska d.o.o. Tel: +385 1 23 50 Rom nia BGP Products SRL Tel: +40 372 579 Ireland Mylan Ireland Limited Tel: +353 1 8711Slovenija Viatris d.o.o.. Tel: + 386 1 23 63 sland Icepharma hf S mi: +354 540 8Slovensk republika Viatris Slovakia s.r.o. Tel: +421 2 32 199 Italia Viatris Italia S.r.l. Tel: + 39 (0)2 612 46Suomi/Finland Viatris OY Puh/Tel: +358 20 720 9<br/>Varnavas Hadjipanayis Ltd<br/>: +357 2220 7Sverige Viatris AB<br/>Tel: + 46 (0) 8 630 19 Latvija Mylan Healthcare SIA Tel: +371 676 055 United Kingdom (Northern Ireland) Mylan IRE Healthcare Limited<br/>Tel: +353 18711This leaflet was last revised in {MM/YYYY}</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_mpfa9d30a0cae60aa39e101b95ccee3379"> </a><p class="res-header-id"><b>Generated Narrative: MedicinalProductDefinition mpfa9d30a0cae60aa39e101b95ccee3379</b></p><a name="mpfa9d30a0cae60aa39e101b95ccee3379"> </a><a name="hcmpfa9d30a0cae60aa39e101b95ccee3379"> </a><a name="mpfa9d30a0cae60aa39e101b95ccee3379-en-US"> </a><p><b>identifier</b>: <code>http://ema.europa.eu/identifier</code>/EU/1/20/1437/001</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>: Dovprela 200 mg tablet</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/1/20/1437/001"/>
</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="Dovprela 200 mg tablet"/>
<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.
