Systems and methods are provided for look-alike sound-alike medication error messaging. Prescription data relating to a prescription is parsed to identify a submitted drug product and a submitted daily dosage. An absolute dose screening process may be executed to determine whether the submitted daily dosage meets absolute dosing criteria for the submitted drug product. A typical dose screening process may be executed to determine whether the submitted daily dosage meets statistically derived typical dosing criteria for the submitted drug product and any look-alike sound-alike alternative drug products. In addition, one or more likelihood indicators may be assigned to the submitted drug product in relation to associated look-alike sound-alike drug pairs. If it is determined that the prescription should be rejected based on typical dosing criteria, absolute dosing criteria, or the likelihood indicator(s), a reject message may be built for presentation to the pharmacist.