Dosage.maxDosePerPeriod
Used to define a maxiumum dose over a given time period.
An example would be a Sumatriptan 6mg injection which can be repeated after an hour but not again over a 24 hour period. The maxDosePerPeriod is defined as 12mg/24hours.
The maxDosePerPeriod is defined for each dosage instruction. For a multi-sequence instruction it would therefore be possible to define different maximum dosing periods within different sequences of the complete instruction. A real-world example of where this would be required has not yet been identified.
Dosage.maxDosePerAdministration
Used to define a maximum dose for a single administration.
An example would be Anagrelide for which a single dose should not exceed 2.5 mg. The maxDosePerAdministration is defined as 2.5mg.
In many scenarios it is expected that the dosage.doseRange would be used instead of maxDosePerAdministration.
The maxDosePerAdministration is defined for each dosage instruction. For a multi-sequence instruction it would therefore be possible to define different maximum dose administrations within different sequences of the complete instruction. A real-world example of where this would be required has not yet been identified.
Dosage.maxDosePerLifetime
Used to define the maximum cumulative dose over the lifetime of a patient.
An example would be Daunorubicin which may have a maximum cumulative dose of 600mg/m2 (based on the size of the patient). The maxDosePerAdministration is defined as 600 mg/m2.
The maxDosePerLifetime is defined for each dosage instruction which. For a multi-sequence instructions this is illogical as any maxDosePerLifetime need only be defined once as a single instruction can only relate to a single medication coded concept. If a maxDosePerLifetime statement is required within a multi-sequence instruction the recommendation is to define it within the last/final sequence. This would ensure the information is presented at the end of the complete instruction and not in the middle which could be overlooked.