# Medicinal Product and Medicinal Product Forms When a clinical drug is created, the following supertypes must either already exist or must be created: {% content-ref url="index-1/medicinal-product-containing-only" %} [medicinal-product-containing-only](https://docs.snomed.org/snomed-ct-specifications/snomed-ct-editorial-guide/readme/authoring/domain-specific-modeling/pharmaceutical-and-biologic-product/medicinal-product/index-1/medicinal-product-containing-only) {% endcontent-ref %} {% content-ref url="index-1/medicinal-product-containing" %} [medicinal-product-containing](https://docs.snomed.org/snomed-ct-specifications/snomed-ct-editorial-guide/readme/authoring/domain-specific-modeling/pharmaceutical-and-biologic-product/medicinal-product/index-1/medicinal-product-containing) {% endcontent-ref %} {% content-ref url="index-1/index" %} [index](https://docs.snomed.org/snomed-ct-specifications/snomed-ct-editorial-guide/readme/authoring/domain-specific-modeling/pharmaceutical-and-biologic-product/medicinal-product/index-1/index) {% endcontent-ref %} For example, 1172863005 Paracetamol 1 g oral tablet has the following supertypes:
These concepts in the International Release, their descriptions, and their `|Has active ingredient (attribute)|` value, represent the **base** ingredient, not a modification. For example, `1204319004 |Product containing precisely retinol (as retinol palmitate) 50000 unit/1 milliliter conventional release solution for injection (clinical drug)|` has medicinal product and medicinal product form supertypes with *retinol*, not *retinol palmitate*. Retinol palmitate is a modification of Retinol and thus should not be used in the creation of the medicinal product and medicinal product form supertypes.
Exceptions to use a modified substance are explicitly identified below:
ExceptionsElucidationExamples
BenzylpenicillinWhen the active ingredient has an Is modification of (attribute) value of 323389000 |Benzylpenicillin (substance)|.

1234765004 |Product containing only benzathine benzylpenicillin in parenteral dose form (medicinal product form)|


323404007 |Product containing benzathine benzylpenicillin (medicinal product)|


Benzylpenicillin is the base, but use the modified substance
in the FSN for the MP/MPF.

Chemical element compound with multiple modificationInstances where the chemical element compound has two or more Is Modification of (attribute)s

422232005 |Calcium lactate gluconate (substance)|

-Has |Is modification of (attribute)| = Calcium gluconate

-Has |Is modification of (attribute)| = Calcium lactate

1359973006 |Copper (64-Cu) labeled somatostatin analog (substance)|

-Has |Is modification of (attribute)| = Somatostatin analog

-Has |Is modification of (attribute)| = Copper-64

Chloral hydrate273948005 |Chloral hydrate (substance)| is a modification of Chloral. However, chloral is unstable on its own and always exists in the hydrated form.

778711000 |Product containing only chloral hydrate in oral dose form (medicinal product form)|


386735001 |Product containing chloral hydrate in oral dose form (medicinal product form)|


775158004 |Product containing only chloral hydrate (medicinal product)|

Liposome or lipid complex substances

< 414612001 |Liposomal
agent (substance)
These subtypes have some sort of modification, but they can be used to create:

  • Product containing only x (medicinal product)
  • Product containing only x in y dose form (medicinal product form)

Do not use to create:

  • Product containing x (medicinal product)
  • Product containing x in y dose form (medicinal product form)

426490000 |Vincristine liposome (substance)|


425953004 |Amphotericin B lipid complex (substance)|


768664009 |Amphotericin B phospholipid complex
(substance)|


427544000 |Amphotericin B cholesteryl sulfate complex
(substance)|

Pegylated substanceThere is no technical way to identify these concepts, though they will often begin with peg-.

385544005 |Pegfilgrastim (substance)|


770965008 |Pegvaliase (substance)|

Radiopharmaceutical< 89457008 Radioactive isotope (substance)|

783865003 |Product containing only cyanocobalamin (58-Co) (medicinal product)|


783867006 |Product containing only cyanocobalamin (58-Co) in oral dose form (medicinal product form)|


783856005 |Product containing sodium iodide (131-I) in parenteral dose form (medicinal product form)|


783854008 |Product containing sodium iodide (131-I) (medicinal product)|

Silver sulfadiazine387112002 |Silver sulfadiazine
(substance)| is a modification of 74523009 |Sulfadiazine (substance)|

864009007 |Product containing only silver sulfadiazine in cutaneous dose form (medicinal product form)|


771756000 |Product containing silver sulfadiazine in cutaneous dose form (medicinal product form)|

Sodium valproate387481005 |Sodium valproate (substance)| is a modification of 387080000 |Valproic acid (substance)|

766519009 |Product containing precisely sodium valproate 40 milligram/1 milliliter conventional release oral solution (clinical drug)|


1204386001 |Product containing precisely sodium valproate 133 milligram and valproic acid 58 milligram/1 each prolonged-release oral tablet (clinical drug)|

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