ID
35553
Beschrijving
Study ID: 101468/192 Clinical Study ID: 101468/192 Study Title:A 52 Week Open-Label Extension Study of the Long-Term Safety of Ropinirole in Subjects Suffering from Restless Legs Syndrome (RLS) Patient Level Data: Study Listed on ClinicalStudyDataRequest.com Clinicaltrials.gov Identifier: Sponsor: GlaxoSmithKline Collaborators: N/A Phase: phase 3 Study Recruitment Status: Completed Generic Name: ropinirole Trade Name: Modutab,ZIPEREVE,ZEPREVE,REPREVE,ADARTREL,REQUIP,Zygara; Zygara,ZIPEREVE,ZEPREVE,Requip Depot,REQUIP,REPREVE,Modutab,ADARTREL Study Indication : Restless Legs Syndrome The study consists of 16 visits which are devided in 3 study books: Book 1: Screening (+Baseline), Day 2, Week 1, Week 2 , Week 3 , Week 4, Week 5, Week 6, Week 7, Week 8 Book 2: Week 12, Week 24, Week 36, Week 48, Week 52, Follow-up Book 3: Early withdrawal and Follow-up Each follow-up Visit takes place 7 +/- 3 days after last dose This document contains the Pregnancy Dipstick form. It has to be filled in for Screening (+Baseline), Week 24, Week 52 and fpr early withdrawal.
Trefwoorden
Versies (1)
- 08-03-19 08-03-19 -
Houder van rechten
GlaxoSmithKline
Geüploaded op
8 maart 2019
DOI
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Licentie
Creative Commons BY-NC 3.0
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Long-Term Safety of Ropinirole in Subjects Suffering from Restless Legs Syndrome (RLS), 101468/192
Pregnancy Dipstick
- StudyEvent: ODM
Beschrijving
Pregnancy Dipstick
Alias
- UMLS CUI-1
- C0430056
Beschrijving
child-bearing potential
Datatype
boolean
Alias
- UMLS CUI [1]
- C1960468
Beschrijving
If patient is of child-bearing potential, please perform a pregnancy dipstick test and record result below. If ’Positive’, please record details on the Pregnancy Notification Form and withdraw the patient.
Datatype
text
Alias
- UMLS CUI [1,1]
- C0430056
- UMLS CUI [1,2]
- C0456984
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Pregnancy Dipstick
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