The potential benefits of the wise use of medicines by older adults are great. Properly used, medicines can reduce or make unnecessary the need for surgery and hospital care, prevent premature death, and help you to live independently.

Improper use of medicines, however, may pose significant risks for older people. Factors that contribute to the misuse of medicine among older adults include:

• poor communication about medication between the health profession and the older adult

• use of several prescription (and nonprescription) drugs

• use of prescription drugs from several physicians

• potential for drug reactions because of advancing age

• inability to take medication as prescribed.

Improving Communication

Communication about medication between the older adult and doctors or pharmacists may need improving. You may not have received information about possible drug reactions from your doctor or your pharmacist. In addition, you may not have asked questions.

Talk to your doctor 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 Medications Safely

If you are taking several medicines, different dosage schedules can be confusing and inconvenient. In addition, taking several medicines increases the potential for adverse drug reactions. Furthermore, if you are taking nonprescription medicines along with your prescription medicines, you may be increasing the chances of unwanted drug effects.

Another problem is that a medicine prescribed for one of your medical problems may worsen another illness or condition. In addition, a new symptom may not be caused by an illness but by a reaction to a drug. Sometimes a symptom can be treated by reducing the dosage of a medicine instead of taking a new medicine.

Ask your doctor if instead of taking another medicine you can try nondrug treatments first such as diet, stress management, and exercise. In addition, ask if you can begin therapy at a low dosage of a medicine.

Keep a list of all medicines you take and review this list with your doctor(s) on every visit, especially if a new medicine is prescribed. Ask your doctor if you can reduce the dosage of any medicine you are taking or if you can safely stop taking any medicine.

Informing All Providers About Medicines

Your doctor may prescribe a medicine for you without realizing how many medicines you are already taking that were prescribed by other doctors. Often you may end up taking too many medicines, some of which may interact harmfully with each other.

It is important to inform every doctor who treats you about all the medicines you are taking, including alcohol and nonprescription drugs. Bring a list of these medicines when you visit any of your doctors.

Recognizing Drug Reactions

As the body ages it becomes more sensitive to medicine-related problems. Aging affects your body's absorption, use, and elimination of medications. It may be harder for your liver to break down medicines and get rid of them from your body. Your kidneys may be slower to clear medicines from your system. Therefore, medicines stay in your body longer, which can become a serious problem.

Drug action varies widely in older people, making it difficult for your doctor to predict your response to a medicine. You usually need lower doses than younger people to achieve the desired effects and to avoid toxic (poisonous) overdoses. Ask your doctor to adjust your drug dosage to your age. Also, ask which drugs are most likely to cause problems and about symptoms that may result.

The difficulty of predicting your response to a drug contributes to the tendency of both the doctor and the older person to mistake undesirable medication effects for the natural effects of aging. Disorientation, fatigue, depression, and fainting are often caused by medicine but people may mistake these symptoms as old age.

Adverse reactions to a medicine can occur soon after you begin taking a medicine or after you have been on a medicine for years. You can develop an allergy to a medicine at any point. In the most extreme cases, reactions to medicines can threaten your life and are a common reason for hospitalization of older people. Ask your doctor if he or she will monitor the effects of the medicine or medicines you are taking. Ask your doctor what side effects you might have.

Depending on the medicine or combination of medicines, unwanted medication side effects may include one or more of 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 doctor if:

• Any symptom, such as vomiting, breathing difficulties, 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.

Taking Medicines as Prescribed

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

Avoid taking a lower dosage of a medicine than is prescribed. Often the medicine will not be effective at a lower dosage. Your doctor may increase the dosage or switch to a more potent medicine, which may have more side effects. It is best to take the dosage prescribed for you.

For More Information

For more information about the safe use of medicines in the older adult, write or call:

National Council on Patient Information and Education
666 Eleventh Street, N.W., Suite 810
Washington, D.C. 20001
Phone: (202) 347-6711

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