How many prescription medications are you taking? Here are six reasons to make sure you take only what you need
If you aren’t taking any, you are certainly in the minority (according to research from 2017, only 1 in 13 over-65s do not take any regular medication). 
You might be taking one or two – perhaps a statin, something for your blood pressure, or an anti-inflammatory (like ibuprofen) to help your arthritis.
Or you could be in the 50% of over-65s who take at least five drugs a day (according to a recent study carried out at Cambridge University ). If you aren’t, you will certainly know friends, family or neighbours who are.
Someone told me last week ‘I feel like I am rattling with all these pills inside me!’. Elizabeth was worried about the potential side effects of the four different pills she’s now taking. She had started reading the information leaflets, but that just made her more anxious, which seemed to defeat the point (one of them is an anti-anxiety medication!).
You might also be worrying about possible side-effects, or just struggling to keep track of what you are meant to take when. Or you could be concerned about a family member who seems to be taking a lot of pills (and is no longer even sure why they are taking them all).
Even though we are confused and worried, we tend to avoid asking questions or we don’t know who to ask. We are conditioned to follow instructions from doctors and other health professionals, and it can feel disrespectful to question their advice. Often these questions occur to us after an appointment, when it can be difficult to get back to ask them. We don’t want to feel like we are bothering health professionals with endless questions.
However, there are many reasons why we should stop and think about the medications we are taking (and why many pharmacists and doctors also think this is a good idea).
Here are some of the reasons why ‘rattling with pills’ may not be such a good idea after all:
- All medications have potential side effects. These can be serious or, in rare cases, fatal. Even if the side effects are less serious, they can lead to a ‘prescribing cascade’. This happens when you are prescribed one medication but experience an unpleasant side-effect. You are then prescribed another medication to help manage the side effect. Soon the number of pills you are taking escalates, as does the risk of interactions and other side effects.
- Your risk of falling (and the associated likelihood of broken bones) increases as your prescription list gets longer. You are at a significantly higher risk of falling if you are taking 3 or more prescription medicines. Certain medications are known to cause dizziness and problems with your balance, (e.g. benzodiazepines and certain anti-histamines).
- Interactions are important but less well-understood than side-effects. Some medications interact with others or affect the levels of the enzymes needed to absorb another medication. The impact of this can be either that none of the drug is absorbed, or that too much is, leading to a sort of overdose effect. The more medications you are taking, the more likely you are to experience difficulties from these interactions.
- Many people don’t realise that nutritional and herbal supplements can also interact with prescription medicines. Research has shown that two popular supplements – St John’s Wort and omega-3 oils –can affect common blood pressure medications (amlodipine and bisoprolol) . Flaxseed and cod liver oil are also known to interact with commonly-prescribed medications.
- Unfortunately, prescription errors can occur. Mistakes can include giving the wrong medication, the wrong dose or format, or not checking whether something is appropriate for the patient. Research published in Feb 2018 identified more than 230 million medication errors every year in the NHS.
- It becomes harder to metabolise medicines with age. This can mean we absorb less of the medicine, or are more sensitive to side effects. So what worked for us 5 or 10 years ago may no longer be appropriate.
The last thing I want to do here is to worry you further.
It is most likely that the medications you are taking are crucial to keeping you well and living a full life. In that case, it is vital that you ensure you are on the correct dose, taking them correctly and not taking anything else (medical or herbal) which could affect them.
It could be that there are some medications which you no longer need, or where the side effects outweigh the benefits, and it would be worth considering an alternative.
Over recent years there has been a move towards something called de-prescribing. De-prescribing acknowledges the many risks of taking too many medications, especially for older people. It involves a considered review of your health status, personal situation and medications. The goal is for you to be taking the minimum number of medications needed to stay healthy. It works best in conjunction with considering lifestyle approaches (e.g. eating well, being active and reducing stress, amongst other things).
Please be aware that it can be dangerous to stop taking any prescription medication suddenly. You should not change or stop taking any medications without consulting your doctor first.
We recommend all our clients to book a medications review with their pharmacist or doctor. In the UK, you can book a Medicine Use Review (MUR) with a pharmacist. The recommendation is to book this review session once a year. However, if you are worried about anything relating to your medications, you should call or visit your pharmacist. They will be able to talk to you without needing to book an appointment.
If you are concerned about your balance, you may also be interested in this article: Could your medications be affecting your balance?
How many medications are you taking? Are you worried about side effects or concerned about a friend or family member with an ever-increasing prescription list? Let me know in the comments below or using our contact us page. I look forward to hearing from you!
Footnotes for research