Enter product details

Field or Control Name Description

First Dose

The earliest regimen start date.

Last Dose

The latest regimen stop date.

Duration of Administration

Calculated automatically if full dates are available for the first and last doses.

Total Dosage

Calculated based on daily dose and duration.

Time Between First Dose/Primary Event

The time from the first dose to primary event onset.

Time between Last Dose/Primary Event

The time from the last dose to primary event onset.

Total Dose to Primary Event

The cumulative dose to the time of the event.

Action Taken

Select a term.

If you select Dose Increased or No change, the dechallenge and rechallenge fields are disabled.

Contact your administrator to adjust this list.

Dechallenge Results

Indicates the drug stopped for the purpose of determining if it was the drug that caused the adverse event.

Date

Enter the date the dechallenge was carried out.

Gestation Period at Exposure

Gestation Period at Exposure is automatically calculated for all Products in the case by using the formula: Date of First Dose of the respective Product – LMP Date. It is calculated only if full dates are available for both fields. If the First Dose occurs before the LMP Date, then this field is not populated with any data.

Taken Previously / Tolerated

Select a response from the list.

Rechallenge Results

Make a selection based on whether the drug was taken again.

If Pos or Neg or UNK is selected for the Rechallenge field, the following fields are enabled:

  • Rechallenge Start Date/Time
  • Rechallenge Stop Date/Time
  • Rechallenge Outcome

Start Date/Time

Enter the date and/or time when the rechallenge was started.

Stop Date/Time

Enter the date and/or time when the rechallenge was stopped.

Specialized Product Category

Select specialized FDA product categories such as combination products, compounded and repackaged products used in eVAERS reports.

  • Abuse
  • Batch and lot tested and found within specifications
  • Batch and lot tested and found not within specifications
  • Counterfeit
  • Drug taken beyond expiry date
  • Drug taken by the father
  • Medication error
  • Misuse
  • Occupational exposure
  • Off label use
  • Overdose
  • Tampering

Select the corresponding check boxes to provide information on the drug populated as Additional Information on Drug (G.k.10.r) in the E2B(R3) reports.

Related Device Comments Enter the details about the devices used with the drug that caused an adverse reaction.

When entering data entries, only up to 2000 characters are allowed.

Multi-language data entry is supported.

This field is also displayed in the Japanese split-screen of the case form. A separate data entry field is applicable when using the Japanese language.

Note:

This field is visible only in the Drug and Vaccine tab, under the Product tab.