How to Prevent the Danger of Taking Too Many Medications

By Stephen Land, MD, Geriatrics and Family Medicine—Virtua Primary Care

As you get older, you’re more likely to develop chronic conditions or health problems that need treatment with prescription and over-the-counter medications or supplements. And, if you have a chronic condition or more than one health issue, you may need to take several medications on a daily basis.

Medications are often necessary to help you stay healthy. But, taking many medications—known as polypharmacy—can put you at a higher risk for problems such as drug interactions or medication misuse. 

Here’s what you need to know about polypharmacy, and what you can do to prevent serious problems.

What is polypharmacy?

Polypharmacy occurs when you use multiple medications to treat one or more health conditions. For example, you might take one prescription medication to treat high blood pressure, another for pain relief, a multivitamin and an over-the-counter medication for seasonal allergies, as needed.

How does polypharmacy happen?

Polypharmacy is most common among people with multiple chronic health conditions, such as diabetes, heart failure and heart disease, and in people age 65 and older. That’s because they usually need several medications to stay healthy.

If you’re older or have a chronic health condition, you may see many doctors for different health problems. For example, you might see a primary care physician, a cardiologist and an endocrinologist. Each doctor prescribes medications to treat specific health problems, and they may not be aware of what your other doctors are prescribing.

When you receive prescriptions from different doctors, it can be confusing. It can make it difficult for you to remember to update your medication list with each of your doctors. It also can make it tough for you to remember when and how you’re supposed to take each of your medications. 

Polypharmacy also can occur when you continue to take medications you no longer need. Or, it can happen when you fill your prescriptions at different pharmacies, such as a community pharmacy, a mail-order pharmacy and a hospital pharmacy.

How do I prevent problems related to polypharmacy?

The biggest concern with polypharmacy is having a harmful drug interaction, which can be very serious and require an emergency hospital visit. 

But, taking multiple medications isn’t necessarily dangerous—as long as the medications are managed properly. It’s very important that all your healthcare providers know about all the medications you’re taking.

Here are a few things you can do to prevent problems related to polypharmacy:

• Keep your medication list up-to-date. At each specialist or primary care appointment, your provider should review your medication list. Bring your current prescription and over-the-counter medications in their original bottles to every doctor’s appointment. Also, tell your doctor about any medications that you’re no longer taking or aren’t taking as prescribed.
• Only take necessary medications. At each doctor’s visit, ask your doctor to review your medications and your medical problems to make sure your medications are still necessary.
• Start low and go slow. Starting with the lowest possible dose can help reduce side effects of a new medication. And, if your medication list isn’t up to date, it can lower your risk of having a serious drug interaction. If the lowest-possible dose doesn’t provide the desired result, your doctor can slowly increase the dosage over time. If you experience new side effects or worrisome symptoms after a dosage change, let your doctor know right away.
• Bring a loved one along. Most patients only remember about one-third of what the doctor tells them during a typical appointment. It’s a good idea to bring someone with you to your doctor’s appointments so he or she can take notes and help you remember important instructions.
• Follow your doctor’s exact instructions. Carefully follow your doctor’s instructions on when and how to take your medications. Don’t adjust your dosage, stop taking your medications or make any other changes without first talking to the doctor who prescribed the medication.
• Fill prescriptions in one location, if possible. Many patients shop around for the lowest-cost prescription drugs. But, it’s a good idea to fill all your prescriptions at the same pharmacy. This increases the chances that your pharmacist will spot potentially harmful drug interactions. If you must use different pharmacies to keep costs down, be careful to keep your medication list up to date with each of your healthcare providers.
• Speak up about cost concerns. Medications are expensive, and many people are embarrassed to admit that they can’t afford their prescriptions. Instead of adjusting the dose on your own or skipping a medication entirely because of cost, talk to your doctor. In some cases, a less-expensive medication may be available, or you may qualify for special assistance.
• Ask your doctor if she/he uses an electronic medical record. Virtua Medical Group primary care doctors and specialists use the My Virtua electronic medical record. This lets them see your medical history as well as your medications, tests and procedures. Your doctors can use this information to make informed decisions about your medications and treatment. You also can order prescription refills through My Virtua so you have your medication when you need it.

If you have concerns related to polypharmacy, your primary care doctor can help.

Call 1-888-847-8823 today to schedule an appointment with a Virtua primary care provider.

Updated November 7, 2019