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SAE Report from Foreign Country in 2016 - Samsca

Name of Company: PT Otsuka Indonesia


Date of Update: 28-Jan-16

No

File Code

MFR Control No.

Product

Country

2015_015280-2-YNY-27-Jan-2016-161110.324

2015_015280

Samsca

Japan

2016_001628-0-YNY-27-Jan-2016-195404.503

2016_001628

Samsca

Japan

Report Source
Health Professional,
Other

Health Professional,
Other

Report Type

Event Term/Describe Reaction(s)

FU2

Cardiac failure aggravated (Pleural effusion);


[Cardiac failure aggravated]; Hepatic function
disorder [Hepatic function disorder]

Initial

Other Serious Criteria: Medically Significant;


Increased levels of sugar blood and haemoglobin
A1c [Haemoglobin A1C increased]; Increased levels
of sugar blood and haemoglobin A1c [Sugar blood
level increased]; Symptoms like diabetes mellitus
[Diabetes mellitus]

Version

3.0.196

Date Received Date Forwarded to Date Forwarded


to BPOM (by
by PTOI
RA
RA)
27-Jan-16

Submission
Deadline
30-Jan-16

28-Jan-16
2.0.151

28-Jan-16

30-Jan-16

SAE Report from Foreign Country in 2016

No

MFR Control No.

Product

Date Received
by Email

2015_015280

Samsca

27-Jan-16

2016_001628

Samsca

28-Jan-16

Date Submission
by Email

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