Release 5

This page is part of the FHIR Specification (v5.0.0: R5 - STU). This is the current published version. For a full list of available versions, see the Directory of published versions . Page versions: R5 R4B R4 R3

11.10.0 Dosage

Pharmacy

Work Group

Maturity Level: 3

Standards Status: Trial Use

Types Framework Cross Reference: Base Types | Datatypes | Resources | Patterns

The Dosage structure defines general dosage instruction information typically represented in medication requests, medication dispenses and medication statements.

Note: the Dosage structure allows modifier extensions.

Structure

Name	Flags	Card.	Type	Description & Constraints
Dosage	Σ TU		Element	How the medication is/was taken or should be taken + Rule: AsNeededFor can only be set if AsNeeded is empty or true Elements defined in Ancestors: id, extension, modifierExtension
sequence	Σ	0..1	integer	The order of the dosage instructions
text	Σ	0..1	string	Free text dosage instructions e.g. SIG
additionalInstruction	Σ	0..*	CodeableConcept	Supplemental instruction or warnings to the patient - e.g. "with meals", "may cause drowsiness" Binding: SNOMED CT Additional Dosage Instructions (Example)
patientInstruction	Σ	0..1	string	Patient or consumer oriented instructions
timing	Σ	0..1	Timing	When medication should be administered
asNeeded	Σ C	0..1	boolean	Take "as needed"
asNeededFor	Σ C	0..*	CodeableConcept	Take "as needed" (for x) Binding: SNOMED CT Medication As Needed Reason Codes (Example)
site	Σ	0..1	CodeableConcept	Body site to administer to Binding: SNOMED CT Anatomical Structure for Administration Site Codes (Example)
route	Σ	0..1	CodeableConcept	How drug should enter body Binding: SNOMED CT Route Codes (Example)
method	Σ	0..1	CodeableConcept	Technique for administering medication Binding: SNOMED CT Administration Method Codes (Example)
doseAndRate	Σ	0..*	Element	Amount of medication administered, to be administered or typical amount to be administered
type	Σ	0..1	CodeableConcept	The kind of dose or rate specified Binding: DoseAndRateType (Example)
dose[x]	Σ	0..1		Amount of medication per dose
doseRange			Range
doseQuantity			SimpleQuantity
rate[x]	Σ	0..1		Amount of medication per unit of time
rateRatio			Ratio
rateRange			Range
rateQuantity			SimpleQuantity
maxDosePerPeriod	Σ	0..*	Ratio	Upper limit on medication per unit of time
maxDosePerAdministration	Σ	0..1	SimpleQuantity	Upper limit on medication per administration
maxDosePerLifetime	Σ	0..1	SimpleQuantity	Upper limit on medication per lifetime of the patient
Documentation for this format

Definition: XML | JSON

UML Diagram (Legend)

XML Template

<Dosage xmlns="http://hl7.org/fhir">
 <!-- from Element: extension -->
 <sequence value="[integer]"/><!-- 0..1 The order of the dosage instructions -->
 <text value="[string]"/><!-- 0..1 Free text dosage instructions e.g. SIG -->
 <additionalInstruction><!-- 0..* CodeableConcept Supplemental instruction or warnings to the patient - e.g. "with meals", "may cause drowsiness" --></additionalInstruction>
 <patientInstruction value="[string]"/><!-- 0..1 Patient or consumer oriented instructions -->
 <timing><!-- 0..1 Timing When medication should be administered --></timing>
 <asNeeded value="[boolean]"/><!-- I 0..1 Take "as needed" -->
 <asNeededFor><!-- I 0..* CodeableConcept Take "as needed" (for x) --></asNeededFor>
 <site><!-- 0..1 CodeableConcept Body site to administer to --></site>
 <route><!-- 0..1 CodeableConcept How drug should enter body --></route>
 <method><!-- 0..1 CodeableConcept Technique for administering medication --></method>
 <doseAndRate>  <!-- 0..* Amount of medication administered, to be administered or typical amount to be administered -->
  <type><!-- 0..1 CodeableConcept The kind of dose or rate specified  --></type>
  <dose[x]><!-- 0..1 Range|Quantity(SimpleQuantity) Amount of medication per dose --></dose[x]>
  <rate[x]><!-- 0..1 Ratio|Range|Quantity(SimpleQuantity) Amount of medication per unit of time --></rate[x]>
 </doseAndRate>
 <maxDosePerPeriod><!-- 0..* Ratio Upper limit on medication per unit of time --></maxDosePerPeriod>
 <maxDosePerAdministration><!-- 0..1 Quantity(SimpleQuantity) Upper limit on medication per administration --></maxDosePerAdministration>
 <maxDosePerLifetime><!-- 0..1 Quantity(SimpleQuantity) Upper limit on medication per lifetime of the patient --></maxDosePerLifetime>
</Dosage>

JSON Template

{
  // from Element: extension
  "sequence" : <integer>, // The order of the dosage instructions
  "text" : "<string>", // Free text dosage instructions e.g. SIG
  "additionalInstruction" : [{ CodeableConcept }], // Supplemental instruction or warnings to the patient - e.g. "with meals", "may cause drowsiness"
  "patientInstruction" : "<string>", // Patient or consumer oriented instructions
  "timing" : { Timing }, // When medication should be administered
  "asNeeded" : <boolean>, // I Take "as needed"
  "asNeededFor" : [{ CodeableConcept }], // I Take "as needed" (for x)
  "site" : { CodeableConcept }, // Body site to administer to
  "route" : { CodeableConcept }, // How drug should enter body
  "method" : { CodeableConcept }, // Technique for administering medication
  "doseAndRate" : [{ // Amount of medication administered, to be administered or typical amount to be administered
    "type" : { CodeableConcept }, // The kind of dose or rate specified 
    // dose[x]: Amount of medication per dose. One of these 2:
    "doseRange" : { Range },
    "doseQuantity" : { Quantity(SimpleQuantity) },
    // rate[x]: Amount of medication per unit of time. One of these 3:
    "rateRatio" : { Ratio },
    "rateRange" : { Range },
    "rateQuantity" : { Quantity(SimpleQuantity) }
  }],
  "maxDosePerPeriod" : [{ Ratio }], // Upper limit on medication per unit of time
  "maxDosePerAdministration" : { Quantity(SimpleQuantity) }, // Upper limit on medication per administration
  "maxDosePerLifetime" : { Quantity(SimpleQuantity) } // Upper limit on medication per lifetime of the patient
}

Turtle Template

@prefix fhir: <http://hl7.org/fhir/> .

[
 # from Element: Element.extension
  fhir:sequence [ integer ] ; # 0..1 The order of the dosage instructions
  fhir:text [ string ] ; # 0..1 Free text dosage instructions e.g. SIG
  fhir:additionalInstruction  ( [ CodeableConcept ] ... ) ; # 0..* Supplemental instruction or warnings to the patient - e.g. "with meals", "may cause drowsiness"
  fhir:patientInstruction [ string ] ; # 0..1 Patient or consumer oriented instructions
  fhir:timing [ Timing ] ; # 0..1 When medication should be administered
  fhir:asNeeded [ boolean ] ; # 0..1 I Take "as needed"
  fhir:asNeededFor  ( [ CodeableConcept ] ... ) ; # 0..* I Take "as needed" (for x)
  fhir:site [ CodeableConcept ] ; # 0..1 Body site to administer to
  fhir:route [ CodeableConcept ] ; # 0..1 How drug should enter body
  fhir:method [ CodeableConcept ] ; # 0..1 Technique for administering medication
  fhir:doseAndRate ( [ # 0..* Amount of medication administered, to be administered or typical amount to be administered
    fhir:type [ CodeableConcept ] ; # 0..1 The kind of dose or rate specified
    # dose[x] : 0..1 Amount of medication per dose. One of these 2
      fhir:dose [  a fhir:Range ; Range ]
      fhir:dose [  a fhir:SimpleQuantity ; Quantity(SimpleQuantity) ]
    # rate[x] : 0..1 Amount of medication per unit of time. One of these 3
      fhir:rate [  a fhir:Ratio ; Ratio ]
      fhir:rate [  a fhir:Range ; Range ]
      fhir:rate [  a fhir:SimpleQuantity ; Quantity(SimpleQuantity) ]
  ] ... ) ;
  fhir:maxDosePerPeriod  ( [ Ratio ] ... ) ; # 0..* Upper limit on medication per unit of time
  fhir:maxDosePerAdministration [ Quantity(SimpleQuantity) ] ; # 0..1 Upper limit on medication per administration
  fhir:maxDosePerLifetime [ Quantity(SimpleQuantity) ] ; # 0..1 Upper limit on medication per lifetime of the patient
]

Changes since Release 3

Changes from both R4 and R4B

Dosage

Dosage.asNeeded

Renamed from asNeeded[x] to asNeeded
Remove Type CodeableConcept

Dosage.asNeededFor

Added Element

Dosage.maxDosePerPeriod

Max Cardinality changed from 1 to *

See the Full Difference for further information

Structure

Name	Flags	Card.	Type	Description & Constraints
Dosage	Σ TU		Element	How the medication is/was taken or should be taken + Rule: AsNeededFor can only be set if AsNeeded is empty or true Elements defined in Ancestors: id, extension, modifierExtension
sequence	Σ	0..1	integer	The order of the dosage instructions
text	Σ	0..1	string	Free text dosage instructions e.g. SIG
additionalInstruction	Σ	0..*	CodeableConcept	Supplemental instruction or warnings to the patient - e.g. "with meals", "may cause drowsiness" Binding: SNOMED CT Additional Dosage Instructions (Example)
patientInstruction	Σ	0..1	string	Patient or consumer oriented instructions
timing	Σ	0..1	Timing	When medication should be administered
asNeeded	Σ C	0..1	boolean	Take "as needed"
asNeededFor	Σ C	0..*	CodeableConcept	Take "as needed" (for x) Binding: SNOMED CT Medication As Needed Reason Codes (Example)
site	Σ	0..1	CodeableConcept	Body site to administer to Binding: SNOMED CT Anatomical Structure for Administration Site Codes (Example)
route	Σ	0..1	CodeableConcept	How drug should enter body Binding: SNOMED CT Route Codes (Example)
method	Σ	0..1	CodeableConcept	Technique for administering medication Binding: SNOMED CT Administration Method Codes (Example)
doseAndRate	Σ	0..*	Element	Amount of medication administered, to be administered or typical amount to be administered
type	Σ	0..1	CodeableConcept	The kind of dose or rate specified Binding: DoseAndRateType (Example)
dose[x]	Σ	0..1		Amount of medication per dose
doseRange			Range
doseQuantity			SimpleQuantity
rate[x]	Σ	0..1		Amount of medication per unit of time
rateRatio			Ratio
rateRange			Range
rateQuantity			SimpleQuantity
maxDosePerPeriod	Σ	0..*	Ratio	Upper limit on medication per unit of time
maxDosePerAdministration	Σ	0..1	SimpleQuantity	Upper limit on medication per administration
maxDosePerLifetime	Σ	0..1	SimpleQuantity	Upper limit on medication per lifetime of the patient
Documentation for this format

UML Diagram (Legend)

XML Template

<Dosage xmlns="http://hl7.org/fhir">
 <!-- from Element: extension -->
 <sequence value="[integer]"/><!-- 0..1 The order of the dosage instructions -->
 <text value="[string]"/><!-- 0..1 Free text dosage instructions e.g. SIG -->
 <additionalInstruction><!-- 0..* CodeableConcept Supplemental instruction or warnings to the patient - e.g. "with meals", "may cause drowsiness" --></additionalInstruction>
 <patientInstruction value="[string]"/><!-- 0..1 Patient or consumer oriented instructions -->
 <timing><!-- 0..1 Timing When medication should be administered --></timing>
 <asNeeded value="[boolean]"/><!-- I 0..1 Take "as needed" -->
 <asNeededFor><!-- I 0..* CodeableConcept Take "as needed" (for x) --></asNeededFor>
 <site><!-- 0..1 CodeableConcept Body site to administer to --></site>
 <route><!-- 0..1 CodeableConcept How drug should enter body --></route>
 <method><!-- 0..1 CodeableConcept Technique for administering medication --></method>
 <doseAndRate>  <!-- 0..* Amount of medication administered, to be administered or typical amount to be administered -->
  <type><!-- 0..1 CodeableConcept The kind of dose or rate specified  --></type>
  <dose[x]><!-- 0..1 Range|Quantity(SimpleQuantity) Amount of medication per dose --></dose[x]>
  <rate[x]><!-- 0..1 Ratio|Range|Quantity(SimpleQuantity) Amount of medication per unit of time --></rate[x]>
 </doseAndRate>
 <maxDosePerPeriod><!-- 0..* Ratio Upper limit on medication per unit of time --></maxDosePerPeriod>
 <maxDosePerAdministration><!-- 0..1 Quantity(SimpleQuantity) Upper limit on medication per administration --></maxDosePerAdministration>
 <maxDosePerLifetime><!-- 0..1 Quantity(SimpleQuantity) Upper limit on medication per lifetime of the patient --></maxDosePerLifetime>
</Dosage>

JSON Template

{
  // from Element: extension
  "sequence" : <integer>, // The order of the dosage instructions
  "text" : "<string>", // Free text dosage instructions e.g. SIG
  "additionalInstruction" : [{ CodeableConcept }], // Supplemental instruction or warnings to the patient - e.g. "with meals", "may cause drowsiness"
  "patientInstruction" : "<string>", // Patient or consumer oriented instructions
  "timing" : { Timing }, // When medication should be administered
  "asNeeded" : <boolean>, // I Take "as needed"
  "asNeededFor" : [{ CodeableConcept }], // I Take "as needed" (for x)
  "site" : { CodeableConcept }, // Body site to administer to
  "route" : { CodeableConcept }, // How drug should enter body
  "method" : { CodeableConcept }, // Technique for administering medication
  "doseAndRate" : [{ // Amount of medication administered, to be administered or typical amount to be administered
    "type" : { CodeableConcept }, // The kind of dose or rate specified 
    // dose[x]: Amount of medication per dose. One of these 2:
    "doseRange" : { Range },
    "doseQuantity" : { Quantity(SimpleQuantity) },
    // rate[x]: Amount of medication per unit of time. One of these 3:
    "rateRatio" : { Ratio },
    "rateRange" : { Range },
    "rateQuantity" : { Quantity(SimpleQuantity) }
  }],
  "maxDosePerPeriod" : [{ Ratio }], // Upper limit on medication per unit of time
  "maxDosePerAdministration" : { Quantity(SimpleQuantity) }, // Upper limit on medication per administration
  "maxDosePerLifetime" : { Quantity(SimpleQuantity) } // Upper limit on medication per lifetime of the patient
}

Turtle Template

@prefix fhir: <http://hl7.org/fhir/> .

[
 # from Element: Element.extension
  fhir:sequence [ integer ] ; # 0..1 The order of the dosage instructions
  fhir:text [ string ] ; # 0..1 Free text dosage instructions e.g. SIG
  fhir:additionalInstruction  ( [ CodeableConcept ] ... ) ; # 0..* Supplemental instruction or warnings to the patient - e.g. "with meals", "may cause drowsiness"
  fhir:patientInstruction [ string ] ; # 0..1 Patient or consumer oriented instructions
  fhir:timing [ Timing ] ; # 0..1 When medication should be administered
  fhir:asNeeded [ boolean ] ; # 0..1 I Take "as needed"
  fhir:asNeededFor  ( [ CodeableConcept ] ... ) ; # 0..* I Take "as needed" (for x)
  fhir:site [ CodeableConcept ] ; # 0..1 Body site to administer to
  fhir:route [ CodeableConcept ] ; # 0..1 How drug should enter body
  fhir:method [ CodeableConcept ] ; # 0..1 Technique for administering medication
  fhir:doseAndRate ( [ # 0..* Amount of medication administered, to be administered or typical amount to be administered
    fhir:type [ CodeableConcept ] ; # 0..1 The kind of dose or rate specified
    # dose[x] : 0..1 Amount of medication per dose. One of these 2
      fhir:dose [  a fhir:Range ; Range ]
      fhir:dose [  a fhir:SimpleQuantity ; Quantity(SimpleQuantity) ]
    # rate[x] : 0..1 Amount of medication per unit of time. One of these 3
      fhir:rate [  a fhir:Ratio ; Ratio ]
      fhir:rate [  a fhir:Range ; Range ]
      fhir:rate [  a fhir:SimpleQuantity ; Quantity(SimpleQuantity) ]
  ] ... ) ;
  fhir:maxDosePerPeriod  ( [ Ratio ] ... ) ; # 0..* Upper limit on medication per unit of time
  fhir:maxDosePerAdministration [ Quantity(SimpleQuantity) ] ; # 0..1 Upper limit on medication per administration
  fhir:maxDosePerLifetime [ Quantity(SimpleQuantity) ] ; # 0..1 Upper limit on medication per lifetime of the patient
]