Dose syntax implementation guidance for FHIR STU3

This guidance is under active development by NHS Digital and content may be added or updated on a regular basis.

Fully Coded Examples

The following medicationRequest examples are fully machine-readable in that they do not include any free-text instructions within either additionalInstruction, patientInstruction or text.

Examples use combinations of the following elements of the CareConnect medicationRequest and FHIR Dosage structure;

  • form
  • method
  • doseQuantity
  • frequency, period and frequencyMax
  • when
  • route
  • site
  • asNeededBoolean
  • boundsDuration
  • count
  • event

Where clinically appropriate, each example is shown as both a dose-based and product-based instruction.

Important: Examples are not complete with respect to all mandatory or required data for a CareConnect implementation but instead highlight the variety of use of the FHIR Dosage structure

Oxytetracycline, 250mg, oral, 6 hourly

Product-based instruction using a VMP. Dose expressed 6 hourly.
<MedicationRequest xmlns="http://hl7.org/fhir">
<id value="720b6ba6-19e5-4168-a412-e5cb1332837a" />
<contained>
<Medication>
<id value="med1" />
<code>
<coding>
<system value="http://snomed.info/sct" />
<code value="324095003" />
<display value="Oxytetracycline 250mg tablets" />
</coding>
</code>
</Medication>
</contained>
<status value="active" />
<intent value="order" />
<medicationReference>
<reference value="#med1" />
</medicationReference>
<subject>
<identifier>
<system value="https://fhir.nhs.uk/Id/nhs-number" />
<value value="9999999999" />
</identifier>
</subject>
<dosageInstruction>
<timing>
<repeat>
<frequency value="1" />
<period value="6" />
<periodUnit value="h" />
</repeat>
</timing>
<route>
<coding>
<system value="http://snomed.info/sct" />
<code value="26643006" />
<display value="oral" />
</coding>
</route>
<doseQuantity>
<value value="1" />
<unit value="tablet" />
<system value="http://snomed.info/sct" />
<code value="428673006" />
</doseQuantity>
</dosageInstruction>
</MedicationRequest>
{
"resourceType": "MedicationRequest",
"id": "720b6ba6-19e5-4168-a412-e5cb1332837a",
"contained": [
{
"resourceType": "Medication",
"id": "med1",
"code": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "324095003",
"display": "Oxytetracycline 250mg tablets"
}
]
}
}
],
"status": "active",
"intent": "order",
"medicationReference": {
"reference": "#med1"
},
"subject": {
"identifier": {
"system": "https://fhir.nhs.uk/Id/nhs-number",
"value": "9999999999"
}
},
"dosageInstruction": [
{
"timing": {
"repeat": {
"frequency": 1,
"period": 6,
"periodUnit": "h"
}
},
"route": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "26643006",
"display": "oral"
}
]
},
"doseQuantity": {
"value": 1,
"unit": "tablet",
"system": "http://snomed.info/sct",
"code": "428673006"
}
}
]
}
MedicationRequest.id[0]720b6ba6-19e5-4168-a412-e5cb1332837a
MedicationRequest.contained[0].id[0]med1
MedicationRequest.contained[0].code[0].coding[0].system[0]http://snomed.info/sct
MedicationRequest.contained[0].code[0].coding[0].code[0]324095003
MedicationRequest.contained[0].code[0].coding[0].display[0]Oxytetracycline 250mg tablets
MedicationRequest.status[0]active
MedicationRequest.intent[0]order
MedicationRequest.medication[0].reference[0]#med1
MedicationRequest.subject[0].identifier[0].system[0]https://fhir.nhs.uk/Id/nhs-number
MedicationRequest.subject[0].identifier[0].value[0]9999999999
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].frequency[0]1
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].period[0]6
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].periodUnit[0]h
MedicationRequest.dosageInstruction[0].route[0].coding[0].system[0]http://snomed.info/sct
MedicationRequest.dosageInstruction[0].route[0].coding[0].code[0]26643006
MedicationRequest.dosageInstruction[0].route[0].coding[0].display[0]oral
MedicationRequest.dosageInstruction[0].dose[0].value[0]1
MedicationRequest.dosageInstruction[0].dose[0].unit[0]tablet
MedicationRequest.dosageInstruction[0].dose[0].system[0]http://snomed.info/sct
MedicationRequest.dosageInstruction[0].dose[0].code[0]428673006
MedicationRequest
Dose-based instruction using a VTM. Dose expressed 6 hourly.
<MedicationRequest xmlns="http://hl7.org/fhir">
<id value="b13724a0-7433-4c01-9c88-968baf91c6b4" />
<contained>
<Medication>
<id value="med1" />
<code>
<coding>
<system value="http://snomed.info/sct" />
<code value="22969001" />
<display value="Oxytetracycline" />
</coding>
</code>
</Medication>
</contained>
<status value="active" />
<intent value="order" />
<medicationReference>
<reference value="#med1" />
</medicationReference>
<subject>
<identifier>
<system value="https://fhir.nhs.uk/Id/nhs-number" />
<value value="9999999999" />
</identifier>
</subject>
<dosageInstruction>
<timing>
<repeat>
<frequency value="1" />
<period value="6" />
<periodUnit value="h" />
</repeat>
</timing>
<route>
<coding>
<system value="http://snomed.info/sct" />
<code value="26643006" />
<display value="oral" />
</coding>
</route>
<doseQuantity>
<value value="250" />
<unit value="milligram" />
<system value="http://unitsofmeasure.org" />
<code value="mg" />
</doseQuantity>
</dosageInstruction>
</MedicationRequest>
{
"resourceType": "MedicationRequest",
"id": "b13724a0-7433-4c01-9c88-968baf91c6b4",
"contained": [
{
"resourceType": "Medication",
"id": "med1",
"code": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "22969001",
"display": "Oxytetracycline"
}
]
}
}
],
"status": "active",
"intent": "order",
"medicationReference": {
"reference": "#med1"
},
"subject": {
"identifier": {
"system": "https://fhir.nhs.uk/Id/nhs-number",
"value": "9999999999"
}
},
"dosageInstruction": [
{
"timing": {
"repeat": {
"frequency": 1,
"period": 6,
"periodUnit": "h"
}
},
"route": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "26643006",
"display": "oral"
}
]
},
"doseQuantity": {
"value": 250,
"unit": "milligram",
"system": "http://unitsofmeasure.org",
"code": "mg"
}
}
]
}
MedicationRequest.id[0]b13724a0-7433-4c01-9c88-968baf91c6b4
MedicationRequest.contained[0].id[0]med1
MedicationRequest.contained[0].code[0].coding[0].system[0]http://snomed.info/sct
MedicationRequest.contained[0].code[0].coding[0].code[0]22969001
MedicationRequest.contained[0].code[0].coding[0].display[0]Oxytetracycline
MedicationRequest.status[0]active
MedicationRequest.intent[0]order
MedicationRequest.medication[0].reference[0]#med1
MedicationRequest.subject[0].identifier[0].system[0]https://fhir.nhs.uk/Id/nhs-number
MedicationRequest.subject[0].identifier[0].value[0]9999999999
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].frequency[0]1
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].period[0]6
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].periodUnit[0]h
MedicationRequest.dosageInstruction[0].route[0].coding[0].system[0]http://snomed.info/sct
MedicationRequest.dosageInstruction[0].route[0].coding[0].code[0]26643006
MedicationRequest.dosageInstruction[0].route[0].coding[0].display[0]oral
MedicationRequest.dosageInstruction[0].dose[0].value[0]250
MedicationRequest.dosageInstruction[0].dose[0].unit[0]milligram
MedicationRequest.dosageInstruction[0].dose[0].system[0]http://unitsofmeasure.org
MedicationRequest.dosageInstruction[0].dose[0].code[0]mg
MedicationRequest

Omeprazole, 10mg, gastro-resistant, oral, once daily

Product-based instruction using a VMP. Dose expressed per day.
<MedicationRequest xmlns="http://hl7.org/fhir">
<id value="d8360782-bbcb-486d-bcad-e268e68d5a74" />
<contained>
<Medication>
<id value="med1" />
<code>
<coding>
<system value="http://snomed.info/sct" />
<code value="407846000" />
<display value="Omeprazole 10mg gastro-resistant tablets" />
</coding>
</code>
</Medication>
</contained>
<status value="active" />
<intent value="order" />
<medicationReference>
<reference value="#med1" />
</medicationReference>
<subject>
<identifier>
<system value="https://fhir.nhs.uk/Id/nhs-number" />
<value value="9999999999" />
</identifier>
</subject>
<dosageInstruction>
<timing>
<repeat>
<frequency value="1" />
<period value="1" />
<periodUnit value="d" />
</repeat>
</timing>
<route>
<coding>
<system value="http://snomed.info/sct" />
<code value="26643006" />
<display value="oral" />
</coding>
</route>
<doseQuantity>
<value value="1" />
<unit value="tablet" />
<system value="http://snomed.info/sct" />
<code value="428673006" />
</doseQuantity>
</dosageInstruction>
</MedicationRequest>
{
"resourceType": "MedicationRequest",
"id": "d8360782-bbcb-486d-bcad-e268e68d5a74",
"contained": [
{
"resourceType": "Medication",
"id": "med1",
"code": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "407846000",
"display": "Omeprazole 10mg gastro-resistant tablets"
}
]
}
}
],
"status": "active",
"intent": "order",
"medicationReference": {
"reference": "#med1"
},
"subject": {
"identifier": {
"system": "https://fhir.nhs.uk/Id/nhs-number",
"value": "9999999999"
}
},
"dosageInstruction": [
{
"timing": {
"repeat": {
"frequency": 1,
"period": 1,
"periodUnit": "d"
}
},
"route": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "26643006",
"display": "oral"
}
]
},
"doseQuantity": {
"value": 1,
"unit": "tablet",
"system": "http://snomed.info/sct",
"code": "428673006"
}
}
]
}
MedicationRequest.id[0]d8360782-bbcb-486d-bcad-e268e68d5a74
MedicationRequest.contained[0].id[0]med1
MedicationRequest.contained[0].code[0].coding[0].system[0]http://snomed.info/sct
MedicationRequest.contained[0].code[0].coding[0].code[0]407846000
MedicationRequest.contained[0].code[0].coding[0].display[0]Omeprazole 10mg gastro-resistant tablets
MedicationRequest.status[0]active
MedicationRequest.intent[0]order
MedicationRequest.medication[0].reference[0]#med1
MedicationRequest.subject[0].identifier[0].system[0]https://fhir.nhs.uk/Id/nhs-number
MedicationRequest.subject[0].identifier[0].value[0]9999999999
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].frequency[0]1
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].period[0]1
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].periodUnit[0]d
MedicationRequest.dosageInstruction[0].route[0].coding[0].system[0]http://snomed.info/sct
MedicationRequest.dosageInstruction[0].route[0].coding[0].code[0]26643006
MedicationRequest.dosageInstruction[0].route[0].coding[0].display[0]oral
MedicationRequest.dosageInstruction[0].dose[0].value[0]1
MedicationRequest.dosageInstruction[0].dose[0].unit[0]tablet
MedicationRequest.dosageInstruction[0].dose[0].system[0]http://snomed.info/sct
MedicationRequest.dosageInstruction[0].dose[0].code[0]428673006
MedicationRequest
Dose-based instruction using a VTM. Dose expressed per day.
<MedicationRequest xmlns="http://hl7.org/fhir">
<id value="4de51441-b8af-4362-a825-3efbba3a645b" />
<contained>
<Medication>
<id value="med1" />
<code>
<coding>
<system value="http://snomed.info/sct" />
<code value="25673006" />
<display value="Omeprazole" />
</coding>
</code>
<form>
<coding>
<system value="http://snomed.info/sct" />
<code value="385059007" />
<display value="gastro-resistant tablet" />
</coding>
</form>
</Medication>
</contained>
<status value="active" />
<intent value="order" />
<medicationReference>
<reference value="#med1" />
</medicationReference>
<subject>
<identifier>
<system value="https://fhir.nhs.uk/Id/nhs-number" />
<value value="9999999999" />
</identifier>
</subject>
<dosageInstruction>
<timing>
<repeat>
<frequency value="1" />
<period value="1" />
<periodUnit value="d" />
</repeat>
</timing>
<route>
<coding>
<system value="http://snomed.info/sct" />
<code value="26643006" />
<display value="oral" />
</coding>
</route>
<doseQuantity>
<value value="10" />
<unit value="milligram" />
<system value="http://unitsofmeasure.org" />
<code value="mg" />
</doseQuantity>
</dosageInstruction>
</MedicationRequest>
{
"resourceType": "MedicationRequest",
"id": "4de51441-b8af-4362-a825-3efbba3a645b",
"contained": [
{
"resourceType": "Medication",
"id": "med1",
"code": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "25673006",
"display": "Omeprazole"
}
]
},
"form": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "385059007",
"display": "gastro-resistant tablet"
}
]
}
}
],
"status": "active",
"intent": "order",
"medicationReference": {
"reference": "#med1"
},
"subject": {
"identifier": {
"system": "https://fhir.nhs.uk/Id/nhs-number",
"value": "9999999999"
}
},
"dosageInstruction": [
{
"timing": {
"repeat": {
"frequency": 1,
"period": 1,
"periodUnit": "d"
}
},
"route": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "26643006",
"display": "oral"
}
]
},
"doseQuantity": {
"value": 10,
"unit": "milligram",
"system": "http://unitsofmeasure.org",
"code": "mg"
}
}
]
}
MedicationRequest.id[0]4de51441-b8af-4362-a825-3efbba3a645b
MedicationRequest.contained[0].id[0]med1
MedicationRequest.contained[0].code[0].coding[0].system[0]http://snomed.info/sct
MedicationRequest.contained[0].code[0].coding[0].code[0]25673006
MedicationRequest.contained[0].code[0].coding[0].display[0]Omeprazole
MedicationRequest.contained[0].form[0].coding[0].system[0]http://snomed.info/sct
MedicationRequest.contained[0].form[0].coding[0].code[0]385059007
MedicationRequest.contained[0].form[0].coding[0].display[0]gastro-resistant tablet
MedicationRequest.status[0]active
MedicationRequest.intent[0]order
MedicationRequest.medication[0].reference[0]#med1
MedicationRequest.subject[0].identifier[0].system[0]https://fhir.nhs.uk/Id/nhs-number
MedicationRequest.subject[0].identifier[0].value[0]9999999999
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].frequency[0]1
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].period[0]1
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].periodUnit[0]d
MedicationRequest.dosageInstruction[0].route[0].coding[0].system[0]http://snomed.info/sct
MedicationRequest.dosageInstruction[0].route[0].coding[0].code[0]26643006
MedicationRequest.dosageInstruction[0].route[0].coding[0].display[0]oral
MedicationRequest.dosageInstruction[0].dose[0].value[0]10
MedicationRequest.dosageInstruction[0].dose[0].unit[0]milligram
MedicationRequest.dosageInstruction[0].dose[0].system[0]http://unitsofmeasure.org
MedicationRequest.dosageInstruction[0].dose[0].code[0]mg
MedicationRequest

Trimethoprim, 200mg, oral, twice a day, for 3 days

Product-based instruction using an AMP. Dose expressed per day. Duration of 3 days.
<MedicationRequest xmlns="http://hl7.org/fhir">
<id value="10169939-6a5b-47ae-b820-524b584eecc8" />
<contained>
<Medication>
<id value="med1" />
<code>
<coding>
<system value="http://snomed.info/sct" />
<code value="28917911000001104" />
<display value="Trimethoprim 100mg tablets (Crescent Pharma Ltd)" />
</coding>
</code>
</Medication>
</contained>
<status value="active" />
<intent value="order" />
<medicationReference>
<reference value="#med1" />
</medicationReference>
<subject>
<identifier>
<system value="https://fhir.nhs.uk/Id/nhs-number" />
<value value="9999999999" />
</identifier>
</subject>
<dosageInstruction>
<timing>
<repeat>
<boundsDuration>
<value value="3" />
<unit value="day" />
<system value="http://unitsofmeasure.org" />
<code value="d" />
</boundsDuration>
<frequency value="2" />
<period value="1" />
<periodUnit value="d" />
</repeat>
</timing>
<route>
<coding>
<system value="http://snomed.info/sct" />
<code value="26643006" />
<display value="oral" />
</coding>
</route>
<doseQuantity>
<value value="2" />
<unit value="tablet" />
<system value="http://snomed.info/sct" />
<code value="428673006" />
</doseQuantity>
</dosageInstruction>
</MedicationRequest>
{
"resourceType": "MedicationRequest",
"id": "10169939-6a5b-47ae-b820-524b584eecc8",
"contained": [
{
"resourceType": "Medication",
"id": "med1",
"code": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "28917911000001104",
"display": "Trimethoprim 100mg tablets (Crescent Pharma Ltd)"
}
]
}
}
],
"status": "active",
"intent": "order",
"medicationReference": {
"reference": "#med1"
},
"subject": {
"identifier": {
"system": "https://fhir.nhs.uk/Id/nhs-number",
"value": "9999999999"
}
},
"dosageInstruction": [
{
"timing": {
"repeat": {
"boundsDuration": {
"value": 3,
"unit": "day",
"system": "http://unitsofmeasure.org",
"code": "d"
},
"frequency": 2,
"period": 1,
"periodUnit": "d"
}
},
"route": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "26643006",
"display": "oral"
}
]
},
"doseQuantity": {
"value": 2,
"unit": "tablet",
"system": "http://snomed.info/sct",
"code": "428673006"
}
}
]
}
MedicationRequest.id[0]10169939-6a5b-47ae-b820-524b584eecc8
MedicationRequest.contained[0].id[0]med1
MedicationRequest.contained[0].code[0].coding[0].system[0]http://snomed.info/sct
MedicationRequest.contained[0].code[0].coding[0].code[0]28917911000001104
MedicationRequest.contained[0].code[0].coding[0].display[0]Trimethoprim 100mg tablets (Crescent Pharma Ltd)
MedicationRequest.status[0]active
MedicationRequest.intent[0]order
MedicationRequest.medication[0].reference[0]#med1
MedicationRequest.subject[0].identifier[0].system[0]https://fhir.nhs.uk/Id/nhs-number
MedicationRequest.subject[0].identifier[0].value[0]9999999999
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].bounds[0].value[0]3
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].bounds[0].unit[0]day
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].bounds[0].system[0]http://unitsofmeasure.org
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].bounds[0].code[0]d
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].frequency[0]2
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].period[0]1
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].periodUnit[0]d
MedicationRequest.dosageInstruction[0].route[0].coding[0].system[0]http://snomed.info/sct
MedicationRequest.dosageInstruction[0].route[0].coding[0].code[0]26643006
MedicationRequest.dosageInstruction[0].route[0].coding[0].display[0]oral
MedicationRequest.dosageInstruction[0].dose[0].value[0]2
MedicationRequest.dosageInstruction[0].dose[0].unit[0]tablet
MedicationRequest.dosageInstruction[0].dose[0].system[0]http://snomed.info/sct
MedicationRequest.dosageInstruction[0].dose[0].code[0]428673006
MedicationRequest
Dose-based instruction using a VTM. Dose expressed per day. Duration of 3 days.
<MedicationRequest xmlns="http://hl7.org/fhir">
<id value="b65fd46e-4f4e-4676-b135-852ca16f2c91" />
<contained>
<Medication>
<id value="med1" />
<code>
<coding>
<system value="http://snomed.info/sct" />
<code value="32792001" />
<display value="Trimethoprim" />
</coding>
</code>
</Medication>
</contained>
<status value="active" />
<intent value="order" />
<medicationReference>
<reference value="#med1" />
</medicationReference>
<subject>
<identifier>
<system value="https://fhir.nhs.uk/Id/nhs-number" />
<value value="9999999999" />
</identifier>
</subject>
<dosageInstruction>
<timing>
<repeat>
<boundsDuration>
<value value="3" />
<unit value="day" />
<system value="http://unitsofmeasure.org" />
<code value="d" />
</boundsDuration>
<frequency value="2" />
<period value="1" />
<periodUnit value="d" />
</repeat>
</timing>
<route>
<coding>
<system value="http://snomed.info/sct" />
<code value="26643006" />
<display value="oral" />
</coding>
</route>
<doseQuantity>
<value value="200" />
<unit value="milligram" />
<system value="http://unitsofmeasure.org" />
<code value="mg" />
</doseQuantity>
</dosageInstruction>
</MedicationRequest>
{
"resourceType": "MedicationRequest",
"id": "b65fd46e-4f4e-4676-b135-852ca16f2c91",
"contained": [
{
"resourceType": "Medication",
"id": "med1",
"code": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "32792001",
"display": "Trimethoprim"
}
]
}
}
],
"status": "active",
"intent": "order",
"medicationReference": {
"reference": "#med1"
},
"subject": {
"identifier": {
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}
},
"dosageInstruction": [
{
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"value": 3,
"unit": "day",
"system": "http://unitsofmeasure.org",
"code": "d"
},
"frequency": 2,
"period": 1,
"periodUnit": "d"
}
},
"route": {
"coding": [
{
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"code": "26643006",
"display": "oral"
}
]
},
"doseQuantity": {
"value": 200,
"unit": "milligram",
"system": "http://unitsofmeasure.org",
"code": "mg"
}
}
]
}
MedicationRequest.id[0]b65fd46e-4f4e-4676-b135-852ca16f2c91
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MedicationRequest.contained[0].code[0].coding[0].system[0]http://snomed.info/sct
MedicationRequest.contained[0].code[0].coding[0].code[0]32792001
MedicationRequest.contained[0].code[0].coding[0].display[0]Trimethoprim
MedicationRequest.status[0]active
MedicationRequest.intent[0]order
MedicationRequest.medication[0].reference[0]#med1
MedicationRequest.subject[0].identifier[0].system[0]https://fhir.nhs.uk/Id/nhs-number
MedicationRequest.subject[0].identifier[0].value[0]9999999999
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].bounds[0].value[0]3
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].bounds[0].unit[0]day
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].bounds[0].system[0]http://unitsofmeasure.org
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].bounds[0].code[0]d
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].frequency[0]2
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].period[0]1
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].periodUnit[0]d
MedicationRequest.dosageInstruction[0].route[0].coding[0].system[0]http://snomed.info/sct
MedicationRequest.dosageInstruction[0].route[0].coding[0].code[0]26643006
MedicationRequest.dosageInstruction[0].route[0].coding[0].display[0]oral
MedicationRequest.dosageInstruction[0].dose[0].value[0]200
MedicationRequest.dosageInstruction[0].dose[0].unit[0]milligram
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MedicationRequest.dosageInstruction[0].dose[0].code[0]mg
MedicationRequest

Sodium citrate / Micralax Micro-enema enema, once daily

Product-based instruction using an AMP. Dose expressed per day.
<MedicationRequest xmlns="http://hl7.org/fhir">
<id value="d62bbf77-c6b5-4bac-a66f-147a869eacc7" />
<contained>
<Medication>
<id value="med1" />
<code>
<coding>
<system value="http://snomed.info/sct" />
<code value="3351711000001106" />
<display value="Micralax Micro-enema 5ml (RPH Pharmaceuticals AB)" />
</coding>
</code>
</Medication>
</contained>
<status value="active" />
<intent value="order" />
<medicationReference>
<reference value="#med1" />
</medicationReference>
<subject>
<identifier>
<system value="https://fhir.nhs.uk/Id/nhs-number" />
<value value="9999999999" />
</identifier>
</subject>
<dosageInstruction>
<timing>
<repeat>
<frequency value="1" />
<period value="1" />
<periodUnit value="d" />
</repeat>
</timing>
</dosageInstruction>
</MedicationRequest>
{
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"contained": [
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"code": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "3351711000001106",
"display": "Micralax Micro-enema 5ml (RPH Pharmaceuticals AB)"
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}
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"subject": {
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MedicationRequest.contained[0].code[0].coding[0].code[0]3351711000001106
MedicationRequest.contained[0].code[0].coding[0].display[0]Micralax Micro-enema 5ml (RPH Pharmaceuticals AB)
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MedicationRequest.intent[0]order
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MedicationRequest.subject[0].identifier[0].system[0]https://fhir.nhs.uk/Id/nhs-number
MedicationRequest.subject[0].identifier[0].value[0]9999999999
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].frequency[0]1
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].period[0]1
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].periodUnit[0]d
MedicationRequest
Dose-based instruction using a VTM. Dose expressed per day. Duration of 3 days.
<MedicationRequest xmlns="http://hl7.org/fhir">
<id value="63df7dcc-fc54-4eb2-8907-b53b09115bb6" />
<contained>
<Medication>
<id value="med1" />
<code>
<coding>
<system value="http://snomed.info/sct" />
<code value="412547001" />
<display value="Sodium citrate" />
</coding>
</code>
<form>
<coding>
<system value="http://snomed.info/sct" />
<code value="385186005" />
<display value="Enema" />
</coding>
</form>
</Medication>
</contained>
<status value="active" />
<intent value="order" />
<medicationReference>
<reference value="#med1" />
</medicationReference>
<subject>
<identifier>
<system value="https://fhir.nhs.uk/Id/nhs-number" />
<value value="9999999999" />
</identifier>
</subject>
<dosageInstruction>
<timing>
<repeat>
<frequency value="1" />
<period value="1" />
<periodUnit value="d" />
</repeat>
</timing>
<route>
<coding>
<system value="http://snomed.info/sct" />
<code value="37161004" />
<display value="Rectal" />
</coding>
</route>
<doseQuantity>
<value value="450" />
<unit value="milligram" />
<system value="http://unitsofmeasure.org" />
<code value="mg" />
</doseQuantity>
</dosageInstruction>
</MedicationRequest>
{
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"id": "63df7dcc-fc54-4eb2-8907-b53b09115bb6",
"contained": [
{
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"id": "med1",
"code": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "412547001",
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}
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},
"form": {
"coding": [
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}
}
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"subject": {
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"route": {
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"doseQuantity": {
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"code": "mg"
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MedicationRequest.id[0]63df7dcc-fc54-4eb2-8907-b53b09115bb6
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MedicationRequest.contained[0].code[0].coding[0].system[0]http://snomed.info/sct
MedicationRequest.contained[0].code[0].coding[0].code[0]412547001
MedicationRequest.contained[0].code[0].coding[0].display[0]Sodium citrate
MedicationRequest.contained[0].form[0].coding[0].system[0]http://snomed.info/sct
MedicationRequest.contained[0].form[0].coding[0].code[0]385186005
MedicationRequest.contained[0].form[0].coding[0].display[0]Enema
MedicationRequest.status[0]active
MedicationRequest.intent[0]order
MedicationRequest.medication[0].reference[0]#med1
MedicationRequest.subject[0].identifier[0].system[0]https://fhir.nhs.uk/Id/nhs-number
MedicationRequest.subject[0].identifier[0].value[0]9999999999
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].frequency[0]1
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].period[0]1
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].periodUnit[0]d
MedicationRequest.dosageInstruction[0].route[0].coding[0].system[0]http://snomed.info/sct
MedicationRequest.dosageInstruction[0].route[0].coding[0].code[0]37161004
MedicationRequest.dosageInstruction[0].route[0].coding[0].display[0]Rectal
MedicationRequest.dosageInstruction[0].dose[0].value[0]450
MedicationRequest.dosageInstruction[0].dose[0].unit[0]milligram
MedicationRequest.dosageInstruction[0].dose[0].system[0]http://unitsofmeasure.org
MedicationRequest.dosageInstruction[0].dose[0].code[0]mg
MedicationRequest

Diprobase ointment, 1 application, Topical, 3 times a day

Product-based instruction using an AMP. Where no dose quantity.
<MedicationRequest xmlns="http://hl7.org/fhir">
<id value="dad3ae68-f7d7-4bad-8d6d-09e114842b53" />
<contained>
<Medication>
<id value="med1" />
<code>
<coding>
<system value="http://snomed.info/sct" />
<code value="3491511000001101" />
<display value="Diprobase ointment (Bayer Plc)" />
</coding>
</code>
</Medication>
</contained>
<status value="active" />
<intent value="order" />
<medicationReference>
<reference value="#med1" />
</medicationReference>
<subject>
<identifier>
<system value="https://fhir.nhs.uk/Id/nhs-number" />
<value value="9999999999" />
</identifier>
</subject>
<dosageInstruction>
<timing>
<repeat>
<frequency value="3" />
<period value="1" />
<periodUnit value="d" />
</repeat>
</timing>
<route>
<coding>
<system value="http://snomed.info/sct" />
<code value="6064005" />
<display value="Topical" />
</coding>
</route>
<doseQuantity>
<value value="1" />
<unit value="application" />
<system value="http://snomed.info/sct" />
<code value="10692211000001108" />
</doseQuantity>
</dosageInstruction>
</MedicationRequest>
{
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"id": "dad3ae68-f7d7-4bad-8d6d-09e114842b53",
"contained": [
{
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"id": "med1",
"code": {
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{
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"code": "3491511000001101",
"display": "Diprobase ointment (Bayer Plc)"
}
]
}
}
],
"status": "active",
"intent": "order",
"medicationReference": {
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"subject": {
"identifier": {
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"value": "9999999999"
}
},
"dosageInstruction": [
{
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"period": 1,
"periodUnit": "d"
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},
"route": {
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"code": "6064005",
"display": "Topical"
}
]
},
"doseQuantity": {
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"unit": "application",
"system": "http://snomed.info/sct",
"code": "10692211000001108"
}
}
]
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MedicationRequest.contained[0].code[0].coding[0].system[0]http://snomed.info/sct
MedicationRequest.contained[0].code[0].coding[0].code[0]3491511000001101
MedicationRequest.contained[0].code[0].coding[0].display[0]Diprobase ointment (Bayer Plc)
MedicationRequest.status[0]active
MedicationRequest.intent[0]order
MedicationRequest.medication[0].reference[0]#med1
MedicationRequest.subject[0].identifier[0].system[0]https://fhir.nhs.uk/Id/nhs-number
MedicationRequest.subject[0].identifier[0].value[0]9999999999
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].frequency[0]3
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].period[0]1
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].periodUnit[0]d
MedicationRequest.dosageInstruction[0].route[0].coding[0].system[0]http://snomed.info/sct
MedicationRequest.dosageInstruction[0].route[0].coding[0].code[0]6064005
MedicationRequest.dosageInstruction[0].route[0].coding[0].display[0]Topical
MedicationRequest.dosageInstruction[0].dose[0].value[0]1
MedicationRequest.dosageInstruction[0].dose[0].unit[0]application
MedicationRequest.dosageInstruction[0].dose[0].system[0]http://snomed.info/sct
MedicationRequest.dosageInstruction[0].dose[0].code[0]10692211000001108
MedicationRequest
Dose-based instruction using a VTM. Where no dose quantity.

The VTM related to the Diprobase AMP’s is a multi-ingredient concept “White soft paraffin + Liquid paraffin” and cannot be used as a prescribing concept.

Beclometasone 0.025% cream, Apply Thigh, twice a day

Product-based instruction using a VMP. Body site identified.
<MedicationRequest xmlns="http://hl7.org/fhir">
<id value="1c7d802c-71b2-4ac1-9cf2-8423e38b95fe" />
<contained>
<Medication>
<id value="med1" />
<code>
<coding>
<system value="http://snomed.info/sct" />
<code value="331792000" />
<display value="Beclometasone 0.025% cream" />
</coding>
</code>
</Medication>
</contained>
<status value="active" />
<intent value="order" />
<medicationReference>
<reference value="#med1" />
</medicationReference>
<subject>
<identifier>
<system value="https://fhir.nhs.uk/Id/nhs-number" />
<value value="9999999999" />
</identifier>
</subject>
<dosageInstruction>
<timing>
<repeat>
<frequency value="2" />
<period value="1" />
<periodUnit value="d" />
</repeat>
</timing>
<site>
<coding>
<system value="http://snomed.info/sct" />
<code value="68367000" />
<display value="Thigh" />
</coding>
<text value="Thigh" />
</site>
<method>
<coding>
<system value="http://snomed.info/sct" />
<code value="417924000" />
<display value="Apply" />
</coding>
</method>
</dosageInstruction>
</MedicationRequest>
{
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"id": "1c7d802c-71b2-4ac1-9cf2-8423e38b95fe",
"contained": [
{
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"id": "med1",
"code": {
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"display": "Beclometasone 0.025% cream"
}
]
}
}
],
"status": "active",
"intent": "order",
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"subject": {
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"value": "9999999999"
}
},
"dosageInstruction": [
{
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"period": 1,
"periodUnit": "d"
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},
"site": {
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{
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"code": "68367000",
"display": "Thigh"
}
],
"text": "Thigh"
},
"method": {
"coding": [
{
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"code": "417924000",
"display": "Apply"
}
]
}
}
]
}
MedicationRequest.id[0]1c7d802c-71b2-4ac1-9cf2-8423e38b95fe
MedicationRequest.contained[0].id[0]med1
MedicationRequest.contained[0].code[0].coding[0].system[0]http://snomed.info/sct
MedicationRequest.contained[0].code[0].coding[0].code[0]331792000
MedicationRequest.contained[0].code[0].coding[0].display[0]Beclometasone 0.025% cream
MedicationRequest.status[0]active
MedicationRequest.intent[0]order
MedicationRequest.medication[0].reference[0]#med1
MedicationRequest.subject[0].identifier[0].system[0]https://fhir.nhs.uk/Id/nhs-number
MedicationRequest.subject[0].identifier[0].value[0]9999999999
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].frequency[0]2
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].period[0]1
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].periodUnit[0]d
MedicationRequest.dosageInstruction[0].site[0].coding[0].system[0]http://snomed.info/sct
MedicationRequest.dosageInstruction[0].site[0].coding[0].code[0]68367000
MedicationRequest.dosageInstruction[0].site[0].coding[0].display[0]Thigh
MedicationRequest.dosageInstruction[0].site[0].text[0]Thigh
MedicationRequest.dosageInstruction[0].method[0].coding[0].system[0]http://snomed.info/sct
MedicationRequest.dosageInstruction[0].method[0].coding[0].code[0]417924000
MedicationRequest.dosageInstruction[0].method[0].coding[0].display[0]Apply
MedicationRequest
Dose-based instruction using a VTM. Body site identified.

Where a concentration is required it is expected that the prescribing concept would be a VMP or AMP.

Zopiclone 3.75mg tablets, 1 tablet, at BEDTIME, PRN, oral

Product-based instruction using a VMP. When required dosing.
<!-- Zopiclone 3.75mg tablets, 1 tablet, at BEDTIME, PRN, oral -->
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<id value="c804eca2-8b32-44d7-b654-b88bb9b1edd2" />
<contained>
<Medication>
<id value="med1" />
<code>
<coding>
<system value="http://snomed.info/sct" />
<code value="321177003" />
<display value="Zopiclone 3.75mg tablets" />
</coding>
</code>
</Medication>
</contained>
<status value="active" />
<intent value="order" />
<medicationReference>
<reference value="#med1" />
</medicationReference>
<subject>
<identifier>
<system value="https://fhir.nhs.uk/Id/nhs-number" />
<value value="9999999999" />
</identifier>
</subject>
<dosageInstruction>
<timing>
<repeat>
<frequency value="1" />
<period value="1" />
<periodUnit value="d" />
<when value="HS" />
</repeat>
</timing>
<asNeededBoolean value="true" />
<route>
<coding>
<system value="http://snomed.info/sct" />
<code value="26643006" />
<display value="oral" />
</coding>
</route>
<doseQuantity>
<value value="1" />
<unit value="tablet" />
<system value="http://snomed.info/sct" />
<code value="428673006" />
</doseQuantity>
</dosageInstruction>
</MedicationRequest>
{
"resourceType": "MedicationRequest",
"id": "c804eca2-8b32-44d7-b654-b88bb9b1edd2",
"contained": [
{
"resourceType": "Medication",
"id": "med1",
"code": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "321177003",
"display": "Zopiclone 3.75mg tablets"
}
]
}
}
],
"status": "active",
"intent": "order",
"medicationReference": {
"reference": "#med1"
},
"subject": {
"identifier": {
"system": "https://fhir.nhs.uk/Id/nhs-number",
"value": "9999999999"
}
},
"dosageInstruction": [
{
"timing": {
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"period": 1,
"periodUnit": "d",
"when": [
"HS"
]
}
},
"asNeededBoolean": true,
"route": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "26643006",
"display": "oral"
}
]
},
"doseQuantity": {
"value": 1,
"unit": "tablet",
"system": "http://snomed.info/sct",
"code": "428673006"
}
}
]
}
MedicationRequest.id[0]c804eca2-8b32-44d7-b654-b88bb9b1edd2
MedicationRequest.contained[0].id[0]med1
MedicationRequest.contained[0].code[0].coding[0].system[0]http://snomed.info/sct
MedicationRequest.contained[0].code[0].coding[0].code[0]321177003
MedicationRequest.contained[0].code[0].coding[0].display[0]Zopiclone 3.75mg tablets
MedicationRequest.status[0]active
MedicationRequest.intent[0]order
MedicationRequest.medication[0].reference[0]#med1
MedicationRequest.subject[0].identifier[0].system[0]https://fhir.nhs.uk/Id/nhs-number
MedicationRequest.subject[0].identifier[0].value[0]9999999999
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].frequency[0]1
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].period[0]1
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].periodUnit[0]d
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].when[0]HS
MedicationRequest.dosageInstruction[0].asNeeded[0]True
MedicationRequest.dosageInstruction[0].route[0].coding[0].system[0]http://snomed.info/sct
MedicationRequest.dosageInstruction[0].route[0].coding[0].code[0]26643006
MedicationRequest.dosageInstruction[0].route[0].coding[0].display[0]oral
MedicationRequest.dosageInstruction[0].dose[0].value[0]1
MedicationRequest.dosageInstruction[0].dose[0].unit[0]tablet
MedicationRequest.dosageInstruction[0].dose[0].system[0]http://snomed.info/sct
MedicationRequest.dosageInstruction[0].dose[0].code[0]428673006
MedicationRequest

Ibuprofen 400mg orally three times daily for 5 days to start tomorrow

Dose-based instruction using a VTM. Specified start date and course length.
<MedicationRequest xmlns="http://hl7.org/fhir">
<id value="23406593-8209-4b3f-8afd-4bd9e8f72212" />
<contained>
<Medication>
<id value="med1" />
<code>
<coding>
<system value="http://snomed.info/sct" />
<code value="38268001" />
<display value="Ibuprofen" />
</coding>
</code>
</Medication>
</contained>
<status value="active" />
<intent value="order" />
<medicationReference>
<reference value="#med1" />
</medicationReference>
<subject>
<identifier>
<system value="https://fhir.nhs.uk/Id/nhs-number" />
<value value="9999999999" />
</identifier>
</subject>
<dosageInstruction>
<timing>
<repeat>
<boundsPeriod>
<start value="2019-03-10" />
<end value="2019-03-14" />
</boundsPeriod>
<frequency value="3" />
<period value="1" />
<periodUnit value="d" />
</repeat>
</timing>
<route>
<coding>
<system value="http://snomed.info/sct" />
<code value="26643006" />
<display value="oral" />
</coding>
</route>
<doseQuantity>
<value value="400" />
<unit value="milligram" />
<system value="http://unitsofmeasure.org" />
<code value="mg" />
</doseQuantity>
</dosageInstruction>
</MedicationRequest>
{
"resourceType": "MedicationRequest",
"id": "23406593-8209-4b3f-8afd-4bd9e8f72212",
"contained": [
{
"resourceType": "Medication",
"id": "med1",
"code": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "38268001",
"display": "Ibuprofen"
}
]
}
}
],
"status": "active",
"intent": "order",
"medicationReference": {
"reference": "#med1"
},
"subject": {
"identifier": {
"system": "https://fhir.nhs.uk/Id/nhs-number",
"value": "9999999999"
}
},
"dosageInstruction": [
{
"timing": {
"repeat": {
"boundsPeriod": {
"start": "2019-03-10",
"end": "2019-03-14"
},
"frequency": 3,
"period": 1,
"periodUnit": "d"
}
},
"route": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "26643006",
"display": "oral"
}
]
},
"doseQuantity": {
"value": 400,
"unit": "milligram",
"system": "http://unitsofmeasure.org",
"code": "mg"
}
}
]
}
MedicationRequest.id[0]23406593-8209-4b3f-8afd-4bd9e8f72212
MedicationRequest.contained[0].id[0]med1
MedicationRequest.contained[0].code[0].coding[0].system[0]http://snomed.info/sct
MedicationRequest.contained[0].code[0].coding[0].code[0]38268001
MedicationRequest.contained[0].code[0].coding[0].display[0]Ibuprofen
MedicationRequest.status[0]active
MedicationRequest.intent[0]order
MedicationRequest.medication[0].reference[0]#med1
MedicationRequest.subject[0].identifier[0].system[0]https://fhir.nhs.uk/Id/nhs-number
MedicationRequest.subject[0].identifier[0].value[0]9999999999
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].bounds[0].start[0]2019-03-10
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].bounds[0].end[0]2019-03-14
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].frequency[0]3
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].period[0]1
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].periodUnit[0]d
MedicationRequest.dosageInstruction[0].route[0].coding[0].system[0]http://snomed.info/sct
MedicationRequest.dosageInstruction[0].route[0].coding[0].code[0]26643006
MedicationRequest.dosageInstruction[0].route[0].coding[0].display[0]oral
MedicationRequest.dosageInstruction[0].dose[0].value[0]400
MedicationRequest.dosageInstruction[0].dose[0].unit[0]milligram
MedicationRequest.dosageInstruction[0].dose[0].system[0]http://unitsofmeasure.org
MedicationRequest.dosageInstruction[0].dose[0].code[0]mg
MedicationRequest
For this example, assume today’s date is 9th March 2019, hence ‘tomorrow’ is 10th March 2019.

Timolol 0.1% gel eye drops, 1 drop in the left eye once daily

Product-based instruction using a VMP. Body site identified.
<MedicationRequest xmlns="http://hl7.org/fhir">
<id value="e8534d74-1b23-4a1a-90dd-04c71dad2f5f" />
<contained>
<Medication>
<id value="med1" />
<code>
<coding>
<system value="http://snomed.info/sct" />
<code value="496811000001108" />
<display value="Timolol 0.1% gel eye drops" />
</coding>
</code>
</Medication>
</contained>
<status value="active" />
<intent value="order" />
<medicationReference>
<reference value="#med1" />
</medicationReference>
<subject>
<identifier>
<system value="https://fhir.nhs.uk/Id/nhs-number" />
<value value="9999999999" />
</identifier>
</subject>
<dosageInstruction>
<timing>
<repeat>
<frequency value="1" />
<period value="1" />
<periodUnit value="d" />
</repeat>
</timing>
<site>
<coding>
<system value="http://snomed.info/sct" />
<code value="8966001" />
<display value="Left eye" />
</coding>
</site>
<doseQuantity>
<value value="1" />
<unit value="Drop" />
<system value="http://snomed.info/sct" />
<code value="404218003" />
</doseQuantity>
</dosageInstruction>
</MedicationRequest>
{
"resourceType": "MedicationRequest",
"id": "e8534d74-1b23-4a1a-90dd-04c71dad2f5f",
"contained": [
{
"resourceType": "Medication",
"id": "med1",
"code": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "496811000001108",
"display": "Timolol 0.1% gel eye drops"
}
]
}
}
],
"status": "active",
"intent": "order",
"medicationReference": {
"reference": "#med1"
},
"subject": {
"identifier": {
"system": "https://fhir.nhs.uk/Id/nhs-number",
"value": "9999999999"
}
},
"dosageInstruction": [
{
"timing": {
"repeat": {
"frequency": 1,
"period": 1,
"periodUnit": "d"
}
},
"site": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "8966001",
"display": "Left eye"
}
]
},
"doseQuantity": {
"value": 1,
"unit": "Drop",
"system": "http://snomed.info/sct",
"code": "404218003"
}
}
]
}
MedicationRequest.id[0]e8534d74-1b23-4a1a-90dd-04c71dad2f5f
MedicationRequest.contained[0].id[0]med1
MedicationRequest.contained[0].code[0].coding[0].system[0]http://snomed.info/sct
MedicationRequest.contained[0].code[0].coding[0].code[0]496811000001108
MedicationRequest.contained[0].code[0].coding[0].display[0]Timolol 0.1% gel eye drops
MedicationRequest.status[0]active
MedicationRequest.intent[0]order
MedicationRequest.medication[0].reference[0]#med1
MedicationRequest.subject[0].identifier[0].system[0]https://fhir.nhs.uk/Id/nhs-number
MedicationRequest.subject[0].identifier[0].value[0]9999999999
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].frequency[0]1
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].period[0]1
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].periodUnit[0]d
MedicationRequest.dosageInstruction[0].site[0].coding[0].system[0]http://snomed.info/sct
MedicationRequest.dosageInstruction[0].site[0].coding[0].code[0]8966001
MedicationRequest.dosageInstruction[0].site[0].coding[0].display[0]Left eye
MedicationRequest.dosageInstruction[0].dose[0].value[0]1
MedicationRequest.dosageInstruction[0].dose[0].unit[0]Drop
MedicationRequest.dosageInstruction[0].dose[0].system[0]http://snomed.info/sct
MedicationRequest.dosageInstruction[0].dose[0].code[0]404218003
MedicationRequest
For this example, assume today’s date is 9th March 2019, hence ‘tomorrow’ is 10th March 2019.

Epoetin alfa, 4500units, ONCE a DAY, subcutaneous injection

Dose-based instruction using a VTM. Route and method identified.
<MedicationRequest xmlns="http://hl7.org/fhir">
<id value="a8ca980c-72aa-11e7-8cf7-a6006ad3dba0" />
<contained>
<Medication>
<id value="med1" />
<code>
<coding>
<system value="http://snomed.info/sct" />
<code value="108964008" />
<display value="Epoetin alfa" />
</coding>
</code>
</Medication>
</contained>
<status value="active" />
<intent value="order" />
<medicationReference>
<reference value="#med1" />
</medicationReference>
<subject>
<identifier>
<system value="https://fhir.nhs.uk/Id/nhs-number" />
<value value="9999999999" />
</identifier>
</subject>
<dosageInstruction>
<timing>
<repeat>
<frequency value="1" />
<period value="1" />
<periodUnit value="d" />
</repeat>
</timing>
<route>
<coding>
<system value="http://snomed.info/sct" />
<code value="34206005" />
<display value="subcutaneous route" />
</coding>
</route>
<method>
<coding>
<system value="http://snomed.info/sct" />
<code value="422145002" />
<display value="inject" />
</coding>
</method>
<doseQuantity>
<value value="4500" />
<unit value="unit" />
<system value="http://snomed.info/sct" />
<code value="767525000" />
</doseQuantity>
</dosageInstruction>
</MedicationRequest>
{
"resourceType": "MedicationRequest",
"id": "a8ca980c-72aa-11e7-8cf7-a6006ad3dba0",
"contained": [
{
"resourceType": "Medication",
"id": "med1",
"code": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "108964008",
"display": "Epoetin alfa"
}
]
}
}
],
"status": "active",
"intent": "order",
"medicationReference": {
"reference": "#med1"
},
"subject": {
"identifier": {
"system": "https://fhir.nhs.uk/Id/nhs-number",
"value": "9999999999"
}
},
"dosageInstruction": [
{
"timing": {
"repeat": {
"frequency": 1,
"period": 1,
"periodUnit": "d"
}
},
"route": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "34206005",
"display": "subcutaneous route"
}
]
},
"method": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "422145002",
"display": "inject"
}
]
},
"doseQuantity": {
"value": 4500,
"unit": "unit",
"system": "http://snomed.info/sct",
"code": "767525000"
}
}
]
}
MedicationRequest.id[0]a8ca980c-72aa-11e7-8cf7-a6006ad3dba0
MedicationRequest.contained[0].id[0]med1
MedicationRequest.contained[0].code[0].coding[0].system[0]http://snomed.info/sct
MedicationRequest.contained[0].code[0].coding[0].code[0]108964008
MedicationRequest.contained[0].code[0].coding[0].display[0]Epoetin alfa
MedicationRequest.status[0]active
MedicationRequest.intent[0]order
MedicationRequest.medication[0].reference[0]#med1
MedicationRequest.subject[0].identifier[0].system[0]https://fhir.nhs.uk/Id/nhs-number
MedicationRequest.subject[0].identifier[0].value[0]9999999999
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].frequency[0]1
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].period[0]1
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].periodUnit[0]d
MedicationRequest.dosageInstruction[0].route[0].coding[0].system[0]http://snomed.info/sct
MedicationRequest.dosageInstruction[0].route[0].coding[0].code[0]34206005
MedicationRequest.dosageInstruction[0].route[0].coding[0].display[0]subcutaneous route
MedicationRequest.dosageInstruction[0].method[0].coding[0].system[0]http://snomed.info/sct
MedicationRequest.dosageInstruction[0].method[0].coding[0].code[0]422145002
MedicationRequest.dosageInstruction[0].method[0].coding[0].display[0]inject
MedicationRequest.dosageInstruction[0].dose[0].value[0]4500
MedicationRequest.dosageInstruction[0].dose[0].unit[0]unit
MedicationRequest.dosageInstruction[0].dose[0].system[0]http://snomed.info/sct
MedicationRequest.dosageInstruction[0].dose[0].code[0]767525000
MedicationRequest

Morphine modified release capsule, 20mg orally every 12 hours

Dose-based instruction sing a VTM with a specific form. Dose expressed as hourly dose interval.
<MedicationRequest xmlns="http://hl7.org/fhir">
<id value="cec8f082-4c5b-4ccd-9187-c066c8057498" />
<contained>
<Medication>
<id value="med1" />
<code>
<coding>
<system value="http://snomed.info/sct" />
<code value="73572009" />
<display value="Morphine" />
</coding>
</code>
<form>
<coding>
<system value="http://snomed.info/sct" />
<code value="385054002" />
<display value="Modified-release capsule" />
</coding>
</form>
</Medication>
</contained>
<status value="active" />
<intent value="order" />
<medicationReference>
<reference value="#med1" />
</medicationReference>
<subject>
<identifier>
<system value="https://fhir.nhs.uk/Id/nhs-number" />
<value value="9999999999" />
</identifier>
</subject>
<dosageInstruction>
<timing>
<repeat>
<frequency value="1" />
<period value="12" />
<periodUnit value="h" />
</repeat>
</timing>
<route>
<coding>
<system value="http://snomed.info/sct" />
<code value="26643006" />
<display value="oral" />
</coding>
</route>
<doseQuantity>
<value value="20" />
<unit value="milligram" />
<system value="http://unitsofmeasure.org" />
<code value="mg" />
</doseQuantity>
</dosageInstruction>
</MedicationRequest>
{
"resourceType": "MedicationRequest",
"id": "cec8f082-4c5b-4ccd-9187-c066c8057498",
"contained": [
{
"resourceType": "Medication",
"id": "med1",
"code": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "73572009",
"display": "Morphine"
}
]
},
"form": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "385054002",
"display": "Modified-release capsule"
}
]
}
}
],
"status": "active",
"intent": "order",
"medicationReference": {
"reference": "#med1"
},
"subject": {
"identifier": {
"system": "https://fhir.nhs.uk/Id/nhs-number",
"value": "9999999999"
}
},
"dosageInstruction": [
{
"timing": {
"repeat": {
"frequency": 1,
"period": 12,
"periodUnit": "h"
}
},
"route": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "26643006",
"display": "oral"
}
]
},
"doseQuantity": {
"value": 20,
"unit": "milligram",
"system": "http://unitsofmeasure.org",
"code": "mg"
}
}
]
}
MedicationRequest.id[0]cec8f082-4c5b-4ccd-9187-c066c8057498
MedicationRequest.contained[0].id[0]med1
MedicationRequest.contained[0].code[0].coding[0].system[0]http://snomed.info/sct
MedicationRequest.contained[0].code[0].coding[0].code[0]73572009
MedicationRequest.contained[0].code[0].coding[0].display[0]Morphine
MedicationRequest.contained[0].form[0].coding[0].system[0]http://snomed.info/sct
MedicationRequest.contained[0].form[0].coding[0].code[0]385054002
MedicationRequest.contained[0].form[0].coding[0].display[0]Modified-release capsule
MedicationRequest.status[0]active
MedicationRequest.intent[0]order
MedicationRequest.medication[0].reference[0]#med1
MedicationRequest.subject[0].identifier[0].system[0]https://fhir.nhs.uk/Id/nhs-number
MedicationRequest.subject[0].identifier[0].value[0]9999999999
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].frequency[0]1
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].period[0]12
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].periodUnit[0]h
MedicationRequest.dosageInstruction[0].route[0].coding[0].system[0]http://snomed.info/sct
MedicationRequest.dosageInstruction[0].route[0].coding[0].code[0]26643006
MedicationRequest.dosageInstruction[0].route[0].coding[0].display[0]oral
MedicationRequest.dosageInstruction[0].dose[0].value[0]20
MedicationRequest.dosageInstruction[0].dose[0].unit[0]milligram
MedicationRequest.dosageInstruction[0].dose[0].system[0]http://unitsofmeasure.org
MedicationRequest.dosageInstruction[0].dose[0].code[0]mg
MedicationRequest

Morphine, 30mg, intrav, injection, four times a day, for 1 day

Dose-based instruction using a VTM. Route and method identified and course duration.
<MedicationRequest xmlns="http://hl7.org/fhir">
<id value="1558295a-9213-44cb-81e1-e1ab8fcc3e81" />
<contained>
<Medication>
<id value="med1" />
<code>
<coding>
<system value="http://snomed.info/sct" />
<code value="73572009" />
<display value="Morphine" />
</coding>
</code>
</Medication>
</contained>
<status value="active" />
<intent value="order" />
<medicationReference>
<reference value="#med1" />
</medicationReference>
<subject>
<identifier>
<system value="https://fhir.nhs.uk/Id/nhs-number" />
<value value="9999999999" />
</identifier>
</subject>
<dosageInstruction>
<timing>
<repeat>
<boundsDuration>
<value value="1" />
<unit value="day" />
<system value="http://unitsofmeasure.org" />
<code value="d" />
</boundsDuration>
<frequency value="4" />
<period value="1" />
<periodUnit value="d" />
</repeat>
</timing>
<route>
<coding>
<system value="http://snomed.info/sct" />
<code value="47625008" />
<display value="intravenous route" />
</coding>
</route>
<method>
<coding>
<system value="http://snomed.info/sct" />
<code value="422145002" />
<display value="inject" />
</coding>
</method>
<doseQuantity>
<value value="30" />
<unit value="milligram" />
<system value="http://unitsofmeasure.org" />
<code value="mg" />
</doseQuantity>
</dosageInstruction>
</MedicationRequest>
{
"resourceType": "MedicationRequest",
"id": "1558295a-9213-44cb-81e1-e1ab8fcc3e81",
"contained": [
{
"resourceType": "Medication",
"id": "med1",
"code": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "73572009",
"display": "Morphine"
}
]
}
}
],
"status": "active",
"intent": "order",
"medicationReference": {
"reference": "#med1"
},
"subject": {
"identifier": {
"system": "https://fhir.nhs.uk/Id/nhs-number",
"value": "9999999999"
}
},
"dosageInstruction": [
{
"timing": {
"repeat": {
"boundsDuration": {
"value": 1,
"unit": "day",
"system": "http://unitsofmeasure.org",
"code": "d"
},
"frequency": 4,
"period": 1,
"periodUnit": "d"
}
},
"route": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "47625008",
"display": "intravenous route"
}
]
},
"method": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "422145002",
"display": "inject"
}
]
},
"doseQuantity": {
"value": 30,
"unit": "milligram",
"system": "http://unitsofmeasure.org",
"code": "mg"
}
}
]
}
MedicationRequest.id[0]1558295a-9213-44cb-81e1-e1ab8fcc3e81
MedicationRequest.contained[0].id[0]med1
MedicationRequest.contained[0].code[0].coding[0].system[0]http://snomed.info/sct
MedicationRequest.contained[0].code[0].coding[0].code[0]73572009
MedicationRequest.contained[0].code[0].coding[0].display[0]Morphine
MedicationRequest.status[0]active
MedicationRequest.intent[0]order
MedicationRequest.medication[0].reference[0]#med1
MedicationRequest.subject[0].identifier[0].system[0]https://fhir.nhs.uk/Id/nhs-number
MedicationRequest.subject[0].identifier[0].value[0]9999999999
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].bounds[0].value[0]1
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].bounds[0].unit[0]day
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].bounds[0].system[0]http://unitsofmeasure.org
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].bounds[0].code[0]d
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].frequency[0]4
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].period[0]1
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].periodUnit[0]d
MedicationRequest.dosageInstruction[0].route[0].coding[0].system[0]http://snomed.info/sct
MedicationRequest.dosageInstruction[0].route[0].coding[0].code[0]47625008
MedicationRequest.dosageInstruction[0].route[0].coding[0].display[0]intravenous route
MedicationRequest.dosageInstruction[0].method[0].coding[0].system[0]http://snomed.info/sct
MedicationRequest.dosageInstruction[0].method[0].coding[0].code[0]422145002
MedicationRequest.dosageInstruction[0].method[0].coding[0].display[0]inject
MedicationRequest.dosageInstruction[0].dose[0].value[0]30
MedicationRequest.dosageInstruction[0].dose[0].unit[0]milligram
MedicationRequest.dosageInstruction[0].dose[0].system[0]http://unitsofmeasure.org
MedicationRequest.dosageInstruction[0].dose[0].code[0]mg
MedicationRequest

Zoladex 3.6mg implant SafeSystem pre-filled syringes (AstraZeneca UK Ltd), one to be given by IM injection into the anterior abdominal wall on 1st November 2019

Product-based instruction using an AMP. Identified route, method and site. Specific date.
<MedicationRequest xmlns="http://hl7.org/fhir">
<id value="905d34ad-ea20-4371-8bf7-5208fbf146ce" />
<contained>
<Medication>
<id value="med1" />
<code>
<coding>
<system value="http://snomed.info/sct" />
<code value="824211000001107" />
<display value="Zoladex 3.6mg implant SafeSystem pre-filled syringes (AstraZeneca UK Ltd)" />
</coding>
</code>
</Medication>
</contained>
<status value="active" />
<intent value="order" />
<medicationReference>
<reference value="#med1" />
</medicationReference>
<subject>
<identifier>
<system value="https://fhir.nhs.uk/Id/nhs-number" />
<value value="9999999999" />
</identifier>
</subject>
<dosageInstruction>
<timing>
<event value="2019-11-01" />
<repeat>
<count value="1" />
</repeat>
</timing>
<site>
<coding>
<system value="http://snomed.info/sct" />
<code value="59380008" />
<display value="Anterior abdominal wall structure" />
</coding>
</site>
<route>
<coding>
<system value="http://snomed.info/sct" />
<code value="78421000" />
<display value="intramuscular route" />
</coding>
</route>
<method>
<coding>
<system value="http://snomed.info/sct" />
<code value="422145002" />
<display value="inject" />
</coding>
</method>
</dosageInstruction>
</MedicationRequest>
{
"resourceType": "MedicationRequest",
"id": "905d34ad-ea20-4371-8bf7-5208fbf146ce",
"contained": [
{
"resourceType": "Medication",
"id": "med1",
"code": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "824211000001107",
"display": "Zoladex 3.6mg implant SafeSystem pre-filled syringes (AstraZeneca UK Ltd)"
}
]
}
}
],
"status": "active",
"intent": "order",
"medicationReference": {
"reference": "#med1"
},
"subject": {
"identifier": {
"system": "https://fhir.nhs.uk/Id/nhs-number",
"value": "9999999999"
}
},
"dosageInstruction": [
{
"timing": {
"event": [
"2019-11-01"
],
"repeat": {
"count": 1
}
},
"site": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "59380008",
"display": "Anterior abdominal wall structure"
}
]
},
"route": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "78421000",
"display": "intramuscular route"
}
]
},
"method": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "422145002",
"display": "inject"
}
]
}
}
]
}
MedicationRequest.id[0]905d34ad-ea20-4371-8bf7-5208fbf146ce
MedicationRequest.contained[0].id[0]med1
MedicationRequest.contained[0].code[0].coding[0].system[0]http://snomed.info/sct
MedicationRequest.contained[0].code[0].coding[0].code[0]824211000001107
MedicationRequest.contained[0].code[0].coding[0].display[0]Zoladex 3.6mg implant SafeSystem pre-filled syringes (AstraZeneca UK Ltd)
MedicationRequest.status[0]active
MedicationRequest.intent[0]order
MedicationRequest.medication[0].reference[0]#med1
MedicationRequest.subject[0].identifier[0].system[0]https://fhir.nhs.uk/Id/nhs-number
MedicationRequest.subject[0].identifier[0].value[0]9999999999
MedicationRequest.dosageInstruction[0].timing[0].event[0]2019-11-01
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].count[0]1
MedicationRequest.dosageInstruction[0].site[0].coding[0].system[0]http://snomed.info/sct
MedicationRequest.dosageInstruction[0].site[0].coding[0].code[0]59380008
MedicationRequest.dosageInstruction[0].site[0].coding[0].display[0]Anterior abdominal wall structure
MedicationRequest.dosageInstruction[0].route[0].coding[0].system[0]http://snomed.info/sct
MedicationRequest.dosageInstruction[0].route[0].coding[0].code[0]78421000
MedicationRequest.dosageInstruction[0].route[0].coding[0].display[0]intramuscular route
MedicationRequest.dosageInstruction[0].method[0].coding[0].system[0]http://snomed.info/sct
MedicationRequest.dosageInstruction[0].method[0].coding[0].code[0]422145002
MedicationRequest.dosageInstruction[0].method[0].coding[0].display[0]inject
MedicationRequest

Hyoscine 1mg/72hours transdermal patches, one patch to be applied once every 3 days

Product-based instruction using a VMP. Dosing every 3 days. Specific method.
<MedicationRequest xmlns="http://hl7.org/fhir">
<id value="a8ca980c-72aa-11e7-8cf7-a6006ad3dba0" />
<contained>
<Medication>
<id value="med1" />
<code>
<coding>
<system value="http://snomed.info/sct" />
<code value="322087003" />
<display value="Hyoscine 1mg/72hours transdermal patches" />
</coding>
</code>
</Medication>
</contained>
<status value="active" />
<intent value="order" />
<medicationReference>
<reference value="#med1" />
</medicationReference>
<subject>
<identifier>
<system value="https://fhir.nhs.uk/Id/nhs-number" />
<value value="9999999999" />
</identifier>
</subject>
<dosageInstruction>
<timing>
<repeat>
<frequency value="1" />
<period value="3" />
<periodUnit value="d" />
</repeat>
</timing>
<method>
<coding>
<system value="http://snomed.info/sct" />
<code value="417924000" />
<display value="Apply" />
</coding>
</method>
<doseQuantity>
<value value="1" />
<unit value="patch" />
<system value="http://snomed.info/sct" />
<code value="733005001" />
</doseQuantity>
</dosageInstruction>
</MedicationRequest>
{
"resourceType": "MedicationRequest",
"id": "a8ca980c-72aa-11e7-8cf7-a6006ad3dba0",
"contained": [
{
"resourceType": "Medication",
"id": "med1",
"code": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "322087003",
"display": "Hyoscine 1mg/72hours transdermal patches"
}
]
}
}
],
"status": "active",
"intent": "order",
"medicationReference": {
"reference": "#med1"
},
"subject": {
"identifier": {
"system": "https://fhir.nhs.uk/Id/nhs-number",
"value": "9999999999"
}
},
"dosageInstruction": [
{
"timing": {
"repeat": {
"frequency": 1,
"period": 3,
"periodUnit": "d"
}
},
"method": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "417924000",
"display": "Apply"
}
]
},
"doseQuantity": {
"value": 1,
"unit": "patch",
"system": "http://snomed.info/sct",
"code": "733005001"
}
}
]
}
MedicationRequest.id[0]a8ca980c-72aa-11e7-8cf7-a6006ad3dba0
MedicationRequest.contained[0].id[0]med1
MedicationRequest.contained[0].code[0].coding[0].system[0]http://snomed.info/sct
MedicationRequest.contained[0].code[0].coding[0].code[0]322087003
MedicationRequest.contained[0].code[0].coding[0].display[0]Hyoscine 1mg/72hours transdermal patches
MedicationRequest.status[0]active
MedicationRequest.intent[0]order
MedicationRequest.medication[0].reference[0]#med1
MedicationRequest.subject[0].identifier[0].system[0]https://fhir.nhs.uk/Id/nhs-number
MedicationRequest.subject[0].identifier[0].value[0]9999999999
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].frequency[0]1
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].period[0]3
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].periodUnit[0]d
MedicationRequest.dosageInstruction[0].method[0].coding[0].system[0]http://snomed.info/sct
MedicationRequest.dosageInstruction[0].method[0].coding[0].code[0]417924000
MedicationRequest.dosageInstruction[0].method[0].coding[0].display[0]Apply
MedicationRequest.dosageInstruction[0].dose[0].value[0]1
MedicationRequest.dosageInstruction[0].dose[0].unit[0]patch
MedicationRequest.dosageInstruction[0].dose[0].system[0]http://snomed.info/sct
MedicationRequest.dosageInstruction[0].dose[0].code[0]733005001
MedicationRequest

Co-trimoxazole 80mg/400mg tablets (Actavis UK Ltd), one tablet to be taken twice daily on Mondays, Wednesdays and Fridays

Product-based instruction using an AMP. Dosing given only on specific days.
<MedicationRequest xmlns="http://hl7.org/fhir">
<id value="a8ca980c-72aa-11e7-8cf7-a6006ad3dba0" />
<contained>
<Medication>
<id value="med1" />
<code>
<coding>
<system value="http://snomed.info/sct" />
<code value="688711000001107" />
<display value="Co-trimoxazole 80mg/400mg tablets (Actavis UK Ltd)" />
</coding>
</code>
</Medication>
</contained>
<status value="active" />
<intent value="order" />
<medicationReference>
<reference value="#med1" />
</medicationReference>
<subject>
<identifier>
<system value="https://fhir.nhs.uk/Id/nhs-number" />
<value value="9999999999" />
</identifier>
</subject>
<dosageInstruction>
<timing>
<repeat>
<frequency value="2" />
<period value="1" />
<periodUnit value="d" />
<dayOfWeek value="mon" />
<dayOfWeek value="wed" />
<dayOfWeek value="fri" />
</repeat>
</timing>
<doseQuantity>
<value value="1" />
<unit value="tablet" />
<system value="http://snomed.info/sct" />
<code value="428673006" />
</doseQuantity>
</dosageInstruction>
</MedicationRequest>
{
"resourceType": "MedicationRequest",
"id": "a8ca980c-72aa-11e7-8cf7-a6006ad3dba0",
"contained": [
{
"resourceType": "Medication",
"id": "med1",
"code": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "688711000001107",
"display": "Co-trimoxazole 80mg/400mg tablets (Actavis UK Ltd)"
}
]
}
}
],
"status": "active",
"intent": "order",
"medicationReference": {
"reference": "#med1"
},
"subject": {
"identifier": {
"system": "https://fhir.nhs.uk/Id/nhs-number",
"value": "9999999999"
}
},
"dosageInstruction": [
{
"timing": {
"repeat": {
"frequency": 2,
"period": 1,
"periodUnit": "d",
"dayOfWeek": [
"mon",
"wed",
"fri"
]
}
},
"doseQuantity": {
"value": 1,
"unit": "tablet",
"system": "http://snomed.info/sct",
"code": "428673006"
}
}
]
}
MedicationRequest.id[0]a8ca980c-72aa-11e7-8cf7-a6006ad3dba0
MedicationRequest.contained[0].id[0]med1
MedicationRequest.contained[0].code[0].coding[0].system[0]http://snomed.info/sct
MedicationRequest.contained[0].code[0].coding[0].code[0]688711000001107
MedicationRequest.contained[0].code[0].coding[0].display[0]Co-trimoxazole 80mg/400mg tablets (Actavis UK Ltd)
MedicationRequest.status[0]active
MedicationRequest.intent[0]order
MedicationRequest.medication[0].reference[0]#med1
MedicationRequest.subject[0].identifier[0].system[0]https://fhir.nhs.uk/Id/nhs-number
MedicationRequest.subject[0].identifier[0].value[0]9999999999
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].frequency[0]2
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].period[0]1
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].periodUnit[0]d
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].dayOfWeek[0]mon
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].dayOfWeek[1]wed
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].dayOfWeek[2]fri
MedicationRequest.dosageInstruction[0].dose[0].value[0]1
MedicationRequest.dosageInstruction[0].dose[0].unit[0]tablet
MedicationRequest.dosageInstruction[0].dose[0].system[0]http://snomed.info/sct
MedicationRequest.dosageInstruction[0].dose[0].code[0]428673006
MedicationRequest

Furosemide 40mg tablets, take two in the morning and one at midday for one week

Product-based prescription demonstrating concurrent dosing schedules.
<!-- Example use of the FHIR STU3 Dosage using multiple parallel sequences -->
<!-- Furosemide 40mg tablets, take two in the morning and one at midday for one week -->
<!-- Using a contained Medication resource -->
<MedicationRequest xmlns="http://hl7.org/fhir">
<id value="79159c4f-13c4-457a-8962-67fa22432c15" />
<contained>
<Medication>
<id value="med1" />
<code>
<coding>
<system value="http://snomed.info/sct" />
<code value="317972000" />
<display value="Furosemide 40mg tablets" />
</coding>
</code>
</Medication>
</contained>
<status value="active" />
<intent value="order" />
<medicationReference>
<reference value="#med1" />
</medicationReference>
<subject>
<identifier>
<system value="https://fhir.nhs.uk/Id/nhs-number" />
<value value="9999999999" />
</identifier>
</subject>
<dosageInstruction>
<sequence value="1" />
<timing>
<repeat>
<boundsDuration>
<value value="1" />
<unit value="week" />
<system value="http://unitsofmeasure.org" />
<code value="wk" />
</boundsDuration>
<frequency value="1" />
<period value="1" />
<periodUnit value="d" />
<when value="MORN" />
</repeat>
</timing>
<doseQuantity>
<value value="2" />
<unit value="tablet" />
<system value="http://snomed.info/sct" />
<code value="428673006" />
</doseQuantity>
</dosageInstruction>
<dosageInstruction>
<sequence value="1" />
<timing>
<repeat>
<boundsDuration>
<value value="1" />
<unit value="week" />
<system value="http://unitsofmeasure.org" />
<code value="wk" />
</boundsDuration>
<frequency value="1" />
<period value="1" />
<periodUnit value="d" />
<timeOfDay value="12:00:00" />
</repeat>
</timing>
<doseQuantity>
<value value="1" />
<unit value="tablet" />
<system value="http://snomed.info/sct" />
<code value="428673006" />
</doseQuantity>
</dosageInstruction>
</MedicationRequest>
{
"resourceType": "MedicationRequest",
"id": "79159c4f-13c4-457a-8962-67fa22432c15",
"contained": [
{
"resourceType": "Medication",
"id": "med1",
"code": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "317972000",
"display": "Furosemide 40mg tablets"
}
]
}
}
],
"status": "active",
"intent": "order",
"medicationReference": {
"reference": "#med1"
},
"subject": {
"identifier": {
"system": "https://fhir.nhs.uk/Id/nhs-number",
"value": "9999999999"
}
},
"dosageInstruction": [
{
"sequence": 1,
"timing": {
"repeat": {
"boundsDuration": {
"value": 1,
"unit": "week",
"system": "http://unitsofmeasure.org",
"code": "wk"
},
"frequency": 1,
"period": 1,
"periodUnit": "d",
"when": [
"MORN"
]
}
},
"doseQuantity": {
"value": 2,
"unit": "tablet",
"system": "http://snomed.info/sct",
"code": "428673006"
}
},
{
"sequence": 1,
"timing": {
"repeat": {
"boundsDuration": {
"value": 1,
"unit": "week",
"system": "http://unitsofmeasure.org",
"code": "wk"
},
"frequency": 1,
"period": 1,
"periodUnit": "d",
"timeOfDay": [
"12:00:00"
]
}
},
"doseQuantity": {
"value": 1,
"unit": "tablet",
"system": "http://snomed.info/sct",
"code": "428673006"
}
}
]
}
MedicationRequest.id[0]79159c4f-13c4-457a-8962-67fa22432c15
MedicationRequest.contained[0].id[0]med1
MedicationRequest.contained[0].code[0].coding[0].system[0]http://snomed.info/sct
MedicationRequest.contained[0].code[0].coding[0].code[0]317972000
MedicationRequest.contained[0].code[0].coding[0].display[0]Furosemide 40mg tablets
MedicationRequest.status[0]active
MedicationRequest.intent[0]order
MedicationRequest.medication[0].reference[0]#med1
MedicationRequest.subject[0].identifier[0].system[0]https://fhir.nhs.uk/Id/nhs-number
MedicationRequest.subject[0].identifier[0].value[0]9999999999
MedicationRequest.dosageInstruction[0].sequence[0]1
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].bounds[0].value[0]1
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].bounds[0].unit[0]week
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].bounds[0].system[0]http://unitsofmeasure.org
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].bounds[0].code[0]wk
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].frequency[0]1
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].period[0]1
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].periodUnit[0]d
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].when[0]MORN
MedicationRequest.dosageInstruction[0].dose[0].value[0]2
MedicationRequest.dosageInstruction[0].dose[0].unit[0]tablet
MedicationRequest.dosageInstruction[0].dose[0].system[0]http://snomed.info/sct
MedicationRequest.dosageInstruction[0].dose[0].code[0]428673006
MedicationRequest.dosageInstruction[1].sequence[0]1
MedicationRequest.dosageInstruction[1].timing[0].repeat[0].bounds[0].value[0]1
MedicationRequest.dosageInstruction[1].timing[0].repeat[0].bounds[0].unit[0]week
MedicationRequest.dosageInstruction[1].timing[0].repeat[0].bounds[0].system[0]http://unitsofmeasure.org
MedicationRequest.dosageInstruction[1].timing[0].repeat[0].bounds[0].code[0]wk
MedicationRequest.dosageInstruction[1].timing[0].repeat[0].frequency[0]1
MedicationRequest.dosageInstruction[1].timing[0].repeat[0].period[0]1
MedicationRequest.dosageInstruction[1].timing[0].repeat[0].periodUnit[0]d
MedicationRequest.dosageInstruction[1].timing[0].repeat[0].timeOfDay[0]12:00:00
MedicationRequest.dosageInstruction[1].dose[0].value[0]1
MedicationRequest.dosageInstruction[1].dose[0].unit[0]tablet
MedicationRequest.dosageInstruction[1].dose[0].system[0]http://snomed.info/sct
MedicationRequest.dosageInstruction[1].dose[0].code[0]428673006
MedicationRequest
Example use of the FHIR STU3 Dosage using multiple parallel sequences, using a contained `Medication` resource.

Metformin 500mg tablets, initially 500 mg once daily for 1 week, dose to be taken with breakfast, then 500 mg twice daily for week, dose to be taken with breakfast and evening meal, then 500 mg 3 times a day, dose to be taken with breakfast, lunch and evening meal; maximum 2 g per day

Product-based prescription demonstrating sequential dosing schedules for an increasing dose.
<MedicationRequest xmlns="http://hl7.org/fhir">
<id value="921aa4f4-c84e-4bf6-bc86-279d53e28d76" />
<contained>
<Medication>
<id value="med1" />
<code>
<coding>
<system value="http://snomed.info/sct" />
<code value="325278007" />
<display value="Metformin 500mg tablets" />
</coding>
</code>
</Medication>
</contained>
<status value="active" />
<intent value="order" />
<medicationReference>
<reference value="#med1" />
</medicationReference>
<subject>
<identifier>
<system value="https://fhir.nhs.uk/Id/nhs-number" />
<value value="9999999999" />
</identifier>
</subject>
<dosageInstruction>
<sequence value="1" />
<timing>
<repeat>
<duration value="1" />
<durationUnit value="wk" />
<frequency value="1" />
<period value="1" />
<periodUnit value="d" />
<when value="CM" />
</repeat>
</timing>
<doseQuantity>
<value value="500" />
<unit value="milligram" />
<system value="http://unitsofmeasure.org" />
<code value="mg" />
</doseQuantity>
<maxDosePerPeriod>
<numerator>
<value value="2" />
<unit value="gram" />
<system value="http://unitsofmeasure.org" />
<code value="g" />
</numerator>
<denominator>
<value value="1" />
<unit value="day" />
<system value="http://unitsofmeasure.org" />
<code value="d" />
</denominator>
</maxDosePerPeriod>
</dosageInstruction>
<dosageInstruction>
<sequence value="2" />
<timing>
<repeat>
<duration value="1" />
<durationUnit value="wk" />
<frequency value="2" />
<period value="1" />
<periodUnit value="d" />
<when value="CM" />
<when value="CV" />
</repeat>
</timing>
<doseQuantity>
<value value="500" />
<unit value="milligram" />
<system value="http://unitsofmeasure.org" />
<code value="mg" />
</doseQuantity>
<maxDosePerPeriod>
<numerator>
<value value="2" />
<unit value="gram" />
<system value="http://unitsofmeasure.org" />
<code value="g" />
</numerator>
<denominator>
<value value="1" />
<unit value="day" />
<system value="http://unitsofmeasure.org" />
<code value="d" />
</denominator>
</maxDosePerPeriod>
</dosageInstruction>
<dosageInstruction>
<sequence value="3" />
<timing>
<repeat>
<duration value="1" />
<durationUnit value="wk" />
<frequency value="2" />
<period value="1" />
<periodUnit value="d" />
<when value="CM" />
<when value="CV" />
</repeat>
</timing>
<doseQuantity>
<value value="500" />
<unit value="milligram" />
<system value="http://unitsofmeasure.org" />
<code value="mg" />
</doseQuantity>
<maxDosePerPeriod>
<numerator>
<value value="2" />
<unit value="gram" />
<system value="http://unitsofmeasure.org" />
<code value="g" />
</numerator>
<denominator>
<value value="1" />
<unit value="day" />
<system value="http://unitsofmeasure.org" />
<code value="d" />
</denominator>
</maxDosePerPeriod>
</dosageInstruction>
<dosageInstruction>
<sequence value="4" />
<timing>
<repeat>
<duration value="1" />
<durationUnit value="wk" />
<frequency value="3" />
<period value="1" />
<periodUnit value="d" />
<when value="CM" />
<when value="CV" />
<when value="CD" />
</repeat>
</timing>
<doseQuantity>
<value value="500" />
<unit value="milligram" />
<system value="http://unitsofmeasure.org" />
<code value="mg" />
</doseQuantity>
<maxDosePerPeriod>
<numerator>
<value value="2" />
<unit value="gram" />
<system value="http://unitsofmeasure.org" />
<code value="g" />
</numerator>
<denominator>
<value value="1" />
<unit value="day" />
<system value="http://unitsofmeasure.org" />
<code value="d" />
</denominator>
</maxDosePerPeriod>
</dosageInstruction>
</MedicationRequest>
{
"resourceType": "MedicationRequest",
"id": "921aa4f4-c84e-4bf6-bc86-279d53e28d76",
"contained": [
{
"resourceType": "Medication",
"id": "med1",
"code": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "325278007",
"display": "Metformin 500mg tablets"
}
]
}
}
],
"status": "active",
"intent": "order",
"medicationReference": {
"reference": "#med1"
},
"subject": {
"identifier": {
"system": "https://fhir.nhs.uk/Id/nhs-number",
"value": "9999999999"
}
},
"dosageInstruction": [
{
"sequence": 1,
"timing": {
"repeat": {
"duration": 1,
"durationUnit": "wk",
"frequency": 1,
"period": 1,
"periodUnit": "d",
"when": [
"CM"
]
}
},
"doseQuantity": {
"value": 500,
"unit": "milligram",
"system": "http://unitsofmeasure.org",
"code": "mg"
},
"maxDosePerPeriod": {
"numerator": {
"value": 2,
"unit": "gram",
"system": "http://unitsofmeasure.org",
"code": "g"
},
"denominator": {
"value": 1,
"unit": "day",
"system": "http://unitsofmeasure.org",
"code": "d"
}
}
},
{
"sequence": 2,
"timing": {
"repeat": {
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MedicationRequest.dosageInstruction[1].timing[0].repeat[0].when[0]CM
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MedicationRequest.dosageInstruction[3].timing[0].repeat[0].when[0]CM
MedicationRequest.dosageInstruction[3].timing[0].repeat[0].when[1]CV
MedicationRequest.dosageInstruction[3].timing[0].repeat[0].when[2]CD
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MedicationRequest

Metoclopramide, orally 10mg to be taken when required for nausea up to three times daily

Dose-based prescription with when required dosing and daily maximum frequency.
<!-- Metoclopramide, orally 10mg to be taken when required for nausea up to three times daily -->
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MedicationRequest

Aspirin suppository, 600mg rectally every 4 hours. Maximum 3.6gm per 24 hours

Dose-based prescription with maximum dose.
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MedicationRequest.dosageInstruction[0].dose[0].value[0]600
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MedicationRequest

Glucose 5% infusion 500ml bags, 500ml, intravenous, continuous infusion, over 8 hours

Non dm+d (ingredient) based prescription. Route, method and dose duration.
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<code value="768547002" />
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<numerator>
<value value="50" />
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<value value="1" />
<unit value="liter" />
<system value="http://unitsofmeasure.org" />
<code value="L" />
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<status value="active" />
<intent value="order" />
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<reference value="#med1" />
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<timing>
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<value value="100" />
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<system value="http://unitsofmeasure.org" />
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<value value="1" />
<unit value="hour" />
<system value="http://unitsofmeasure.org" />
<code value="h" />
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"coding": [
{
"system": "http://snomed.info/sct",
"code": "261754007",
"display": "Continuous infusion"
}
]
},
"rateRatio": {
"numerator": {
"value": 100,
"unit": "millilitre",
"system": "http://unitsofmeasure.org",
"code": "mL"
},
"denominator": {
"value": 1,
"unit": "hour",
"system": "http://unitsofmeasure.org",
"code": "h"
}
}
}
]
}
MedicationRequest.id[0]6b122dc2-89b2-4f93-9139-3012f6669857
MedicationRequest.contained[0].id[0]med1
MedicationRequest.contained[0].form[0].coding[0].system[0]http://snomed.info/sct
MedicationRequest.contained[0].form[0].coding[0].code[0]14964511000001102
MedicationRequest.contained[0].form[0].coding[0].display[0]Infusion
MedicationRequest.contained[0].ingredient[0].item[0].coding[0].system[0]http://snomed.info/sct
MedicationRequest.contained[0].ingredient[0].item[0].coding[0].code[0]768547002
MedicationRequest.contained[0].ingredient[0].item[0].coding[0].display[0]Anhydrous Glucose
MedicationRequest.contained[0].ingredient[0].amount[0].numerator[0].value[0]50
MedicationRequest.contained[0].ingredient[0].amount[0].numerator[0].unit[0]gram
MedicationRequest.contained[0].ingredient[0].amount[0].numerator[0].system[0]http://unitsofmeasure.org
MedicationRequest.contained[0].ingredient[0].amount[0].numerator[0].code[0]g
MedicationRequest.contained[0].ingredient[0].amount[0].denominator[0].value[0]1
MedicationRequest.contained[0].ingredient[0].amount[0].denominator[0].unit[0]liter
MedicationRequest.contained[0].ingredient[0].amount[0].denominator[0].system[0]http://unitsofmeasure.org
MedicationRequest.contained[0].ingredient[0].amount[0].denominator[0].code[0]L
MedicationRequest.status[0]active
MedicationRequest.intent[0]order
MedicationRequest.medication[0].reference[0]#med1
MedicationRequest.subject[0].identifier[0].system[0]https://fhir.nhs.uk/Id/nhs-number
MedicationRequest.subject[0].identifier[0].value[0]9999999999
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].duration[0]8
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].durationUnit[0]h
MedicationRequest.dosageInstruction[0].method[0].coding[0].system[0]http://snomed.info/sct
MedicationRequest.dosageInstruction[0].method[0].coding[0].code[0]261754007
MedicationRequest.dosageInstruction[0].method[0].coding[0].display[0]Continuous infusion
MedicationRequest.dosageInstruction[0].rate[0].numerator[0].value[0]100
MedicationRequest.dosageInstruction[0].rate[0].numerator[0].unit[0]millilitre
MedicationRequest.dosageInstruction[0].rate[0].numerator[0].system[0]http://unitsofmeasure.org
MedicationRequest.dosageInstruction[0].rate[0].numerator[0].code[0]mL
MedicationRequest.dosageInstruction[0].rate[0].denominator[0].value[0]1
MedicationRequest.dosageInstruction[0].rate[0].denominator[0].unit[0]hour
MedicationRequest.dosageInstruction[0].rate[0].denominator[0].system[0]http://unitsofmeasure.org
MedicationRequest.dosageInstruction[0].rate[0].denominator[0].code[0]h
MedicationRequest

Voluven 10% infusion 500ml Freeflex bags (Fresenius Kabi Ltd), infuse intravenously at a rate of 30ml/kg for 10 hours

Product-based prescription. Route method, dose duration, and dose expressed a rate ratio.

Note The rateRatio could also be modelled using a UCUM unit within a doseQuantity. In this example we are using the slightly more complex rateRatio structre.

<doseQuantity>
  <value value="30"/>
  <unit value="millilitres per kilogram"/>
  <system value="http://unitsofmeasure.org"/>
  <code value="ml/kg"/>
</doseQuantity>

<MedicationRequest xmlns="http://hl7.org/fhir">
<id value="10850aa9-133b-4a33-aea7-5bef3b71ab9b" />
<contained>
<Medication>
<id value="med1" />
<code>
<coding>
<system value="http://snomed.info/sct" />
<code value="21514511000001103" />
<display value="Voluven 10% infusion 500ml Freeflex bags (Fresenius Kabi Ltd)" />
</coding>
</code>
</Medication>
</contained>
<status value="active" />
<intent value="order" />
<medicationReference>
<reference value="#med1" />
</medicationReference>
<subject>
<identifier>
<system value="https://fhir.nhs.uk/Id/nhs-number" />
<value value="9999999999" />
</identifier>
</subject>
<dosageInstruction>
<timing>
<repeat>
<duration value="10" />
<durationUnit value="h" />
</repeat>
</timing>
<route>
<coding>
<system value="http://snomed.info/sct" />
<code value="47625008" />
<display value="intravenous" />
</coding>
</route>
<method>
<coding>
<system value="http://snomed.info/sct" />
<code value="129330003" />
<display value="infusion" />
</coding>
</method>
<rateRatio>
<numerator>
<value value="30" />
<unit value="millilitre" />
<system value="http://unitsofmeasure.org" />
<code value="mL" />
</numerator>
<denominator>
<value value="1" />
<unit value="kilogram" />
<system value="http://unitsofmeasure.org" />
<code value="kg" />
</denominator>
</rateRatio>
</dosageInstruction>
</MedicationRequest>
{
"resourceType": "MedicationRequest",
"id": "10850aa9-133b-4a33-aea7-5bef3b71ab9b",
"contained": [
{
"resourceType": "Medication",
"id": "med1",
"code": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "21514511000001103",
"display": "Voluven 10% infusion 500ml Freeflex bags (Fresenius Kabi Ltd)"
}
]
}
}
],
"status": "active",
"intent": "order",
"medicationReference": {
"reference": "#med1"
},
"subject": {
"identifier": {
"system": "https://fhir.nhs.uk/Id/nhs-number",
"value": "9999999999"
}
},
"dosageInstruction": [
{
"timing": {
"repeat": {
"duration": 10,
"durationUnit": "h"
}
},
"route": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "47625008",
"display": "intravenous"
}
]
},
"method": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "129330003",
"display": "infusion"
}
]
},
"rateRatio": {
"numerator": {
"value": 30,
"unit": "millilitre",
"system": "http://unitsofmeasure.org",
"code": "mL"
},
"denominator": {
"value": 1,
"unit": "kilogram",
"system": "http://unitsofmeasure.org",
"code": "kg"
}
}
}
]
}
MedicationRequest.id[0]10850aa9-133b-4a33-aea7-5bef3b71ab9b
MedicationRequest.contained[0].id[0]med1
MedicationRequest.contained[0].code[0].coding[0].system[0]http://snomed.info/sct
MedicationRequest.contained[0].code[0].coding[0].code[0]21514511000001103
MedicationRequest.contained[0].code[0].coding[0].display[0]Voluven 10% infusion 500ml Freeflex bags (Fresenius Kabi Ltd)
MedicationRequest.status[0]active
MedicationRequest.intent[0]order
MedicationRequest.medication[0].reference[0]#med1
MedicationRequest.subject[0].identifier[0].system[0]https://fhir.nhs.uk/Id/nhs-number
MedicationRequest.subject[0].identifier[0].value[0]9999999999
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].duration[0]10
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].durationUnit[0]h
MedicationRequest.dosageInstruction[0].route[0].coding[0].system[0]http://snomed.info/sct
MedicationRequest.dosageInstruction[0].route[0].coding[0].code[0]47625008
MedicationRequest.dosageInstruction[0].route[0].coding[0].display[0]intravenous
MedicationRequest.dosageInstruction[0].method[0].coding[0].system[0]http://snomed.info/sct
MedicationRequest.dosageInstruction[0].method[0].coding[0].code[0]129330003
MedicationRequest.dosageInstruction[0].method[0].coding[0].display[0]infusion
MedicationRequest.dosageInstruction[0].rate[0].numerator[0].value[0]30
MedicationRequest.dosageInstruction[0].rate[0].numerator[0].unit[0]millilitre
MedicationRequest.dosageInstruction[0].rate[0].numerator[0].system[0]http://unitsofmeasure.org
MedicationRequest.dosageInstruction[0].rate[0].numerator[0].code[0]mL
MedicationRequest.dosageInstruction[0].rate[0].denominator[0].value[0]1
MedicationRequest.dosageInstruction[0].rate[0].denominator[0].unit[0]kilogram
MedicationRequest.dosageInstruction[0].rate[0].denominator[0].system[0]http://unitsofmeasure.org
MedicationRequest.dosageInstruction[0].rate[0].denominator[0].code[0]kg
MedicationRequest

Hydroxocobalamin 10mg/2ml solution for injection ampoules, one to be given by IM injection into the shoulder, 3 times per week for 6 doses, then every 3 months, starting on 1st November 2019

Product-based prescription with course length as number of doses, sequential dosing.
<MedicationRequest xmlns="http://hl7.org/fhir">
<id value="6062d3bb-f6cf-41ec-aa71-dcd42299b10f" />
<contained>
<Medication>
<id value="med1" />
<code>
<coding>
<system value="http://snomed.info/sct" />
<code value="24856311000001103" />
<display value="Hydroxocobalamin 10mg/2ml solution for injection ampoules" />
</coding>
</code>
</Medication>
</contained>
<status value="active" />
<intent value="order" />
<medicationReference>
<reference value="#med1" />
</medicationReference>
<subject>
<identifier>
<system value="https://fhir.nhs.uk/Id/nhs-number" />
<value value="9999999999" />
</identifier>
</subject>
<dosageInstruction>
<sequence value="1" />
<timing>
<repeat>
<count value="6" />
<frequency value="3" />
<period value="1" />
<periodUnit value="wk" />
</repeat>
</timing>
<site>
<coding>
<system value="http://snomed.info/sct" />
<code value="16982005" />
<display value="Shoulder" />
</coding>
</site>
<route>
<coding>
<system value="http://snomed.info/sct" />
<code value="78421000" />
<display value="intramuscular route" />
</coding>
</route>
<doseQuantity>
<value value="1" />
<unit value="ampoule" />
<system value="http://snomed.info/sct" />
<code value="413516001" />
</doseQuantity>
</dosageInstruction>
<dosageInstruction>
<sequence value="2" />
<timing>
<repeat>
<boundsPeriod>
<start value="2019-11-01" />
</boundsPeriod>
<frequency value="1" />
<period value="3" />
<periodUnit value="mo" />
</repeat>
</timing>
<site>
<coding>
<system value="http://snomed.info/sct" />
<code value="16982005" />
<display value="Shoulder" />
</coding>
</site>
<route>
<coding>
<system value="http://snomed.info/sct" />
<code value="78421000" />
<display value="intramuscular route" />
</coding>
</route>
<doseQuantity>
<value value="1" />
<unit value="ampoule" />
<system value="http://snomed.info/sct" />
<code value="413516001" />
</doseQuantity>
</dosageInstruction>
</MedicationRequest>
{
"resourceType": "MedicationRequest",
"id": "6062d3bb-f6cf-41ec-aa71-dcd42299b10f",
"contained": [
{
"resourceType": "Medication",
"id": "med1",
"code": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "24856311000001103",
"display": "Hydroxocobalamin 10mg/2ml solution for injection ampoules"
}
]
}
}
],
"status": "active",
"intent": "order",
"medicationReference": {
"reference": "#med1"
},
"subject": {
"identifier": {
"system": "https://fhir.nhs.uk/Id/nhs-number",
"value": "9999999999"
}
},
"dosageInstruction": [
{
"sequence": 1,
"timing": {
"repeat": {
"count": 6,
"frequency": 3,
"period": 1,
"periodUnit": "wk"
}
},
"site": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "16982005",
"display": "Shoulder"
}
]
},
"route": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "78421000",
"display": "intramuscular route"
}
]
},
"doseQuantity": {
"value": 1,
"unit": "ampoule",
"system": "http://snomed.info/sct",
"code": "413516001"
}
},
{
"sequence": 2,
"timing": {
"repeat": {
"boundsPeriod": {
"start": "2019-11-01"
},
"frequency": 1,
"period": 3,
"periodUnit": "mo"
}
},
"site": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "16982005",
"display": "Shoulder"
}
]
},
"route": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "78421000",
"display": "intramuscular route"
}
]
},
"doseQuantity": {
"value": 1,
"unit": "ampoule",
"system": "http://snomed.info/sct",
"code": "413516001"
}
}
]
}
MedicationRequest.id[0]6062d3bb-f6cf-41ec-aa71-dcd42299b10f
MedicationRequest.contained[0].id[0]med1
MedicationRequest.contained[0].code[0].coding[0].system[0]http://snomed.info/sct
MedicationRequest.contained[0].code[0].coding[0].code[0]24856311000001103
MedicationRequest.contained[0].code[0].coding[0].display[0]Hydroxocobalamin 10mg/2ml solution for injection ampoules
MedicationRequest.status[0]active
MedicationRequest.intent[0]order
MedicationRequest.medication[0].reference[0]#med1
MedicationRequest.subject[0].identifier[0].system[0]https://fhir.nhs.uk/Id/nhs-number
MedicationRequest.subject[0].identifier[0].value[0]9999999999
MedicationRequest.dosageInstruction[0].sequence[0]1
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].count[0]6
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].frequency[0]3
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].period[0]1
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].periodUnit[0]wk
MedicationRequest.dosageInstruction[0].site[0].coding[0].system[0]http://snomed.info/sct
MedicationRequest.dosageInstruction[0].site[0].coding[0].code[0]16982005
MedicationRequest.dosageInstruction[0].site[0].coding[0].display[0]Shoulder
MedicationRequest.dosageInstruction[0].route[0].coding[0].system[0]http://snomed.info/sct
MedicationRequest.dosageInstruction[0].route[0].coding[0].code[0]78421000
MedicationRequest.dosageInstruction[0].route[0].coding[0].display[0]intramuscular route
MedicationRequest.dosageInstruction[0].dose[0].value[0]1
MedicationRequest.dosageInstruction[0].dose[0].unit[0]ampoule
MedicationRequest.dosageInstruction[0].dose[0].system[0]http://snomed.info/sct
MedicationRequest.dosageInstruction[0].dose[0].code[0]413516001
MedicationRequest.dosageInstruction[1].sequence[0]2
MedicationRequest.dosageInstruction[1].timing[0].repeat[0].bounds[0].start[0]2019-11-01
MedicationRequest.dosageInstruction[1].timing[0].repeat[0].frequency[0]1
MedicationRequest.dosageInstruction[1].timing[0].repeat[0].period[0]3
MedicationRequest.dosageInstruction[1].timing[0].repeat[0].periodUnit[0]mo
MedicationRequest.dosageInstruction[1].site[0].coding[0].system[0]http://snomed.info/sct
MedicationRequest.dosageInstruction[1].site[0].coding[0].code[0]16982005
MedicationRequest.dosageInstruction[1].site[0].coding[0].display[0]Shoulder
MedicationRequest.dosageInstruction[1].route[0].coding[0].system[0]http://snomed.info/sct
MedicationRequest.dosageInstruction[1].route[0].coding[0].code[0]78421000
MedicationRequest.dosageInstruction[1].route[0].coding[0].display[0]intramuscular route
MedicationRequest.dosageInstruction[1].dose[0].value[0]1
MedicationRequest.dosageInstruction[1].dose[0].unit[0]ampoule
MedicationRequest.dosageInstruction[1].dose[0].system[0]http://snomed.info/sct
MedicationRequest.dosageInstruction[1].dose[0].code[0]413516001
MedicationRequest

Insulin lispro, 16units to be given by subcutaneous injection at meal times

<MedicationRequest xmlns="http://hl7.org/fhir">
<id value="95542550-a4ad-4807-b1af-fcaff9980f9e" />
<contained>
<Medication>
<id value="med1" />
<code>
<coding>
<system value="http://snomed.info/sct" />
<code value="388454007" />
<display value="Insulin lispro" />
</coding>
</code>
</Medication>
</contained>
<status value="active" />
<intent value="order" />
<medicationReference>
<reference value="#med1" />
</medicationReference>
<subject>
<identifier>
<system value="https://fhir.nhs.uk/Id/nhs-number" />
<value value="9999999999" />
</identifier>
</subject>
<dosageInstruction>
<timing>
<repeat>
<when value="C" />
</repeat>
</timing>
<route>
<coding>
<system value="http://snomed.info/sct" />
<code value="34206005" />
<display value="subcutaneous" />
</coding>
</route>
<method>
<coding>
<system value="http://snomed.info/sct" />
<code value="422145002" />
<display value="inject" />
</coding>
</method>
<doseQuantity>
<value value="16" />
<unit value="Unit" />
<system value="http://snomed.info/sct" />
<code value="767525000" />
</doseQuantity>
</dosageInstruction>
</MedicationRequest>
{
"resourceType": "MedicationRequest",
"id": "95542550-a4ad-4807-b1af-fcaff9980f9e",
"contained": [
{
"resourceType": "Medication",
"id": "med1",
"code": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "388454007",
"display": "Insulin lispro"
}
]
}
}
],
"status": "active",
"intent": "order",
"medicationReference": {
"reference": "#med1"
},
"subject": {
"identifier": {
"system": "https://fhir.nhs.uk/Id/nhs-number",
"value": "9999999999"
}
},
"dosageInstruction": [
{
"timing": {
"repeat": {
"when": [
"C"
]
}
},
"route": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "34206005",
"display": "subcutaneous"
}
]
},
"method": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "422145002",
"display": "inject"
}
]
},
"doseQuantity": {
"value": 16,
"unit": "Unit",
"system": "http://snomed.info/sct",
"code": "767525000"
}
}
]
}
MedicationRequest.id[0]95542550-a4ad-4807-b1af-fcaff9980f9e
MedicationRequest.contained[0].id[0]med1
MedicationRequest.contained[0].code[0].coding[0].system[0]http://snomed.info/sct
MedicationRequest.contained[0].code[0].coding[0].code[0]388454007
MedicationRequest.contained[0].code[0].coding[0].display[0]Insulin lispro
MedicationRequest.status[0]active
MedicationRequest.intent[0]order
MedicationRequest.medication[0].reference[0]#med1
MedicationRequest.subject[0].identifier[0].system[0]https://fhir.nhs.uk/Id/nhs-number
MedicationRequest.subject[0].identifier[0].value[0]9999999999
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].when[0]C
MedicationRequest.dosageInstruction[0].route[0].coding[0].system[0]http://snomed.info/sct
MedicationRequest.dosageInstruction[0].route[0].coding[0].code[0]34206005
MedicationRequest.dosageInstruction[0].route[0].coding[0].display[0]subcutaneous
MedicationRequest.dosageInstruction[0].method[0].coding[0].system[0]http://snomed.info/sct
MedicationRequest.dosageInstruction[0].method[0].coding[0].code[0]422145002
MedicationRequest.dosageInstruction[0].method[0].coding[0].display[0]inject
MedicationRequest.dosageInstruction[0].dose[0].value[0]16
MedicationRequest.dosageInstruction[0].dose[0].unit[0]Unit
MedicationRequest.dosageInstruction[0].dose[0].system[0]http://snomed.info/sct
MedicationRequest.dosageInstruction[0].dose[0].code[0]767525000
MedicationRequest

Levothyroxine 100mcg on one day alternating with 125mcg on another day

The dose should be 100mcg/125mcg, and it the label on the dispensed item for the patient will likely by a VTM such as:

Levothyroxine sodium 100mcg tablets - one to be taken daily and Levothyroxine sodium 25mcg tablets - one to be taken on alternate days

To account for this, the example below shows how to describe a dose instruction containing concurrent sequences.

<MedicationRequest xmlns="http://hl7.org/fhir">
<id value="efaae147-81bb-4abd-b1d4-dd394a7ffc0c" />
<contained>
<Medication>
<id value="med1" />
<code>
<coding>
<system value="http://snomed.info/sct" />
<code value="126202002" />
<display value="Levothyroxine sodium" />
</coding>
</code>
</Medication>
</contained>
<status value="active" />
<intent value="order" />
<medicationReference>
<reference value="#med1" />
</medicationReference>
<subject>
<identifier>
<system value="https://fhir.nhs.uk/Id/nhs-number" />
<value value="4857773456" />
</identifier>
</subject>
<dosageInstruction>
<sequence value="1" />
<timing>
<repeat>
<frequency value="1" />
<period value="1" />
<periodUnit value="d" />
</repeat>
</timing>
<doseQuantity>
<value value="100" />
<unit value="microgram" />
<system value="http://unitsofmeasure.org" />
<code value="ug" />
</doseQuantity>
</dosageInstruction>
<dosageInstruction>
<sequence value="1" />
<timing>
<repeat>
<frequency value="1" />
<period value="2" />
<periodUnit value="d" />
</repeat>
</timing>
<doseQuantity>
<value value="25" />
<unit value="microgram" />
<system value="http://unitsofmeasure.org" />
<code value="ug" />
</doseQuantity>
</dosageInstruction>
</MedicationRequest>
{
"resourceType": "MedicationRequest",
"id": "efaae147-81bb-4abd-b1d4-dd394a7ffc0c",
"contained": [
{
"resourceType": "Medication",
"id": "med1",
"code": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "126202002",
"display": "Levothyroxine sodium"
}
]
}
}
],
"status": "active",
"intent": "order",
"medicationReference": {
"reference": "#med1"
},
"subject": {
"identifier": {
"system": "https://fhir.nhs.uk/Id/nhs-number",
"value": "4857773456"
}
},
"dosageInstruction": [
{
"sequence": 1,
"timing": {
"repeat": {
"frequency": 1,
"period": 1,
"periodUnit": "d"
}
},
"doseQuantity": {
"value": 100,
"unit": "microgram",
"system": "http://unitsofmeasure.org",
"code": "ug"
}
},
{
"sequence": 1,
"timing": {
"repeat": {
"frequency": 1,
"period": 2,
"periodUnit": "d"
}
},
"doseQuantity": {
"value": 25,
"unit": "microgram",
"system": "http://unitsofmeasure.org",
"code": "ug"
}
}
]
}
MedicationRequest.id[0]efaae147-81bb-4abd-b1d4-dd394a7ffc0c
MedicationRequest.contained[0].id[0]med1
MedicationRequest.contained[0].code[0].coding[0].system[0]http://snomed.info/sct
MedicationRequest.contained[0].code[0].coding[0].code[0]126202002
MedicationRequest.contained[0].code[0].coding[0].display[0]Levothyroxine sodium
MedicationRequest.status[0]active
MedicationRequest.intent[0]order
MedicationRequest.medication[0].reference[0]#med1
MedicationRequest.subject[0].identifier[0].system[0]https://fhir.nhs.uk/Id/nhs-number
MedicationRequest.subject[0].identifier[0].value[0]4857773456
MedicationRequest.dosageInstruction[0].sequence[0]1
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].frequency[0]1
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].period[0]1
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].periodUnit[0]d
MedicationRequest.dosageInstruction[0].dose[0].value[0]100
MedicationRequest.dosageInstruction[0].dose[0].unit[0]microgram
MedicationRequest.dosageInstruction[0].dose[0].system[0]http://unitsofmeasure.org
MedicationRequest.dosageInstruction[0].dose[0].code[0]ug
MedicationRequest.dosageInstruction[1].sequence[0]1
MedicationRequest.dosageInstruction[1].timing[0].repeat[0].frequency[0]1
MedicationRequest.dosageInstruction[1].timing[0].repeat[0].period[0]2
MedicationRequest.dosageInstruction[1].timing[0].repeat[0].periodUnit[0]d
MedicationRequest.dosageInstruction[1].dose[0].value[0]25
MedicationRequest.dosageInstruction[1].dose[0].unit[0]microgram
MedicationRequest.dosageInstruction[1].dose[0].system[0]http://unitsofmeasure.org
MedicationRequest.dosageInstruction[1].dose[0].code[0]ug
MedicationRequest
Levothyroxine sodium - 100 microgram - once a day, and 25 microgram - every 2 days
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