Objective. To investigate the prescribing of analgesic agents in a def
ined South African patient population. Design. Retrospective drug util
isation study. Setting. Prescribing behaviour of a sample of 50 dispen
sing doctors in Port Elizabeth. Data were obtained from a medical aid
which used a formulary system. Main outcome measures. Percentage of ce
ntral nervous system drugs that analgesics comprised; proportion of pa
tients using combination analgesics; cost of analgesics. Results. On a
verage, 83.3% of all central nervous system drugs dispensed were analg
esic agents. These agents represented 70.9% of the total cost of centr
al nervous system drugs. A high percentage (82.2%) of the analgesic ag
ents dispensed were combination or polycomponent analgesics. The combi
nation analgesic tablet, consisting of paracetamol, meprobamate, caffe
ine and codeine phosphate, was the most frequently prescribed central
nervous system drug. This product accounted on average for 40.4% of al
l analgesics dispensed. Nearly half (46.0%) of all the analgesics disp
ensed by the sample of doctors were available without a prescription.
Conclusion. The high prescribing rate of combination analgesic prescri
ption was a cause for concern, given the dependence-producing potentia
l of some of the ingredients, e.g. meprobamate. The prescribing and us
e of analgesics should be carefully monitored by further drug utilisat
ion studies in light of the serious adverse effects, such as analgesic
nephropathy, associated with the longterm use of these agents.