Implementation guide for digital medicines

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

Dosage Examples - Fully coded

To illustrate how the FHIR Dosage structure should be used using 29 clinically verified examples using fully coded data. Where appropriate, examples have been modelled as both product-based and dose-based instructions. All examples are based on the MedicationRequest resource but equally could apply to MedicationDispense and MedicationStatement.

Note: All dosageInstruction.text element values have been constructed using the dose to text translation algorithm from within this guide.

Aspirin dispersible tablets

Product-based VMP prescription using a coded additional instruction. 
<MedicationRequest xmlns="http://hl7.org/fhir">
    <id value="18a8ea33-dc5f-4fb7-985e-acc474bf97cd" />
    <meta>
        <profile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationRequest" />
    </meta>
    <status value="active" />
    <intent value="order" />
    <category>
        <coding>
            <system value="http://terminology.hl7.org/CodeSystem/medicationrequest-category" />
            <code value="outpatient" />
            <display value="outpatient" />
        </coding>
    </category>
    <medicationCodeableConcept>
        <coding>
            <system value="https://dmd.nhs.uk" />
            <code value="329526003" />
            <display value="Aspirin 300mg dispersible tablets" />
        </coding>
    </medicationCodeableConcept>
    <subject>
        <identifier>
            <system value="https://fhir.nhs.uk/Id/nhs-number" />
            <value value="9999999999" />
        </identifier>
    </subject>
    <authoredOn value="2019-01-15T15:00:00Z" />
    <requester>
        <reference value="urn:staff-1112" />
        <display value="Dr Maikeu Well" />
    </requester>
    <recorder>
        <reference value="urn:staff-1112" />
        <display value="Dr Maikeu Well" />
    </recorder>
    <dosageInstruction>
        <text value="2 tablet - 4 times a day - at a meal - Dissolve or mix with water before taking - up to a maximum of 3.6 gram in 24 hours" />
        <additionalInstruction>
            <coding>
                <system value="http://snomed.info/sct" />
                <code value="417995008" />
                <display value="Dissolve or mix with water before taking" />
            </coding>
        </additionalInstruction>
        <timing>
            <repeat>
                <frequency value="4" />
                <period value="1" />
                <periodUnit value="d" />
                <when value="C" />
            </repeat>
        </timing>
        <doseAndRate>
            <doseQuantity>
                <value value="2" />
                <unit value="tablet" />
                <system value="http://snomed.info/sct" />
                <code value="428673006" />
            </doseQuantity>
        </doseAndRate>
        <maxDosePerPeriod>
            <numerator>
                <value value="3.6" />
                <unit value="gram" />
                <system value="http://unitsofmeasure.org" />
                <code value="g" />
            </numerator>
            <denominator>
                <value value="24" />
                <unit value="hour" />
                <system value="http://unitsofmeasure.org" />
                <code value="h" />
            </denominator>
        </maxDosePerPeriod>
    </dosageInstruction>
    <substitution>
        <allowedBoolean value="false" />
    </substitution>
</MedicationRequest>

{
    "resourceType": "MedicationRequest",
    "id": "18a8ea33-dc5f-4fb7-985e-acc474bf97cd",
    "meta": {
        "profile":  [
            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationRequest"
        ]
    },
    "status": "active",
    "intent": "order",
    "category":  [
        {
            "coding":  [
                {
                    "system": "http://terminology.hl7.org/CodeSystem/medicationrequest-category",
                    "code": "outpatient",
                    "display": "outpatient"
                }
            ]
        }
    ],
    "medicationCodeableConcept": {
        "coding":  [
            {
                "system": "https://dmd.nhs.uk",
                "code": "329526003",
                "display": "Aspirin 300mg dispersible tablets"
            }
        ]
    },
    "subject": {
        "identifier": {
            "system": "https://fhir.nhs.uk/Id/nhs-number",
            "value": "9999999999"
        }
    },
    "authoredOn": "2019-01-15T15:00:00Z",
    "requester": {
        "reference": "urn:staff-1112",
        "display": "Dr Maikeu Well"
    },
    "recorder": {
        "reference": "urn:staff-1112",
        "display": "Dr Maikeu Well"
    },
    "dosageInstruction":  [
        {
            "text": "2 tablet - 4 times a day - at a meal - Dissolve or mix with water before taking - up to a maximum of 3.6 gram in 24 hours",
            "additionalInstruction":  [
                {
                    "coding":  [
                        {
                            "system": "http://snomed.info/sct",
                            "code": "417995008",
                            "display": "Dissolve or mix with water before taking"
                        }
                    ]
                }
            ],
            "timing": {
                "repeat": {
                    "frequency": 4,
                    "period": 1,
                    "periodUnit": "d",
                    "when":  [
                        "C"
                    ]
                }
            },
            "doseAndRate":  [
                {
                    "doseQuantity": {
                        "value": 2,
                        "unit": "tablet",
                        "system": "http://snomed.info/sct",
                        "code": "428673006"
                    }
                }
            ],
            "maxDosePerPeriod": {
                "numerator": {
                    "value": 3.6,
                    "unit": "gram",
                    "system": "http://unitsofmeasure.org",
                    "code": "g"
                },
                "denominator": {
                    "value": 24,
                    "unit": "hour",
                    "system": "http://unitsofmeasure.org",
                    "code": "h"
                }
            }
        }
    ],
    "substitution": {
        "allowedBoolean": false
    }
}
MedicationRequest.id[0]18a8ea33-dc5f-4fb7-985e-acc474bf97cd
MedicationRequest.meta[0].profile[0]https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationRequest
MedicationRequest.status[0]active
MedicationRequest.intent[0]order
MedicationRequest.category[0].coding[0].system[0]http://terminology.hl7.org/CodeSystem/medicationrequest-category
MedicationRequest.category[0].coding[0].code[0]outpatient
MedicationRequest.category[0].coding[0].display[0]outpatient
MedicationRequest.medicationCodeableConcept[0].coding[0].system[0]https://dmd.nhs.uk
MedicationRequest.medicationCodeableConcept[0].coding[0].code[0]329526003
MedicationRequest.medicationCodeableConcept[0].coding[0].display[0]Aspirin 300mg dispersible tablets
MedicationRequest.subject[0].identifier[0].system[0]https://fhir.nhs.uk/Id/nhs-number
MedicationRequest.subject[0].identifier[0].value[0]9999999999
MedicationRequest.authoredOn[0]2019-01-15T15:00:00Z
MedicationRequest.requester[0].reference[0]urn:staff-1112
MedicationRequest.requester[0].display[0]Dr Maikeu Well
MedicationRequest.recorder[0].reference[0]urn:staff-1112
MedicationRequest.recorder[0].display[0]Dr Maikeu Well
MedicationRequest.dosageInstruction[0].text[0]2 tablet - 4 times a day - at a meal - Dissolve or mix with water before taking - up to a maximum of 3.6 gram in 24 hours
MedicationRequest.dosageInstruction[0].additionalInstruction[0].coding[0].system[0]http://snomed.info/sct
MedicationRequest.dosageInstruction[0].additionalInstruction[0].coding[0].code[0]417995008
MedicationRequest.dosageInstruction[0].additionalInstruction[0].coding[0].display[0]Dissolve or mix with water before taking
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].timing[0].repeat[0].when[0]C
MedicationRequest.dosageInstruction[0].doseAndRate[0].doseQuantity[0].value[0]2
MedicationRequest.dosageInstruction[0].doseAndRate[0].doseQuantity[0].unit[0]tablet
MedicationRequest.dosageInstruction[0].doseAndRate[0].doseQuantity[0].system[0]http://snomed.info/sct
MedicationRequest.dosageInstruction[0].doseAndRate[0].doseQuantity[0].code[0]428673006
MedicationRequest.dosageInstruction[0].maxDosePerPeriod[0].numerator[0].value[0]3.6
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]24
MedicationRequest.dosageInstruction[0].maxDosePerPeriod[0].denominator[0].unit[0]hour
MedicationRequest.dosageInstruction[0].maxDosePerPeriod[0].denominator[0].system[0]http://unitsofmeasure.org
MedicationRequest.dosageInstruction[0].maxDosePerPeriod[0].denominator[0].code[0]h
MedicationRequest.substitution[0].allowedBoolean[0]False
MedicationRequest

Example on-screen presentation:

Aspirin 300mg dispersible tablets
2 tablet - 4 times a day - at a meal - Dissolve or mix with water before taking - up to a maximum of 3.6 gram in 24 hours

Aspirin suppository

Dose-based VTM prescription with maximum dose.
IMPORTANT: This example cannot use the simple medicationCodeableConcept element. The VTM medication needs to be qualified with a form. This example uses a contained resource which would be suitable for a RESTful implementation. When using a FHIR Messaging implementation the instance of the Medication resource as another resource within the Bundle. 
<MedicationRequest xmlns="http://hl7.org/fhir">
    <id value="41dab799-fdbb-4a1e-bee2-a1a73dacac8d" />
    <meta>
        <profile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationRequest" />
    </meta>
    <contained>
        <Medication>
            <id value="med1" />
            <code>
                <coding>
                    <system value="https://dmd.nhs.uk" />
                    <code value="7947003" />
                    <display value="Aspirin" />
                </coding>
            </code>
            <form>
                <coding>
                    <system value="http://snomed.info/sct" />
                    <code value="385194003" />
                    <display value="Suppository" />
                </coding>
            </form>
        </Medication>
    </contained>
    <status value="active" />
    <intent value="order" />
    <category>
        <coding>
            <system value="http://terminology.hl7.org/CodeSystem/medicationrequest-category" />
            <code value="outpatient" />
            <display value="outpatient" />
        </coding>
    </category>
    <medicationReference>
        <reference value="#med1" />
    </medicationReference>
    <subject>
        <identifier>
            <system value="https://fhir.nhs.uk/Id/nhs-number" />
            <value value="9999999999" />
        </identifier>
    </subject>
    <authoredOn value="2020-05-15T15:00:00Z" />
    <requester>
        <reference value="urn:staff-1112" />
        <display value="Dr Maikeu Well" />
    </requester>
    <recorder>
        <reference value="urn:staff-1112" />
        <display value="Dr Maikeu Well" />
    </recorder>
    <dosageInstruction>
        <text value="600 milligram - every 4 hours - Rectal - up to a maximum of 3.6 gram in 24 hours" />
        <timing>
            <repeat>
                <frequency value="1" />
                <period value="4" />
                <periodUnit value="h" />
            </repeat>
        </timing>
        <route>
            <coding>
                <system value="http://snomed.info/sct" />
                <code value="37161004" />
                <display value="Rectal" />
            </coding>
        </route>
        <doseAndRate>
            <doseQuantity>
                <value value="600" />
                <unit value="milligram" />
                <system value="http://unitsofmeasure.org" />
                <code value="mg" />
            </doseQuantity>
        </doseAndRate>
        <maxDosePerPeriod>
            <numerator>
                <value value="3.6" />
                <unit value="gram" />
                <system value="http://unitsofmeasure.org" />
                <code value="g" />
            </numerator>
            <denominator>
                <value value="24" />
                <unit value="hour" />
                <system value="http://unitsofmeasure.org" />
                <code value="h" />
            </denominator>
        </maxDosePerPeriod>
    </dosageInstruction>
    <substitution>
        <allowedBoolean value="false" />
    </substitution>
</MedicationRequest>

{
    "resourceType": "MedicationRequest",
    "id": "41dab799-fdbb-4a1e-bee2-a1a73dacac8d",
    "meta": {
        "profile":  [
            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationRequest"
        ]
    },
    "contained":  [
        {
            "resourceType": "Medication",
            "id": "med1",
            "code": {
                "coding":  [
                    {
                        "system": "https://dmd.nhs.uk",
                        "code": "7947003",
                        "display": "Aspirin"
                    }
                ]
            },
            "form": {
                "coding":  [
                    {
                        "system": "http://snomed.info/sct",
                        "code": "385194003",
                        "display": "Suppository"
                    }
                ]
            }
        }
    ],
    "status": "active",
    "intent": "order",
    "category":  [
        {
            "coding":  [
                {
                    "system": "http://terminology.hl7.org/CodeSystem/medicationrequest-category",
                    "code": "outpatient",
                    "display": "outpatient"
                }
            ]
        }
    ],
    "medicationReference": {
        "reference": "#med1"
    },
    "subject": {
        "identifier": {
            "system": "https://fhir.nhs.uk/Id/nhs-number",
            "value": "9999999999"
        }
    },
    "authoredOn": "2020-05-15T15:00:00Z",
    "requester": {
        "reference": "urn:staff-1112",
        "display": "Dr Maikeu Well"
    },
    "recorder": {
        "reference": "urn:staff-1112",
        "display": "Dr Maikeu Well"
    },
    "dosageInstruction":  [
        {
            "text": "600 milligram - every 4 hours - Rectal - up to a maximum of 3.6 gram in 24 hours",
            "timing": {
                "repeat": {
                    "frequency": 1,
                    "period": 4,
                    "periodUnit": "h"
                }
            },
            "route": {
                "coding":  [
                    {
                        "system": "http://snomed.info/sct",
                        "code": "37161004",
                        "display": "Rectal"
                    }
                ]
            },
            "doseAndRate":  [
                {
                    "doseQuantity": {
                        "value": 600,
                        "unit": "milligram",
                        "system": "http://unitsofmeasure.org",
                        "code": "mg"
                    }
                }
            ],
            "maxDosePerPeriod": {
                "numerator": {
                    "value": 3.6,
                    "unit": "gram",
                    "system": "http://unitsofmeasure.org",
                    "code": "g"
                },
                "denominator": {
                    "value": 24,
                    "unit": "hour",
                    "system": "http://unitsofmeasure.org",
                    "code": "h"
                }
            }
        }
    ],
    "substitution": {
        "allowedBoolean": false
    }
}
MedicationRequest.id[0]41dab799-fdbb-4a1e-bee2-a1a73dacac8d
MedicationRequest.meta[0].profile[0]https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationRequest
MedicationRequest.contained[0].id[0]med1
MedicationRequest.contained[0].code[0].coding[0].system[0]https://dmd.nhs.uk
MedicationRequest.contained[0].code[0].coding[0].code[0]7947003
MedicationRequest.contained[0].code[0].coding[0].display[0]Aspirin
MedicationRequest.contained[0].form[0].coding[0].system[0]http://snomed.info/sct
MedicationRequest.contained[0].form[0].coding[0].code[0]385194003
MedicationRequest.contained[0].form[0].coding[0].display[0]Suppository
MedicationRequest.status[0]active
MedicationRequest.intent[0]order
MedicationRequest.category[0].coding[0].system[0]http://terminology.hl7.org/CodeSystem/medicationrequest-category
MedicationRequest.category[0].coding[0].code[0]outpatient
MedicationRequest.category[0].coding[0].display[0]outpatient
MedicationRequest.medicationReference[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.authoredOn[0]2020-05-15T15:00:00Z
MedicationRequest.requester[0].reference[0]urn:staff-1112
MedicationRequest.requester[0].display[0]Dr Maikeu Well
MedicationRequest.recorder[0].reference[0]urn:staff-1112
MedicationRequest.recorder[0].display[0]Dr Maikeu Well
MedicationRequest.dosageInstruction[0].text[0]600 milligram - every 4 hours - Rectal - up to a maximum of 3.6 gram in 24 hours
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].frequency[0]1
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].period[0]4
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]37161004
MedicationRequest.dosageInstruction[0].route[0].coding[0].display[0]Rectal
MedicationRequest.dosageInstruction[0].doseAndRate[0].doseQuantity[0].value[0]600
MedicationRequest.dosageInstruction[0].doseAndRate[0].doseQuantity[0].unit[0]milligram
MedicationRequest.dosageInstruction[0].doseAndRate[0].doseQuantity[0].system[0]http://unitsofmeasure.org
MedicationRequest.dosageInstruction[0].doseAndRate[0].doseQuantity[0].code[0]mg
MedicationRequest.dosageInstruction[0].maxDosePerPeriod[0].numerator[0].value[0]3.6
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]24
MedicationRequest.dosageInstruction[0].maxDosePerPeriod[0].denominator[0].unit[0]hour
MedicationRequest.dosageInstruction[0].maxDosePerPeriod[0].denominator[0].system[0]http://unitsofmeasure.org
MedicationRequest.dosageInstruction[0].maxDosePerPeriod[0].denominator[0].code[0]h
MedicationRequest.substitution[0].allowedBoolean[0]False
MedicationRequest

Example on-screen presentation:

Aspirin
Suppository - 600 milligram - every 4 hours - Rectal - up to a maximum of 3.6 gram in 24 hours

Beclometasone cream

Product-based VMP instruction with a site. 
<MedicationRequest xmlns="http://hl7.org/fhir">
    <id value="1c7d802c-71b2-4ac1-9cf2-8423e38b95fe" />
    <meta>
        <profile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationRequest" />
    </meta>
    <status value="active" />
    <intent value="order" />
    <category>
        <coding>
            <system value="http://terminology.hl7.org/CodeSystem/medicationrequest-category" />
            <code value="inpatient" />
            <display value="inpatient" />
        </coding>
    </category>
    <medicationCodeableConcept>
        <coding>
            <system value="https://dmd.nhs.uk" />
            <code value="331792000" />
            <display value="Beclometasone 0.025% cream" />
        </coding>
    </medicationCodeableConcept>
    <subject>
        <identifier>
            <system value="https://fhir.nhs.uk/Id/nhs-number" />
            <value value="9999999999" />
        </identifier>
    </subject>
    <authoredOn value="2020-05-15T15:00:00Z" />
    <requester>
        <reference value="urn:staff-1112" />
        <display value="Dr Maikeu Well" />
    </requester>
    <recorder>
        <reference value="urn:staff-1112" />
        <display value="Dr Maikeu Well" />
    </recorder>
    <dosageInstruction>
        <text value="Apply twice a day - Topical - Left thigh" />
        <timing>
            <repeat>
                <frequency value="2" />
                <period value="1" />
                <periodUnit value="d" />
            </repeat>
        </timing>
        <site>
            <coding>
                <system value="http://snomed.info/sct" />
                <code value="61396006" />
                <display value="Left thigh" />
            </coding>
        </site>
        <route>
            <coding>
                <system value="http://snomed.info/sct" />
                <code value="6064005" />
                <display value="Topical" />
            </coding>
        </route>
        <method>
            <coding>
                <system value="http://snomed.info/sct" />
                <code value="417924000" />
                <display value="Apply" />
            </coding>
        </method>
    </dosageInstruction>
    <substitution>
        <allowedBoolean value="false" />
    </substitution>
</MedicationRequest>

{
    "resourceType": "MedicationRequest",
    "id": "1c7d802c-71b2-4ac1-9cf2-8423e38b95fe",
    "meta": {
        "profile":  [
            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationRequest"
        ]
    },
    "status": "active",
    "intent": "order",
    "category":  [
        {
            "coding":  [
                {
                    "system": "http://terminology.hl7.org/CodeSystem/medicationrequest-category",
                    "code": "inpatient",
                    "display": "inpatient"
                }
            ]
        }
    ],
    "medicationCodeableConcept": {
        "coding":  [
            {
                "system": "https://dmd.nhs.uk",
                "code": "331792000",
                "display": "Beclometasone 0.025% cream"
            }
        ]
    },
    "subject": {
        "identifier": {
            "system": "https://fhir.nhs.uk/Id/nhs-number",
            "value": "9999999999"
        }
    },
    "authoredOn": "2020-05-15T15:00:00Z",
    "requester": {
        "reference": "urn:staff-1112",
        "display": "Dr Maikeu Well"
    },
    "recorder": {
        "reference": "urn:staff-1112",
        "display": "Dr Maikeu Well"
    },
    "dosageInstruction":  [
        {
            "text": "Apply twice a day - Topical - Left thigh",
            "timing": {
                "repeat": {
                    "frequency": 2,
                    "period": 1,
                    "periodUnit": "d"
                }
            },
            "route": {
                "coding":  [
                    {
                        "system": "http://snomed.info/sct",
                        "code": "6064005",
                        "display": "Topical"
                    }
                ]
            },
            "site": {
                "coding":  [
                    {
                        "system": "http://snomed.info/sct",
                        "code": "61396006",
                        "display": "Left thigh"
                    }
                ]
            },
            "method": {
                "coding":  [
                    {
                        "system": "http://snomed.info/sct",
                        "code": "417924000",
                        "display": "Apply"
                    }
                ]
            }
        }
    ],
    "substitution": {
        "allowedBoolean": false
    }
}
MedicationRequest.id[0]1c7d802c-71b2-4ac1-9cf2-8423e38b95fe
MedicationRequest.meta[0].profile[0]https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationRequest
MedicationRequest.status[0]active
MedicationRequest.intent[0]order
MedicationRequest.category[0].coding[0].system[0]http://terminology.hl7.org/CodeSystem/medicationrequest-category
MedicationRequest.category[0].coding[0].code[0]inpatient
MedicationRequest.category[0].coding[0].display[0]inpatient
MedicationRequest.medicationCodeableConcept[0].coding[0].system[0]https://dmd.nhs.uk
MedicationRequest.medicationCodeableConcept[0].coding[0].code[0]331792000
MedicationRequest.medicationCodeableConcept[0].coding[0].display[0]Beclometasone 0.025% cream
MedicationRequest.subject[0].identifier[0].system[0]https://fhir.nhs.uk/Id/nhs-number
MedicationRequest.subject[0].identifier[0].value[0]9999999999
MedicationRequest.authoredOn[0]2020-05-15T15:00:00Z
MedicationRequest.requester[0].reference[0]urn:staff-1112
MedicationRequest.requester[0].display[0]Dr Maikeu Well
MedicationRequest.recorder[0].reference[0]urn:staff-1112
MedicationRequest.recorder[0].display[0]Dr Maikeu Well
MedicationRequest.dosageInstruction[0].text[0]Apply twice a day - Topical - Left thigh
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]6064005
MedicationRequest.dosageInstruction[0].route[0].coding[0].display[0]Topical
MedicationRequest.dosageInstruction[0].site[0].coding[0].system[0]http://snomed.info/sct
MedicationRequest.dosageInstruction[0].site[0].coding[0].code[0]61396006
MedicationRequest.dosageInstruction[0].site[0].coding[0].display[0]Left 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.substitution[0].allowedBoolean[0]False
MedicationRequest

Example on-screen presentation:

Beclometasone 0.025% cream
Apply twice a day - Topical - Left thigh

Co-trimoxazole tablets

Product-based AMP prescription with specific day timing instructions. 
<MedicationRequest xmlns="http://hl7.org/fhir">
    <id value="973f9bdc-ad20-4ff4-bc01-9c727eaf5919" />
    <meta>
        <profile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationRequest" />
    </meta>
    <status value="active" />
    <intent value="order" />
    <category>
        <coding>
            <system value="http://terminology.hl7.org/CodeSystem/medicationrequest-category" />
            <code value="inpatient" />
            <display value="inpatient" />
        </coding>
    </category>
    <medicationCodeableConcept>
        <coding>
            <system value="https://dmd.nhs.uk" />
            <code value="688711000001107" />
            <display value="Co-trimoxazole 80mg/400mg tablets (Accord Healthcare Ltd)" />
        </coding>
    </medicationCodeableConcept>
    <subject>
        <identifier>
            <system value="https://fhir.nhs.uk/Id/nhs-number" />
            <value value="9999999999" />
        </identifier>
    </subject>
    <authoredOn value="2020-05-15T15:00:00Z" />
    <requester>
        <reference value="urn:staff-1112" />
        <display value="Dr Maikeu Well" />
    </requester>
    <recorder>
        <reference value="urn:staff-1112" />
        <display value="Dr Maikeu Well" />
    </recorder>
    <dosageInstruction>
        <text value="1 tablet - twice a day - on Monday, Wednesday and Friday" />
        <timing>
            <repeat>
                <frequency value="2" />
                <period value="1" />
                <periodUnit value="d" />
                <dayOfWeek value="mon" />
                <dayOfWeek value="wed" />
                <dayOfWeek value="fri" />
            </repeat>
        </timing>
        <doseAndRate>
            <doseQuantity>
                <value value="1" />
                <unit value="tablet" />
                <system value="http://snomed.info/sct" />
                <code value="428673006" />
            </doseQuantity>
        </doseAndRate>
    </dosageInstruction>
    <substitution>
        <allowedBoolean value="false" />
    </substitution>
</MedicationRequest>

{
    "resourceType": "MedicationRequest",
    "id": "973f9bdc-ad20-4ff4-bc01-9c727eaf5919",
    "meta": {
        "profile":  [
            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationRequest"
        ]
    },
    "status": "active",
    "intent": "order",
    "category":  [
        {
            "coding":  [
                {
                    "system": "http://terminology.hl7.org/CodeSystem/medicationrequest-category",
                    "code": "inpatient",
                    "display": "inpatient"
                }
            ]
        }
    ],
    "medicationCodeableConcept": {
        "coding":  [
            {
                "system": "https://dmd.nhs.uk",
                "code": "688711000001107",
                "display": "Co-trimoxazole 80mg/400mg tablets (Accord Healthcare Ltd)"
            }
        ]
    },
    "subject": {
        "identifier": {
            "system": "https://fhir.nhs.uk/Id/nhs-number",
            "value": "9999999999"
        }
    },
    "authoredOn": "2020-05-15T15:00:00Z",
    "requester": {
        "reference": "urn:staff-1112",
        "display": "Dr Maikeu Well"
    },
    "recorder": {
        "reference": "urn:staff-1112",
        "display": "Dr Maikeu Well"
    },
    "dosageInstruction":  [
        {
            "text": "1 tablet - twice a day - on Monday, Wednesday and Friday",
            "timing": {
                "repeat": {
                    "frequency": 2,
                    "period": 1,
                    "periodUnit": "d",
                    "dayOfWeek":  [
                        "mon",
                        "wed",
                        "fri"
                    ]
                }
            },
            "doseAndRate":  [
                {
                    "doseQuantity": {
                        "value": 1,
                        "unit": "tablet",
                        "system": "http://snomed.info/sct",
                        "code": "428673006"
                    }
                }
            ]
        }
    ],
    "substitution": {
        "allowedBoolean": false
    }
}
MedicationRequest.id[0]973f9bdc-ad20-4ff4-bc01-9c727eaf5919
MedicationRequest.meta[0].profile[0]https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationRequest
MedicationRequest.status[0]active
MedicationRequest.intent[0]order
MedicationRequest.category[0].coding[0].system[0]http://terminology.hl7.org/CodeSystem/medicationrequest-category
MedicationRequest.category[0].coding[0].code[0]inpatient
MedicationRequest.category[0].coding[0].display[0]inpatient
MedicationRequest.medicationCodeableConcept[0].coding[0].system[0]https://dmd.nhs.uk
MedicationRequest.medicationCodeableConcept[0].coding[0].code[0]688711000001107
MedicationRequest.medicationCodeableConcept[0].coding[0].display[0]Co-trimoxazole 80mg/400mg tablets (Accord Healthcare Ltd)
MedicationRequest.subject[0].identifier[0].system[0]https://fhir.nhs.uk/Id/nhs-number
MedicationRequest.subject[0].identifier[0].value[0]9999999999
MedicationRequest.authoredOn[0]2020-05-15T15:00:00Z
MedicationRequest.requester[0].reference[0]urn:staff-1112
MedicationRequest.requester[0].display[0]Dr Maikeu Well
MedicationRequest.recorder[0].reference[0]urn:staff-1112
MedicationRequest.recorder[0].display[0]Dr Maikeu Well
MedicationRequest.dosageInstruction[0].text[0]1 tablet - twice a day - on Monday, Wednesday and Friday
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].doseAndRate[0].doseQuantity[0].value[0]1
MedicationRequest.dosageInstruction[0].doseAndRate[0].doseQuantity[0].unit[0]tablet
MedicationRequest.dosageInstruction[0].doseAndRate[0].doseQuantity[0].system[0]http://snomed.info/sct
MedicationRequest.dosageInstruction[0].doseAndRate[0].doseQuantity[0].code[0]428673006
MedicationRequest.substitution[0].allowedBoolean[0]False
MedicationRequest

Example on-screen presentation:

Co-trimoxazole 80mg/400mg tablets (Accord Healthcare Ltd)
1 tablet - twice a day - on Monday, Wednesday and Friday

Diprobase ointment

Product-based AMP prescription instruction.

Note this example cannot use a VTM concept as Diprobase is a multi-ingredient concept “White soft paraffin + Liquid paraffin” which cannot be used as a prescribing concept.

<MedicationRequest xmlns="http://hl7.org/fhir">
    <id value="dad3ae68-f7d7-4bad-8d6d-09e114842b53" />
    <meta>
        <profile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationRequest" />
    </meta>
    <status value="active" />
    <intent value="order" />
    <category>
        <coding>
            <system value="http://terminology.hl7.org/CodeSystem/medicationrequest-category" />
            <code value="inpatient" />
            <display value="inpatient" />
        </coding>
    </category>
    <medicationCodeableConcept>
        <coding>
            <system value="https://dmd.nhs.uk" />
            <code value="3491511000001101" />
            <display value="Diprobase ointment (Bayer Plc)" />
        </coding>
    </medicationCodeableConcept>
    <subject>
        <identifier>
            <system value="https://fhir.nhs.uk/Id/nhs-number" />
            <value value="9999999999" />
        </identifier>
    </subject>
    <authoredOn value="2020-05-15T15:00:00Z" />
    <requester>
        <reference value="urn:staff-1112" />
        <display value="Dr Maikeu Well" />
    </requester>
    <recorder>
        <reference value="urn:staff-1112" />
        <display value="Dr Maikeu Well" />
    </recorder>
    <dosageInstruction>
        <text value="Apply 1 application - 3 times a day - Topical - Affected area" />
        <timing>
            <repeat>
                <frequency value="3" />
                <period value="1" />
                <periodUnit value="d" />
            </repeat>
        </timing>
        <site>
            <coding>
                <system value="http://snomed.info/sct" />
                <code value="22201000087104" />
                <display value="Affected area" />
            </coding>
        </site>
        <route>
            <coding>
                <system value="http://snomed.info/sct" />
                <code value="6064005" />
                <display value="Topical" />
            </coding>
        </route>
        <method>
            <coding>
                <system value="http://snomed.info/sct" />
                <code value="417924000" />
                <display value="Apply" />
            </coding>
        </method>
        <doseAndRate>
            <doseQuantity>
                <value value="1" />
                <unit value="application" />
                <system value="http://snomed.info/sct" />
                <code value="10692211000001108" />
            </doseQuantity>
        </doseAndRate>
    </dosageInstruction>
    <substitution>
        <allowedBoolean value="false" />
    </substitution>
</MedicationRequest>

{
    "resourceType": "MedicationRequest",
    "id": "dad3ae68-f7d7-4bad-8d6d-09e114842b53",
    "meta": {
        "profile":  [
            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationRequest"
        ]
    },
    "status": "active",
    "intent": "order",
    "category":  [
        {
            "coding":  [
                {
                    "system": "http://terminology.hl7.org/CodeSystem/medicationrequest-category",
                    "code": "inpatient",
                    "display": "inpatient"
                }
            ]
        }
    ],
    "medicationCodeableConcept": {
        "coding":  [
            {
                "system": "https://dmd.nhs.uk",
                "code": "3491511000001101",
                "display": "Diprobase ointment (Bayer Plc)"
            }
        ]
    },
    "subject": {
        "identifier": {
            "system": "https://fhir.nhs.uk/Id/nhs-number",
            "value": "9999999999"
        }
    },
    "authoredOn": "2020-05-15T15:00:00Z",
    "requester": {
        "reference": "urn:staff-1112",
        "display": "Dr Maikeu Well"
    },
    "recorder": {
        "reference": "urn:staff-1112",
        "display": "Dr Maikeu Well"
    },
    "dosageInstruction":  [
        {
            "text": "Apply 1 application - 3 times a day - Topical - Affected area",
            "timing": {
                "repeat": {
                    "frequency": 3,
                    "period": 1,
                    "periodUnit": "d"
                }
            },
            "method": {
                "coding":  [
                    {
                        "system": "http://snomed.info/sct",
                        "code": "417924000",
                        "display": "Apply"
                    }
                ]
            },
            "route": {
                "coding":  [
                    {
                        "system": "http://snomed.info/sct",
                        "code": "6064005",
                        "display": "Topical"
                    }
                ]
            },
            "site": {
                "coding":  [
                    {
                        "system": "http://snomed.info/sct",
                        "code": "22201000087104",
                        "display": "Affected area"
                    }
                ]
            },
            "doseAndRate":  [
                {
                    "doseQuantity": {
                        "value": 1,
                        "unit": "application",
                        "system": "http://snomed.info/sct",
                        "code": "10692211000001108"
                    }
                }
            ]
        }
    ],
    "substitution": {
        "allowedBoolean": false
    }
}
MedicationRequest.id[0]dad3ae68-f7d7-4bad-8d6d-09e114842b53
MedicationRequest.meta[0].profile[0]https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationRequest
MedicationRequest.status[0]active
MedicationRequest.intent[0]order
MedicationRequest.category[0].coding[0].system[0]http://terminology.hl7.org/CodeSystem/medicationrequest-category
MedicationRequest.category[0].coding[0].code[0]inpatient
MedicationRequest.category[0].coding[0].display[0]inpatient
MedicationRequest.medicationCodeableConcept[0].coding[0].system[0]https://dmd.nhs.uk
MedicationRequest.medicationCodeableConcept[0].coding[0].code[0]3491511000001101
MedicationRequest.medicationCodeableConcept[0].coding[0].display[0]Diprobase ointment (Bayer Plc)
MedicationRequest.subject[0].identifier[0].system[0]https://fhir.nhs.uk/Id/nhs-number
MedicationRequest.subject[0].identifier[0].value[0]9999999999
MedicationRequest.authoredOn[0]2020-05-15T15:00:00Z
MedicationRequest.requester[0].reference[0]urn:staff-1112
MedicationRequest.requester[0].display[0]Dr Maikeu Well
MedicationRequest.recorder[0].reference[0]urn:staff-1112
MedicationRequest.recorder[0].display[0]Dr Maikeu Well
MedicationRequest.dosageInstruction[0].text[0]Apply 1 application - 3 times a day - Topical - Affected area
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].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].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].site[0].coding[0].system[0]http://snomed.info/sct
MedicationRequest.dosageInstruction[0].site[0].coding[0].code[0]22201000087104
MedicationRequest.dosageInstruction[0].site[0].coding[0].display[0]Affected area
MedicationRequest.dosageInstruction[0].doseAndRate[0].doseQuantity[0].value[0]1
MedicationRequest.dosageInstruction[0].doseAndRate[0].doseQuantity[0].unit[0]application
MedicationRequest.dosageInstruction[0].doseAndRate[0].doseQuantity[0].system[0]http://snomed.info/sct
MedicationRequest.dosageInstruction[0].doseAndRate[0].doseQuantity[0].code[0]10692211000001108
MedicationRequest.substitution[0].allowedBoolean[0]False
MedicationRequest

Example on-screen presentation:

Diprobase ointment (Bayer Plc)
Apply 1 application - 3 times a day - Topical - Affected area

Epoetin alfa subcutaneous injection

Dose-based VTM prescription with coded route and method. 
<MedicationRequest xmlns="http://hl7.org/fhir">
    <id value="e8675beb-dc9b-4281-a82f-d73a938d981f" />
    <meta>
        <profile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationRequest" />
    </meta>
    <status value="active" />
    <intent value="order" />
    <category>
        <coding>
            <system value="http://terminology.hl7.org/CodeSystem/medicationrequest-category" />
            <code value="inpatient" />
            <display value="inpatient" />
        </coding>
    </category>
    <medicationCodeableConcept>
        <coding>
            <system value="https://dmd.nhs.uk" />
            <code value="108964008" />
            <display value="Epoetin alfa" />
        </coding>
    </medicationCodeableConcept>
    <subject>
        <identifier>
            <system value="https://fhir.nhs.uk/Id/nhs-number" />
            <value value="9999999999" />
        </identifier>
    </subject>
    <authoredOn value="2020-05-15T15:00:00Z" />
    <requester>
        <reference value="urn:staff-1112" />
        <display value="Dr Maikeu Well" />
    </requester>
    <recorder>
        <reference value="urn:staff-1112" />
        <display value="Dr Maikeu Well" />
    </recorder>
    <dosageInstruction>
        <text value="Inject 4500 unit - once a week - Subcutaneous route" />
        <timing>
            <repeat>
                <frequency value="1" />
                <period value="1" />
                <periodUnit value="wk" />
            </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>
        <doseAndRate>
            <doseQuantity>
                <value value="4500" />
                <unit value="unit" />
                <system value="http://snomed.info/sct" />
                <code value="767525000" />
            </doseQuantity>
        </doseAndRate>
    </dosageInstruction>
    <substitution>
        <allowedBoolean value="false" />
    </substitution>
</MedicationRequest>

{
    "resourceType": "MedicationRequest",
    "id": "e8675beb-dc9b-4281-a82f-d73a938d981f",
    "meta": {
        "profile":  [
            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationRequest"
        ]
    },
    "intent": "order",
    "status": "active",
    "category":  [
        {
            "coding":  [
                {
                    "system": "http://terminology.hl7.org/CodeSystem/medicationrequest-category",
                    "code": "inpatient",
                    "display": "inpatient"
                }
            ]
        }
    ],
    "medicationCodeableConcept": {
        "coding":  [
            {
                "system": "https://dmd.nhs.uk",
                "code": "108964008",
                "display": "Epoetin alfa"
            }
        ]
    },
    "subject": {
        "identifier": {
            "system": "https://fhir.nhs.uk/Id/nhs-number",
            "value": "9999999999"
        }
    },
    "authoredOn": "2020-05-15T15:00:00Z",
    "requester": {
        "reference": "urn:staff-1112",
        "display": "Dr Maikeu Well"
    },
    "recorder": {
        "reference": "urn:staff-1112",
        "display": "Dr Maikeu Well"
    },
    "dosageInstruction":  [
        {
            "text": "Inject 4500 unit - once a week - Subcutaneous route",
            "timing": {
                "repeat": {
                    "frequency": 1,
                    "period": 1,
                    "periodUnit": "wk"
                }
            },
            "route": {
                "coding":  [
                    {
                        "system": "http://snomed.info/sct",
                        "code": "34206005",
                        "display": "Subcutaneous route"
                    }
                ]
            },
            "method": {
                "coding":  [
                    {
                        "system": "http://snomed.info/sct",
                        "code": "422145002",
                        "display": "Inject"
                    }
                ]
            },
            "doseAndRate":  [
                {
                    "doseQuantity": {
                        "value": 4500,
                        "unit": "unit",
                        "system": "http://snomed.info/sct",
                        "code": "767525000"
                    }
                }
            ]
        }
    ],
    "substitution": {
        "allowedBoolean": false
    }
}
MedicationRequest.id[0]e8675beb-dc9b-4281-a82f-d73a938d981f
MedicationRequest.meta[0].profile[0]https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationRequest
MedicationRequest.intent[0]order
MedicationRequest.status[0]active
MedicationRequest.category[0].coding[0].system[0]http://terminology.hl7.org/CodeSystem/medicationrequest-category
MedicationRequest.category[0].coding[0].code[0]inpatient
MedicationRequest.category[0].coding[0].display[0]inpatient
MedicationRequest.medicationCodeableConcept[0].coding[0].system[0]https://dmd.nhs.uk
MedicationRequest.medicationCodeableConcept[0].coding[0].code[0]108964008
MedicationRequest.medicationCodeableConcept[0].coding[0].display[0]Epoetin alfa
MedicationRequest.subject[0].identifier[0].system[0]https://fhir.nhs.uk/Id/nhs-number
MedicationRequest.subject[0].identifier[0].value[0]9999999999
MedicationRequest.authoredOn[0]2020-05-15T15:00:00Z
MedicationRequest.requester[0].reference[0]urn:staff-1112
MedicationRequest.requester[0].display[0]Dr Maikeu Well
MedicationRequest.recorder[0].reference[0]urn:staff-1112
MedicationRequest.recorder[0].display[0]Dr Maikeu Well
MedicationRequest.dosageInstruction[0].text[0]Inject 4500 unit - once a week - Subcutaneous route
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]wk
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].doseAndRate[0].doseQuantity[0].value[0]4500
MedicationRequest.dosageInstruction[0].doseAndRate[0].doseQuantity[0].unit[0]unit
MedicationRequest.dosageInstruction[0].doseAndRate[0].doseQuantity[0].system[0]http://snomed.info/sct
MedicationRequest.dosageInstruction[0].doseAndRate[0].doseQuantity[0].code[0]767525000
MedicationRequest.substitution[0].allowedBoolean[0]False
MedicationRequest

Example on-screen presentation:

Epoetin alfa
Inject 4500 unit - once a week - Subcutaneous route

Furosemide tablets

Product-based prescription demonstrating concurrent dosing schedules. 
<MedicationRequest xmlns="http://hl7.org/fhir">
    <id value="79159c4f-13c4-457a-8962-67fa22432c15" />
    <meta>
        <profile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationRequest" />
    </meta>
    <status value="active" />
    <intent value="order" />
    <category>
        <coding>
            <system value="http://terminology.hl7.org/CodeSystem/medicationrequest-category" />
            <code value="inpatient" />
            <display value="inpatient" />
        </coding>
    </category>
    <priority value="routine" />
    <medicationCodeableConcept>
        <coding>
            <system value="https://dmd.nhs.uk" />
            <code value="317972000" />
            <display value="Furosemide 40mg tablets" />
        </coding>
    </medicationCodeableConcept>
    <subject>
        <identifier>
            <system value="https://fhir.nhs.uk/Id/nhs-number" />
            <value value="9999999999" />
        </identifier>
    </subject>
    <authoredOn value="2020-05-15T15:00:00Z" />
    <requester>
        <reference value="urn:staff-1112" />
        <display value="Dr Maikeu Well" />
    </requester>
    <recorder>
        <reference value="urn:staff-1112" />
        <display value="Dr Maikeu Well" />
    </recorder>
    <dosageInstruction>
        <sequence value="1" />
        <text value="2 tablet - daily - at 08:00 - for 1 week" />
        <timing>
            <repeat>
                <boundsDuration>
                    <value value="1" />
                    <unit value="week" />
                    <system value="http://unitsofmeasure.org" />
                    <code value="wk" />
                </boundsDuration>
                <period value="1" />
                <periodUnit value="d" />
                <timeOfDay value="08:00:00" />
            </repeat>
        </timing>
        <doseAndRate>
            <doseQuantity>
                <value value="2" />
                <unit value="tablet" />
                <system value="http://snomed.info/sct" />
                <code value="428673006" />
            </doseQuantity>
        </doseAndRate>
    </dosageInstruction>
    <dosageInstruction>
        <sequence value="1" />
        <text value="1 tablet - daily - at 12:00 - for 1 week" />
        <timing>
            <repeat>
                <boundsDuration>
                    <value value="1" />
                    <unit value="week" />
                    <system value="http://unitsofmeasure.org" />
                    <code value="wk" />
                </boundsDuration>
                <period value="1" />
                <periodUnit value="d" />
                <timeOfDay value="12:00:00" />
            </repeat>
        </timing>
        <doseAndRate>
            <doseQuantity>
                <value value="1" />
                <unit value="tablet" />
                <system value="http://snomed.info/sct" />
                <code value="428673006" />
            </doseQuantity>
        </doseAndRate>
    </dosageInstruction>
    <substitution>
        <allowedBoolean value="false" />
    </substitution>
</MedicationRequest>

{
    "resourceType": "MedicationRequest",
    "id": "79159c4f-13c4-457a-8962-67fa22432c15",
    "meta": {
        "profile":  [
            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationRequest"
        ]
    },
    "status": "active",
    "intent": "order",
    "category":  [
        {
            "coding":  [
                {
                    "system": "http://terminology.hl7.org/CodeSystem/medicationrequest-category",
                    "code": "inpatient",
                    "display": "inpatient"
                }
            ]
        }
    ],
    "priority": "routine",
    "medicationCodeableConcept": {
        "coding":  [
            {
                "system": "https://dmd.nhs.uk",
                "code": "317972000",
                "display": "Furosemide 40mg tablets"
            }
        ]
    },
    "subject": {
        "identifier": {
            "system": "https://fhir.nhs.uk/Id/nhs-number",
            "value": "9999999999"
        }
    },
    "authoredOn": "2020-05-15T15:00:00Z",
    "requester": {
        "reference": "urn:staff-1112",
        "display": "Dr Maikeu Well"
    },
    "recorder": {
        "reference": "urn:staff-1112",
        "display": "Dr Maikeu Well"
    },
    "dosageInstruction":  [
        {
            "sequence": 1,
            "text": "2 tablet - daily - at 08:00 - for 1 week",
            "timing": {
                "repeat": {
                    "boundsDuration": {
                        "value": 1,
                        "unit": "week",
                        "system": "http://unitsofmeasure.org",
                        "code": "wk"
                    },
                    "period": 1,
                    "periodUnit": "d",
                    "timeOfDay":  [
                        "08:00:00"
                    ]
                }
            },
            "doseAndRate":  [
                {
                    "doseQuantity": {
                        "value": 2,
                        "unit": "tablet",
                        "system": "http://snomed.info/sct",
                        "code": "428673006"
                    }
                }
            ]
        },
        {
            "sequence": 1,
            "text": "1 tablet - daily - at 12:00 - for 1 week",
            "timing": {
                "repeat": {
                    "boundsDuration": {
                        "value": 1,
                        "unit": "week",
                        "system": "http://unitsofmeasure.org",
                        "code": "wk"
                    },
                    "period": 1,
                    "periodUnit": "d",
                    "timeOfDay":  [
                        "12:00:00"
                    ]
                }
            },
            "doseAndRate":  [
                {
                    "doseQuantity": {
                        "value": 1,
                        "unit": "tablet",
                        "system": "http://snomed.info/sct",
                        "code": "428673006"
                    }
                }
            ]
        }
    ],
    "substitution": {
        "allowedBoolean": false
    }
}
MedicationRequest.id[0]79159c4f-13c4-457a-8962-67fa22432c15
MedicationRequest.meta[0].profile[0]https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationRequest
MedicationRequest.status[0]active
MedicationRequest.intent[0]order
MedicationRequest.category[0].coding[0].system[0]http://terminology.hl7.org/CodeSystem/medicationrequest-category
MedicationRequest.category[0].coding[0].code[0]inpatient
MedicationRequest.category[0].coding[0].display[0]inpatient
MedicationRequest.priority[0]routine
MedicationRequest.medicationCodeableConcept[0].coding[0].system[0]https://dmd.nhs.uk
MedicationRequest.medicationCodeableConcept[0].coding[0].code[0]317972000
MedicationRequest.medicationCodeableConcept[0].coding[0].display[0]Furosemide 40mg tablets
MedicationRequest.subject[0].identifier[0].system[0]https://fhir.nhs.uk/Id/nhs-number
MedicationRequest.subject[0].identifier[0].value[0]9999999999
MedicationRequest.authoredOn[0]2020-05-15T15:00:00Z
MedicationRequest.requester[0].reference[0]urn:staff-1112
MedicationRequest.requester[0].display[0]Dr Maikeu Well
MedicationRequest.recorder[0].reference[0]urn:staff-1112
MedicationRequest.recorder[0].display[0]Dr Maikeu Well
MedicationRequest.dosageInstruction[0].sequence[0]1
MedicationRequest.dosageInstruction[0].text[0]2 tablet - daily - at 08:00 - for 1 week
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].boundsDuration[0].value[0]1
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].boundsDuration[0].unit[0]week
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].boundsDuration[0].system[0]http://unitsofmeasure.org
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].boundsDuration[0].code[0]wk
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].timeOfDay[0]08:00:00
MedicationRequest.dosageInstruction[0].doseAndRate[0].doseQuantity[0].value[0]2
MedicationRequest.dosageInstruction[0].doseAndRate[0].doseQuantity[0].unit[0]tablet
MedicationRequest.dosageInstruction[0].doseAndRate[0].doseQuantity[0].system[0]http://snomed.info/sct
MedicationRequest.dosageInstruction[0].doseAndRate[0].doseQuantity[0].code[0]428673006
MedicationRequest.dosageInstruction[1].sequence[0]1
MedicationRequest.dosageInstruction[1].text[0]1 tablet - daily - at 12:00 - for 1 week
MedicationRequest.dosageInstruction[1].timing[0].repeat[0].boundsDuration[0].value[0]1
MedicationRequest.dosageInstruction[1].timing[0].repeat[0].boundsDuration[0].unit[0]week
MedicationRequest.dosageInstruction[1].timing[0].repeat[0].boundsDuration[0].system[0]http://unitsofmeasure.org
MedicationRequest.dosageInstruction[1].timing[0].repeat[0].boundsDuration[0].code[0]wk
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].doseAndRate[0].doseQuantity[0].value[0]1
MedicationRequest.dosageInstruction[1].doseAndRate[0].doseQuantity[0].unit[0]tablet
MedicationRequest.dosageInstruction[1].doseAndRate[0].doseQuantity[0].system[0]http://snomed.info/sct
MedicationRequest.dosageInstruction[1].doseAndRate[0].doseQuantity[0].code[0]428673006
MedicationRequest.substitution[0].allowedBoolean[0]False
MedicationRequest

Example on-screen presentation:

Furosemide 40mg tablets
2 tablet - daily - at 08:00 - for 1 week, and 1 tablet - daily - at 12:00 - for 1 week

Glucose infusion

Example has been removed. See infusion examples.

Hydroxocobalamin solution for injection

Dose-based instruction using a VTM. 
<MedicationRequest xmlns="http://hl7.org/fhir">
    <id value="18a8ea33-dc5f-4fb7-985e-acc474bf97cd" />
    <meta>
        <profile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationRequest" />
    </meta>
    <status value="active" />
    <intent value="order" />
    <category>
        <coding>
            <system value="http://terminology.hl7.org/CodeSystem/medicationrequest-category" />
            <code value="outpatient" />
            <display value="outpatient" />
        </coding>
    </category>
    <medicationCodeableConcept>
        <coding>
            <system value="https://dmd.nhs.uk" />
            <code value="327529002" />
            <display value="Hydroxocobalamin" />
        </coding>
    </medicationCodeableConcept>
    <subject>
        <identifier>
            <system value="https://fhir.nhs.uk/Id/nhs-number" />
            <value value="9999999999" />
        </identifier>
    </subject>
    <authoredOn value="2019-01-15T15:00:00Z" />
    <requester>
        <reference value="urn:staff-1112" />
        <display value="Dr Maikeu Well" />
    </requester>
    <recorder>
        <reference value="urn:staff-1112" />
        <display value="Dr Maikeu Well" />
    </recorder>
    <dosageInstruction>
        <text value="Inject 1 milligram - 3 times a week - Intramuscular route - for 2 weeks" />
        <timing>
            <repeat>
                <boundsDuration>
                    <value value="2" />
                    <unit value="week" />
                    <system value="http://unitsofmeasure.org" />
                    <code value="wk" />
                </boundsDuration>
                <frequency value="3" />
                <period value="1" />
                <periodUnit value="wk" />
            </repeat>
        </timing>
        <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>
        <doseAndRate>
            <doseQuantity>
                <value value="1" />
                <unit value="milligram" />
                <system value="http://unitsofmeasure.org" />
                <code value="mg" />
            </doseQuantity>
        </doseAndRate>
    </dosageInstruction>
    <substitution>
        <allowedBoolean value="false" />
    </substitution>
</MedicationRequest>

{
    "resourceType": "MedicationRequest",
    "id": "18a8ea33-dc5f-4fb7-985e-acc474bf97cd",
    "meta": {
        "profile":  [
            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationRequest"
        ]
    },
    "status": "active",
    "intent": "order",
    "category":  [
        {
            "coding":  [
                {
                    "system": "http://terminology.hl7.org/CodeSystem/medicationrequest-category",
                    "code": "outpatient",
                    "display": "outpatient"
                }
            ]
        }
    ],
    "medicationCodeableConcept": {
        "coding":  [
            {
                "system": "https://dmd.nhs.uk",
                "code": "327529002",
                "display": "Hydroxocobalamin"
            }
        ]
    },
    "subject": {
        "identifier": {
            "system": "https://fhir.nhs.uk/Id/nhs-number",
            "value": "9999999999"
        }
    },
    "authoredOn": "2019-01-15T15:00:00Z",
    "requester": {
        "reference": "urn:staff-1112",
        "display": "Dr Maikeu Well"
    },
    "recorder": {
        "reference": "urn:staff-1112",
        "display": "Dr Maikeu Well"
    },
    "dosageInstruction":  [
        {
            "text": "Inject 1 milligram - 3 times a week - Intramuscular route - for 2 weeks",
            "route": {
                "coding":  [
                    {
                        "system": "http://snomed.info/sct",
                        "code": "78421000",
                        "display": "Intramuscular route"
                    }
                ]
            },
            "method": {
                "coding":  [
                    {
                        "system": "http://snomed.info/sct",
                        "code": "422145002",
                        "display": "Inject"
                    }
                ]
            },
            "timing": {
                "repeat": {
                    "boundsDuration": {
                        "value": 2,
                        "unit": "week",
                        "system": "http://unitsofmeasure.org",
                        "code": "wk"
                    },
                    "frequency": 3,
                    "period": 1,
                    "periodUnit": "wk"
                }
            },
            "doseAndRate":  [
                {
                    "doseQuantity": {
                        "value": 1,
                        "unit": "milligram",
                        "system": "http://unitsofmeasure.org",
                        "code": "mg"
                    }
                }
            ]
        }
    ],
    "substitution": {
        "allowedBoolean": false
    }
}
MedicationRequest.id[0]18a8ea33-dc5f-4fb7-985e-acc474bf97cd
MedicationRequest.meta[0].profile[0]https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationRequest
MedicationRequest.status[0]active
MedicationRequest.intent[0]order
MedicationRequest.category[0].coding[0].system[0]http://terminology.hl7.org/CodeSystem/medicationrequest-category
MedicationRequest.category[0].coding[0].code[0]outpatient
MedicationRequest.category[0].coding[0].display[0]outpatient
MedicationRequest.medicationCodeableConcept[0].coding[0].system[0]https://dmd.nhs.uk
MedicationRequest.medicationCodeableConcept[0].coding[0].code[0]327529002
MedicationRequest.medicationCodeableConcept[0].coding[0].display[0]Hydroxocobalamin
MedicationRequest.subject[0].identifier[0].system[0]https://fhir.nhs.uk/Id/nhs-number
MedicationRequest.subject[0].identifier[0].value[0]9999999999
MedicationRequest.authoredOn[0]2019-01-15T15:00:00Z
MedicationRequest.requester[0].reference[0]urn:staff-1112
MedicationRequest.requester[0].display[0]Dr Maikeu Well
MedicationRequest.recorder[0].reference[0]urn:staff-1112
MedicationRequest.recorder[0].display[0]Dr Maikeu Well
MedicationRequest.dosageInstruction[0].text[0]Inject 1 milligram - 3 times a week - Intramuscular route - for 2 weeks
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.dosageInstruction[0].timing[0].repeat[0].boundsDuration[0].value[0]2
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].boundsDuration[0].unit[0]week
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].boundsDuration[0].system[0]http://unitsofmeasure.org
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].boundsDuration[0].code[0]wk
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].doseAndRate[0].doseQuantity[0].value[0]1
MedicationRequest.dosageInstruction[0].doseAndRate[0].doseQuantity[0].unit[0]milligram
MedicationRequest.dosageInstruction[0].doseAndRate[0].doseQuantity[0].system[0]http://unitsofmeasure.org
MedicationRequest.dosageInstruction[0].doseAndRate[0].doseQuantity[0].code[0]mg
MedicationRequest.substitution[0].allowedBoolean[0]False
MedicationRequest

Example on-screen presentation:

Hydroxocobalamin
Inject 1 milligram - 3 times a week - Intramuscular route - for 2 weeks

Ibuprofen

Product-based instruction using a VMP. 
<MedicationRequest xmlns="http://hl7.org/fhir">
    <id value="18a8ea33-dc5f-4fb7-985e-acc474bf97cd" />
    <meta>
        <profile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationRequest" />
    </meta>
    <status value="active" />
    <intent value="order" />
    <category>
        <coding>
            <system value="http://terminology.hl7.org/CodeSystem/medicationrequest-category" />
            <code value="community" />
            <display value="community" />
        </coding>
    </category>
    <medicationCodeableConcept>
        <coding>
            <system value="https://dmd.nhs.uk" />
            <code value="329653008" />
            <display value="Ibuprofen 400mg tablets" />
        </coding>
    </medicationCodeableConcept>
    <subject>
        <identifier>
            <system value="https://fhir.nhs.uk/Id/nhs-number" />
            <value value="9999999999" />
        </identifier>
    </subject>
    <authoredOn value="2019-01-15T15:00:00Z" />
    <requester>
        <reference value="urn:staff-1112" />
        <display value="Dr Maikeu Well" />
    </requester>
    <recorder>
        <reference value="urn:staff-1112" />
        <display value="Dr Maikeu Well" />
    </recorder>
    <dosageInstruction>
        <text value="1 tablet - 4 times a day - at a meal - oral" />
        <timing>
            <repeat>
                <frequency value="4" />
                <period value="1" />
                <periodUnit value="d" />
                <when value="C" />
            </repeat>
        </timing>
        <route>
            <coding>
                <system value="http://snomed.info/sct" />
                <code value="26643006" />
                <display value="oral" />
            </coding>
        </route>
        <doseAndRate>
            <doseQuantity>
                <value value="1" />
                <unit value="tablet" />
                <system value="http://snomed.info/sct" />
                <code value="385055001" />
            </doseQuantity>
        </doseAndRate>
    </dosageInstruction>
    <substitution>
        <allowedBoolean value="false" />
    </substitution>
</MedicationRequest>

{
    "resourceType": "MedicationRequest",
    "id": "18a8ea33-dc5f-4fb7-985e-acc474bf97cd",
    "meta": {
        "profile":  [
            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationRequest"
        ]
    },
    "status": "active",
    "intent": "order",
    "category":  [
        {
            "coding":  [
                {
                    "system": "http://terminology.hl7.org/CodeSystem/medicationrequest-category",
                    "code": "community",
                    "display": "community"
                }
            ]
        }
    ],
    "medicationCodeableConcept": {
        "coding":  [
            {
                "system": "https://dmd.nhs.uk",
                "code": "329653008",
                "display": "Ibuprofen 400mg tablets"
            }
        ]
    },
    "subject": {
        "identifier": {
            "system": "https://fhir.nhs.uk/Id/nhs-number",
            "value": "9999999999"
        }
    },
    "authoredOn": "2019-01-15T15:00:00Z",
    "requester": {
        "reference": "urn:staff-1112",
        "display": "Dr Maikeu Well"
    },
    "recorder": {
        "reference": "urn:staff-1112",
        "display": "Dr Maikeu Well"
    },
    "dosageInstruction":  [
        {
            "text": "1 tablet - 4 times a day - at a meal - oral",
            "route": {
                "coding":  [
                    {
                        "system": "http://snomed.info/sct",
                        "code": "26643006",
                        "display": "oral"
                    }
                ]
            },
            "timing": {
                "repeat": {
                    "frequency": 4,
                    "period": 1,
                    "periodUnit": "d",
                    "when":  [
                        "C"
                    ]
                }
            },
            "doseAndRate":  [
                {
                    "doseQuantity": {
                        "value": 1,
                        "unit": "tablet",
                        "system": "http://snomed.info/sct",
                        "code": "385055001"
                    }
                }
            ]
        }
    ],
    "substitution": {
        "allowedBoolean": false
    }
}
MedicationRequest.id[0]18a8ea33-dc5f-4fb7-985e-acc474bf97cd
MedicationRequest.meta[0].profile[0]https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationRequest
MedicationRequest.status[0]active
MedicationRequest.intent[0]order
MedicationRequest.category[0].coding[0].system[0]http://terminology.hl7.org/CodeSystem/medicationrequest-category
MedicationRequest.category[0].coding[0].code[0]community
MedicationRequest.category[0].coding[0].display[0]community
MedicationRequest.medicationCodeableConcept[0].coding[0].system[0]https://dmd.nhs.uk
MedicationRequest.medicationCodeableConcept[0].coding[0].code[0]329653008
MedicationRequest.medicationCodeableConcept[0].coding[0].display[0]Ibuprofen 400mg tablets
MedicationRequest.subject[0].identifier[0].system[0]https://fhir.nhs.uk/Id/nhs-number
MedicationRequest.subject[0].identifier[0].value[0]9999999999
MedicationRequest.authoredOn[0]2019-01-15T15:00:00Z
MedicationRequest.requester[0].reference[0]urn:staff-1112
MedicationRequest.requester[0].display[0]Dr Maikeu Well
MedicationRequest.recorder[0].reference[0]urn:staff-1112
MedicationRequest.recorder[0].display[0]Dr Maikeu Well
MedicationRequest.dosageInstruction[0].text[0]1 tablet - 4 times a day - at a meal - oral
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].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].timing[0].repeat[0].when[0]C
MedicationRequest.dosageInstruction[0].doseAndRate[0].doseQuantity[0].value[0]1
MedicationRequest.dosageInstruction[0].doseAndRate[0].doseQuantity[0].unit[0]tablet
MedicationRequest.dosageInstruction[0].doseAndRate[0].doseQuantity[0].system[0]http://snomed.info/sct
MedicationRequest.dosageInstruction[0].doseAndRate[0].doseQuantity[0].code[0]385055001
MedicationRequest.substitution[0].allowedBoolean[0]False
MedicationRequest

Example on-screen presentation:

Ibuprofen 400mg tablets
1 tablet - 4 times a day - at a meal - oral

Dose-based instruction using a VTM. 
<MedicationRequest xmlns="http://hl7.org/fhir">
    <id value="18a8ea33-dc5f-4fb7-985e-acc474bf97cd" />
    <meta>
        <profile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationRequest" />
    </meta>
    <status value="active" />
    <intent value="order" />
    <category>
        <coding>
            <system value="http://terminology.hl7.org/CodeSystem/medicationrequest-category" />
            <code value="inpatient" />
            <display value="inpatient" />
        </coding>
    </category>
    <medicationCodeableConcept>
        <coding>
            <system value="https://dmd.nhs.uk" />
            <code value="38268001" />
            <display value="Ibuprofen" />
        </coding>
    </medicationCodeableConcept>
    <subject>
        <identifier>
            <system value="https://fhir.nhs.uk/Id/nhs-number" />
            <value value="9999999999" />
        </identifier>
    </subject>
    <authoredOn value="2019-01-15T15:00:00Z" />
    <requester>
        <reference value="urn:staff-1112" />
        <display value="Dr Maikeu Well" />
    </requester>
    <recorder>
        <reference value="urn:staff-1112" />
        <display value="Dr Maikeu Well" />
    </recorder>
    <dosageInstruction>
        <text value="400 milligram - 4 times a day - at a meal - oral" />
        <timing>
            <repeat>
                <frequency value="4" />
                <period value="1" />
                <periodUnit value="d" />
                <when value="C" />
            </repeat>
        </timing>
        <route>
            <coding>
                <system value="http://snomed.info/sct" />
                <code value="26643006" />
                <display value="oral" />
            </coding>
        </route>
        <doseAndRate>
            <doseQuantity>
                <value value="400" />
                <unit value="milligram" />
                <system value="http://unitsofmeasure.org" />
                <code value="mg" />
            </doseQuantity>
        </doseAndRate>
    </dosageInstruction>
    <substitution>
        <allowedBoolean value="false" />
    </substitution>
</MedicationRequest>

{
    "resourceType": "MedicationRequest",
    "id": "18a8ea33-dc5f-4fb7-985e-acc474bf97cd",
    "meta": {
        "profile":  [
            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationRequest"
        ]
    },
    "status": "active",
    "intent": "order",
    "category":  [
        {
            "coding":  [
                {
                    "system": "http://terminology.hl7.org/CodeSystem/medicationrequest-category",
                    "code": "inpatient",
                    "display": "inpatient"
                }
            ]
        }
    ],
    "medicationCodeableConcept": {
        "coding":  [
            {
                "system": "https://dmd.nhs.uk",
                "code": "38268001",
                "display": "Ibuprofen"
            }
        ]
    },
    "subject": {
        "identifier": {
            "system": "https://fhir.nhs.uk/Id/nhs-number",
            "value": "9999999999"
        }
    },
    "authoredOn": "2019-01-15T15:00:00Z",
    "requester": {
        "reference": "urn:staff-1112",
        "display": "Dr Maikeu Well"
    },
    "recorder": {
        "reference": "urn:staff-1112",
        "display": "Dr Maikeu Well"
    },
    "dosageInstruction":  [
        {
            "text": "400 milligram - 4 times a day - at a meal - oral",
            "route": {
                "coding":  [
                    {
                        "system": "http://snomed.info/sct",
                        "code": "26643006",
                        "display": "oral"
                    }
                ]
            },
            "timing": {
                "repeat": {
                    "frequency": 4,
                    "period": 1,
                    "periodUnit": "d",
                    "when":  [
                        "C"
                    ]
                }
            },
            "doseAndRate":  [
                {
                    "doseQuantity": {
                        "value": 400,
                        "unit": "milligram",
                        "system": "http://unitsofmeasure.org",
                        "code": "mg"
                    }
                }
            ]
        }
    ],
    "substitution": {
        "allowedBoolean": false
    }
}
MedicationRequest.id[0]18a8ea33-dc5f-4fb7-985e-acc474bf97cd
MedicationRequest.meta[0].profile[0]https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationRequest
MedicationRequest.status[0]active
MedicationRequest.intent[0]order
MedicationRequest.category[0].coding[0].system[0]http://terminology.hl7.org/CodeSystem/medicationrequest-category
MedicationRequest.category[0].coding[0].code[0]inpatient
MedicationRequest.category[0].coding[0].display[0]inpatient
MedicationRequest.medicationCodeableConcept[0].coding[0].system[0]https://dmd.nhs.uk
MedicationRequest.medicationCodeableConcept[0].coding[0].code[0]38268001
MedicationRequest.medicationCodeableConcept[0].coding[0].display[0]Ibuprofen
MedicationRequest.subject[0].identifier[0].system[0]https://fhir.nhs.uk/Id/nhs-number
MedicationRequest.subject[0].identifier[0].value[0]9999999999
MedicationRequest.authoredOn[0]2019-01-15T15:00:00Z
MedicationRequest.requester[0].reference[0]urn:staff-1112
MedicationRequest.requester[0].display[0]Dr Maikeu Well
MedicationRequest.recorder[0].reference[0]urn:staff-1112
MedicationRequest.recorder[0].display[0]Dr Maikeu Well
MedicationRequest.dosageInstruction[0].text[0]400 milligram - 4 times a day - at a meal - oral
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].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].timing[0].repeat[0].when[0]C
MedicationRequest.dosageInstruction[0].doseAndRate[0].doseQuantity[0].value[0]400
MedicationRequest.dosageInstruction[0].doseAndRate[0].doseQuantity[0].unit[0]milligram
MedicationRequest.dosageInstruction[0].doseAndRate[0].doseQuantity[0].system[0]http://unitsofmeasure.org
MedicationRequest.dosageInstruction[0].doseAndRate[0].doseQuantity[0].code[0]mg
MedicationRequest.substitution[0].allowedBoolean[0]False
MedicationRequest

Example on-screen presentation:

Ibuprofen
400 milligram - 4 times a day - at a meal - oral

Insulin lispro subcutaneous injection

Product-based instruction using an AMP. Uses a doseQuantity expressed as a number of Unit. The SNOMED-CT definition of this product contains an attribute for Has unit of administration (attribute) linked to Unit (qualifier value). This relationship is not contained within dm+d data therefore the medicationCodeableConcept.coding.system is "http://snomed.info/sct" instead of "https://dmd.nhs.uk".

Note: This representation using a doseQuantity as a number Units should only be used where the consumer system(s) are known to support it. This is opposed to those systems that expect all units of measure to be based on dm+d data such a GP and community pharmacy systems. 
<MedicationRequest xmlns="http://hl7.org/fhir">
    <id value="18a8ea33-dc5f-4fb7-985e-acc474bf97cd" />
    <meta>
        <profile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationRequest" />
    </meta>
    <status value="active" />
    <intent value="order" />
    <category>
        <coding>
            <system value="http://terminology.hl7.org/CodeSystem/medicationrequest-category" />
            <code value="inpatient" />
            <display value="inpatient" />
        </coding>
    </category>
    <medicationCodeableConcept>
        <coding>
            <system value="http://snomed.info/sct" />
            <code value="35776411000001102" />
            <display value="Insulin lispro Sanofi 100units/ml solution for injection 10ml vials (Sanofi)" />
        </coding>
    </medicationCodeableConcept>
    <subject>
        <identifier>
            <system value="https://fhir.nhs.uk/Id/nhs-number" />
            <value value="9999999999" />
        </identifier>
    </subject>
    <authoredOn value="2019-01-15T15:00:00Z" />
    <requester>
        <reference value="urn:staff-1112" />
        <display value="Dr Maikeu Well" />
    </requester>
    <recorder>
        <reference value="urn:staff-1112" />
        <display value="Dr Maikeu Well" />
    </recorder>
    <dosageInstruction>
        <text value="Inject 8 Unit - 3 times a day - at a meal - Subcutaneous route" />
        <timing>
            <repeat>
                <frequency value="3" />
                <period value="1" />
                <periodUnit value="d" />
                <when value="C" />
            </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>
        <doseAndRate>
            <doseQuantity>
                <value value="8" />
                <unit value="Unit" />
                <system value="http://snomed.info/sct" />
                <code value="767525000" />
            </doseQuantity>
        </doseAndRate>
    </dosageInstruction>
    <substitution>
        <allowedBoolean value="false" />
    </substitution>
</MedicationRequest>

{
    "resourceType": "MedicationRequest",
    "id": "18a8ea33-dc5f-4fb7-985e-acc474bf97cd",
    "meta": {
        "profile":  [
            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationRequest"
        ]
    },
    "status": "active",
    "intent": "order",
    "category":  [
        {
            "coding":  [
                {
                    "system": "http://terminology.hl7.org/CodeSystem/medicationrequest-category",
                    "code": "inpatient",
                    "display": "inpatient"
                }
            ]
        }
    ],
    "medicationCodeableConcept": {
        "coding":  [
            {
                "system": "http://snomed.info/sct",
                "code": "35776411000001102",
                "display": "Insulin lispro Sanofi 100units/ml solution for injection 10ml vials (Sanofi)"
            }
        ]
    },
    "subject": {
        "identifier": {
            "system": "https://fhir.nhs.uk/Id/nhs-number",
            "value": "9999999999"
        }
    },
    "authoredOn": "2019-01-15T15:00:00Z",
    "requester": {
        "reference": "urn:staff-1112",
        "display": "Dr Maikeu Well"
    },
    "recorder": {
        "reference": "urn:staff-1112",
        "display": "Dr Maikeu Well"
    },
    "dosageInstruction":  [
        {
            "text": "Inject 8 Unit - 3 times a day - at a meal - Subcutaneous route",
            "method": {
                "coding":  [
                    {
                        "system": "http://snomed.info/sct",
                        "code": "422145002",
                        "display": "Inject"
                    }
                ]
            },
            "route": {
                "coding":  [
                    {
                        "system": "http://snomed.info/sct",
                        "code": "34206005",
                        "display": "Subcutaneous route"
                    }
                ]
            },
            "timing": {
                "repeat": {
                    "frequency": 3,
                    "period": 1,
                    "periodUnit": "d",
                    "when":  [
                        "C"
                    ]
                }
            },
            "doseAndRate":  [
                {
                    "doseQuantity": {
                        "value": 8,
                        "unit": "Unit",
                        "system": "http://snomed.info/sct",
                        "code": "767525000"
                    }
                }
            ]
        }
    ],
    "substitution": {
        "allowedBoolean": false
    }
}
MedicationRequest.id[0]18a8ea33-dc5f-4fb7-985e-acc474bf97cd
MedicationRequest.meta[0].profile[0]https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationRequest
MedicationRequest.status[0]active
MedicationRequest.intent[0]order
MedicationRequest.category[0].coding[0].system[0]http://terminology.hl7.org/CodeSystem/medicationrequest-category
MedicationRequest.category[0].coding[0].code[0]inpatient
MedicationRequest.category[0].coding[0].display[0]inpatient
MedicationRequest.medicationCodeableConcept[0].coding[0].system[0]http://snomed.info/sct
MedicationRequest.medicationCodeableConcept[0].coding[0].code[0]35776411000001102
MedicationRequest.medicationCodeableConcept[0].coding[0].display[0]Insulin lispro Sanofi 100units/ml solution for injection 10ml vials (Sanofi)
MedicationRequest.subject[0].identifier[0].system[0]https://fhir.nhs.uk/Id/nhs-number
MedicationRequest.subject[0].identifier[0].value[0]9999999999
MedicationRequest.authoredOn[0]2019-01-15T15:00:00Z
MedicationRequest.requester[0].reference[0]urn:staff-1112
MedicationRequest.requester[0].display[0]Dr Maikeu Well
MedicationRequest.recorder[0].reference[0]urn:staff-1112
MedicationRequest.recorder[0].display[0]Dr Maikeu Well
MedicationRequest.dosageInstruction[0].text[0]Inject 8 Unit - 3 times a day - at a meal - 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].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].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].timing[0].repeat[0].when[0]C
MedicationRequest.dosageInstruction[0].doseAndRate[0].doseQuantity[0].value[0]8
MedicationRequest.dosageInstruction[0].doseAndRate[0].doseQuantity[0].unit[0]Unit
MedicationRequest.dosageInstruction[0].doseAndRate[0].doseQuantity[0].system[0]http://snomed.info/sct
MedicationRequest.dosageInstruction[0].doseAndRate[0].doseQuantity[0].code[0]767525000
MedicationRequest.substitution[0].allowedBoolean[0]False
MedicationRequest

Example on-screen presentation:

Insulin lispro Sanofi 100units/ml solution for injection 10ml vials (Sanofi)
Inject 8 Unit - 3 times a day - at a meal - Subcutaneous route

Levothyroxine

Dose-based instruction using an VTM. 
<MedicationRequest xmlns="http://hl7.org/fhir">
    <id value="18a8ea33-dc5f-4fb7-985e-acc474bf97cd" />
    <meta>
        <profile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationRequest" />
    </meta>
    <status value="active" />
    <intent value="order" />
    <category>
        <coding>
            <system value="http://terminology.hl7.org/CodeSystem/medicationrequest-category" />
            <code value="outpatient" />
            <display value="outpatient" />
        </coding>
    </category>
    <medicationCodeableConcept>
        <coding>
            <system value="https://dmd.nhs.uk" />
            <code value="10071011000001106" />
            <display value="Levothyroxine" />
        </coding>
    </medicationCodeableConcept>
    <subject>
        <identifier>
            <system value="https://fhir.nhs.uk/Id/nhs-number" />
            <value value="9999999999" />
        </identifier>
    </subject>
    <authoredOn value="2019-01-15T15:00:00Z" />
    <requester>
        <reference value="urn:staff-1112" />
        <display value="Dr Maikeu Well" />
    </requester>
    <recorder>
        <reference value="urn:staff-1112" />
        <display value="Dr Maikeu Well" />
    </recorder>
    <dosageInstruction>
        <text value="150 microgram - daily - during the morning and before breakfast - oral" />
        <timing>
            <repeat>
                <period value="1" />
                <periodUnit value="d" />
                <when value="MORN" />
                <when value="ACM" />
            </repeat>
        </timing>
        <route>
            <coding>
                <system value="http://snomed.info/sct" />
                <code value="26643006" />
                <display value="oral" />
            </coding>
        </route>
        <doseAndRate>
            <doseQuantity>
                <value value="150" />
                <unit value="microgram" />
                <system value="http://unitsofmeasure.org" />
                <code value="ug" />
            </doseQuantity>
        </doseAndRate>
    </dosageInstruction>
    <substitution>
        <allowedBoolean value="false" />
    </substitution>
</MedicationRequest>

{
    "resourceType": "MedicationRequest",
    "id": "18a8ea33-dc5f-4fb7-985e-acc474bf97cd",
    "meta": {
        "profile":  [
            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationRequest"
        ]
    },
    "status": "active",
    "intent": "order",
    "category":  [
        {
            "coding":  [
                {
                    "system": "http://terminology.hl7.org/CodeSystem/medicationrequest-category",
                    "code": "outpatient",
                    "display": "outpatient"
                }
            ]
        }
    ],
    "medicationCodeableConcept": {
        "coding":  [
            {
                "system": "https://dmd.nhs.uk",
                "code": "10071011000001106",
                "display": "Levothyroxine"
            }
        ]
    },
    "subject": {
        "identifier": {
            "system": "https://fhir.nhs.uk/Id/nhs-number",
            "value": "9999999999"
        }
    },
    "authoredOn": "2019-01-15T15:00:00Z",
    "requester": {
        "reference": "urn:staff-1112",
        "display": "Dr Maikeu Well"
    },
    "recorder": {
        "reference": "urn:staff-1112",
        "display": "Dr Maikeu Well"
    },
    "dosageInstruction":  [
        {
            "text": "150 microgram - daily - during the morning and before breakfast - oral",
            "route": {
                "coding":  [
                    {
                        "system": "http://snomed.info/sct",
                        "code": "26643006",
                        "display": "oral"
                    }
                ]
            },
            "timing": {
                "repeat": {
                    "period": 1,
                    "periodUnit": "d",
                    "when":  [
                        "MORN",
                        "ACM"
                    ]
                }
            },
            "doseAndRate":  [
                {
                    "doseQuantity": {
                        "value": 150,
                        "unit": "microgram",
                        "system": "http://unitsofmeasure.org",
                        "code": "ug"
                    }
                }
            ]
        }
    ],
    "substitution": {
        "allowedBoolean": false
    }
}
MedicationRequest.id[0]18a8ea33-dc5f-4fb7-985e-acc474bf97cd
MedicationRequest.meta[0].profile[0]https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationRequest
MedicationRequest.status[0]active
MedicationRequest.intent[0]order
MedicationRequest.category[0].coding[0].system[0]http://terminology.hl7.org/CodeSystem/medicationrequest-category
MedicationRequest.category[0].coding[0].code[0]outpatient
MedicationRequest.category[0].coding[0].display[0]outpatient
MedicationRequest.medicationCodeableConcept[0].coding[0].system[0]https://dmd.nhs.uk
MedicationRequest.medicationCodeableConcept[0].coding[0].code[0]10071011000001106
MedicationRequest.medicationCodeableConcept[0].coding[0].display[0]Levothyroxine
MedicationRequest.subject[0].identifier[0].system[0]https://fhir.nhs.uk/Id/nhs-number
MedicationRequest.subject[0].identifier[0].value[0]9999999999
MedicationRequest.authoredOn[0]2019-01-15T15:00:00Z
MedicationRequest.requester[0].reference[0]urn:staff-1112
MedicationRequest.requester[0].display[0]Dr Maikeu Well
MedicationRequest.recorder[0].reference[0]urn:staff-1112
MedicationRequest.recorder[0].display[0]Dr Maikeu Well
MedicationRequest.dosageInstruction[0].text[0]150 microgram - daily - during the morning and before breakfast - oral
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].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].timing[0].repeat[0].when[1]ACM
MedicationRequest.dosageInstruction[0].doseAndRate[0].doseQuantity[0].value[0]150
MedicationRequest.dosageInstruction[0].doseAndRate[0].doseQuantity[0].unit[0]microgram
MedicationRequest.dosageInstruction[0].doseAndRate[0].doseQuantity[0].system[0]http://unitsofmeasure.org
MedicationRequest.dosageInstruction[0].doseAndRate[0].doseQuantity[0].code[0]ug
MedicationRequest.substitution[0].allowedBoolean[0]False
MedicationRequest

Example on-screen presentation:

Levothyroxine
150 microgram - daily - during the morning and before breakfast - oral

Loperamide capsules

Product-based instruction using an VMP. 
<MedicationRequest xmlns="http://hl7.org/fhir">
    <id value="18a8ea33-dc5f-4fb7-985e-acc474bf97cd" />
    <meta>
        <profile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationRequest" />
    </meta>
    <status value="active" />
    <intent value="order" />
    <category>
        <coding>
            <system value="http://terminology.hl7.org/CodeSystem/medicationrequest-category" />
            <code value="outpatient" />
            <display value="outpatient" />
        </coding>
    </category>
    <medicationCodeableConcept>
        <coding>
            <system value="https://dmd.nhs.uk" />
            <code value="317378005" />
            <display value="Loperamide 2mg capsules" />
        </coding>
    </medicationCodeableConcept>
    <subject>
        <identifier>
            <system value="https://fhir.nhs.uk/Id/nhs-number" />
            <value value="9999999999" />
        </identifier>
    </subject>
    <authoredOn value="2019-01-15T15:00:00Z" />
    <requester>
        <reference value="urn:staff-1112" />
        <display value="Dr Maikeu Well" />
    </requester>
    <recorder>
        <reference value="urn:staff-1112" />
        <display value="Dr Maikeu Well" />
    </recorder>
    <dosageInstruction>
        <sequence value="1" />
        <text value="2 capsule - Now" />
        <additionalInstruction>
            <coding>
                <system value="http://snomed.info/sct" />
                <code value="421723005" />
                <display value="Now" />
            </coding>
        </additionalInstruction>
        <doseAndRate>
            <doseQuantity>
                <value value="2" />
                <unit value="capsule" />
                <system value="http://snomed.info/sct" />
                <code value="428641000" />
            </doseQuantity>
        </doseAndRate>
    </dosageInstruction>
    <dosageInstruction>
        <sequence value="2" />
        <text value="1 capsule - as required for Diarrhea - up to a maximum of 8 capsule in 1 day" />
        <asNeededCodeableConcept>
            <coding>
                <system value="http://snomed.info/sct" />
                <code value="62315008" />
                <display value="Diarrhea" />
            </coding>
        </asNeededCodeableConcept>
        <doseAndRate>
            <doseQuantity>
                <value value="1" />
                <unit value="capsule" />
                <system value="http://snomed.info/sct" />
                <code value="428641000" />
            </doseQuantity>
        </doseAndRate>
        <maxDosePerPeriod>
            <numerator>
                <value value="8" />
                <unit value="capsule" />
                <system value="http://snomed.info/sct" />
                <code value="428641000" />
            </numerator>
            <denominator>
                <value value="1" />
                <unit value="day" />
                <system value="http://unitsofmeasure.org/" />
                <code value="d" />
            </denominator>
        </maxDosePerPeriod>
    </dosageInstruction>
    <substitution>
        <allowedBoolean value="false" />
    </substitution>
</MedicationRequest>

{
    "resourceType": "MedicationRequest",
    "id": "18a8ea33-dc5f-4fb7-985e-acc474bf97cd",
    "meta": {
        "profile":  [
            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationRequest"
        ]
    },
    "status": "active",
    "intent": "order",
    "category":  [
        {
            "coding":  [
                {
                    "system": "http://terminology.hl7.org/CodeSystem/medicationrequest-category",
                    "code": "outpatient",
                    "display": "outpatient"
                }
            ]
        }
    ],
    "medicationCodeableConcept": {
        "coding":  [
            {
                "system": "https://dmd.nhs.uk",
                "code": "317378005",
                "display": "Loperamide 2mg capsules"
            }
        ]
    },
    "subject": {
        "identifier": {
            "system": "https://fhir.nhs.uk/Id/nhs-number",
            "value": "9999999999"
        }
    },
    "authoredOn": "2019-01-15T15:00:00Z",
    "requester": {
        "reference": "urn:staff-1112",
        "display": "Dr Maikeu Well"
    },
    "recorder": {
        "reference": "urn:staff-1112",
        "display": "Dr Maikeu Well"
    },
    "dosageInstruction":  [
        {
            "sequence": 1,
            "text": "2 capsule - Now",
            "additionalInstruction":  [
                {
                    "coding":  [
                        {
                            "system": "http://snomed.info/sct",
                            "code": "421723005",
                            "display": "Now"
                        }
                    ]
                }
            ],
            "doseAndRate":  [
                {
                    "doseQuantity": {
                        "value": 2,
                        "unit": "capsule",
                        "system": "http://snomed.info/sct",
                        "code": "428641000"
                    }
                }
            ]
        },
        {
            "sequence": 2,
            "text": "1 capsule - as required for Diarrhea - up to a maximum of 8 capsule in 1 day",
            "asNeededCodeableConcept": {
                "coding":  [
                    {
                        "system": "http://snomed.info/sct",
                        "code": "62315008",
                        "display": "Diarrhea"
                    }
                ]
            },
            "doseAndRate":  [
                {
                    "doseQuantity": {
                        "value": 1,
                        "unit": "capsule",
                        "system": "http://snomed.info/sct",
                        "code": "428641000"
                    }
                }
            ],
            "maxDosePerPeriod": {
                "numerator": {
                    "value": 8,
                    "unit": "capsule",
                    "system": "http://snomed.info/sct",
                    "code": "428641000"
                },
                "denominator": {
                    "value": 1,
                    "unit": "day",
                    "system": "http://unitsofmeasure.org/",
                    "code": "d"
                }
            }
        }
    ],
    "substitution": {
        "allowedBoolean": false
    }
}
MedicationRequest.id[0]18a8ea33-dc5f-4fb7-985e-acc474bf97cd
MedicationRequest.meta[0].profile[0]https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationRequest
MedicationRequest.status[0]active
MedicationRequest.intent[0]order
MedicationRequest.category[0].coding[0].system[0]http://terminology.hl7.org/CodeSystem/medicationrequest-category
MedicationRequest.category[0].coding[0].code[0]outpatient
MedicationRequest.category[0].coding[0].display[0]outpatient
MedicationRequest.medicationCodeableConcept[0].coding[0].system[0]https://dmd.nhs.uk
MedicationRequest.medicationCodeableConcept[0].coding[0].code[0]317378005
MedicationRequest.medicationCodeableConcept[0].coding[0].display[0]Loperamide 2mg capsules
MedicationRequest.subject[0].identifier[0].system[0]https://fhir.nhs.uk/Id/nhs-number
MedicationRequest.subject[0].identifier[0].value[0]9999999999
MedicationRequest.authoredOn[0]2019-01-15T15:00:00Z
MedicationRequest.requester[0].reference[0]urn:staff-1112
MedicationRequest.requester[0].display[0]Dr Maikeu Well
MedicationRequest.recorder[0].reference[0]urn:staff-1112
MedicationRequest.recorder[0].display[0]Dr Maikeu Well
MedicationRequest.dosageInstruction[0].sequence[0]1
MedicationRequest.dosageInstruction[0].text[0]2 capsule - Now
MedicationRequest.dosageInstruction[0].additionalInstruction[0].coding[0].system[0]http://snomed.info/sct
MedicationRequest.dosageInstruction[0].additionalInstruction[0].coding[0].code[0]421723005
MedicationRequest.dosageInstruction[0].additionalInstruction[0].coding[0].display[0]Now
MedicationRequest.dosageInstruction[0].doseAndRate[0].doseQuantity[0].value[0]2
MedicationRequest.dosageInstruction[0].doseAndRate[0].doseQuantity[0].unit[0]capsule
MedicationRequest.dosageInstruction[0].doseAndRate[0].doseQuantity[0].system[0]http://snomed.info/sct
MedicationRequest.dosageInstruction[0].doseAndRate[0].doseQuantity[0].code[0]428641000
MedicationRequest.dosageInstruction[1].sequence[0]2
MedicationRequest.dosageInstruction[1].text[0]1 capsule - as required for Diarrhea - up to a maximum of 8 capsule in 1 day
MedicationRequest.dosageInstruction[1].asNeededCodeableConcept[0].coding[0].system[0]http://snomed.info/sct
MedicationRequest.dosageInstruction[1].asNeededCodeableConcept[0].coding[0].code[0]62315008
MedicationRequest.dosageInstruction[1].asNeededCodeableConcept[0].coding[0].display[0]Diarrhea
MedicationRequest.dosageInstruction[1].doseAndRate[0].doseQuantity[0].value[0]1
MedicationRequest.dosageInstruction[1].doseAndRate[0].doseQuantity[0].unit[0]capsule
MedicationRequest.dosageInstruction[1].doseAndRate[0].doseQuantity[0].system[0]http://snomed.info/sct
MedicationRequest.dosageInstruction[1].doseAndRate[0].doseQuantity[0].code[0]428641000
MedicationRequest.dosageInstruction[1].maxDosePerPeriod[0].numerator[0].value[0]8
MedicationRequest.dosageInstruction[1].maxDosePerPeriod[0].numerator[0].unit[0]capsule
MedicationRequest.dosageInstruction[1].maxDosePerPeriod[0].numerator[0].system[0]http://snomed.info/sct
MedicationRequest.dosageInstruction[1].maxDosePerPeriod[0].numerator[0].code[0]428641000
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.substitution[0].allowedBoolean[0]False
MedicationRequest

Example on-screen presentation:

Loperamide 2mg capsules
2 capsule - Now, then 1 capsule - as required for Diarrhea - up to a maximum of 8 capsule in 1 day

Metformin tablets

Product-based instruction using an VMP. 
<MedicationRequest xmlns="http://hl7.org/fhir">
    <id value="18a8ea33-dc5f-4fb7-985e-acc474bf97cd" />
    <meta>
        <profile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationRequest" />
    </meta>
    <status value="active" />
    <intent value="order" />
    <category>
        <coding>
            <system value="http://terminology.hl7.org/CodeSystem/medicationrequest-category" />
            <code value="community" />
            <display value="community" />
        </coding>
    </category>
    <medicationCodeableConcept>
        <coding>
            <system value="https://dmd.nhs.uk" />
            <code value="325278007" />
            <display value="Metformin 500mg tablets" />
        </coding>
    </medicationCodeableConcept>
    <subject>
        <identifier>
            <system value="https://fhir.nhs.uk/Id/nhs-number" />
            <value value="9999999999" />
        </identifier>
    </subject>
    <authoredOn value="2019-01-15T15:00:00Z" />
    <requester>
        <reference value="urn:staff-1112" />
        <display value="Dr Maikeu Well" />
    </requester>
    <recorder>
        <reference value="urn:staff-1112" />
        <display value="Dr Maikeu Well" />
    </recorder>
    <dosageInstruction>
        <sequence value="1" />
        <text value="1 tablet - once a day - at breakfast - for 1 week" />
        <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="CM" />
            </repeat>
        </timing>
        <doseAndRate>
            <doseQuantity>
                <value value="1" />
                <unit value="tablet" />
                <system value="http://snomed.info/sct" />
                <code value="428673006" />
            </doseQuantity>
        </doseAndRate>
    </dosageInstruction>
    <dosageInstruction>
        <sequence value="2" />
        <text value="1 tablet - twice a day - at breakfast and at dinner - for 1 week" />
        <timing>
            <repeat>
                <boundsDuration>
                    <value value="1" />
                    <unit value="week" />
                    <system value="http://unitsofmeasure.org" />
                    <code value="wk" />
                </boundsDuration>
                <frequency value="2" />
                <period value="1" />
                <periodUnit value="d" />
                <when value="CM" />
                <when value="CV" />
            </repeat>
        </timing>
        <doseAndRate>
            <doseQuantity>
                <value value="1" />
                <unit value<