This Editorial Guide is used for Education Purposes Only. It is used in the Authoring Courses and Certifications. It is based on the January 2026 Editorial Guide.

Describing Dose forms

A Clinical Drug concept has a pharmaceutical dose form, the physical manifestation of a medicinal product that contains the active ingredient substance(s) and inactive ingredient substances that are intended for administration for the patient. The Clinical Drug concept in the international release is defined by its manufactured dose form, the dose form as the item is presented by the manufacturer into the supply chain. This may be the same as the administrable dose form, which is the dose form that can be given to the patient after any necessary transformation (such as dissolution or dispersion) has taken place, or it may be different. Examples of the relationship between manufactured and administrable dose forms and transformation are given below. Note that both manufactured dose forms and administrable dose forms are types of pharmaceutical dose form.

The exception to the principle of using the manufactured dose form to describe Clinical Drugs in the international release is for oral antimicrobial liquid products (solutions, suspensions) that are supplied by the manufacturer as powders but undergo dissolution or dispersion prior to dispensing for administration. The exception is because of the need to describe these products using a clinically relevant strength reflecting the concentration of the administered liquid.

Concept model will include attributes necessary to define the concepts to ensure consistent and reproducible modeling of concepts, whose use is primarily to describe or group concepts in the hierarchy.

Any requirement to align to external standards or registries will be explicitly documented.

Concept model will be compatible with the following ISO (International Organization for Standardization) IDMP (Identification of Medicinal Products) standards where appropriate:

• ISO 11239 Health informatics, Data elements and structures for the unique identification and exchange of regulated information on pharmaceutical dose forms, units of presentation, routes of administration and packaging

• ISO/TS 20440 Health informatics, Implementation guide for ISO 11239 data elements and structures for the unique identification and exchange of regulated information on pharmaceutical dose forms, units of presentation, routes of administration and packaging

Concepts in the 736542009 |Pharmaceutical dose form (dose form)| hierarchy:

• shall be sufficiently defined using proximal primitive modeling methodology unless explicitly noted as an exception in the editorial guidelines,

• is not intended to eliminate the need for a national extension.

• Concepts representing combined pharmaceutical dose forms

  • single concepts describing the multiple dose forms found in kit products such as cream and pessary

  • two pharmaceutical dose forms are put together like powder and solvent for solution for injection

• Concepts in pattern "x for y for z" (e.g. Powder for concentrate for dispersion for infusion)

The 736542009 |Pharmaceutical dose form (dose form)| hierarchy is comprised of the types of concepts as shown in the table below. Detailed editorial guidelines for each distinct concept type, including required attributes and naming guidelines, are found in the sections that follow.

For the purposes of the following editorial guidelines, pharmaceutical dose form refers to the physical manifestation of a medicinal product that contains the active ingredient substance(s) and inactive ingredient substances that are intended for administration for the patient.

The following definitions explain the differences between dose form intended site and route of administration:

736474004 |Has dose form intended site (attribute)|

• Dose form intended site describes the general anatomic location that the dose form has been formulated for administration to or at. The intended site is not intended to describe a precise site or route of administration. For example, eye drops (prepared for ocular intended site) are subject to pharmacopoeial standards for pH and sterility.

410675002 |Route of administration (attribute)|

• The route of administration is the path by which the product is taken into, or makes contact with, the body and is a property of the administration action. The route of administration of a medication is determined by the prescriber in their prescription dosage instructions for a particular patient.

736479009 |Dose form intended site (intended site)|

• The set of values for dose form intended site that relate to characteristics associated with a pharmaceutical dose form and do not refer to a precise anatomic location.

284009009 |Route of administration value (qualifier value)|

• The set of values for route of administration. For medicinal products, these values are associated with the action of administration.

Pharmaceutical dose forms with two or more intended sites will use 'and' in their terming and include all intended sites in the model. Representing combinations of intended sites as a conjunction ('and' in the description) will facilitate searching by end users. The concepts are logically modeled as conjunction.

Pharmaceutical dose forms with two or more administration methods is a less common requirement, thus requests for this type of dose form are reviewed on a case by case basis.

This Editorial Guide is used for Education Purposes Only. It is used in the Authoring Courses and Certifications. It is based on the January 2026 Editorial Guide.

Descendants of 105904009 |Type of drug preparation (qualifier value)| do not meet the criteria to be considered Pharmaceutical dose forms. This subhierarchy will be retained as a primitive subhierarchy until such time that use cases and/or detailed requirements are known. Requests for addition of new concepts or modification of existing concepts will be evaluated on a case-by-case basis.

This Editorial Guide is used for Education Purposes Only. It is used in the Authoring Courses and Certifications. It is based on the January 2026 Editorial Guide.

Pharmaceutical dose form grouper concepts based on intended site of use for the dose form that are deemed to be clinically useful, or which provide a helpful organizing grouper, and that can be sufficiently defined, may be included in the 736542009 |Pharmaceutical dose form (dose form)| hierarchy.

These concepts are used in modeling (medicinal product form) concepts in the International Release; they are not allowed to model (clinical drug) concepts in the International Release.

Pharmaceutical dose form grouper concepts based on intended site shall be modeled using the proximal primitive modeling pattern.

This Editorial Guide is used for Education Purposes Only. It is used in the Authoring Courses and Certifications. It is based on the January 2026 Editorial Guide.

736479009 |Dose form intended site (intended site)| represents a general type of site of administration (e.g. cutaneous, nasal, oral, parenteral). This subhierarchy is a descendant of 362981000 |Qualifier value (qualifier value)| that supports fully defining the 736542009 |Pharmaceutical dose form (dose form)| hierarchy. |Dose form intended site (intended site)| is used to model concepts in the |Pharmaceutical dose form (dose form)| hierarchy; they are not used to model 763158003 |Medicinal product (product)|.

|Dose form intended site| should not be confused with route of administration , which is a concept used in dosage instructions for the administration of a particular medicinal product to a particular patient.

This Editorial Guide is used for Education Purposes Only. It is used in the Authoring Courses and Certifications. It is based on the January 2026 Editorial Guide.

736480007 |Dose form release characteristic (release characteristic)| represents a general type of pattern of release (e.g. conventional, modified, delayed, prolonged) of the active ingredient substance(s) from the dose form.

|Dose form release characteristic (release characteristic)| is a descendant of 362981000 |Qualifier value (qualifier value) that supports fully defining the 736542009 |Pharmaceutical dose form (dose form)| hierarchy.

|Dose form release characteristic (release characteristic)| is used to model the 736542009 |Pharmaceutical dose form (dose form)| hierarchy; it is not used to model 763158003 |Medicinal product (product)|.

This Editorial Guide is used for Education Purposes Only. It is used in the Authoring Courses and Certifications. It is based on the January 2026 Editorial Guide.

The 736542009 |Pharmaceutical dose form (dose form)| subhierarchy of 362981000 |Qualifier value (qualifier value)| contains concepts which support the Medicinal product model.

Editorial guidelines for the supporting hierarchies required to support creation of sufficiently defined pharmaceutical dose form concepts are documented in the following sections.

This Editorial Guide is used for Education Purposes Only. It is used in the Authoring Courses and Certifications. It is based on the January 2026 Editorial Guide.

Overview

The dose form administration method represents a general type of method of administration (e.g. apply, chew, spray, swallow) that a dose form is designed to be administered by (e.g. a chewable tablet is formulated to be administered by chewing). To support fully defining concepts in the 736542009 |Pharmaceutical dose form (dose form)| hierarchy, a hierarchy representing dose form administration method is required.

Concepts in the 736665006 |Dose form administration method (administration method)| hierarchy will be used to model concepts in the 736542009 |Pharmaceutical dose form (dose form)| hierarchy; they will not be used to model concepts in the 763158003 |Medicinal product (product)| hierarchy.

The 736665006 |Dose form administration method (administration method)| hierarchy is a descendant of 362981000 |Qualifier value (qualifier value)|.

Modeling

Use the following pattern for the FSN where X is the administration method and is in the form of an imperative:

X (administration method)

For example,

• Administer (administration method)

• Apply (administration method)

• Instill (administration method)

• Spray (administration method)

Use the following pattern for the PT where X is the administration method:

X

For example,

• Administer

• Apply

• Instill

• Spray

Synonyms are not allowed unless explicitly identified as an exception in the Editorial Guidelines.

Preferred; not required.

This Editorial Guide is used for Education Purposes Only. It is used in the Authoring Courses and Certifications. It is based on the January 2026 Editorial Guide.

Overview

736477006 |Dose form transformation (transformation)| represents a process where a dose form is transformed from that supplied by the manufacturer into a new dose form, usually to make it suitable for administration (e.g. dissolving a "powder for solution for injection" dose form into a "solution for injection" dose form). This may occur as part of the dispensing act or immediately before administration.

|Dose form transformation (transformation)| is a descendant of 362981000 |Qualifier value (qualifier value) that supports fully defining the 736542009 |Pharmaceutical dose form (dose form)| hierarchy. |Dose form transformation (transformation)| is used to model the |Pharmaceutical dose form (dose form)| hierarchy; they are not used to model the 763158003 |Medicinal product (product)| hierarchy.

Modeling

Use the following pattern for the FSN where X is the transformation:

• X (transformation)

For example,

• Dissolve (transformation)

• Disperse (transformation)

• No transformation (transformation)

• Disperse or dissolve (transformation)

Use the following pattern for the PT where X is the transformation:

• X

For example,

• Dissolve

• Disperse

• No transformation

• Disperse or dissolve

Synonyms are not allowed unless explicitly identified as an exception in the Editorial Guidelines.

Preferred; not required.

This Editorial Guide is used for Education Purposes Only. It is used in the Authoring Courses and Certifications. It is based on the January 2026 Editorial Guide.

Overview

736471007 |State of matter (state of matter)| represents a physical state of matter.

|State of matter (state of matter)| is a descendant of 362981000 |Qualifier value (qualifier value) that supports fully defining concepts in the 736542009 |Pharmaceutical dose form (dose form)| hierarchy. |State of matter (state of matter)| is used to model concepts in the 736478001 |Basic dose form (basic dose form)| hierarchy; they are not used to model the 736542009 |Pharmaceutical dose form (dose form)| or 763158003 |Medicinal product (product)| hierarchies.

Modeling

Use the following pattern for the FSN where X is the state of matter:

X (state of matter)

For example,

• Gas (state of matter)

• Liquid (state of matter)

• Semi-solid (state of matter)

• Solid (state of matter)

Use the following pattern for the PT where X is the state of matter:

X

For example,

• Gas

• Liquid

• Semi-solid

• Solid

Synonyms are not allowed unless explicitly identified as an exception in the Editorial Guidelines.

Preferred; not required.

This Editorial Guide is used for Education Purposes Only. It is used in the Authoring Courses and Certifications. It is based on the January 2026 Editorial Guide.

Overview

Pharmaceutical dose form concepts (e.g. conventional release oral tablet, prolonged-release oral capsule) that are deemed to be clinically useful and that can be sufficiently defined will be included in the 736542009 |Pharmaceutical dose form (dose form)| hierarchy. Primitive concepts may be included if documented as an exception.

Out of Scope

Lyophilized dose forms are out of scope for the international edition of SNOMED CT.

Modeling

Use the following pattern for the FSN; align naming and case sensitivity with the FSN for the concepts that are selected as the attribute values, excluding the semantic tag. For multiple intended sites, the sites must be in alphabetical order and separated by the word “and”.

<Dose form release characteristic FSN> <Dose form intended site FSN> <Basic dose form> (dose form)

For example,

• Conventional release oral capsule (dose form)

• Conventional release oral suspension (dose form)

• Prolonged-release oral capsule (dose form)

• Conventional release and prolonged-release oral tablet (dose form)

Use the following pattern for the PT; align naming and case sensitivity with the PT for the concepts that are selected as the attribute values, excluding the semantic tag. For multiple intended sites, the sites must be in alphabetical order and separated by the word “and”. Exclude <Dose form release characteristic> when = 736849007 |Conventional release (release characteristic)|.

<Dose form release characteristic FSN> <Dose form intended site FSN> <Basic dose form>

For example,

• Oral capsule

• Oral suspension

• Prolonged-release oral capsule

• Conventional release and prolonged-release oral tablet

A synonym matching the FSN is required; other synonyms are not allowed unless explicitly identified as an exception in the Editorial Guidelines.

Exceptions:

• Synonyms with eye instead of ocular, ear instead of otic, or nose instead of nasal may be created.

Optional

This Editorial Guide is used for Education Purposes Only. It is used in the Authoring Courses and Certifications. It is based on the January 2026 Editorial Guide.

Overview

Pharmaceutical dose form grouper concepts that do not include a basic dose form but are deemed to be clinically useful and that can be sufficiently defined will be included in the 736542009 |Pharmaceutical dose form (dose form)| hierarchy.

Modeling

Grouper concepts concepts that do not include a basic dose form shall be modeled using the proximal primitive modeling pattern.

For concepts with 736472000 |Has dose form administration method (attribute)| = 738996007 |Spray (administration method)|, use the following pattern for the FSN; align naming and case sensitivity with the FSN for the concept that is selected as the attribute value. For multiple intended sites, the intended sites must be in alphabetical order and separated by the word “and”.

• <Dose form release characteristic> <Dose form intended site FSN> <Dose form administration method> (dose form)

For example,

• Conventional release cutaneous spray (dose form)

• Conventional release nasal spray (dose form)

• Conventional release sublingual spray (dose form)

For concepts representing drops with 736472000 |Has dose form administration method (attribute)| = 738994005 |Instill (administration method)|, use the following pattern for the FSN; align naming and case sensitivity with the FSN for the concept that is selected as the attribute value. For multiple intended sites, the intended sites must be in alphabetical order and separated by the word “and”.

• <Dose form release characteristic> <Dose form intended site FSN> <Dose form administration method> (dose form)

For example,

• Conventional release nasal drops (dose form)

• Prolonged-release eye drops (dose form)

For concepts representing drug delivery systems, use the following pattern for the FSN; align naming and case sensitivity with the FSN for the concept that is selected as the attribute value. For multiple intended sites, the intended sites must be in alphabetical order and separated by the word “and”.

• <Dose form release characteristic> <Dose form intended site FSN> drug delivery system

For example,

• Prolonged-release intrauterine drug delivery system (dose form)

• Prolonged-release transdermal drug delivery system (dose form)

For concepts with 736472000 |Has dose form administration method (attribute)| = 738996007 |Spray (administration method)|, use the following pattern for the PT; align naming and case sensitivity with the PT for the concept that is selected as the attribute value. For multiple intended sites, the intended sites must be in alphabetical order and separated by the word “and”. Exclude <Dose form release characteristic> when = 736849007 |Conventional release (release characteristic)|.

• <Dose form release characteristic> <Dose form intended site FSN> <Dose form administration method>

For example,

• Cutaneous spray

• Nasal spray

• Sublingual spray

For concepts representing drops with 736472000 |Has dose form administration method (attribute)| = 738994005 |Instill (administration method)|, use the following pattern for the PT; align naming and case sensitivity with the PT for the concept that is selected as the attribute value. For multiple intended sites, the intended sites must be in alphabetical order and separated by the word “and”. Exclude <Dose form release characteristic> when = 736849007 |Conventional release (release characteristic)|.

• <Dose form release characteristic> <Dose form intended site FSN> <Dose form administration method>

For example,

• Nasal drops

• Prolonged-release eye drops

For concepts representing drug delivery systems, use the following pattern for the PT; align naming and case sensitivity with the PT for the concept that is selected as the attribute value. For multiple intended sites, the intended sites must be in alphabetical order and separated by the word “and”. Exclude <Dose form release characteristic> when = 736849007 |Conventional release (release characteristic)|.

• <Dose form release characteristic> <Dose form intended site FSN> drug delivery system

For example,

• Prolonged-release intrauterine drug delivery system (dose form)

• Prolonged-release transdermal drug delivery system (dose form)

A synonym matching the FSN is required; additional synonyms are not allowed unless explicitly identified as an exception in the Editorial Guidelines.

Exceptions:

• Synonyms with eye instead of ocular, ear instead of otic, or nose instead of nasal may be created.

Optional

This Editorial Guide is used for Education Purposes Only. It is used in the Authoring Courses and Certifications. It is based on the January 2026 Editorial Guide.

Overview

The basic dose form represents a general type of pharmaceutical formulation (e.g. tablet, capsule, cream, ointment, solution, emulsion) used for medicinal products. To support fully defining concepts in the 736542009 |Pharmaceutical dose form (dose form)| hierarchy, a hierarchy representing basic dose form is required.

Concepts in the 736478001 |Basic dose form (basic dose form)| hierarchy will be used to model concepts in the 736542009 |Pharmaceutical dose form (dose form)| hierarchy; they will not be used to model concepts in the 763158003 |Medicinal product (product)| hierarchy.

The 736478001 |Basic dose form (basic dose form)| hierarchy is a descendant of 362981000 |Qualifier value (qualifier value)|.

Descendants shall be modeled as follows.

Use the following pattern for the FSN; align naming and case sensitivity with the FSN for the concept that is selected as the attribute value, excluding the semantic tag.

• Basic dose form with <State of matter> state of matter (basic dose form)

For example,

• Basic dose form with liquid state of matter (basic dose form)

• Basic dose form with solid state of matter (basic dose form)

Use the following pattern for the PT; align naming and case sensitivity with the PT for the concept that is selected as the attribute value.

• <State of matter PT> state of matter

For example,

• Liquid dose form

• Solid dose form

A synonym to match the FSN is required.

Additional synonyms are not allowed unless explicitly identified as an exception in the Editorial Guidelines.

Preferred; not required.

Use the following pattern for the FSN where X is the basic dose form:

• X (basic dose form)

For example,

• Cream (basic dose form)

• Gel (basic dose form)

• Suppository (basic dose form)

• Tablet (basic dose form)

Exceptions:

• Plural form to be used for Granules (basic dose form)

Use the following pattern for the PT where X is the basic dose form:

• X

For example,

• Cream

• Gel

• Suppository

• Tablet

Exceptions:

• Plural form to be used for Granules

Synonyms are not allowed unless explicitly identified as an exception in the Editorial Guidelines.

Text definitions are not required but are encouraged.

This Editorial Guide is used for Education Purposes Only. It is used in the Authoring Courses and Certifications. It is based on the January 2026 Editorial Guide.

This section explains subtypes of 362981000 |Qualifier value (qualifier value)| that are pertinent to Pharmaceutical and Biological Product and the drug model.

This Editorial Guide is used for Education Purposes Only. It is used in the Authoring Courses and Certifications. It is based on the January 2026 Editorial Guide.

A unit of presentation represents a qualitative concept that describes a countable entity in which the clinical drug is presented (e.g. tablet, capsule) or in which it is bounded (vial, ampule). The 732935002 | Unit of presentation (unit of presentation)| is used to support expression of presentation strength, where it provides the denominator for the strength ratio, and to differentiate different clinical drug products when the "intimate container" (see below) is clinically important (e.g. differentiating pre-filled syringes from ampoules for a solution for injection product). As described in the Strength section above and detailed further in Appendix A, there are various patterns for describing how unit of presentation and expression of strength relate together, based on whether the unit of presentation relates to the basic dose form or the intimate container (which is therefore the countable unit) of the medicinal product. As the countable entity for a medicinal product, unit of presentation is also important in describing packages, which although out of scope of the international edition, may be of major importance for national extensions describing medicinal products.

There are three types of unit of presentation:

1. those that are basic solid dosage forms: e.g. tablets, capsules, suppositories, pessaries etc.

   1. in this type, the solid dosage form, because of its discrete nature, is the countable unit; it provides the physical boundary in which the active ingredient substance(s) of the medicinal product are presented

2. those that are created by metered dosing valves: e.g. the "actuation" of inhalers, sprays etc.

   1. in this type, the countable unit is the "actuation" provided by the metering valve; it is the valve that determines (bounds) the physical amount of the active ingredient substance(s) of the medicinal product are presented

3. those that are intimate containers: e.g. ampoules, vials, sachets, cartridges etc.

   1. The "intimate container" of a medicinal product is the receptacle or vessel used to contain (or bound) liquid and some solid or semi-solid medicinal products into countable entities. A medicinal product presented in an intimate container will almost always have at least one layer of additional packaging added to it in order to make it into a packaged medicinal product; this external packaging is not described in the international edition. For example: an ampoule is an intimate container to present a solution for injection dosage form; the ampoule will always be supplied in a box or a moulded carton, possibly additionally with a blister strip as intermediate packaging. Particularly for liquid parenteral products for nebuliser liquids, and for some semi-solid presentations, the intimate container/unit of presentation may have clinical significance: providing a patient heparin in a pre-filled syringe is different from supplying that same concentration of heparin in a (multi-dose) vial. Similarly, hormone replacement gels may be supplied in single dose sachets to provide the correct administration amount.

In IDMP, the "one countable instance of a whole of medicinal product" is managed through the information model: it is (generally) one instance of the Manufactured Item, with its manufactured dose form and unit of presentation or one instance of the Pharmaceutical Product (with its administrable dose form and unit of presentation). The Manufactured Item is therefore the concept/class that most closely resembles the SNOMED CT Clinical Drug, but both Manufactured Item and Pharmaceutical Product contain the key "unit of presentation" attribute. However, the Manufactured Item is a representation of something that is real, with (at least in theory) all its excipient substances described and therefore is not directly compatible to the Clinical Drug - indeed the Clinical Drug could be seen as a grouper concept for similar Manufactured Items, if excipient substances etc. and packaging are disregarded. The unit of presentation in IDMP is what specifies the "real world" units in which the quantity of the manufactured item is described. The unit of presentation can be specified in accordance with ISO 11239 and ISO/TS 20440 and its resulting terminology [implemented through EDQM]. IDMP goes on to state: "For items where their quantity is a measured quantity of weight or volume, the "unit of presentation" shall not be given since it is the same as the units of that quantity (that is ml, mg, or %). For solid dose forms and other items that are measured by counting integer quantities, the unit for quantity shall be "unit" and the "unit of presentation" shall be the item that is counted." In EDQM, unit of presentation is defined as the "Qualitative term describing the discrete countable entity in which a pharmaceutical product or manufactured item is presented, in cases where strength or quantity is expressed referring to one instance of this countable entity."

• EXAMPLE 1: To describe strength: "Contains 100 mg per tablet" ('tablet' is the unit of presentation)

• EXAMPLE 2: To describe quantity: "Contains 100 mL per bottle" ('bottle' is the unit of presentation)

Unit of Presentation is therefore sometimes known as "the countable unit".

• Concepts representing proprietary dose forms

• Concepts that contain modifiers, e.g., hard capsule, capsule for inhalation

X (unit of presentation)

For example,

• Actuation (unit of presentation)

• Capsule (unit of presentation)

• Suppository (unit of presentation)

• Tablet (unit of presentation)

X

For example,

• Actuation

• Capsule

• Suppository

• Tablet

Synonyms are not allowed