Guidelines for ATCvet classification 2021 ISSN 1020-9891 ISBN 978-82-8406-167-2 Suggested citation: WHO Collaborating Centre for Drug Statistics Methodology, Guidelines for ATCvet classification 2021. Oslo, 2021. © Copyright WHO Collaborating Centre for Drug Statistics Methodology, Oslo, Norway. Use of all or parts of the material requires reference to the WHO Collaborating Centre for Drug Statistics Methodology. Copying and distribution for commercial purposes is not allowed. Changing or manipulating the material is not allowed. Guidelines for ATCvet classification 23rd edition WHO Collaborating Centre for Drug Statistics Methodology Norwegian Institute of Public Health P.O.Box 222 Skøyen N-0213 Oslo Norway Telephone: +47 21078160 E-mail: [email protected] Website: www.whocc.no Previous editions: 1992: Guidelines on ATCvet classification, 1st edition1) 1995: Guidelines on ATCvet classification, 2nd edition1) 1999: Guidelines on ATCvet classification, 3rd edition1) 2002: Guidelines for ATCvet classification, 4th edition2) 2003: Guidelines for ATCvet classification, 5th edition2) 2004: Guidelines for ATCvet classification, 6th edition2) 2005: Guidelines for ATCvet classification, 7th edition2) 2006: Guidelines for ATCvet classification, 8th edition2) 2007: Guidelines for ATCvet classification, 9th edition2) 2008: Guidelines for ATCvet classification, 10th edition2) 2009: Guidelines for ATCvet classification, 11th edition2) 2010: Guidelines for ATCvet classification, 12th edition2) 2011: Guidelines for ATCvet classification, 13th edition2) 2012: Guidelines for ATCvet classification, 14th edition2) 2013: Guidelines for ATCvet classification, 15th edition2) 2014: Guidelines for ATCvet classification, 16th edition2) 2015: Guidelines for ATCvet classification, 17th edition2) 2016: Guidelines for ATCvet classification, 18th edition2) 2017: Guidelines for ATCvet classification, 19th edition2) 2018: Guidelines for ATCvet classification, 20th edition2) 2019: Guidelines for ATCvet classification, 21st edition2) 2020: Guidelines for ATCvet classification, 22nd edition2) 1) Published by the Nordic Council on Medicines 2) Published by the WHO Collaborating Centre for Drug Statistics Methodology Preface The Anatomical Therapeutic Chemical classification system for veterinary medicinal products, ATCvet, has been developed by the Nordic Council on Medicines (NLN) in collaboration with the NLN’s ATCvet working group. The ATCvet system is based on the same main principles as the ATC classification system for substances used in human medicine. The ATCvet system has been developed in association with the WHO Collaborating Centre for Drug Statistics Methodology in Oslo. The WHO Collaborating Centre for Drug Statistics Methodology is responsible for developing and maintaining the ATC system under the guidance of WHO, and has since January 2001 also had the responsibility for the ATCvet classification system. The first edition of the Guidelines on ATCvet classification was published in 1992 followed by revised editions in 1995 and in 1999. Since 2002 the Guidelines have been revised annually. The ATCvet classification system will be continuously revised in line with the ATC system and in response to the expanding range of preparations available in the field of veterinary medicine. Details of the classification codes assigned to all the substances classified can be found in the ATCvet Index, which is issued annually. The Guidelines on ATCvet classification are needed to explain and provide comments on the classifications recommended. Copies of the Guidelines and the Index can be ordered from the WHO Collaborating Centre for Drug Statistics Methodology. The ATCvet Index, as well as further information about the ATCvet classification system, is also available at the website of the WHO Collaborating Centre, http://www.whocc.no/atcvet/. Oslo, January 2021 WHO Collaborating Centre for Drug Statistics Methodology Norwegian Institute of Public Health Staff of the Centre Christian Lie Berg, MScPharm/MPH Hege Salvesen Blix, MScPharm/PhD Live Storehagen Dansie, MScPharm/MPhil Int Comm Health Irene Litleskare, MScPharm Mohammad Nouri Sharikabad, MScPharm, PhD Kristine Olsen, MScPharm Hilchen Thode Sommerschild, MD, PhD Tove Granum, secretary Contents 1 Introduction to the ATCvet classification system ............................................. 11 1.1 History of the ATC/DDD- and the ATCvet systems ...................................... 11 1.2 The purpose of the ATCvet classification system ........................................ 11 1.3 Relationship between the ATCvet system and the ATC system for medicines for human use .............................................................................................. 12 1.4 The ATCvet classification system ................................................................. 12 2. Classification principles .................................................................................. 13 2.1 General principles ........................................................................................ 13 2.2 Classification of plain preparations ............................................................. 16 2.3 Classification of combination products ....................................................... 16 3. Procedures and data requirements for ATCvet classifications and alterations . 17 3.1 Classification of new substances and data requirements ........................... 17 3.2 Principles regarding alterations to the ATCvet system ............................... 18 3.3 Reporting...................................................................................................... 19 4. ATCvet Index .................................................................................................. 19 5. ATCvet main groups ....................................................................................... 21 QA - Alimentary tract and metabolism ....................................................................... 20 This group comprises preparations used for the treatment of diseases affecting the alimentary tract or metabolism, e.g. antacids and antiemetics. It also includes e.g. antispasmodic and anticholinergic agents, vitamins and drugs used in diabetes. QB - Blood and blood forming organs ........................................................................ 36 The group QB comprises preparations mainly affecting the blood or the blood forming organs. For example, it includes antithrombotic agents, antianemic preparations and plasma substitutes. QC - Cardiovascular system ........................................................................................ 41 This group comprises preparations used in the treatment of diseases affecting the cardiovascular system, or whose action is believed to be mediated mainly via the cardiovascular system. Included are, for example, antihypertensives and drugs for cardiac diseases. QD - Dermatologicals .................................................................................................. 53 This main group comprises dermatological preparations. Most of these preparations are intended for topical use, e.g. antifungals, antibiotics, corticosteroids and antiseptics for topical use. QG - Genito-urinary system and sex hormones .......................................................... 64 The group QG comprises gynecological antiinfectives and antiseptics for local and intravaginal/intrauterine use. In addition e.g. urologicals and hormonal contraceptives are included. QH - Systemic hormonal preparations, excl. sex hormones and insulins .................... 73 This group comprises hormonal preparations for systemic use, excluding sex hormones and insulins. Included are also, for example, pancreatic hormones and hormonal preparations acting on calcium homeostasis. QI - Immunologicals ................................................................................................... 78 This group comprises immunologicals for veterinary use and includes vaccines, immune sera and immunoglobulins. The group QI does not correspond to the ATC classification of immunologicals for human use. QJ - Antiinfectives for systemic use ............................................................................ 94 Group QJ comprises antiinfectives, antibacterials and antimycobacterials for systemic and intramammary use. Antiinfectives for local use are classified in other groups. QL - Antineoplastic and immunomodulating agents ............................................... 105 The group QL comprises preparations, e.g. alkylating agents, antimetabolites, plant alkaloids and cytotoxic antibiotics, used in the treatment of malignant neoplastic diseases. Immunomodulating agents, both stimulating and suppressive agents, are also classified here. QM - Musculo-skeletal system ................................................................................... 111 Preparations used for the treatment of disease in or symptoms of the musculo-skeletal system can be classified in this group. Many drugs classified in this group, as the antiinflammatory agents, commonly affect other organs as well. Included are both topical preparations and products for systemic use. QN - Nervous system ................................................................................................. 116 Preparations affecting the nervous system, both centrally and peripherally, are classified in this group. Antidepressants and antipsychotics, for example, are included. Group headings are kept consistent