By Kunal Sindhu
In 2017, over four billion prescriptions were filled at pharmacies across the United States. Given their sheer prevalence, prescriptions are a key source of medical errors. In fact, prescription errors account for 70% of medication errors that result in harm. Thus, it is crucial that all clinicians master the ability to properly write a prescription.
Before we go over how to properly write a prescription, it is worth briefly discussing two common sources of prescription errors. First, if you are handwriting your prescription, make sure that it is legible. While e-prescribing is increasingly making handwritten prescriptions a thing of the past, you will likely have to manually prescribe medications at some point in your career. Illegible prescriptions are a source of frustration for patients, pharmacists, and other medical providers, and can increase the risk of medication errors. No matter how busy you are, it is always better to spend a few extra seconds slowly writing out a legible prescription than risk your patient’s health.
Second, be cautious when using abbreviations. While abbreviations are commonly used in medicine, you should keep in mind that the risk of a medication error is increased when abbreviations are ambiguous or used incorrectly. So if you choose to use abbreviations in your prescriptions, be sure to only use well-known ones (some commonly used medical abbreviations can be found here). If you are unsure whether or not you should use an abbreviation, just spend the extra few seconds to write out your directions completely.
Now we will go over how to properly write a prescription. Every prescription consists of seven parts: the prescriber’s information, the patient’s information, the recipe (the medication, or Rx), the signatura (the patient instructions or Sig), the dispensing instructions (how much medication to be dispensed to the patient or Disp), the number of refills (or Rf), and the prescriber’s signature (including his or her National Provider Identifier and/or Drug Enforcement Agency number). Below, we will review each of these sections in more detail.
How to write a prescription in 7 steps:
- Prescriber’s Information
This information is usually found at the top of the prescription. It generally consists of the prescribing clinician’s name, office address, and contact information (usually the office’s telephone number).
- Patient’s Information
Below the prescriber’s information is the patient’s information. This section will include the patient’s full name, age, and date of birth. Sometimes the patient’s home address will be found here, as well. You should also specify the date the prescription was written.
- Recipe (Rx)
The recipe should include the medication being prescribed, its dose, and its dosage form. For example, if you are prescribing 650 milligram (mg) tablets of acetaminophen, you would write “acetaminophen 650 mg tablets” or “acetaminophen 650 mg tabs.”
- Signatura (Sig)
After the recipe comes the signatura, which provides the patient with instructions on how to take the medication you are prescribing. This should include information on how much medication to take, how to take it, and how often to take it.
For example, if you would like your patient to take one 650 mg tablet of acetaminophen every six hours, you would write “Take 1 tablet by mouth every six hours” or, using abbreviations, “1 tab PO q6h.”
For as needed or pro re nata (PRN) prescriptions, you should indicate that the prescription is PRN and describe the conditions under which your patient can take the prescribed medication. Writing your prescription as a PRN order essentially gives the patient the option to take the medication when he or she needs it.
Let’s say that you would like your patient to be able to take one 650 mg tablet of acetaminophen every six hours when he or she has a headache. In that case, your instructions would read “Take 1 tablet by mouth every six hours as needed for a headache” or “1 tab PO q6h prn headache.”
- Dispensing Instructions (Disp)
Next comes the dispensing instructions, which let the pharmacist know how much medication you would like your patient to receive. You should include the amount of medication you would like to be dispensed and the form it should be released in. You should also make sure to write out any numbers you use here to minimize the risk of a medication error. For our acetaminophen example, if you would like your patient to receive a one week supply (or 28 tablets) of the medication, you would write “28 (twenty-eight) tablets” or “28 (twenty-eight) tabs.”
- Number of Refills (Rf)
After the dispensing instructions, specify how many times you would like your patient to be able to use this prescription to refill his or her medication. Be sure to again write out any numbers you use. If you do not want to prescribe any refills, write “zero refills.” For our hypothetical acetaminophen example, if you are prescribing one refill, you would write “1 (one) refill.”
- Prescriber’s Signature
At the bottom of the prescription, you should sign your name. Oftentimes, the prescriber’s National Provider Identifier (NPI) will be included in this section. For controlled substances, the prescriber’s Drug Enforcement Agency Number will also be included.
So for our hypothetical acetaminophen example, our prescription would look like this:
About the Author
Kunal Sindhu is a resident physician in New York City. You can follow him on Twitter @sindhu_kunal.