ATC

Anatomical Therapeutic Chemical Classification System

The Anatomical Therapeutic Chemical (ATC) Classification System is used for the classification of active ingredients of drugs according to the organ or system on which they act and their therapeutic, pharmacological and chemical properties. It is controlled by the World Health Organization Collaborating Centre for Drug Statistics Methodology.

This pharmaceutical coding system divides drugs into different groups according to the organ or system on which they act and/or their therapeutic and chemical characteristics. Each bottom-level ATC code stands for a pharmaceutically used substance, or a combination of substances, in a single indication (or use). This means that one drug can have more than one code: acetylsalicylic acid (aspirin), for example, has A01AD05 as a drug for local oral treatment, B01AC06 as a platelet inhibitor, and N02BA01 as an analgesic and antipyretic. On the other hand, several different brands share the same code if they have the same active substance and indications.

Classification

In this system, drugs are classified into groups at 5 different levels:

First level

The first level of the code indicates the anatomical main group and consists of one letter. There are 14 main groups:

  • A – Alimentary tract and metabolism
  • B – Blood and blood forming organs
  • C – Cardiovascular system
  • D – Dermatologicals
  • G – Genito-urinary system and sex hormones
  • H – Systemic hormonal preparations, excluding sex hormones and insulins
  • J – Antiinfectives for systemic use
  • L – Antineoplastic and immunomodulating agents
  • M – Musculo-skeletal system
  • N – Nervous system
  • P – Antiparasitic products, insecticides and repellents
  • R – Respiratory system
  • S – Sensory organs
  • V – Various

Example: C Cardiovascular system

Second level

The second level of the code indicates the therapeutic main group and consists of two digits.

Example: C03 Diuretics

Third level

The third level of the code indicates the therapeutic/pharmacological subgroup and consists of one letter.

Example: C03C High-ceiling diuretics

Fourth level

The fourth level of the code indicates the chemical/therapeutic/pharmacological subgroup and consists of one letter.

Example: C03CA Sulfonamides

Fifth level

The fifth level of the code indicates the chemical substance and consists of two digits.

Example: C03CA01 Furosemide

ATCvet

The Anatomical Therapeutic Chemical Classification System for veterinary medicinal products (ATCvet) is used to classify veterinary drugs. ATCvet codes can be created by placing the letter Q in front of the ATC code of most human medications. For example, furosemide for veterinary use has the code QC03CA01.

Some codes are used exclusively for veterinary drugs, such as QI Immunologicals, QJ51 Antibacterials for intramammary use or QN05AX90 amperozide.

Defined daily dose

The ATC system also includes defined daily doses (DDDs) for many drugs. This is a measurement of drug consumption based on the usual daily dose for a given drug. According to the definition, “the DDD is the assumed average maintenance dose per day for a drug used for its main indication in adults.

National adaptations

National issues of the ATC classification, such as the German Anatomisch-therapeutisch-chemische Klassifikation mit Tagesdosen, may include additional codes and DDDs not present in the World Health Organization version.
Updates to ATC

ATC follows guidelines in creating new codes for newly approved drugs. In order to create a new ATC code, an application has to be sent to ATC. New ATC codes are published twice annually. A formal release of new ATC edition occurs once a year.

ATC anatomical main groups:

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