Senior Health

1/18/2022 | By Howard LeWine, M.D.

Three in five older adults take five medications per person. Besides possible benefits, taking a large number of medications comes with significant health risks. One reader asks, is there a way to safely reduce daily pill count? Howard LeWine, M.D., is an internist at Brigham and Women’s Hospital in Boston and assistant professor at Harvard Medical School, answers.

Question:

I take of a lot of pills, and the list keeps growing. What’s a good way to think about decreasing my medications safely?

Answer:

Medication regimens often start simply, perhaps with a multivitamin and a single prescription drug to treat a chronic condition. But with age and more health problems, a regimen may grow to include additional prescription drugs and dietary supplements (such as vitamin D and calcium), plus over-the-counter medicines to reduce symptoms such as pain or heartburn. In time, you can find yourself facing a crowded pillbox and a complicated regimen.

You have lots of company. Among older adults, a third will take five medications per person. High pill burdens have led to a trend called deprescribing, a process of eliminating unnecessary medications. There continues to be a push for more patients to cut down on their medications because of the potential downsides, but it isn’t happening often enough.

Related: Medication and supplement interactions

Health risks

It can be a hassle to take even one pill on a regular basis. But the challenge of a large drug regimen goes well beyond inconvenience. As the number of pills you take increases, so do the costs – to your insurance, and to you. Less obvious are the following potential problems.

  • Side effects: The more medications you take, the more chance there is that you’ll experience side effects.
  • Medication errors: It’s easier to get confused about which pill you took when, so you may wind up skipping a dose or taking too many.
  • Drug interactions: Particularly if you are seeing a number of different doctors, or if you use several different pharmacies, you run the risk for drug interactions.
  • Drug regimen fatigue: The more complicated a medication schedule is, the more likely it is that someone won’t take the pills as prescribed. People may pick and choose what they want to take that day because they get tired of taking pills.

Related: How seniors can practice safe medication management

How to reduce daily pill count

If you have a complicated drug regimen that is causing problems like these, you definitely want to consider downsizing. But don’t try to simplify your regimen on your own. That can worsen the control of your condition and lead to feeling worse.

Talk with your doctor or pharmacist about deprescribing. It’s best to be direct and say you feel like you’re taking too many pills. Then ask what you can do to reduce your medications.

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Related: Reduce the risk of medication errors

Howard LeWine, M.D.

Howard LeWine, M.D., is an internist at Brigham and Women’s Hospital in Boston and assistant professor at Harvard Medical School. For additional consumer health information, please visit www.health.harvard.edu.