NHS Fife has paid out £163, 500 settling three cases involving prescription drug errors.
Figures obtained by the Scottish Conservatives, as part of a Freedom of Information request, reveals 232 incidents have been recorded in the Kingdom since 2010.
Scotland-wide, that equates to 3331 incidents in community pharmacies and hospitals.
Health boards weren’t able to say what the medical impact of these mistakes were, but compensation pay-outs have hit nearly £200,000 in that time.
In addition, the data showed there are a further 10 live claims against the NHS for mistaken prescriptions.
Included in the figures are instances of patients being wrongly given insulin, steroids, warfarin and even heroin substitute methadone.
The most incidents occurred in Scotland’s largest health board, NHS Greater Glasgow and Clyde, while health boards in Dumfries and Galloway, Grampian and the Highlands also featured prominently.
Scottish Conservative health spokesman Jackson Carlaw said: “While so much of the focus recently has been on the cost of prescriptions, we must also recognise there’s an issue with errors in prescribing.
“I appreciate many of these will have resulted in no harm to the patient.
“But to see thousands of such incidents occurring in the last five years threatens the confidence patients and their relatives have in the NHS.
“There is also the risk of serious harm occurring to the most vulnerable people.
“And with the free prescriptions bill ever rising, health boards can hardly afford the potentially hefty compensation bills associated with mistaken prescriptions.”
NHS Fife Medical Director, Dr Frances Elliot said: "Providing effective prescriptions is a significant facet of healthcare provision and over the last five years NHS Fife has prescribed over 32 and a half million items - currently averaging just under seven million prescriptions per year.
"Patient safety is central to everything we do and NHS Fife constantly strives to achieve the highest possible standards of care for our patients. In any instance where there has been an incorrect prescription or administration of medicines, we actively encourage our staff to report this through our risk management processes. Our reporting system allows us to take swift, decisive action to not only reduce the potential for any harm in the short-term, but also to allow us to learn from any incorrect prescription in the longer-term, improving care and reducing the likelihood of similar prescription errors in the future.
"In addition, we are working on the process of Medicines Reconciliation to improve the safety of prescribing. This forms a key strand of the Scottish Patient Safety Programme. "