Ask the Doctor - Polypharmacy

Ask the Doctor
Leslee B. Cochrane, MD.
Medical Director
Ramona Visiting Nurse Association and Hospice

Question: My husband takes 8 different pills each day, I think that is not good but he tells me not to worry. How can you tell if you are taking too many medications?

The Pitfalls of Polypharmacy –

The term polypharmacy refers to the use of multiple medications and is a common problem in the elderly. Patients who take 5 or more drugs daily and those utilizing multiple physicians and/or multiple pharmacies are at greater risk of adverse effects. The potential for drug/drug interactions increases exponentially with the number of drugs used. In other words, taking 4 medicines is more than twice as likely to lead to problems as just taking two. Drugs can also interact with over the counter medicines, vitamins and nutritional products as well as certain foods.

When you see multiple doctors, or use multiple pharmacies, it becomes increasingly difficult to ensure that your providers have an accurate and up to date medication list. Without an accurate list, your doctor or pharmacist can not adequately review your medications to ensure you are on an optimal plan. Additionally, adverse reactions lead to increased hospitalizations not to mention the fact that taking multiple medications is just plain expensive.

There are several things you can do to reduce the risk of polypharmacy. First, place all of your medications in a bag including prescription, over the counter, and nutritional products. Take the bag with you on your next doctor visit and ask your doctor to explain why you take each medicine and to discuss the risks and benefits of discontinuing the medicine. For each medicine you keep, ask the doctor to include the indication for the medication on the prescription bottle: i.e. “Take one pill each morning for blood pressure”; this will help you better understand your medications.

Many patients find that they can safely reduce the number of medicines they take, thereby reducing risk and cost at the same time. Sharing the newly updated medication list with your pharmacist will enable them to run a drug safety profile and advise you of any interactions. Be sure your pharmacist is aware of all the over the counter medicines and vitamins/nutritional products you take as well. Educate yourself and remember: don’t be a Pollyanna when it comes to polypharmacy.

If you would like to submit a question please contact Jennifer Trebler at jtrebler@ramonavna.org.