OBJECTIVE: In our country rational drug prescription and use has not been established yet. Moreover, because there is a lack of pharmacoeconomic research, it is hard to point the real state of art. Use of information technologies in the control of rational prescription habits is nil. We analyzed hypertensive patient prescriptions to evaluate existing practice habits. From the prescription habit profiles thus obtained and taking into consideration the recent reports of JNC-VI and WHO recommendations that are currently used in our country in medical education, we aimed to propose an urgent need for guidelines and hospital formularies. METHODS: 1864 prescriptions were obtained from the social security systems and the relevant data of 253 patients diagnosed as hypertension was entered to SPSS. RESULTS: The analysis of the prescriptions revealed inappropriate initial drug therapy in hypertension (43%). In these cases initial drug therapy for isolated hypertension began with ACE inhibitors. Average ACE inhibitor costs $12.32 and taking Turkeys economic situation, they are not cost effective. Most striking characteristic of analyzed prescriptions was polypharmacy (5 or 4 drugs = 61%). Furthermore we observed unnecessary drug class switch (less then 10 days) in 36 prescriptions. CONCLUSIONS: The results of our analysis has led us to the following conclusions. Drug choice for initial drug therapy and drug class switch is not in accordance with international guidelines. Unethical promotion (a widespread problem in Turkey) probably being the major cause. Polypharmacy, a problem we have been trying to solve since the last 15 years, still exists. By preparation and effective use of therapeutic guidelines and hospital formularies both polypharmacy and irrational drug prescription can be solved.