Attached below are two valid research use cases from Katy Trinkley Pharm D to justify the inclusion of Precise Ingredients RxNorm codes as allowed standard concepts. What is the official process for moving the request forward?
Subject: Clinically meaningful salt forms - RxNorm precise ingredients
Here is some verbiage describing drugs with clinically distinguishable salt forms -
Metoprolol succinate versus metoprolol tartrate are clinically distinct medications. Both can be used to treat a variety of conditions, but only succinate is recommended to prevent complications associated with heart failure and reduced ejection fraction (e.g., prevent hospitalization, prolong survival, improve symptoms). This is explicitly stated in the guidelines.
Isosorbide mononitrate versus isosorbide dinitrate is another example, but potentially less clear. Dinitrate is rarely used in clinical practice because it has poor/inconsistent bioavailability. Dinitrate’s bioavailability is 10-90%, averaging 25% versus nearly 100% with mononitrate.