What is Polypharmacy? Risks, Side Effects, and Safe Medication Management
Need to Know
Issue No. 3: Words from the Wise
Words - Aarti Patel, PA-C
Illustration - Stella Wei + Paloma Diaz-Dickson
What is polypharmacy?
Polypharmacy is the use of multiple medications, usually 5-10, at the same time. This can include vitamins, over-the-counter (OTC) pills, prescriptions, and supplements. Polypharmacy is of particular concern for older adults who tend to have more chronic ailments, making them more likely to be prescribed an increased number of medicines. Nearly 50% of older adults take one or more medicines that are not medically necessary.
What are the side effects and risks of polypharmacy?
Slowing Metabolism
As you age, the body processes medications differently. Kidney and liver function decreases with age, which impairs your body’s ability to break down and excrete medicines, leaving them in your body longer. Some commonly prescribed medications, including certain antibiotics and nonsteroidal anti inflammatory drugs (NSAIDs) like ibuprofen, can cause kidney failure, especially in older adults.
Drug interactions
Sometimes two medicines that are safe to take separately are unsafe to take together, potentially causing life threatening side effects. For example, someone may be on a blood thinner medicine called warfarin. If they recently also started taking ibuprofen for back pain, the combination of the warfarin and an NSAID increases the risk of gastrointestinal bleeding, which can be deadly.
What are “prescribing cascades”?
Polypharmacy increases the risk of “prescribing cascades.” This usually occurs when an adverse drug reaction (ADR) is misinterpreted as a new condition, resulting in a new medication being prescribed.
For example, an older adult may be prescribed Reglan to treat nausea, and then develop issues with movement resembling Parkinson’s disease. They see a health care provider for the new symptoms, which are actually a reaction to the original medication. Instead of discontinuing Reglan, extra medications are added, contributing to the cascade.
Here are some tips to lower your risk of adverse events from taking multiple medications:
Ask your health care provider to conduct a “brown bag review.” Bring all your medicines, herbs, vitamins, and OTC bills to your appointment and have them thoroughly reviewed.
Every time you see any new healthcare provider, bring a list of all your medicines. If possible, carry the list of medicines in your wallet or purse.
Use your pharmacist as a resource when you pick up a new medicine. They can tell you how to take it, as well as any foods, supplements, or other medicines to avoid when receiving a new prescription.
