Unified Medical Language System | |
RxNorm Release Documentation File for 12/03/2007 Full Release |
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INTRODUCTION RxNorm, a standardized nomenclature for clinical drugs, is produced by the National Library of Medicine. In this context, a clinical drug is a pharmaceutical product given to (or taken by) a patient with a therapeutic or diagnostic intent. In RxNorm, the name of a clinical drug combines its ingredients, strengths, and form. In RxNorm, the form is the physical form in which the drug is administered or is specified to be administered in a prescription or order. The RxNorm clinical drug name does not refer to the size of the package, the form in which the product was manufactured, or its form when it arrived at the dispensary. RxNorm's standard names for clinical drugs are connected to the varying names of drugs present in many different controlled vocabularies within the Unified Medical Language System (UMLS) Metathesaurus, including those in commercially available drug information sources. These connections are intended to facilitate interoperability among the computerized systems that record or process data dealing with clinical drugs. Like other vocabularies in the Metathesaurus, RxNorm is organized by concept or meaning. All concepts in RxNorm are assigned at least one semantic type from the Semantic Network (Section 3.0 of the UMLS documentation). This provides consistent categorization of all concepts in RxNorm at the relatively general level represented in the Semantic Network. Scope of RxNorm RxNorm is both a source and a subset of the Metathesaurus. The scope of RxNorm is determined by the combined scope of its source vocabularies. Many relationships (primarily synonymous), concept attributes, and some concept names are added by the NLM during the creation of RxNorm forms, but essentially all the concepts themselves come from one or more of the source vocabularies. Preservation of Content and Meaning from Source Vocabularies RxNorm reflects and preserves the meanings, concept names, and relationships from its source vocabularies in the same way that the Metathesaurus preserves content and meaning. Please refer to the UMLS Metathesaurus documentation for further information on this topic. RxNorm contains source vocabularies produced by different copyright holders. The majority of the content of RxNorm is available for use under the basic and open terms described in sections 1-11 and 13-16 of the Metathesaurus license. Please refer to the UMLS Metathesaurus documentation for further information on this topic. NDC codes and RxNorm RxNorm currently distributes NDC data from four different sources. Each of these sources provides NDC codes in a different format. Examples of these include a 14 digit "6-4-2" format, 10 digit "5-3-2", "4-4-2" or "5-4-1" formats, 12 digits with no dashes format, and the 11 digit, no dashes HIPAA format. The NDCs asserted for the atoms of each of these sources are found in RXNSAT.RRF as values of the attribute ATN='NDC'. Since these NDCs are in separate formats, it is difficult to determine when the NDC assignments are inconsistent across sources. A single RxNorm clinical drug concept may properly have several NDCs (each corresponding to a different package size), but a single NDC would be expected to be assigned to only one RxNorm clinical drug concept (RXCUI). Beginning with the June 2007 release, the NLM is associating normalized NDC codes to RxNorm clinical drugs of the term types 'SCD' and 'SBD' (SAB=RXNORM atoms). The normalized NDCs will follow the 11 digit, no dashes HIPAA format. These normalized NDCs will be associated with an RXCUI where the NLM can determine the "correct" NDCs for that RXCUI. In general, "correctness" of an NDC assignment means there is consistency among the various sources in the association of an RXCUI with a particular NDC. These normalized NLM-asserted NDC associations will be found in RXNSAT.RRF, in additon to all the source-asserted NDC associations that already appear there. The normalized NLM-asserted NDC associations are assigned SAB='RXNORM'. Examples of NDC code normalizations
Examples of RXNSAT.RRF entries for an RXCUI (ATN="NDC") 213684|||2368285|AUI|759|||NDC|MMSL|61646050116|N||213684|||2481750|AUI|100385|||NDC|MTHFDA|061646-*501-16|N|| 213684|||2481751|AUI|108916|||NDC|MTHFDA|058716-*327-16|N|| 213684|||1171481|AUI|213684|||NDC|RXNORM|61646050116|N|| *New data beginning June 2007 213684|||1171481|AUI|213684|||NDC|RXNORM|58716032716|N|| *New data beginning June 2007 Duplicating Source Asserted Atoms Atoms coming from our sources can contain multiple NDC codes for the same atom. In many cases the NDC codes associated with the atoms are describing a similar product. However, there are cases where NDC codes received from sources for the same atom carry different meanings. For example, a source atom may contain "CAP/TAB" as the dose form portion of the atom and have the NDC codes for both the capsule form of the drug and the tablet form of the drug associated to this one atom. Beginning with the September 2007 release, RxNorm is creating duplicates of such source asserted atoms in order to properly associate NDC codes with RxNorm forms. When an atom is duplicated, the original source atom is considered to be a 'Base' atom and it is not assigned an RxNorm form. The duplicate atom's string is created by appending '_#N' to the Base atom string where 'N' is a number from 1 to N number of duplicates for this base atom. The duplicate atoms will carry the same source asserted relationships and attributes as the Base atom except for the NDC code attributes. The NDC code attributes of the base atom will be assigned to the duplicate atoms that represent the different meanings of the base atom. RxNorm forms will be created to reflect the true meaning of the NDC code(s) assigned to each duplicate. An NDC code from a base atom can only be assigned to one duplicate atom at a time, but a duplicate atom can carry more than one similar meaning NDC codes from the base atom. The duplicate atom's term type will be created by prepending 'MTH_RXN_' to the base atom's term type. A Base atom can be identified by the existence of an attribute in RXNSAT.RRF where the ATN='AMBIGUITY_FLAG' and the ATV='Base'. Similarly, the duplicate atoms are identified with ATN='AMBIGUITY_FLAG' and ATV='Duplicate'. This attribute will carry the SAB of the base atom. In addition, a relationship will exist between the base atom and it's duplicate atoms in RXNREL.RRF with "includes" and "included_in" relationship attributes (RELA). This relationship will carry the SAB of the base atom. Examples of RXNCONSO.RRF entries for a base atom and it's duplicates 727359|ENG|P||PF||N|2656259||||GS|BD|28336|Hyalgan 20mg/2ml Solution for Injection||N||727362|ENG|P||PF||N|2719627||||GS|MTH_RXN_BD|28336|Hyalgan 20mg/2ml Solution for Injection_#2||N|| 727308|ENG|P||PF||N|2719626||||GS|MTH_RXN_BD|28336|Hyalgan 20mg/2ml Solution for Injection_#1||N|| Examples of RXNSAT.RRF entries for these atoms (ATN="AMBIGUITY_FLAG") 727362|||2719627|AUI|28336|||AMBIGUITY_FLAG|GS|Duplicate|N||727308|||2719626|AUI|28336|||AMBIGUITY_FLAG|GS|Duplicate|N|| 727359|||2656259|AUI|28336|||AMBIGUITY_FLAG|GS|Base|N|| Examples of RXNREL.RRF entries for these atoms |2656259|AUI|RO||2719626|AUI|included_in|||GS||||N|||2719626|AUI|RO||2656259|AUI|includes|||GS||||N|| |2656259|AUI|RO||2719627|AUI|included_in|||GS||||N|| |2719627|AUI|RO||2656259|AUI|includes|||GS||||N|| Drug Dose Forms and the Modified Format for SCD and SBD Normal Forms To accurately represent factors of time, measures or strength for certain dose forms within RxNorm, an additional format for SCD and SBD forms has been utilized along with a more succinct set of dose forms for certain categories of forms. The factor of time, measure or strength can now be represented by a Quantity Factor appended to the beginning of the SCD or SBD name. This quantity factor consists of a number followed by a unit measure. The number might represent a strength, a unit of time, or a quantity of dosages depending upon the dosage form in use at the time. This quantity factor is stored as an attribute to the RxNorm SAB atom as the value of the ATN='RXN_QUANTITY' in RXNSAT.RRF. Some dose forms have been retired and replaced by more generic dose form names, allowing for greater flexibility in representing drug names. Other dose forms have been added. The following dose forms have been replaced by the more generic dose form shown to the right of the name. The Quantity number is variable according to the clinical drug being represented. For these dose forms, the quantity factor is optional.
Example RxNorm forms before the data transformation: Other dose forms that may contain an optional quantity factor include:
The following dose forms have been added to the RxNorm vocabulary. For these dose forms, a quantity factor is required.
Example forms are shown below: Examples of RXNSAT.RRF entries for an RXCUI (ATN="RXN_QUANTITY") 104420|||2701594|AUI|104420|||RXN_QUANTITY|RXNORM|24 HR|N||104873|||2701596|AUI|104873|||RXN_QUANTITY|RXNORM|72 HR|N|| Release Types and Explanation This Full release of RxNorm is consistent with the 2007AC UMLS Metathesaurus release.
The following counts apply for this release of RxNorm:
Beginning with the August 2007 release, the content of the RXNSAB.RRF file has been modified to reflect changes required by the UMLS. The number of fields in RXNSAB has not changed, but the format of the following fields have been expanded and include semi-colon separated information. The fields affected are: Source License Contact (SLC), Source Content Contact (SCC), and the Source Citation (SCIT). Please refer to the RXNSAB.RRF detailed documentation within this document for more information. New since the July 2007 release is the RXNCUICHANGES.RRF file. This file contains information about changes to the RxNorm Concept_id (RXCUI) for source asserted atoms and for the RxNorm forms (SAB=RXNORM atoms) that have been archived. More information may be found about this file beginning at this portion of this document. In addition, this release contains database control files and SQL commands for use in the automation of the loading process of these files into a RDBMS (Oracle in this case). This release contains complete sets of data and the RxNorm forms (RXNORM source) for the following RxNorm drug data source providers:
The most complete, accurate and up-to-date drug information can be obtained from the use of these RxNorm Release files. RxNorm will also provide Cumulative and Interval Release File updates. Cumulative updates will contain all data from the RxNorm source providers which has changed since the last Full update release. Interval updates will consist of all changes made to RxNorm data since the last Full, Cumulative or Interval update. Each update will be marked and dated in the RXNSAB file to indicate the type of update - Full (FUL or F), Cumulative (CUM or C) or Interval (INT or I). Character Encoding The character set of RxNorm Release Files is Unicode UTF-8 RxNorm Release File Format RxNorm uses the Rich Release Format (RRF), introduced in 2004. All Rich Release Format file names have an extension (.RRF). The RxNorm Rich Release Format is described in this documentation (usually abbreviated as RXNRRF). Refer to the UMLS Metathesaurus documentation for a complete description of the RRF. RxNorm Conventions RxNorm follows all previously established standards and practices of the latest version of the UMLS Metathesaurus. Where RxNorm may differ slightly from these practices is documented here. Uses of Concept and Atom Identifiers In RxNorm, every RXCUI (concept) is linked to at least one RXAUI (atom), but can be linked to many of these. Every RXAUI (atom) is linked to a single RXCUI (concept). Data Files RxNorm Rich Release Format (RXNRRF) All file names begin with the letters RXN (RxNorm) and are followed by letters that denote the file contents (e.g., RXNREL=relationships, RXNSAB=source abbreviations), and then a file extension .RRF. The data in each RxNorm entry may be represented in different "relations" or files. These files correspond to the four logical groups of data elements described in Sections 2.2 - 2.5 of the Metathesaurus documentation. The exceptions to this rule are the RXNATOMARCHIVE.RRF and the RXNCUICHANGES.RRF files. The RXNATOMARCHIVE.RRF file is a file created by RxNorm for use in tracking the archival of names (atoms) no longer provided by RxNorm drug source providers, or atoms no longer used by the RxNorm system. Only atoms from the source RxNorm (SAB=RXNORM) will be in the archive. The RXNCUICHANGES.RRF file is a new file provided by RxNorm for use in tracking the changes to the RxNorm Concept_id (RXCUI) for source asserted atoms, RxNorm OCD atoms, and for RXCUI changes to RxNorm forms (SAB=RXNORM atoms) that have been archived in the RXNATOMARCHIVE.RRF file. For each release, this tracking is provided for data changed since the last release of RxNorm. The data file is not cumulative. RxNorm provides data in the following types of files: Concepts, Concept Names, and their sources (2.2) = RXNCONSO.RRF Attributes (2.3) = RXNSAT.RRF, RXNSTY.RRF Relationships (2.4) = RXNREL.RRF Data about RxNorm (2.5) = RXNDOC.RRF, RXNSAB.RRF Archive Data = RXNATOMARCHIVE.RRF Concept Changes Tracking Data = RXNCUICHANGES.RRF Columns and Rows Each file or named table of data values has by definition a fixed number of columns; the number of rows depends on the content of a particular version of the RxNorm. The RxNorm release files follow the format of the Metathesaurus releases files with a few exceptions which are noted below. Descriptions of Each File The descriptions of the files appear in the following order: Each file description lists the columns or data elements that appear in the file and includes sample rows from the file. Documentation for Abbreviated Values (File = RXNDOC.RRF) This file follows the format of the Metathesaurus MRDOC.RRF file. At this time, this file contains all of the data contained in the UMLS MRDOC.RRF file. In the furture, the contents of this file may be tailored to the RxNorm subset of data only. There is exactly one row in this table for each allowed value of selected data elements or attributes that have a finite number of abbreviations as allowed values. Examples of such data elements include TTY, ATN, TS, STT, REL, RELA.
Sample Records ATN|DDF|expanded_form|Drug Doseform|
This file follows the general format of the MRCONSO.RRF file of the Metathesaurus. Some of the Metathesaurus fields are not provided by RxNorm and are marked as "(no value provided)". There is exactly one row in this file for each atom (each occurrence of each unique string or concept name within each source vocabulary) in RxNorm, i.e., there is exactly one row for each unique RXAUI in RxNorm. Every string or concept name in RxNorm appears in this file, connected to its language, source vocabularies, and its concept identifier (RXCUI).
Sample Records 91348|ENG|P||PF||Y|707001|707001|91348||RXNORM|SCD|RX10091348|Hydrogen Peroxide 300 MG/ML Topical Solution|||| Simple Concept and Atom Attributes (File = RXNSAT.RRF) This file follows the general format of the MRSAT.RRF file of the
Sample Records 178|||4996|AUI|MTHU000146|AT32525185||TYPE|MMSL|bulk compounding chemicals|N|| Semantic Types (File = RXNSTY.RRF) This file follows the general format of the MRSAT.RRF file of the
Sample Records 44|T109|A1.4.1.2.1|Organic Chemical||| Related Concepts (File = RXNREL.RRF) This file follows the general format of the MRREL.RRF file of the Note that for asymmetrical relationships there is one row for each direction of the relationship. Note also the direction of REL - the relationship which the SECOND concept or atom (with Concept Unique Identifier RXCUI2 and Atom Unique Identifier RXAUI2) HAS TO the FIRST concept or atom (with Concept Unique Identifier RXCUI1 and Atom Unique Identifier RXAUI1).
Sample Records 353653|1553161|AUI|RO|102931|779853|AUI|consists_of|||RXNORM|||||| Source Information (File=RXNSAB.RRF) This file follows the general format of the MRSAB.RRF file of the There is one row in this file for every source in RxNorm that is represented in this RxNorm release. The structure of RXNSAB.RRF is as follows:
Sample Record: Archive Data (File = RXNATOMARCHIVE.RRF) This file contains data about RxNorm SAB names (atoms) that are no longer a part of the RxNorm database because the drug data source provider is no longer providing this name to RxNorm. This file is not similar to any Metathesaurus RRF files. It is newly created by RxNorm. The structure of RXNATOMARCHIVE.RRF is as follows:
Sample Records: Concept Changes (File = RXNCUICHANGES.RRF) This file provides information about changes to the concept_id (RXCUI) for atoms in RxNorm from release to release.
For source asserted atoms and SAB=RxNorm OCD term type atoms, all data fields will be populated. For RXCUI changes to
RxNorm forms that have been archived, only the SAB, OLD_RXCUI, and NEW_RXCUI will be provided. Full information about
RxNorm forms that have been archived can be found in the RXNATOMARCHIVE.RRF file. Information is provided here as a
convenience. The file provides data about changes since the last release of RxNorm, it is not cumulative.
Sample Records: 1253224|688059|RXNORM|OCD|CEPHAPIRIN NA 20GM/VIL INJ|688055|688059|426260|117164003|SNOMEDCT|PT|HLA-DQ2 antigen|27034|461862| ||RXNORM|||670619|702633| Database Creation Automation We are providing scripts and control files to help in
the creation and automation of your database loading with the RxNorm Release Files.
The populate_oracle_rxn_db.bat file contains 4 parameters, which should be customized for your particular environment. They are as follows:
Once these parameters are populated, you should remove the '::' (double colon)
characters from the front of each line - this will make the commands active. |
Last reviewed: 28 March 2008
Last updated: 30 November 2007
First published: 03 December 2007
Metadata| Permanence level: Permanent: Dynamic Content