# Presentation: 531056

## RxNorm and DailyMed

- Stuart J. Nelson, MD, FACP, FACMI

## What is RxNorm?

- Public Domain Vocabulary
- Standardized (NORMalized) names for Clinical Drugs
- Supports Interoperability
- Part of UMLS

## The Clinical Drug Problem (1)

- Missed Synonymy in UMLS
- HL7 Discussions
- Clinical Drug Defined
- Ingredient plus Strength or Form or Both

## The Clinical Drug Problem (2)

- Ciprofloxacin 100mg/50mL IV Infusion
- Ciprofloxacin 400mg/200 ml IV Infusion
- Ciprofloxacin Lactate 0.2% in Saline (Base Equiv)
- Ciprofloxacin IV Soln 2 MG/ML
- The Same, or Different?

## Why Clinical Drugs?

- NDC Codes
- Too Granular
- Incomplete Records
- Meaningful Identifiers
- Without Hyphens - Not Unique
- No Source Complete and Accurate

## Propranolol

- NDC: 00555046506
- NDC: 00555046505
- NDC: 00555046502
- NDC: 00054475833
- NDC: 00054475831
- NDC: 00054475825
- NDC: 54441019750
- NDC: 54441019725
- NDC: 54441019715
- NDC: 54441019711
- NDC: 54441019710
- NDC: 00182175810
- NDC: 00182175801
- NDC: 00228232796
- NDC: 00228232710
- NDC: 00046042199
- NDC: 00046042198
- NDC: 00046042195
- NDC: 00603548921
- NDC: 53258015313
- NDC: 54269010901
- NDC: 51813007299
- NDC: 51813007290
- NDC: 51813007260
- NDC: 53492301303
- NDC: 53492301302
- NDC: 53492301301
- NDC: 00591555404
- NDC: 00591555401
- NDC: 52493063960
- NDC: 00839711420

- NDC: 00615256113
- NDC: 40039006001
- NDC: 00025090152
- NDC: 00025090131
- NDC: 47202255103
- NDC: 47202255101
- NDC: 12027008902
- NDC: 12027008901
- NDC: 53487014510
- NDC: 00781134413
- NDC: 00781134410
- NDC: 00781134401
- NDC: 53978003410
- NDC: 00117134405
- NDC: 00117134401
- NDC: 51316009004
- NDC: 11146094210
- NDC: 52544030551
- NDC: 52544030510
- NDC: 00839711416
- NDC: 00536430910
- NDC: 00536430905
- NDC: 00536430901
- NDC: 35470050801
- NDC: 00143150225
- NDC: 51608042104
- NDC: 51608042102
- NDC: 10465042109
- NDC: 00721002301
- NDC: 54421011001
- NDC: 19458042007
- NDC: 19458042001

- NDC: 50053310901
- NDC: 47679070204
- NDC: 47679070201
- NDC: 46703009410
- NDC: 46703009401
- NDC: 52584018410
- NDC: 00363690810
- NDC: 53489045101
- NDC: 00157052610
- NDC: 00157052601
- NDC: 00054875825
- NDC: 00005310931
- NDC: 00005310923
- NDC: 00071007024
- NDC: 00046042191
- NDC: 00046042181
- NDC: 00046042180
- NDC: 00046042162
- NDC: 00046042161
- NDC: 00046042160
- NDC: 00814644630
- NDC: 54697006305
- NDC: 54697006304
- NDC: 54697006303
- NDC: 54697006302
- NDC: 49884010601
- NDC: 00686018201
- NDC: 51079027760
- NDC: 00349845190
- NDC: 00349845110
- NDC: 00349845101
- NDC: 50053310902

- NDC: 51285032190
- NDC: 51285032160
- NDC: 52985003606
- NDC: 52985003601
- NDC: 51285032112
- NDC: 51285032109
- NDC: 51285032105
- NDC: 51285032102
- NDC: 00555036505
- NDC: 00555036502
- NDC: 00308627099
- NDC: 00308627060
- NDC: 00308627030
- NDC: 54697006301
- NDC: 00302573210
- NDC: 11146091299
- NDC: 00719179413
- NDC: 00719179410
- NDC: 00904041180
- NDC: 00904041160
- NDC: 00894633104
- NDC: 00894633103
- NDC: 00894633102
- NDC: 00894633101
- NDC: 10647042101
- NDC: 50111046707
- NDC: 50111046703
- NDC: 50111046701
- NDC: 52555001010
- NDC: 52555001001
- NDC: 00093060010
- NDC: 00093060001

- 10 Mg Oral
- Tablet

- NDC: 00686027720
- NDC: 48695117305
- NDC: 00047007032
- NDC: 0007007024
- NDC: 00223255002
- NDC: 00223255001
- NDC: 00364075690
- NDC: 00364075602
- NDC: 00364075601
- NDC: 52953000304
- NDC: 00378018210
- NDC: 00378018201
- NDC: 51432097106
- NDC: 00677104110
- NDC: 00677104105
- NDC: 00677104101
- NDC: 54569055650
- NDC: 00102333502
- NDC: 46193073810
- NDC: 46193073805
- NDC: 52544030505
- NDC: 52544030501
- NDC: 53633032116
- NDC: 53633032110
- NDC: 12071044010
- NDC: 54441004350
- NDC: 54441004325
- NDC: 54441004310
- NDC: 54441004305
- NDC: 54441004301
- NDC: 49884010610
- NDC: 49884010605

## The RxNorm Model

## Sources of Clinical Drug Vocabularies

- First Databank
- Multum
- Micromedex
- MediSpan
- Gold Standard
- SNOMED-CT
- VA NDF
- FDA  - NDC Registry, DailyMed

## Present Status

- Coverage
- Prescription Drugs (US)
- 99% Complete
- Browser (RxNav)
- _[www.nlm.nih.gov/research/umls/rxnorm](http://www.nlm.nih.gov/research/umls/rxnorm)_

## Differences From UMLS 

- Normalized Names Establish Synonymy
- Frequent Releases
- Limited Scope

## DailyMed Basis

- Structured Product Labels
- FDA Approved Information

## What is a Product Label?                               

- Content Approved by FDA
- Information for Prescribers/ Dispensers
- Rarely Information for Patients

## Product Label Distribution        Old Method

- Printed on Odd Shaped Paper
- Tiny Print
- Folded to Postage Stamp Size
- Stuck Inside Box
- Some Printed in PDR
- Updates Erratic

## Product Label Distribution      New Method

- Submitted and Processed Electronically
- Sent to NLM
- Available Online (Section 508 Compliant)
- Downloadable for Reuse
- First Label November 1, 2005
- Easily Updated

## Other Features of DailyMed

- Links
- PubMed
- MEDLINEplus
- ClinicalTrials
- Presence in Breast Milk
- Reporting Adverse Events
- RxNorm Names and Codes

## DailyMed Functions

- Download Product Labels
- Print Product Labels
- Forward Label
- Search Archive for Old Labels
- Notify of Changes (RSS)

- _[DailyMed](http://dailymed.nlm.nih.gov/dailymed)_