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Medication Management for Older Adults

As we age, our bodies change. Some changes we can see and feel. This includes aches and pains that linger or simple movements, like walking or getting out of a chair, may be slower or more painful than they used to be. Some we can’t feel. For example, how our bodies may change in how they respond to and absorb medicines. In fact, according to the FDA’s medication guide for seniors, changes in the digestive system can affect how fast medicines enter the bloodstream.

A change in body weight can affect the amount of medicine you need to take. It can also affect how long it stays in your body. The circulation system may slow down, which affects how fast drugs get to the liver and kidneys. The liver and kidneys also may work more slowly. This could affect the way a drug breaks down and is removed from the body. As a result, medicines will stay in the body longer. This can cause more severe side effects. Doses must be properly adjusted and monitored. Because of these changes in our body as we age, there is also a higher risk of drug interactions in older adults.

Most older Americans (48%) take at least one medication and many older adults take three or more medications each day.  Older adults comprise 13% of the U.S. population, but account for 34% of all prescription medicine use and 30% of all over-the-counter (OTC) medicine use.

Medication Management for Older Adults: 10 important facts  

  1. Seniors use more medicines—prescription, over-the-counter and supplements—than any other age group in the U.S.
  2. Older adults often use multiple medicines, increasing the risk of drug interactions and the potential for side effects.
  3. Your liver and kidneys may not work as well as when you were younger. Decreased function can affect how medicine works, is absorbed, broken down and removed from the body.
  4. Medicines may stay in the body longer and cause side effects if doses are not properly adjusted.
  5. Age-related changes such as weight loss, decreased body fluid and increased fatty tissue can alter the way drugs are distributed and concentrated in the body.
  6. Increased sensitivity to medicines is more common in older adults.
  7. Impaired memory, hearing and vision make it difficult to understand and remember instructions, especially for those with complicated regimens. Many older Americans also face declining grip strength, mobility and memory lapses—all of which can affect the ability to take medication as prescribed.
  8. Older adults tend to receive prescriptions from different healthcare professionals making it difficult to track medicines and identify drug interactions, harmful doses, and ineffective medicines.
  9. Chronic conditions such as diabetes, high blood pressure, and arthritis are more common in older adults and often require a complex medicine regimen.
  10. Older adults may not follow medication plans because of forgetfulness, side effects, a perception that the medicine isn’t working, or cost. Not following medicine instructions is called non-adherence.

The good news is, many of these risks or challenges can be prevented if you are informed about safe and appropriate medication use and how to get the most from your medications.

Tips to prevent problems 

  1. Learn about your health conditions and medicines. Talk with healthcare providers, read trustworthy websites, join support groups.
  2. Maintain a medication list with:
    • Medication names including OTCs, supplements, herbal remedies
    • Who prescribed each prescription
    • The purpose of each medication and symptoms it should treat
    • How often and at what dose you take each
    • Are refills needed?
    • Update the list when you take something new, if a medicine is stopped or if your dosage changes. Your provider should review your medications so you’re only taking those you need. Discuss allergies or problems you’ve had with medicines. Don’t stop taking prescriptions without checking with him/her first.
  3. Read the Drug Facts label, package inserts or Patient Medicine Information leaflets which tell you:
    • What the medicine is for
    • How to take your medicine
    • How often you should take it and what dosage
    • Side effects or allergic reactions
    • Warnings including who shouldn’t take the medicine, when to stop use and ask a doctor, who is at increased risks of side effects
    • Storage instructions
  4. Use one pharmacy so your pharmacist can monitor your medications and check for drug interactions.
  5. Safely store medicines. Check expiration dates. Keep medications in the bottle/tube they came in so dosage and directions are at hand. Keep medicines up and away from children. Never share your prescriptions or take others’ medications.
  6. Contact your provider if you have problems with your medicine.
  7. Identify a “patient navigator.” Ask your primary care physician to act as “navigator” for the healthcare system so one person/practice can ensure your conditions and treatment regimens are tracked. Medicare’s Medication Therapy Management Program, helps healthcare professionals fulfill this role.

Aging + Alcohol + Prescription medications = Health risk

Drinking alcohol when you are taking a prescription medication is a health risk for many older adults. Aging bodies work more slowly to clear both medications and alcohol, which can make seniors more sensitive to the effects of both. Many prescriptions may interact with alcohol and cause potentially dangerous effects. Prescription medications also may not work as intended when combined with alcohol, may not work at all, or they may become harmful–even toxic. If you have certain health conditions or take certain medications, you may need to drink less or not at all.  Ask your health care professional.


Learn More

See these educational tools and resources to maximize the benefits of your medicines as you age, and reduce risks
  • Medication Use Safety Training for SeniorsTM (MUST for SeniorsTM) toolkit: easy-to-view and download educational materials  and info sheets on avoiding medicine mishaps, managing side effects, and improving medicine use knowledge. 
  • Acetaminophen, Pain Management and Older Adults: a Guide to Safe Use
    Older adults use more pain relievers and use them more often than any other age group. Medicine side effects and interactions between multiple medicines are more common in older adults, so it is important to be aware of certain risks associated with pain relievers and follow instructions for using them safely. 
  • The FDA’s Medicines and You: A Guide for Older Adults
    See the U.S. Food and Drug Administration’s comprehensive information customized to older Americans and their specific medicine safety issues.