![]() ![]() "Titrate up to a high dose if it is tolerated”: the high dose would normally be chosen as the DDD.Examples of interpretation of approved dose titration recommendations: ![]() If the approved dose recommendation provides limited information about maintenance dose, the DDD will usually be the average of the maintenance dose range. The initial dose may differ from the maintenance dose but this is not reflected in the DDD. The recommended maintenance dose (long term therapeutic dose) is usually preferred when establishing the DDD.Exceptions are made for some products only used by children, e.g. mixtures, suppositories) are assigned the DDD used for adults. It should be emphasised that even special pharmaceutical forms mainly intended for children (e.g. When the recommended dose refers to body weight, an adult is considered to be a person of 70 kg. The average adult dose recommended for the main indication as reflected by the ATC code.The assigned DDD is based on the following principles: When a new DDD is assigned, various sources are used to get the best overview of the actual or expected use of a substance. Exceptions to this rule are given in the guidelines of the relevant ATC groups.įor substances indicated for rare disorders with highly individual dosing schedules, the Working Group could decide not to assign a DDD.ĭDDs are not established for topical products, sera, vaccines, antineoplastic agents, allergen extracts, general and local anesthetics and contrast media. The basic principle is to assign only one DDD per route of administration within an ATC code.ĭDDs for single substances are normally based on monotherapy. General principles for DDD assignment (to the top)ĭDDs are only assigned to drugs with an ATC code and a DDD will normally not be assigned for a substance before a product is approved and marketed in at least one country. DDDs provide a fixed unit of measurement independent of price, currencies, package size and strength enabling the researcher to assess trends in drug consumption and to perform comparisons between population groups. The DDD is sometimes a “dose” that is rarely if ever prescribed, because it might be an average of two or more commonly used doses.ĭrug utilization data presented in DDDs only give a rough estimate of consumption and not an exact picture of actual use. ![]() The DDD is nearly always a compromise based on a review of available information including doses used in various countries when this information is available. O nly one DDD is assigned per ATC code and route of administration (e.g. Therapeutic doses for individual patients and patient groups will often differ from the DDD as they will be based on individual characteristics (such as age, weight, ethnic differences, type and severity of disease) and pharmacokinetic considerations. The DDD is a unit of measurement and does not necessarily reflect the recommended or Prescribed Daily Dose. The DDD is the assumed average maintenance dose per day for a drug used for its main indication in adults. National issues of the ATC classification may include additional codes not present in this list, which follows the WHO version.The basic definition of the defined daily dose (DDD) is: Ĭodes for veterinary use ( ATCvet codes) can be created by placing the letter Q in front of the human ATC code: for example, QC09. Subgroup C09 is part of the anatomical group C Cardiovascular system. ATC code C09 Agents acting on the renin–angiotensin system is a therapeutic subgroup of the Anatomical Therapeutic Chemical Classification System, a system of alphanumeric codes developed by the World Health Organization (WHO) for the classification of drugs and other medical products. ![]()
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