diff --git a/api/src/main/java/org/openmrs/module/fhir2/api/translators/impl/DosageTranslatorImpl.java b/api/src/main/java/org/openmrs/module/fhir2/api/translators/impl/DosageTranslatorImpl.java
index d4d18e788..7e0ee7867 100644
--- a/api/src/main/java/org/openmrs/module/fhir2/api/translators/impl/DosageTranslatorImpl.java
+++ b/api/src/main/java/org/openmrs/module/fhir2/api/translators/impl/DosageTranslatorImpl.java
@@ -14,6 +14,7 @@
 import lombok.AccessLevel;
 import lombok.Setter;
 import org.hl7.fhir.r4.model.BooleanType;
+import org.hl7.fhir.r4.model.CodeableConcept;
 import org.hl7.fhir.r4.model.Coding;
 import org.hl7.fhir.r4.model.Dosage;
 import org.hl7.fhir.r4.model.Quantity;
@@ -51,6 +52,12 @@ public Dosage toFhirResource(@Nonnull DrugOrder drugOrder) {
 		dosage.setRoute(conceptTranslator.toFhirResource(drugOrder.getRoute()));
 		dosage.setTiming(timingTranslator.toFhirResource(drugOrder));
 		
+		if (drugOrder.getInstructions() != null) {
+			CodeableConcept additionalInstructions = new CodeableConcept();
+			additionalInstructions.setText(drugOrder.getInstructions());
+			dosage.addAdditionalInstruction(additionalInstructions);
+		}
+		
 		if (drugOrder.getDose() != null) {
 			Dosage.DosageDoseAndRateComponent doseAndRate = new Dosage.DosageDoseAndRateComponent();
 			Quantity dose = new SimpleQuantity();
@@ -73,6 +80,11 @@ public Dosage toFhirResource(@Nonnull DrugOrder drugOrder) {
 	@Override
 	public DrugOrder toOpenmrsType(@Nonnull DrugOrder drugOrder, @Nonnull Dosage dosage) {
 		drugOrder.setDosingInstructions(dosage.getText());
+		
+		if (!dosage.getAdditionalInstruction().isEmpty()) {
+			drugOrder.setInstructions(dosage.getAdditionalInstructionFirstRep().getText());
+		}
+		
 		if (dosage.getAsNeededBooleanType() != null) {
 			drugOrder.setAsNeeded(dosage.getAsNeededBooleanType().getValue());
 		}
diff --git a/api/src/test/java/org/openmrs/module/fhir2/api/translators/impl/DosageTranslatorImplTest.java b/api/src/test/java/org/openmrs/module/fhir2/api/translators/impl/DosageTranslatorImplTest.java
index 30bb8d7f5..ef49b265b 100644
--- a/api/src/test/java/org/openmrs/module/fhir2/api/translators/impl/DosageTranslatorImplTest.java
+++ b/api/src/test/java/org/openmrs/module/fhir2/api/translators/impl/DosageTranslatorImplTest.java
@@ -109,6 +109,14 @@ public void toFhirResource_shouldTranslateDosingInstructionToDosageText() {
 		assertThat(result.getText(), equalTo(DOSING_INSTRUCTION));
 	}
 	
+	@Test
+	public void toFhirResource_shouldTranslateOrdersInstructionToDosageAdditionalInstructions() {
+		drugOrder.setInstructions(DOSING_INSTRUCTION);
+		Dosage result = dosageTranslator.toFhirResource(drugOrder);
+		assertThat(result, notNullValue());
+		assertThat(result.getAdditionalInstruction().get(0).getText(), equalTo(DOSING_INSTRUCTION));
+	}
+	
 	@Test
 	public void toFhirResource_shouldTranslateDrugOrderRouteToRoute() {
 		Concept concept = new Concept();
@@ -317,4 +325,16 @@ public void toOpenmrsType_shouldTranslateDoseQuantityUnitsToDrugOrderDoseUnits()
 		assertThat(result, notNullValue());
 		assertThat(result.getDoseUnits(), equalTo(mg));
 	}
+	
+	@Test
+	public void toOpenmrsType_shouldTranslateAdditionalInstructionsToOrderInstructions() {
+		Dosage dosage = new Dosage();
+		CodeableConcept additionalInstructions = new CodeableConcept();
+		additionalInstructions.setText(DOSING_INSTRUCTION);
+		dosage.addAdditionalInstruction(additionalInstructions);
+		
+		DrugOrder result = dosageTranslator.toOpenmrsType(new DrugOrder(), dosage);
+		assertThat(result, notNullValue());
+		assertThat(result.getInstructions(), equalTo(DOSING_INSTRUCTION));
+	}
 }