1. RxNorm Overview
John Kilbourne MD National Library of Medicine

2. Topics Where does RxNorm data come from? Organizing the data
A current issue we are addressing

3. Where does RxNorm data come from?

4. ‘Source’ names: same or different?

5. Source names vs. normalized name
“Ranitidine Hydrochloride 15 MG ORAL SYRUP”
“Ranitidine Hydrochloride 16.8 MG ORAL SYRUP”
“Ranitidine Hydrochloride 75 MG ORAL SOLUTION”
Ranitidine 15 MG/ML Oral Solution (normalized name)
SY: ranitidine 15 MG (ranitidine hydrochloride 16.8 MG) per ML Oral Solution
SY: ranitidine 75 MG per 5 ML Syrup

6. RxNorm and its sources
Free dataset published monthly (with weekly FDA adds) by NLM
Also a browser and API access to the data
Data sources aggregated and organized
FDA: Structured Product Label – SPL (DailyMed)
First Databank
Multum
MicroMedex
Gold Standard
Medi-Span
VA: NDF-RT and VANDF
SNOMED CT

7. Path of data for RxNorm

8. NLM-authored data RxNorm content determined by the source data
Devices, drug classes, radiopharmaceuticals out of scope
Standalone non-commercial names and codes for e-prescribing and other uses

9. Endorsement and use of RxNorm
Center for Medicare and Medicaid Services (CMS)
Formulary Reference File
Clinical Quality Measures (CQMs), Meaningful Use Value Sets
Office of the National Coordinator (ONC)
Standard for medications and medication allergies
Required for Electronic Health Record (EHR) certification
National Council for Prescription Drug Programs (NCPDP)
SCRIPT e-prescribing standard
Formulary and Benefit standard
Veterans Affairs – Department of Defense (VA-DoD)

10. Organizing the data

11. RxNorm building blocks: term types (TTYs)
SCD: Center of the universe for RxNorm
Ingredient + strength + dose form
Azithromycin 250 MG Oral Tablet
SBD: SCD + Brand name (BN)
Azithromycin 250 MG Oral Tablet [Zithromax]

12. Packs GPCK: Collection of SCDs BPCK: GPCK with a suffix
{6 (Azithromycin 250 MG Oral Tablet) } Pack
{30 (Aspirin 325 MG Oral Tablet) / 30 (Pravastatin Sodium 20 MG Oral Tablet [Pravachol]) } Pack
BPCK: GPCK with a suffix
{6 (Azithromycin 250 MG Oral Tablet [Zithromax]) } Pack [Z-PAKS]
{30 (Aspirin 325 MG Oral Tablet) / 30 (Pravastatin Sodium 20 MG Oral Tablet [Pravachol]) } Pack [Pravigard 325/20]

13. Multiple levels of description
SCD Diazepam 5 MG Oral Tablet SCDC Diazepam 5 MG SCDF Diazepam Oral Tablet SCDG Diazepam Pills SBD Diazepam 5 MG Oral Tablet [Valium] SBDC Diazepam 5 MG [Valium] SBDF Diazepam Oral Tablet [Valium] SBDG Valium Pills BN Valium IN Diazepam

14. Counts of TTYs
SCD 20,094 SBD 11,068 GPCK 413 BPCK 337 IN 9237 MIN 3848 PIN 2184

15. “One-to-many” issues
Adenosine 3 MG/ML Injectable Solution Adenosine 3 MG/ML Prefilled Syringe 1 ML Adenosine 3 MG/ML Prefilled Syringe 2 ML Adenosine 3 MG/ML Prefilled Syringe 4 ML Adenosine 3 MG/ML Prefilled Syringe

16. Wrap-up RxNorm is derived from other drug data
Drug classes, devices, radiopharmaceuticals out of scope
Endorsed and used by CMS, ONC, NCPDP, VA, DoD
RxNorm organized by ‘TTY’; SCD is the center of the universe; SCD, SBD, GPCK, BPCK can be administered

17. John Kilbourne MD kilbourj@mail.nlm.nih.gov
Thank you
John Kilbourne MD