List of abbreviations used in medical prescriptions

This is a list of abbreviations used in medical prescriptions, including hospital orders (the patient-directed part of which is referred to as sig codes). This list does not include abbreviations for pharmaceuticals or drug name suffixes such as CD, CR, ER, XT (See Time release technology § List of abbreviations for those).

Capitalization and the use of periods are a matter of style. In the list, abbreviations in English are capitalized whereas those in Latin are not.

These abbreviations can be verified in reference works, both recent [1] and older.[2][3][4] Some of those works (such as Wyeth 1901[4]) are so comprehensive that their entire content cannot be reproduced here. This list includes all that are frequently encountered in today's health care in English-speaking regions.

Some of these are obsolete; others remain current.

Abbreviations which are deprecated by the Joint Commission are marked in red. Those abbreviations which are deprecated by other organizations, such as the Institute for Safe Medication Practices (ISMP) and the American Medical Association (AMA), are marked in orange.

The Joint Commission is an independent, non-profit, non-governmental organization which offers accreditation to hospitals and other health care organizations in the United States. While their recommendations are not binding on U.S. physicians, they are required of organizations who wish accreditation by the Joint Commission.

Table
Key
Not recommended for use in the United States by the Joint Commission[5]
Not recommended for use by other organizations, such as the ISMP (Institute for Safe Medication Practices)[6])
Abbreviation or symbol Latin, Greek, or New Latin English Possible confusion
aa, āā, ĀĀ ana of each  
AAA   apply to affected area abdominal aortic aneurysm
a.c. ante cibum before meals  
a.c.h.s., ac&hs ante cibum et hora somni before meals and at bedtime  
a.d. auris dextra right ear A single-storey "a" can be mistaken as an "o" which could read "o.d.", meaning right eye
ad., add. adde
addatur		 add
let there be added		  
ad lib. ad libitum Latin, "at one's pleasure"; as much as one desires; freely Compare pro re nata, "as needed", which by convention includes an aspect of "up to some maximum". Similarly, compare s.o.s., q.l., and q.s.
admov. admove
admoveatur		 apply [or] add
add; let there be added		  
ad us. ad usum according to custom  
æq. æquales equal  
agit. agita agitate (stir or shake)  
alt. d., alt. dieb. alternis diebus every other day; on alternate days  
alt. h., alt. hor. alternis horis every other hour; at alternate hours  
a.m. ante meridiem morning, before noon  
amp. ampulla ampule (ampul, ampoule)  
amt   amount  
aq. aqua water  
aq. bull. aqua bulliens boiling water  
aq. com. aqua communis common water  
aq. dest. aqua destillata distilled water  
aq. ferv. aqua fervens hot water  
a.l., a.s. auris laeva, auris sinistra left ear "a" can be mistaken as an "o" which could read "o.s." or "o.l", meaning left eye
ATC   around the clock  
a.u. auris utraque both ears "a" can be mistaken as an "o" which could read "o.u.", meaning both eyes
BDS, b.d.s. bis die sumendum twice daily  
bib. bibe drink  
bis bis twice
b.i.d., b.d. bis in die twice daily AMA style avoids use of this abbreviation (spell out "twice a day")
bis ind. bis indies twice a day  
bis in 7 d. bis in septem diebus twice a week  
BM   bowel movement Commonly used in the United Kingdom when discussing blood sugar. From BM Stix – the measurement sticks used for calculating blood sugar; BM being an abbreviation of Boehringer Mannheim. [7]
BNF   British National Formulary  
bol. bolus as a large single dose (usually intravenously)  
BP, Ph.Br. Pharmacopoeia Britannica British Pharmacopoeia  
BS   blood sugar  
BSA   body surface area  
b.t. bedtime mistaken for "b.i.d", meaning twice daily
bucc. bucca buccal (inside cheek)  
cap., caps. capsula capsule  
cap. capiat let him take (let the patient take)  
c.m. cras mane tomorrow morning  
c.m.s. cras mane sumendus to be taken tomorrow morning  
c̄, c. cum with (usually written with a bar on top of the "c")  
cib. cibus food  
c.c. cum cibo with food [or]
cubic centimetre		 mistaken for "U", meaning units; also has an ambiguous meaning; use "mL" or "milliliters" (1 cm³ = 1 mL)
cf. confer compare  
c.n. cras nocte tomorrow night  
cochl. cochleare spoonful  
cochl. ampl. cochleare amplum an ample spoonful (a tablespoonful)  
cochl. infant. cochleare infantis a small spoonful (a teaspoonful)  
cochl. mag. cochleare magnum a large spoonful (a tablespoonful)  
cochl. mod. cochleare modicum a modest spoonful (a dessert-spoonful)  
cochl. parv. cochleare parvum a scant spoonful (a teaspoonful)  
colet. coletur let it be strained  
comp. compositus compound  
contin. continuetur let it be continued  
cpt. capiat let him take (let the patient take)  
cr., crm   cream  
CST   continue same treatment  
cuj. cujus of which  
c.v. cras vespere tomorrow evening  
cyath. cyathus a glassful  
cyath. vinos. cyathus vinosus a wine-glassful  
D, d. die [or]
dosis		 days [or]
doses		 ambiguous meaning, write out "days" or "doses"
D5LR   dextrose 5% in lactated Ringer's solution (intravenous sugar solution)  
D5NS   dextrose 5% in normal saline (0.9%) (intravenous sugar solution)  
D5W, D5W   dextrose 5% in water (intravenous sugar solution)  
D10W, D10W   dextrose 10% in water (intravenous sugar solution)  
da da give  
DAW   dispense as written (i.e., no generic substitution)  
DC, dc, D/C, disc   discontinue [or]
discharge		 ambiguous meaning
decoct. decoctum decoction  
det. detur let it be given  
dieb. alt. diebus alternis every other day; on alternate days  
dil.   dilute  
dim. dimidius one-half  
d. in p. æ. divide in partes æquales divide into equal parts  
disp.   dispersible [or]
dispense		  
div. divide divide; let it be divided  
dL   deciliter  
DS   double strength  
d.t.d. dentur tales doses give of such doses  
DTO   deodorized tincture of opium can easily be confused with "diluted tincture of opium," which is 1/25th the strength of deodorized tincture of opium; deaths have resulted due to massive morphine overdose.[8] Compare laudanum and paregoric.
DW   distilled water [or]
dextrose in water (intravenous sugar solution)		  
elix. elixir elixir  
e.m.p. ex modo prescripto as directed (in the manner prescribed)  
emuls. emulsum emulsion  
et et and  
EOD   every other day  
ex aq. ex aqua in water; with water  
exhib. exhibiatur let it be given  
f. fiat make; let it be made  
f.h. fiat haustus make a draught  
fl., fld. fluidus fluid (usually meaning specifically liquid in health care)  
f.m. fiat mistura make a mixture  
f. pil. fiat pilula make a pill  
f.s.a. fiat secundum artem make according to art  
ft. fiat make; let it be made  
g, gm   gram (modern SI symbol is g, not gm)  
garg. gargarisma gargle  
gr. granum grain  
gtt(s) gutta(e) drop(s)  
gutt. gutta(e) drop(s)  
H   hypodermic  
h, hr, hor. hora hour  
habt. habeat let him have  
hor. alt. hora alternis every other hour (every second hour; at alternate hours)  
hor. decub. hora decubitus at bedtime  
hor. intermed. horis intermediis at intermediate hours  
hor. tert. horis tertiis every third hour  
h.s. hora somni (at the hour of sleep) at bedtime [or]
half-strength		 ambiguous (2 meanings, easily conflated); spell out
IBW   ideal body weight (for dosing based on clearance estimation)  
ID   intradermal  
IJ, inj. injectio injection mistaken for "IV", meaning intravenously
i.m., IM   intramuscular  
IN   intranasal mistaken for "IM", meaning intramuscular, or "IV", meaning intravenously
ind. indies daily  
inf. infusum infusion (extraction) / intravenous infusion  
i unus tabuletta one tablet  
ii duo tabuletta two tablets  
iii tres tabuletta three tablets  
IO intraossseous
IP   intraperitoneal  
IT   intrathecal mistaken for other abbreviations; spell out
IU   international unit mistaken for "IV" or "10", spell out "international unit"
i.v., IV   intravenous  
i.v.p., IVP   intravenous push  
IVPB   intravenous piggyback  
kg   kilogram  
LAS   label as such  
lat. dol. lateri dolenti to the painful side  
lb. libra pound  
l.c.d. liquor carbonis detergens coal tar solution  
lin linimentum liniment  
liq. liquor solution  
lot. lotio lotion  
M., m. misce mix  
mane mane in the morning  
max. maximum maximum  
mcg   microgram Recommended replacement for "μg" which may be confused with "mg"
mdi   metered dose inhaler  
m.d.u. more dicto utendus to be used as directed  
mEq   milliequivalent  
mg   milligram  
mg/dL   milligrams per deciliter  
MgSO4   magnesium sulfate may be confused with "MSO4", spell out "magnesium sulfate"
midi   at midday  
min. minimum [or]
minim [or]
minutum		 minimum [or]
minim [or]
minute		  
mist. mistura mixture  
mit., mitt. mitte number of tablets provided  
mL   millilitre  
mod. præscript. modo præscripto in the manner directed  
MS   morphine sulfate or magnesium sulfate can mean either morphine sulfate or magnesium sulfate, spell out either
MSO4   morphine sulfate may be confused with "MgSO4", spell out "morphine sulfate"
nebul, neb. nebula a spray (such as for insufflation)- nebulizer  
NMT   not more than  
noct. nocte at night  
non rep. non repetatur no repeats (no refills)  
NPO, n.p.o. nil per os nothing by mouth AMA style avoids use of this abbreviation (spell out "nothing by mouth")
NS   normal saline (0.9%)  
1/2NS   half-normal saline (0.45%)  
NTE   not to exceed  
o 2, o2   both eyes "O2" usually means oxygen or oxygen therapy
o.d. omni die every day (once daily) (preferred to "qd" in the UK[9])  
o.d. oculus dexter right eye "o" can be mistaken as an "a" which could read "a.d.", meaning right ear, confusion with "omni die"
o.m. omni mane every morning  
omn. bih. omni bihora every 2 hours  
omn. hor. omni hora every hour  
o.n. omni nocte every night  
OPD   once per day  
o.s. oculus sinister left eye "o" can be mistaken as an "a" which could read "a.s.", meaning left ear
o.u. oculus uterque both eyes "o" can be mistaken as an "a" which could read "a.u.", meaning both ears
oz   ounce  
p. perstetur continue  
part. æq. partes æquales equal parts  
per per by or through  
p.c. post cibum after meals  
p.c.h.s., pc&hs post cibum et hora somni after meals and at bedtime  
Ph.Br., BP Pharmacopoeia Britannica British Pharmacopoeia  
Ph.Eur. Pharmacopoeia Europaea European Pharmacopoeia  
Ph.Int. Pharmacopoeia Internationalis International Pharmacopoeia  
pig./pigm. pigmentum paint  
p.m. post meridiem evening or afternoon  
p.o. per os by mouth or orally AMA style avoids use of this abbreviation (spell out "orally")
ppt. præparata prepared  
p.r., PR per rectum rectally  
p.r.n., PRN pro re nata as needed  
pt. perstetur continue  
pulv. pulvis powder  
p.v., PV per vaginam vaginally  
q quaque every, per  
q.1 h, q.1° quaque 1 hora every 1 hour (can replace "1" with other numbers)  
q4PM at 4 pm (can replace "4" with other numbers) mistaken to mean every 4 hours
q.a.d. quaque alternis die every other day  
q.a.m. quaque die ante meridiem every morning (every day before noon)  
q.d./q.1.d. quaque die every day mistaken for "QOD" or "qds," spell out "every day" or "daily". AMA style avoids use of this abbreviation (spell out "every day")
q.d.a.m. quaque die ante meridiem once daily in the morning  
q.d.p.m. quaque die post meridiem once daily in the evening  
q.d.s. quater die sumendus 4 times a day can be mistaken for "qd" (every day)
q.p.m. quaque die post meridiem every evening (every day after noon)  
q.h. quaque hora every hour  
q.h.s. quaque hora somni every night at bedtime can be mistaken as "q.h.r." (every hour)
q.i.d. quater in die 4 times a day can be mistaken for "qd" or "qod," write out "4 times a day". AMA style avoids use of this abbreviation (spell out "4 times a day")
q.l. quantum libet as much as is requisite  
q.n. quaque nocte every night can be mistaken as "q.h." (every hour)
q.o.d. quaque altera die every other day mistaken for "QD," spell out "every other day". AMA style avoids use of this abbreviation (spell out "every other day")
q.q. quaque every;[10] each  
q.q.h. quater quaque hora every 4 hours  
q.s. quantum sufficiat (subjunctive), quantum sufficit (indicative), quantum satis as much as suffices; a sufficient quantity  
q.s. a.d add up to
q.v. quantum volueris [or]
quod vide		 at will [or]
which see		  
QWK   every week  
rep., rept. repetatur repeats  
RL, R/L   Ringer's lactate  
Rx, Rx, RX, ℞, Rp recipe take (often effectively a noun meaning "prescription"—medical prescription or prescription drug)  
rep. repetatur let it be repeated  
s. signa write (write on the label)  
s.a. secundum artem according to the art (accepted practice or best practice)  
SC   subcutaneous "SC" can be mistaken for "SL," meaning sublingual. See also SQ
sem. semen seed  
s.i.d. semel in die once a day used exclusively in veterinary medicine
sig. signa, signetur write (write on the label)  
s̄ sine without (usually written with a bar on top of the "s")  
sing. singulorum of each  
SL, s.l. sub lingua sublingually, under the tongue  
SOB   shortness of breath  
sol. solutio solution  
s.o.s., si op. sit si opus sit if there is a need  
s.s., SS semisse one-half [or]
sliding scale		 mistaken for "55" or "1/2"
SSI   sliding scale insulin or sliding scale regular insulin mistaken to mean "strong solution of iodine" or "selective serotonin reuptake inhibitor". See also SSRI
SQ   subcutaneously "SQ" can be mistaken for "5Q" meaning "5 every dose". See also SC
SSRI   selective serotonin reuptake inhibitor [or]
sliding scale regular insulin		 ambiguous. Do not abbreviate
st. stet let it stand (for example, for settling)  
stat statim immediately  
SubQ   subcutaneously  
sum. sumat [or]
sumendum		 let him take [or]
let it be taken		  
supp. suppositorium suppository  
susp. suspensio suspension  
syr. syrupus syrup  
tab. tabella tablet  
tal., t. talus such  
tbsp   tablespoon  
t.d.s., TDS ter die sumendum 3 times a day  
t.i.d., t.d. ter in die 3 times a day AMA style avoids use of this abbreviation (spell out "3 times a day")
tinct. tinctura tincture  
t.i.w.   3 times a week mistaken for "twice a week"
top.   topical  
TPN   total parenteral nutrition  
tr, tinc., tinct. tinctura tincture  
trit. triturate grind to a powder  
troch. trochiscus lozenge  
tsp   teaspoon  
U   unit mistaken for a "4", "0" or "cc", spell out "unit"
u.d., ut. dict. ut dictum as directed  
ung. unguentum ointment  
USP   United States Pharmacopeia  
vag. vagine vaginally  
w   with  
w/a   while awake  
w/f   with food (with meals)  
w/o   without  
X, x   times  
YO, y.o.   years old  
μg   microgram mistaken for "mg", meaning milligram
@   at mistaken for "2"; spell out "at"
>   greater than mistaken for a "7"
<   less than mistaken for an "L"
℔ libra pound  
℥ uncia ounce  
ʒ drachma dram (drachm)  
℈ scrupulus scruple  
° hour  

Similarity of handwritten letters

Especially in handwritten prescriptions or orders, and most especially in hasty handwriting (which is the usual kind), letter shape can be ambiguous. The example below compares "a" and "o" in a script where both consist of an incoming stroke, a loop from about 12 o'clock, and an outgoing stroke. They differ only in the angle of the latter.


Cursive script 'a' and capital 'A' in the U.S. D'Nealian script style

Cursive script 'o' and capital 'O' in the U.S. D'Nealian script style

Numerical notation

When expressing a numerical quantity, Roman numerals are commonly used in place of Arabic digits so as to avoid confusion. The numbers 1 - 3 (I, II, III), usually written as upper-case Roman numerals, often have the appearance of a capital "T" or a series of capital "T's" with a dot above each "T." They are also sometimes written as lower-case Roman numerals (i, ii, iii).

Currently discouraged practices

See also

References
  1. Johnston, Mike (2006). The pharmacy technician series: Fundamentals of pharmacy practice. Pearson Prentice Hall. p. 24. ISBN 9780131147515.
  2. Davidson, Thomas, ed. (1907), Chambers's Twentieth Century Dictionary of the English Language, W & R Chambers Ltd.
  3. Kilner, Walter B., ed. (1886), A Compendium of Modern Pharmacy and Druggists' Formulary, HW Rokker.
  4. John Wyeth & Brother (1901), An Epitome of Therapeutics: With Special Reference to the Laboratory Products of John Wyeth & Brother, John Wyeth & Brother.
  5. "The Official "Do Not Use" List of Abbreviations" (PDF). The Joint Commission. Archived from the original (PDF) on 10 March 2013. Retrieved 23 August 2012.
  6. "ISMP's List of Error Prone Abbreviations, Symbols, and Dose Designations" (PDF). Institute for Safe Medication Practices. Retrieved 11 February 2011.
  7. https://www.diabetes.co.uk/forum/threads/help-bm-problems.74838/
  8. "Recurring Confusion Between Opium Tincture and Paregoric". Pharmacy Times. Retrieved 2015-01-19.
  9. BNF (British National Formulary) - published twice yearly by the British Medical Association and Royal Pharmaceutical Society of Great Britain
  10. Bennett, Reginald Robert (1906), Medical and Pharmaceutical Latin for Students of Pharmacy and Medicine, J. & A. Churchill. Public domain; free ebook at Google Books. Subtitle: A Guide to the Grammatical Construction and Translation of Physicians' Prescriptions, Including Extensive Vocabularies and an Appendix Upon Foreign Prescriptions.
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