Please provide comments on the examples below representing the challenges in harmonizing the US Drug Extension with SNOMED CT international release introduced during the 2025-02-20 DEUSG meeting.  Complete details can be found at 2025-02-20: Virtual.  Slides can be found at: https://drive.google.com/file/d/1rkpoLnmKMecO1Bi5xGJVteT2miJy2vZ0/view. Recording starts at 55:00.  

Summary of 5 examples:

1. Thiothixene: SNOMED has tiotixene hydrochloride but RxNorm has Thiothixene (as active ingredient and BoSS).  Hydrochloride form is no longer in US market.
2. Capmatinib: RxNorm has capmatinib hydrochloride but SNOMED has capmatinib (as active ingredient and BoSS). 
3. Quinacrine/mepacrine: RxNorm uses the US preferred term of mepacrine.  Also, SNOMED specifies the salt/hydrochloride, but RxNorm has the substance as active ingredient and BoSS [same as #1 issue].  Hydrochloride form is not approved in US market.
4. SNOMED is using 108890005 |Botulinum toxin type A (substance)| to model clinical drugs, while RxNorm is using 703368006 |IncobotulinumtoxinA (substance)|. Are these two substances duplicates?  RxNorm uses the United States Adopted Name (USAN).
5. Odevixibat: RxNorm uses a hydrated form, odevbixibat sesquihydrate, while SNOMED uses odevixibat (as active ingredient and BoSS).  Also, RxNorm has oral pellet form while SNOMED has oral capsule.