Taking multiple medicines safely

You may take more than one medicine to treat a single condition. You may also take different medicines to treat more than one health problem. For example, you may take a statin to lower your cholesterol, and a beta-blocker to control your blood pressure.

Older adults often have more than one health condition. So they are more likely to take several medicines.

The more medicines you take, the more you need to use them carefully. There are several risks when taking multiple medicines.

• You may be more likely to have side effects. Because most medicines can have side effects, the more medicines you take, the more likely you will have side effects. Taking certain medicines can also increase the risk for falls.
• You are at higher risk for drug interactions. An interaction is when one medicine affects how another medicine works. For example, taken together, one medicine may make the other medicine stronger. Medicines can also interact with alcohol and even some foods. Some interactions can be serious, even life threatening.
• You may find it hard to keep track of when to take each medicine. You even may forget which medicine you have taken at a certain time.
• You may take a medicine you do not need. This may be more likely to happen if you see more than one health care provider. You may be prescribed different medicines for the same problem.

Certain people are more likely to have problems from taking multiple medicines:

• People who are prescribed 5 or more medicines. The more medicines you take, the higher the chance of interactions or side effects. You may also find it hard to remember all possible drug interactions.
• People who take medicines prescribed by more than one provider. One provider may not know that you are taking medicines another provider has given you.
• Older adults. As you age, your body processes medicines differently. For instance, your kidneys may not work as well as they used to. This can mean that more medicine stays in your body for longer. This can lead to dangerous levels of medicines in your system.
• People in the hospital. When you are in the hospital, you will likely see new providers who are not familiar with your health history. Without this knowledge, they may prescribe a medicine that may interact with medicines you already take.

These suggestions can help you take all of your medicines safely:

• Keep a list of all medicines you take. Your list should include all prescription and over-the-counter (OTC) medicines. OTC medicines include vitamins, supplements, and herbal products. Keep a copy of the list in your wallet and at home.
• Review your medicine list with your providers and pharmacists. Discuss the list with your provider each time you have an appointment. Ask your provider if you still need to take all of the medicines on your list. Also ask if any of the dosages should be changed. Make sure you give all of your providers a copy of your medicine list.
• Ask questions about any new drugs you are prescribed. Make sure you understand how to take them. Also ask if a new medicine could interact with any of the medicines or supplements you are already taking.
• Take your medicines exactly as your provider tells you. If you have questions about how or why to take your medicine, ask your provider. Do not skip doses, or stop taking your medicines.
• If you notice side effects, tell your provider. Do not stop taking your medicines unless your provider tells you to.
• Keep your medicines organized. There are many ways to keep track of your medicines. A pill organizer may help. Try one or more methods and see what works for you.
• If you have a hospital stay, bring your medicine list with you. Talk with your provider about medicine safety while you are in the hospital.

Call if you have questions or you are confused about the directions for your medicine. Call if you have any side effects from your medicines. Do not stop taking any medicine unless your provider tells you to stop.

Polypharmacy

Agency for Healthcare Research and Quality website. 20 tips to help prevent medical errors: patient fact sheet. www.ahrq.gov/patients-consumers/care-planning/errors/20tips/index.html. Updated November 2020. Accessed August 11, 2022.

National Institute on Aging website. www.nia.nih.gov/health/safe-use-medicines-older-adults. Updated June 26, 2019. Accessed August 11, 2022.

Ryan R, Santesso N, Lowe D, et al. Interventions to improve safe and effective medicines use by consumers: an overview of systematic reviews. Cochrane Database Syst Rev. 2014;29(4):CD007768. PMID: 24777444 pubmed.ncbi.nlm.nih.gov/24777444/.

US Food & Drug Administration website. Buying & using medicine safely. www.fda.gov/drugs/information-consumers-and-patients-drugs/buying-using-medicine-safely. Updated April 9, 2024. Accessed April 22, 2024.

US Department of Health and Human Services website. Healthy living: use medicines safely: the basics. health.gov/myhealthfinder/healthy-living/safety/use-medicines-safely#the-basics-tab. Updated July 20, 2022. Accessed August 11, 2022.

US Department of Health and Human Services website. Healthy living: use medicines safely: take action. health.gov/myhealthfinder/healthy-living/safety/use-medicines-safely#take-action-tab. Updated July 20, 2022. Accessed August 11, 2022.

Updated by: Linda J. Vorvick, MD, Clinical Professor, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington, Seattle, WA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.