Comprehensive guidance on how to ‘write up’ (or transcribe) a prescription is given for those working in the United Kingdom in the introduction to the British National Formulary, but many of the points in this bear repetition. While the formal constraints that operate in the community do not apply in a hospital setting (see p. 14), the following guidelines still represent good practice:

Block capitals: Always use UPPERCASE letters when prescribing drug names to ensure legibility (one exception to this is where the Tall man system is in use). A poorly written prescription is, at best, discourteous to nurses and pharmacists who may have to spend time checking what has been written. Illegibility can also be dangerous.

Approved names: These should always be used to ensure consistency between vials, ampoules, bottles and other labels. Proprietary names (‘trade names’) should only be used for compound preparations when a generic name does not exist (e.g. Gaviscon® Infant – half a dual sachet), or where bioavailability of the drug may be affected by changing brands (e.g. anticonvulsants). Avoid abbreviations and contractions other than those universally used and recognised.

The dose: This should be given in grams (g), milligrams (mg), micrograms or, exceptionally, nanograms. Do not use abbreviations for anything other than grams (g) or milligrams (mg).

Units: When the dose is in ‘UNITS’, write this word out in full. Avoid the symbol ‘U’ because it is too easily misread, and avoid the term ‘microunits’. Oxytocin (see p. 383) is one exception to this rule. Some drug companies still use the term ‘international units’ (IU) but, since international agreement has now been reached as to the meaning of all such terms, this terminology is unnecessary, and best avoided.

Volumes: Volumes should always be prescribed in millilitres. This can be abbreviated to ml (but it should not be contracted to cc or cm³).

Decimal places: Carelessness in use of decimals is a major cause of potentially lethal overtreatment. Decimals should be avoided where possible and, where unavoidable, always prefaced by a zero. Write 500 mg not 0.5 g. If a decimal has to be used, write 0.5 ml not .5 ml. Do not use a comma, use a full stop (0.5 ml not 0,5 ml).

Time: This is best written using the 24-hour clock when prescribing for patients in hospital.

Route of administration: This must always be indicated. The following abbreviations are generally acceptable:

All other methods of administration should be written in full (e.g. intradermal and intra-tracheal).

Continuous IV administration

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