The prescribing cascade

Lisa M. Kalisch, Gillian E. Caughey, Elizabeth E. Roughead, Andrew L. Gilbert

Research output: Contribution to journalArticlepeer-review

52 Citations (Scopus)


A prescribing cascade occurs when a new medicine is prescribed to 'treat' an adverse reaction to another drug in the mistaken belief that a new medical condition requiring treatment has developed. Adverse outcomes associated with prescribing cascades can result when the second drug increases the severity of the adverse reaction to the first drug or when the second drug places the patient at risk of additional adverse drug reactions. The factors that are associated with an increased likelihood of an adverse drug reaction may also lead to prescribing cascades. The elderly, those using multiple medicines, women, and people using high risk medicines are more likely to get adverse drug reactions. The key to preventing prescribing cascades lies in the avoidance and early detection of adverse drug reactions and an increased awareness and recognition of the potential for adverse reactions.

Original languageEnglish
Pages (from-to)162-166
JournalAustralian Prescriber
Issue number6
Publication statusPublished or Issued - 2011


  • Adverse effects
  • Polypharmacy

ASJC Scopus subject areas

  • Pharmacology (medical)

Cite this