Prescription Writing

Prescribers may initiate and/or maintain treatment with medicines as per the STGs in accordance with their scope of practice.

Medicines should be prescribed only when they are necessary for treatments following clear diagnosis. Not all patients or conditions need prescriptions for medicine. In certain conditions simple advice and general and supportive measures may be more suitable.

In all cases carefully consider the expected benefit of a prescribed medication against potential risks. This is especially important during pregnancy where the risk to both mother and foetus must be considered.

All prescriptions must:

• be written legibly in ink by the prescriber with the full name, identification number and address of the patient, and signed with the date on the prescription form;
• specify the age and, in the case of children, weight of the patient;
• have prescriber details including the contact details i.e. name, qualification, registration number, address and contact telephone number; 
• indicate the diagnosis on the prescription, where the patient has provided consent

In all prescriptions:

• State the treatment regimen in full:
  • medicine name, strength and formulation
  • dose or dosage,
  • dose frequency,
  • duration of treatment,
    • e.g. amoxicillin 250 mg capsules, 8 hourly orally for 5 days.
• Write the name of the medicine/preparation in full using the generic name.
• Avoid abbreviations to reduce the risk of misinterpretation. Avoid the Greek mu (ų): write mcg as an abbreviation for micrograms.
• Avoid unnecessary use of decimal points. If necessary, write a zero in front of the decimal point only, e.g. 2 mg not 2.0 mg or 0.5 mL and not .5 mL.
• Avoid Greek and Roman frequency abbreviations that cause considerable confusion (qid, qod, tds, tid, etc). Instead either state the frequency in terms of hours (e.g. '8 hourly') or times per day in numerals (e.g. '3x/d').
• In the case of “as required”, a minimum dose interval should be specified, e.g. every 4 hours as required.
• Most monthly outpatient scripts for chronic medication are for 28 days; check that the patient will be able to access a repeat before the 28 days are completed.
• Prescriptions for schedule 6 medicines are not repeatable, requiring to be issued monthly; and the quantity to be issued should be expressed in words.
• After writing a script, check that the dose, dose units, route, frequency, and duration for each item is stated. Consider whether the number of items is too great to be practical for the patient, and check that there are no redundant items or potentially important drug interactions. Check that the script is dated and that the patient’s name, identification number and diagnosis/diagnostic code are on the prescription form. Only then should you sign the prescription and provide some other way for the pharmacy staff to identify the signature if there are problems (print your name, use a stamp, or use a prescriber number from your institution’s pharmacy).

Notes on specific medicines

Standard Treatment Guidelines and Essential Medicines List for South Africa, Hospital Level, Adults 2019 Edition