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.

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": {
"duration": 1,
"durationUnit": "wk",
"frequency": 2,
"period": 1,
"periodUnit": "d",
"when": [
"CM",
"CV"
]
}
},
"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": 3,
"timing": {
"repeat": {
"duration": 1,
"durationUnit": "wk",
"frequency": 2,
"period": 1,
"periodUnit": "d",
"when": [
"CM",
"CV"
]
}
},
"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": 4,
"timing": {
"repeat": {
"duration": 1,
"durationUnit": "wk",
"frequency": 3,
"period": 1,
"periodUnit": "d",
"when": [
"CM",
"CV",
"CD"
]
}
},
"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"
}
}
}
]
}
MedicationRequest.id[0]921aa4f4-c84e-4bf6-bc86-279d53e28d76
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]325278007
MedicationRequest.contained[0].code[0].coding[0].display[0]Metformin 500mg 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].duration[0]1
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].durationUnit[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]CM
MedicationRequest.dosageInstruction[0].dose[0].value[0]500
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.dosageInstruction[0].maxDosePerPeriod[0].numerator[0].value[0]2
MedicationRequest.dosageInstruction[0].maxDosePerPeriod[0].numerator[0].unit[0]gram
MedicationRequest.dosageInstruction[0].maxDosePerPeriod[0].numerator[0].system[0]http://unitsofmeasure.org
MedicationRequest.dosageInstruction[0].maxDosePerPeriod[0].numerator[0].code[0]g
MedicationRequest.dosageInstruction[0].maxDosePerPeriod[0].denominator[0].value[0]1
MedicationRequest.dosageInstruction[0].maxDosePerPeriod[0].denominator[0].unit[0]day
MedicationRequest.dosageInstruction[0].maxDosePerPeriod[0].denominator[0].system[0]http://unitsofmeasure.org
MedicationRequest.dosageInstruction[0].maxDosePerPeriod[0].denominator[0].code[0]d
MedicationRequest.dosageInstruction[1].sequence[0]2
MedicationRequest.dosageInstruction[1].timing[0].repeat[0].duration[0]1
MedicationRequest.dosageInstruction[1].timing[0].repeat[0].durationUnit[0]wk
MedicationRequest.dosageInstruction[1].timing[0].repeat[0].frequency[0]2
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].when[0]CM
MedicationRequest.dosageInstruction[1].timing[0].repeat[0].when[1]CV
MedicationRequest.dosageInstruction[1].dose[0].value[0]500
MedicationRequest.dosageInstruction[1].dose[0].unit[0]milligram
MedicationRequest.dosageInstruction[1].dose[0].system[0]http://unitsofmeasure.org
MedicationRequest.dosageInstruction[1].dose[0].code[0]mg
MedicationRequest.dosageInstruction[1].maxDosePerPeriod[0].numerator[0].value[0]2
MedicationRequest.dosageInstruction[1].maxDosePerPeriod[0].numerator[0].unit[0]gram
MedicationRequest.dosageInstruction[1].maxDosePerPeriod[0].numerator[0].system[0]http://unitsofmeasure.org
MedicationRequest.dosageInstruction[1].maxDosePerPeriod[0].numerator[0].code[0]g
MedicationRequest.dosageInstruction[1].maxDosePerPeriod[0].denominator[0].value[0]1
MedicationRequest.dosageInstruction[1].maxDosePerPeriod[0].denominator[0].unit[0]day
MedicationRequest.dosageInstruction[1].maxDosePerPeriod[0].denominator[0].system[0]http://unitsofmeasure.org
MedicationRequest.dosageInstruction[1].maxDosePerPeriod[0].denominator[0].code[0]d
MedicationRequest.dosageInstruction[2].sequence[0]3
MedicationRequest.dosageInstruction[2].timing[0].repeat[0].duration[0]1
MedicationRequest.dosageInstruction[2].timing[0].repeat[0].durationUnit[0]wk
MedicationRequest.dosageInstruction[2].timing[0].repeat[0].frequency[0]2
MedicationRequest.dosageInstruction[2].timing[0].repeat[0].period[0]1
MedicationRequest.dosageInstruction[2].timing[0].repeat[0].periodUnit[0]d
MedicationRequest.dosageInstruction[2].timing[0].repeat[0].when[0]CM
MedicationRequest.dosageInstruction[2].timing[0].repeat[0].when[1]CV
MedicationRequest.dosageInstruction[2].dose[0].value[0]500
MedicationRequest.dosageInstruction[2].dose[0].unit[0]milligram
MedicationRequest.dosageInstruction[2].dose[0].system[0]http://unitsofmeasure.org
MedicationRequest.dosageInstruction[2].dose[0].code[0]mg
MedicationRequest.dosageInstruction[2].maxDosePerPeriod[0].numerator[0].value[0]2
MedicationRequest.dosageInstruction[2].maxDosePerPeriod[0].numerator[0].unit[0]gram
MedicationRequest.dosageInstruction[2].maxDosePerPeriod[0].numerator[0].system[0]http://unitsofmeasure.org
MedicationRequest.dosageInstruction[2].maxDosePerPeriod[0].numerator[0].code[0]g
MedicationRequest.dosageInstruction[2].maxDosePerPeriod[0].denominator[0].value[0]1
MedicationRequest.dosageInstruction[2].maxDosePerPeriod[0].denominator[0].unit[0]day
MedicationRequest.dosageInstruction[2].maxDosePerPeriod[0].denominator[0].system[0]http://unitsofmeasure.org
MedicationRequest.dosageInstruction[2].maxDosePerPeriod[0].denominator[0].code[0]d
MedicationRequest.dosageInstruction[3].sequence[0]4
MedicationRequest.dosageInstruction[3].timing[0].repeat[0].duration[0]1
MedicationRequest.dosageInstruction[3].timing[0].repeat[0].durationUnit[0]wk
MedicationRequest.dosageInstruction[3].timing[0].repeat[0].frequency[0]3
MedicationRequest.dosageInstruction[3].timing[0].repeat[0].period[0]1
MedicationRequest.dosageInstruction[3].timing[0].repeat[0].periodUnit[0]d
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
MedicationRequest.dosageInstruction[3].dose[0].value[0]500
MedicationRequest.dosageInstruction[3].dose[0].unit[0]milligram
MedicationRequest.dosageInstruction[3].dose[0].system[0]http://unitsofmeasure.org
MedicationRequest.dosageInstruction[3].dose[0].code[0]mg
MedicationRequest.dosageInstruction[3].maxDosePerPeriod[0].numerator[0].value[0]2
MedicationRequest.dosageInstruction[3].maxDosePerPeriod[0].numerator[0].unit[0]gram
MedicationRequest.dosageInstruction[3].maxDosePerPeriod[0].numerator[0].system[0]http://unitsofmeasure.org
MedicationRequest.dosageInstruction[3].maxDosePerPeriod[0].numerator[0].code[0]g
MedicationRequest.dosageInstruction[3].maxDosePerPeriod[0].denominator[0].value[0]1
MedicationRequest.dosageInstruction[3].maxDosePerPeriod[0].denominator[0].unit[0]day
MedicationRequest.dosageInstruction[3].maxDosePerPeriod[0].denominator[0].system[0]http://unitsofmeasure.org
MedicationRequest.dosageInstruction[3].maxDosePerPeriod[0].denominator[0].code[0]d
MedicationRequest
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