In healthcare delivery system, medicines play a key role in reducing patient's suffering. Nonetheless, irrational use of medicines remains a major issue facing most health systems across the world. This might eventually lead to drug interactions and adverse drug reactions (ADRs). Hence a study was planned with an aim to evaluate the prevalence of drug interactions and adverse drug reactions in a tertiary care hospital. A total of 500 patients were selected by convenience sampling method. Complete case records of all the 500 subjects were collected. 26.32% (n = 15) ADRs are seen in the age group of 51-60 years. 70.18% (n = 40) of ADRs are seen in males. Irrational prescribing is seen in 30.2%. Most of the (Potential Drug Drug Interactions) PDDIs are due to the combined use of aspirin and clopidogrel (n = 76). Hence, by evidence based practice and rational drug use guidelines, the adverse drug effects can be minimized. Also, by minimizing polypharmacy the number of ADRs can be reduced, thereby decreasing the cost of health care.

One of the important fundamental human rights is access to health care. Various governments have shown international agreements about this right. Disease management and prevention is mainly through drugs. Complete information about the drugs is given in World Health Organization (WHO) formularies. Aim of the study was to develop a hospital formulary in a tertiary care hospital. Drug list comprising of 450 drugs was collected from hospital pharmacy. After scrutinizing the list for unutilized and banned drugs, a total of 423 drugs were selected to prepare monographs for hospital formulary. The hospital formulary book was distributed to the doctors, nursing staff and pharmacy to avoid medication administrative errors and also to provide ease of reference. The formulary was also designed in a way to help the patients receive drugs economically by including the high quality drugs of affordable brands. Results showed that fixed dose combinations accounts for highest percentage of drugs in Varma hospital formulary i.e., 22.22% (n=94) whereas it is only 8.19% (n=28) in National formulary of India whereas blood products accounts least i.e., 1.89% (n=8) in Varma hospital formulary and 1.46% (n=5) in National formulary of India. Development of hospital formulary system helps in reducing the number of brands for the same drug, selecting the drugs at affordable cost with superior quality. On a whole, the formulary helps in providing quality treatment to the patient in a standardized way.