High risk medications


  • OD 0561/14 WA High Risk Medication Policy


High risk medications are drugs that have a heightened risk of causing significant patient harm when they are used in error.

High risk medicines include medicines:

  • with a low therapeutic index
  • that present a high risk when administered by the wrong route or when other system errors occur

National Safety and Quality Health Service Standard version 2, Medication Safety, High Risk Medications 4.15 (external site) requires health services to identify high risk medicines used within the organisation and take appropriate action to ensure that they are stored, prescribed, dispensed and administered safely.

High risk medicines may vary between hospitals and health care settings depending on the types of medicines used and patients treated. However, evidence suggests a group of medicines which can universally be considered high risk.

At a minimum, the following high risk medication classes, as recommended by the Australian Commission for Safety and Quality in Healthcare, should be considered for inclusion in the high risk medication register.

A – Antimicrobials

P – Potassium and other electrolytes, psychotropic medications

I – Insulin

N – Narcotics, opioids and sedatives

C – Chemotherapeutic agents

H – Heparin and other anticoagulants

S – Safer systems (e.g. safe administration of liquid medications using oral syringes)

Methods to reduce error include strategies such as:

  • improving access to information about these drugs
  • limiting access to high risk medications
  • using Tallman lettering to differentiate high risk medications
  • using auxiliary labels and automated alerts
  • standardising the prescription, storage, preparation, and administration of these products.


Australian Commission on Safety and Quality in Health Care:

More information

Medicines and Technology Unit
Address: 3 Forrest Place, Perth
Email: DoH.MedicinesandTechnologyUnit@health.wa.gov.au 

Produced by

Patient Safety and Clinical Quality