Safe Use of Medicines for the Older Adult

The wise use of medicines can greatly benefit older adults. Properly used, medicines can:

• reduce or make unnecessary surgery and hospital care
• prevent premature death
• help you to live independently.

Improper use of medicines, however, can pose great risks. Factors that contribute to the misuse of medicine among older adults include:

• poor communication about medicine between you and your health care providers
• use of several prescription (and nonprescription) drugs
• use of prescription drugs from several health care providers
• increased chance for drug reactions because of advancing age
• not taking drugs as prescribed.

Improving Communication

Be sure to tell your provider about any allergies or reactions to medicines you have had in the past.

You may not have received information about possible drug reactions from your health care provider or your pharmacist. In addition, you may not have asked questions.

Talk to your health care provider or pharmacist about your medicines. Ask questions and speak up when you do not understand information you are given. Also, ask for written instructions about your medicines.

Taking Several Medicines Safely

If you are taking several medicines, the different dosage schedules can be confusing and troublesome. Also, taking several medicines increases the chance of harmful drug reactions. If you are taking nonprescription medicines along with prescribed drugs, you may also be increasing the chances of unwanted drug effects.

Tell your health care provider about any herbal remedies, vitamins, and supplements you are using. These substances may cause a reaction or serious interaction when used with prescription medicines.

Some nonprescription medicines are dangerous when taken in large quantities. Examples are aspirin and vitamin pills with iron. Before you take nonprescription medicines, check with your health care provider.

A medicine prescribed for one of your medical problems may make another condition worse. A new symptom may not be caused by an illness but by a drug reaction. Sometimes a symptom can be treated by reducing the amount of medicine instead of taking a new medicine.

Ask your health care provider:

• if instead of taking another medicine you can try nondrug treatments first such as diet, stress management, and exercise
• if you can start taking a medicine at a low dosage
• if you can reduce the dosage of any medicine you are taking
• if you can safely stop taking any medicine.

Keep a list of all medicines you take and review this list with your health care provider(s) on every visit. This is especially important when your health care provider prescribes a new medicine.

Telling All Providers About Medicines

Your health care provider may prescribe a medicine without knowing about other medicines you are taking that were prescribed by other health care providers. You may end up taking too many medicines, some of which may interact harmfully with other ones.

Tell every health care provider who treats you about all the medicines you are taking, including nonprescription drugs, and how much alcohol you drink. Bring a list of these medicines when you visit any of your health care providers.

Recognizing Drug Reactions

Problems related to medicine become more likely as you get older. Aging affects the way your body absorbs, uses, and eliminates medicines. It may be harder for your liver to break down medicines and clear them from your body. Your kidneys may be slower to eliminate drugs from your system. Medicines can therefore stay in your body longer and become a serious problem.

Drug action varies widely in older people. That makes it hard for your health care provider to predict your response to a medicine. Older people usually need less of a drug than younger people to get the desired effects and avoid overdoses. Symptoms commonly caused by drug reactions (such as tiredness and confusion) may be mistaken for the natural effects of aging. Ask your health care provider:

• to adjust your drug dosage to your age
• to monitor the effects of the medicine or medicines you take
• which drugs are most likely to cause problems
• about the side effects that may result.

Depending on the medicine or medicines you are taking, adverse effects may include the following:

• falls and muscular weakness
• faintness when rising quickly from a bed or chair
• confusion, forgetfulness, drowsiness, fatigue
• depression or sadness
• difficulty breathing
• skin rashes and bruising
• nausea, indigestion, vomiting
• constipation, diarrhea, incontinence, or difficulty urinating
• headache, ringing in the ears, or blurred vision
• difficulty sleeping, irritability, or nervousness
• dry mouth
• Parkinsonism (tremors, stiffness, and slowness of movement or jerkiness of the legs)
• a feeling of being unable to sit still or sit down
• uncontrollable movements of the face, such as sticking out the tongue and sucking motions.

Call your health care provider if:

• Any symptom, such as vomiting, breathing problems, headache, confusion, or drowsiness is severe or long-lasting.
• Symptoms develop soon after you have started taking a new medicine or after eating a certain food.
• Symptoms such as forgetfulness, depression, confusion, or fatigue develop slowly over a period of weeks or months. Some adverse effects take a while to show up.
• You suspect that a symptom is related to a combination of medicine and alcohol. The use of alcohol may worsen side effects of your medicines.
• A mild symptom, such as dry mouth, lessens your pleasure in life.

You can have an adverse reaction to a medicine the first time you take it or after years of being on it. You can develop an allergy to a medicine at any point. In the most extreme cases, reactions to medicines can be fatal.

Taking Medicines as Prescribed

Keep medicines for emergencies in a place where you can find them easily.

Never take someone else's medicine.

If you are taking several medicines, be careful not to get confused and take too much of one or more medicines.

Avoid changing the dose of a medicine that you have been prescribed. Often the medicine will not be effective at a lower dosage. Your health care provider may increase the dosage or switch to a stronger medicine, which may have more side effects. It is best to take the dosage prescribed for you.

Discard any medicines you are no longer using. Also discard any medicine if you can no longer read its label or if it is outdated. Ask your pharmacist for the best way to dispose of medicine. Do not throw medicines in the trash.

For More Information

For more information about the safe use of medicines in the older adult, contact:

National Council on Patient Information and Education
4915 St. Elmo Avenue
Suite 505
Bethesda, MD 20814-6053
Phone: 301-656-8565
Web site: http://www.talkaboutrx.org

The National Council on Patient Information and Education (NCPIE) is a nonprofit organization. Its goal is to promote the safe and effective use of prescription medicines.