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Methotrexate (MTX) is a folic acid antagonist with cytotoxic and immunosuppressant activity andwith potent antirheumatic action. It is commonly a first choice Disease modifying antirheumatic drug (DMARD). There were some spurious reports of Adverse Drug Reaction (ADR) by this drug. Here we report a rare occurrence of Stevens-Johnson syndrome (SJS) / Toxic Epidermal Necrolysis (TEN) after the use of Methotrexate. Naranjo score for this adverse drug event was six, thereby making it a probable ADR. Symptomatic management of the patient was done and the offending drug was withdrawn. We are presenting this case to highlight the serious adverse reactions possible from a routinely prescribeddrug.

Objective: The objective of our study is to assess the prescription and drug utilization pattern in a tertiary care teaching and referral hospital in Uttar Pradesh, to investigate the rational use of drugs. Methods: The study was carried out in the general medicine outpatient department (OPD) setting for a period of 3 months in our tertiary care teaching and referral hospital. The prescriptions were randomly sampled and the photocopies of all the prescriptions were obtained from the OPD during the period of the study and were processed and analyzed for the demographic profile, drug profile, fixed-dose combinations, therapeutic classes of antibiotic prescribed, morbidity profile according to the disease pattern, and prescription pattern including the errors in prescription and the assessment of polypharmacy. Results: A total of 350 prescriptions were randomly sampled, out of which 312 prescriptions were fit to be analyzed. The total number of drugs in 312 prescriptions was 1022. Basic information of patient was written in 79.25% prescriptions, 84.25% prescriptions were legible, and only 71.21% prescriptions were complete. The majority of prescriptions had at least five drugs ordered which constituted around 43.14% of total number of prescriptions leading to polypharmacy. Conclusions: Our study highlights that there is a scope for improvement in prescribing patterns in areas of writing legible and complete prescriptions. To lay down the principles of rational pharmacotherapeutics, proper training of the prescribers on rational prescription writing is the need of an hour for improving the quality of prescriptions.