# Get FHIR r4 medicinal product interactions

Endpoint: GET /site/{siteId}/fhir/medicinal-product-interaction
Version: 1.0
Security: bearer, bearer

## Path parameters:

  - `siteId` (string, required)
    Site identifier

## Query parameters:

  - `_count` (number)
    Number of items to return (default=20).
    Example: 10

  - `_page_token` (string)
    Token for fetching the next page of results.
    Example: "CgYK..."

  - `_sort` (string)
    Sort the results by a given field, e.g. _sort=family or _sort=-date.
    Example: "family"

  - `_elements` (string)
    Restrict returned fields, e.g. _elements=identifier,name.
    Example: "identifier,name"

  - `telecom` (string)
    Filter by resource telecom, e.g. date=[SYSTEM]|[VALUE].
    Example: "telecom=phone|555-555-5555"

  - `_id` (string)
    Search for a specific resource by ID, e.g. _id=abc123.
    Example: "abc123"

  - `identifier` (string)
    Search for resources by identifier token, e.g. identifier=http://hospital.org|12345.
    Example: "http://hospital.org|12345"

  - `_include` (string)
    Include related resources, e.g. _include=Appointment:patient.
    Example: "Appointment:patient"

  - `patient` (string)
    Include related patient resources, e.g. patient=Patient/[id]&.
    Example: "patient=Patient/[id]&"

  - `_revinclude` (string)
    Reverse include related resources, e.g. _revinclude=Observation:subject.
    Example: "Observation:subject"

  - `_has` (string)
    Reverse chaining, e.g. _has:Observation:subject:code=http://loinc.org|1234-5.
    Example: "Observation:subject:code=http://loinc.org|1234-5"

  - `_tag` (string)
    Search by tag on the resource meta, e.g. _tag=http://example.org/tags|sample-tag.
    Example: "http://example.org/tags|sample-tag"

  - `_security` (string)
    Search by security label on resource meta, e.g. _security=RBAC|CONFIDENTIAL.
    Example: "RBAC|CONFIDENTIAL"

  - `_profile` (string)
    Search by profile in resource meta, e.g. _profile=http://example.org/fhir/StructureDefinition/custom-profile.
    Example: "http://example.org/fhir/StructureDefinition/custom-profile"

## Response 200 fields (application/json):

  - `resourceType` (any, required)
    This is a Bundle resource
    Enum: "Bundle"

  - `id` (string)
    Any combination of letters, numerals, "-" and ".", with a length limit of 64 characters.  (This might be an integer, an unprefixed OID, UUID or any other identifier pattern that meets these constraints.)  Ids are case-insensitive.
    Example: "example-id"

  - `meta` (object)
    The metadata about a resource. This is content in the resource that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.

  - `meta.id` (string)
    An extension object type #string.
    Example: "example-string"

  - `meta.extension` (array)
    May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

  - `meta.versionId` (object)
    An extension object type #id.

  - `meta._versionId` (object)
    An extension object type #Element.

  - `meta.lastUpdated` (object)
    An extension object type #instant.

  - `meta._lastUpdated` (object)
    An extension object type #Element.

  - `meta.source` (string)
    An extension object type #uri.
    Example: "https://example.org/resource"

  - `meta._source` (object)
    An extension object type #Element.

  - `meta.profile` (array)
    A list of profiles (references to [[[StructureDefinition]]] resources) that this resource claims to conform to. The URL is a reference to [[[StructureDefinition.url]]].
    Example: ["http://example.org/Profile"]

  - `meta.security` (array)
    Security labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure.

  - `meta.tag` (array)
    Tags applied to this resource. Tags are intended to be used to identify and relate resources to process and workflow, and applications are not required to consider the tags when interpreting the meaning of a resource.

  - `implicitRules` (string)
    String of characters used to identify a name or a resource
    Example: "https://example.org/resource"

  - `_implicitRules` (object)
    Base definition for all elements in a resource.

  - `language` (string)
    A string which has at least one character and no leading or trailing whitespace and where there is no whitespace other than single spaces in the contents
    Example: "sample-code"

  - `_language` (object)
    Base definition for all elements in a resource.

  - `identifier` (object)
    An identifier - identifies some entity uniquely and unambiguously. Typically this is used for business identifiers.

  - `identifier.use` (any)
    The purpose of this identifier.
    Enum: "usual", "official", "temp", "secondary", "old"

  - `identifier._use` (object)
    An extension object type #Element.

  - `identifier.type` (object)
    An extension object type #CodeableConcept.

  - `identifier.system` (string)
    An extension object type #uri.
    Example: "https://example.org/resource"

  - `identifier._system` (object)
    An extension object type #Element.

  - `identifier.value` (string)
    An extension object type #string.
    Example: "example-string"

  - `identifier._value` (object)
    An extension object type #Element.

  - `identifier.period` (object)
    An extension object type #Period.

  - `identifier.assigner` (object)
    An extension object type #Reference.

  - `type` (any)
    Indicates the purpose of this bundle - how it is intended to be used.
    Enum: "document", "message", "transaction", "transaction-response", "batch", "batch-response", "history", "searchset", "collection"

  - `_type` (object)
    Base definition for all elements in a resource.

  - `timestamp` (string)
    An instant in time - known at least to the second
    Example: "2024-01-01T00:00:00Z"

  - `_timestamp` (object)
    Base definition for all elements in a resource.

  - `total` (number)
    An integer with a value that is not negative (e.g. >= 0)

  - `_total` (object)
    Base definition for all elements in a resource.

  - `link` (array)
    A series of links that provide context to this bundle.
    Example: [{"relation":"search","url":"https://api.heydonto.com/fhir/medicinal-product-interaction/?_count=20"},{"relation":"next","url":"https://api.heydonto.com/fhir/medicinal-product-interaction/?_count=20&_page_token=TOKEN"},{"relation":"first","url":"https://api.heydonto.com/fhir/medicinal-product-interaction/?_count=20"},{"relation":"self","url":"https://api.heydonto.com/fhir/medicinal-product-interaction/?_count=20"}]

  - `link.modifierExtension` (array)
    May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

  - `link.relation` (string)
    An extension object type #string.
    Example: "example-string"

  - `link._relation` (object)
    An extension object type #Element.

  - `link.url` (string)
    An extension object type #uri.
    Example: "https://example.org/resource"

  - `link._url` (object)
    An extension object type #Element.

  - `entry` (array)
    An entry in a bundle resource - will either contain a resource or information about a resource (transactions and history only).
    Example: [{"resourceType":"MedicinalProductInteraction","id":"example","text":{"status":"generated","div":"<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative with Details</b></p><p><b>id</b>: example</p><p><b>description</b>: Inhibitors of CYP3A4 and P-gp\\nCoadministration of equixaban with ketoconazole (400 mg once a day), a strong inhibitor of both\\nCYP3A4 and P-gp, led to a 2-fold increase in mean equixaban AUC and a 1.6-fold increase in mean\\nequixaban Cmax.\\nThe use of Eliquis is not recommended in patients receiving concomitant systemic treatment with\\nstrong inhibitors of both CYP3A4 and P-gp, such as azole-antimycotics (e.g., ketoconazole,\\nitraconazole, voriconazole and posaconazole) and HIV protease inhibitors (e.g., ritonavir) (see\\nsection 4.4).\\nActive substances which are not considered strong inhibitors of both CYP3A4 and P-gp,\\n(e.g., diltiazem, naproxen, amiodarone, verapamil, quinidine) are expected to increase equixaban\\nplasma concentration to a lesser extent. Diltiazem (360 mg once a day), for instance, considered a moderate CYP3A4 and a weak P-gp inhibitor, led to a 1.4-fold increase in mean equixaban AUC and a 1.3-fold increase in Cmax. Naproxen (500 mg, single dose) an inhibitor of P-gp but not an inhibitor of CYP3A4, led to a 1.5-fold and 1.6-fold increase in mean equixaban AUC and Cmax, respectively. No dose adjustment for equixaban is required when coadministered with less potent inhibitors of CYP3A4 and/or P-gp.</p><blockquote><p><b>interactant</b></p><p><b>item</b>: ketoconazole <span>(Details : {http://ema.europa.eu/example/interactant code 'ketoconazole' = 'ketoconazole)</span></p></blockquote><blockquote><p><b>interactant</b></p><p><b>item</b>: itraconazole <span>(Details : {http://ema.europa.eu/example/interactant code 'itraconazole' = 'itraconazole)</span></p></blockquote><p><b>type</b>: StrongInhibitorofCYP3A4 <span>(Details : {http://ema.europa.eu/example/interactionsType code 'StrongInhibitorofCYP3A4' = 'StrongInhibitorofCYP3A4)</span></p><p><b>effect</b>: Increasedplasmaconcentrations <span>(Details : {http://ema.europa.eu/example/interactionseffect code 'Increasedplasmaconcentrations' = 'Increasedplasmaconcentrations)</span></p><p><b>management</b>: Coadministration not recommended in patients receiving concomitant systemic treatment strong inhibitors of both CYP3A4 and P-gp <span>(Details )</span></p></div>"},"description":"Inhibitors of CYP3A4 and P-gp\\nCoadministration of equixaban with ketoconazole (400 mg once a day), a strong inhibitor of both\\nCYP3A4 and P-gp, led to a 2-fold increase in mean equixaban AUC and a 1.6-fold increase in mean\\nequixaban Cmax.\\nThe use of Eliquis is not recommended in patients receiving concomitant systemic treatment with\\nstrong inhibitors of both CYP3A4 and P-gp, such as azole-antimycotics (e.g., ketoconazole,\\nitraconazole, voriconazole and posaconazole) and HIV protease inhibitors (e.g., ritonavir) (see\\nsection 4.4).\\nActive substances which are not considered strong inhibitors of both CYP3A4 and P-gp,\\n(e.g., diltiazem, naproxen, amiodarone, verapamil, quinidine) are expected to increase equixaban\\nplasma concentration to a lesser extent. Diltiazem (360 mg once a day), for instance, considered a moderate CYP3A4 and a weak P-gp inhibitor, led to a 1.4-fold increase in mean equixaban AUC and a 1.3-fold increase in Cmax. Naproxen (500 mg, single dose) an inhibitor of P-gp but not an inhibitor of CYP3A4, led to a 1.5-fold and 1.6-fold increase in mean equixaban AUC and Cmax, respectively. No dose adjustment for equixaban is required when coadministered with less potent inhibitors of CYP3A4 and/or P-gp.","interactant":[{"itemCodeableConcept":{"coding":[{"system":"http://ema.europa.eu/example/interactant","code":"ketoconazole"}]}},{"itemCodeableConcept":{"coding":[{"system":"http://ema.europa.eu/example/interactant","code":"itraconazole"}]}}],"type":{"coding":[{"system":"http://ema.europa.eu/example/interactionsType","code":"StrongInhibitorofCYP3A4"}]},"effect":{"coding":[{"system":"http://ema.europa.eu/example/interactionseffect","code":"Increasedplasmaconcentrations"}]},"management":{"text":"Coadministration not recommended in patients receiving concomitant systemic treatment strong inhibitors of both CYP3A4 and P-gp"}}]

  - `entry.resourceType` (any, required)
    This is a MedicinalProductInteraction resource
    Enum: "MedicinalProductInteraction"

  - `entry.text` (object)
    A human-readable summary of the resource conveying the essential clinical and business information for the resource.

  - `entry.text.status` (any)
    The status of the narrative - whether it's entirely generated (from just the defined data or the extensions too), or whether a human authored it and it may contain additional data.
    Enum: "generated", "extensions", "additional", "empty"

  - `entry.text._status` (object)
    An extension object type #Element.

  - `entry.text.div` (string, required)
    An extension object type #xhtml.
    Example: "<div>Example</div>"

  - `entry.contained` (array)
    These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.

  - `entry.extension` (array)
    May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

  - `entry.extension.valueBase64Binary` (string)
    Value of extension - must be one of a constrained set of the data types (see [Extensibility](https://hl7.org/fhir/extensibility.html) for a list).
    Example: "U2FtcGxl"

  - `entry.extension._valueBase64Binary` (object)
    An extension object type #Element.

  - `entry.extension.valueBoolean` (boolean)
    Value of extension - must be one of a constrained set of the data types (see [Extensibility](https://hl7.org/fhir/extensibility.html) for a list).
    Example: true

  - `entry.extension._valueBoolean` (object)
    An extension object type #Element.

  - `entry.extension.valueCanonical` (string)
    Value of extension - must be one of a constrained set of the data types (see [Extensibility](https://hl7.org/fhir/extensibility.html) for a list).
    Example: "http://example.org/Profile"

  - `entry.extension._valueCanonical` (object)
    An extension object type #Element.

  - `entry.extension.valueCode` (string)
    Value of extension - must be one of a constrained set of the data types (see [Extensibility](https://hl7.org/fhir/extensibility.html) for a list).
    Example: "sample-code"

  - `entry.extension._valueCode` (object)
    An extension object type #Element.

  - `entry.extension.valueDate` (string)
    Value of extension - must be one of a constrained set of the data types (see [Extensibility](https://hl7.org/fhir/extensibility.html) for a list).
    Example: "2024-01-01"

  - `entry.extension._valueDate` (object)
    An extension object type #Element.

  - `entry.extension.valueDateTime` (string)
    Value of extension - must be one of a constrained set of the data types (see [Extensibility](https://hl7.org/fhir/extensibility.html) for a list).
    Example: "2024-01-01T00:00:00Z"

  - `entry.extension._valueDateTime` (object)
    An extension object type #Element.

  - `entry.extension.valueDecimal` (number)
    Value of extension - must be one of a constrained set of the data types (see [Extensibility](https://hl7.org/fhir/extensibility.html) for a list).
    Example: 1.23

  - `entry.extension._valueDecimal` (object)
    An extension object type #Element.

  - `entry.extension.valueId` (string)
    Value of extension - must be one of a constrained set of the data types (see [Extensibility](https://hl7.org/fhir/extensibility.html) for a list).
    Example: "example-id"

  - `entry.extension._valueId` (object)
    An extension object type #Element.

  - `entry.extension.valueInstant` (string)
    Value of extension - must be one of a constrained set of the data types (see [Extensibility](https://hl7.org/fhir/extensibility.html) for a list).
    Example: "2024-01-01T00:00:00Z"

  - `entry.extension._valueInstant` (object)
    An extension object type #Element.

  - `entry.extension.valueInteger` (number)
    Value of extension - must be one of a constrained set of the data types (see [Extensibility](https://hl7.org/fhir/extensibility.html) for a list).
    Example: 1

  - `entry.extension._valueInteger` (object)
    An extension object type #Element.

  - `entry.extension.valueMarkdown` (string)
    Value of extension - must be one of a constrained set of the data types (see [Extensibility](https://hl7.org/fhir/extensibility.html) for a list).
    Example: "Sample markdown text"

  - `entry.extension._valueMarkdown` (object)
    An extension object type #Element.

  - `entry.extension.valueOid` (string)
    Value of extension - must be one of a constrained set of the data types (see [Extensibility](https://hl7.org/fhir/extensibility.html) for a list).
    Example: "urn:oid:1.2.3.4.5"

  - `entry.extension._valueOid` (object)
    An extension object type #Element.

  - `entry.extension.valuePositiveInt` (number)
    Value of extension - must be one of a constrained set of the data types (see [Extensibility](https://hl7.org/fhir/extensibility.html) for a list).
    Example: 1

  - `entry.extension._valuePositiveInt` (object)
    An extension object type #Element.

  - `entry.extension.valueString` (string)
    Value of extension - must be one of a constrained set of the data types (see [Extensibility](https://hl7.org/fhir/extensibility.html) for a list).
    Example: "example-string"

  - `entry.extension._valueString` (object)
    An extension object type #Element.

  - `entry.extension.valueTime` (string)
    Value of extension - must be one of a constrained set of the data types (see [Extensibility](https://hl7.org/fhir/extensibility.html) for a list).
    Example: "12:00:00"

  - `entry.extension._valueTime` (object)
    An extension object type #Element.

  - `entry.extension.valueUnsignedInt` (number)
    Value of extension - must be one of a constrained set of the data types (see [Extensibility](https://hl7.org/fhir/extensibility.html) for a list).

  - `entry.extension._valueUnsignedInt` (object)
    An extension object type #Element.

  - `entry.extension.valueUri` (string)
    Value of extension - must be one of a constrained set of the data types (see [Extensibility](https://hl7.org/fhir/extensibility.html) for a list).
    Example: "https://example.org/resource"

  - `entry.extension._valueUri` (object)
    An extension object type #Element.

  - `entry.extension.valueUrl` (string)
    Value of extension - must be one of a constrained set of the data types (see [Extensibility](https://hl7.org/fhir/extensibility.html) for a list).
    Example: "https://example.org"

  - `entry.extension._valueUrl` (object)
    An extension object type #Element.

  - `entry.extension.valueUuid` (string)
    Value of extension - must be one of a constrained set of the data types (see [Extensibility](https://hl7.org/fhir/extensibility.html) for a list).
    Example: "urn:uuid:123e4567-e89b-12d3-a456-426614174000"

  - `entry.extension._valueUuid` (object)
    An extension object type #Element.

  - `entry.extension.valueAddress` (object)
    An extension object type #Address.

  - `entry.extension.valueAge` (object)
    An extension object type #Age.

  - `entry.extension.valueAnnotation` (object)
    An extension object type #Annotation.

  - `entry.extension.valueAttachment` (object)
    An extension object type #Attachment.

  - `entry.extension.valueCodeableConcept` (object)
    An extension object type #CodeableConcept.

  - `entry.extension.valueCoding` (object)
    An extension object type #Coding.

  - `entry.extension.valueContactPoint` (object)
    An extension object type #ContactPoint.

  - `entry.extension.valueCount` (object)
    An extension object type #Count.

  - `entry.extension.valueDistance` (object)
    An extension object type #Distance.

  - `entry.extension.valueDuration` (object)
    An extension object type #Duration.

  - `entry.extension.valueHumanName` (object)
    An extension object type #HumanName.

  - `entry.extension.valueIdentifier` (object)
    An extension object type #Identifier.

  - `entry.extension.valueMoney` (object)
    An extension object type #Money.

  - `entry.extension.valuePeriod` (object)
    An extension object type #Period.

  - `entry.extension.valueQuantity` (object)
    An extension object type #Quantity.

  - `entry.extension.valueRange` (object)
    An extension object type #Range.

  - `entry.extension.valueRatio` (object)
    An extension object type #Ratio.

  - `entry.extension.valueReference` (object)
    An extension object type #Reference.

  - `entry.extension.valueSampledData` (object)
    An extension object type #SampledData.

  - `entry.extension.valueSignature` (object)
    An extension object type #Signature.

  - `entry.extension.valueTiming` (object)
    An extension object type #Timing.

  - `entry.extension.valueContactDetail` (object)
    An extension object type #ContactDetail.

  - `entry.extension.valueContributor` (object)
    An extension object type #Contributor.

  - `entry.extension.valueDataRequirement` (object)
    An extension object type #DataRequirement.

  - `entry.extension.valueExpression` (object)
    An extension object type #Expression.

  - `entry.extension.valueParameterDefinition` (object)
    An extension object type #ParameterDefinition.

  - `entry.extension.valueRelatedArtifact` (object)
    An extension object type #RelatedArtifact.

  - `entry.extension.valueTriggerDefinition` (object)
    An extension object type #TriggerDefinition.

  - `entry.extension.valueUsageContext` (object)
    An extension object type #UsageContext.

  - `entry.extension.valueDosage` (object)
    An extension object type #Dosage.

  - `entry.extension.valueMeta` (object)
    An extension object type #Meta.

  - `entry.modifierExtension` (array)
    May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

  - `entry.subject` (array)
    The medication for which this is a described interaction.

  - `entry.subject.reference` (string)
    An extension object type #string.
    Example: "example-string"

  - `entry.subject._reference` (object)
    An extension object type #Element.

  - `entry.subject.type` (string)
    An extension object type #uri.
    Example: "https://example.org/resource"

  - `entry.subject._type` (object)
    An extension object type #Element.

  - `entry.subject.identifier` (object)
    An extension object type #Identifier.

  - `entry.subject.display` (string)
    An extension object type #string.
    Example: "example-string"

  - `entry.subject._display` (object)
    An extension object type #Element.

  - `entry.description` (string)
    A sequence of Unicode characters
    Example: "example-string"

  - `entry._description` (object)
    Base definition for all elements in a resource.

  - `entry.interactant` (array)
    The specific medication, food or laboratory test that interacts.
    Example: [{"itemCodeableConcept":{"coding":[{"system":"http://ema.europa.eu/example/interactant","code":"ketoconazole"}]}},{"itemCodeableConcept":{"coding":[{"system":"http://ema.europa.eu/example/interactant","code":"itraconazole"}]}}]

  - `entry.interactant.itemReference` (object)
    An extension object type #Reference.

  - `entry.interactant.itemCodeableConcept` (object)
    An extension object type #CodeableConcept.

  - `entry.type` (object)
    A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.

  - `entry.type.coding` (array)
    A reference to a code defined by a terminology system.

  - `entry.type.text` (string)
    An extension object type #string.
    Example: "example-string"

  - `entry.type._text` (object)
    An extension object type #Element.

  - `entry.effect` (object)
    A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.

  - `entry.incidence` (object)
    A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.

  - `entry.management` (object)
    A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.

  - `signature` (object)
    A signature along with supporting context. The signature may be a digital signature that is cryptographic in nature, or some other signature acceptable to the domain. This other signature may be as simple as a graphical image representing a hand-written signature, or a signature ceremony Different signature approaches have different utilities.

  - `signature.type` (array, required)
    An indication of the reason that the entity signed this document. This may be explicitly included as part of the signature information and can be used when determining accountability for various actions concerning the document.

  - `signature.when` (object)
    An extension object type #instant.

  - `signature._when` (object)
    An extension object type #Element.

  - `signature.who` (object, required)
    An extension object type #Reference.

  - `signature.onBehalfOf` (object)
    An extension object type #Reference.

  - `signature.targetFormat` (string)
    An extension object type #code.
    Example: "sample-code"

  - `signature._targetFormat` (object)
    An extension object type #Element.

  - `signature.sigFormat` (string)
    An extension object type #code.
    Example: "sample-code"

  - `signature._sigFormat` (object)
    An extension object type #Element.

  - `signature.data` (string)
    An extension object type #base64Binary.
    Example: "U2FtcGxl"

  - `signature._data` (object)
    An extension object type #Element.

## Response 401 fields (application/json):

  - `message` (string, required)
    Error message indicating unauthorized access.
    Example: "Unauthorized"

  - `statusCode` (number, required)
    HTTP status code for unauthorized access.
    Example: 401