As you get older you may be faced with more health conditions that you need to treat on a regular basis. It is important to be aware that more use of medicines and normal body changes caused by aging can increase the chance of unwanted or maybe even harmful drug interactions. The more you know about your medicines and the more you talk with your health care professionals, the easier it is to avoid problems with medicines.

As you get older, body changes can affect the way medicines are absorbed and used. For example, changes in the digestive system can affect how fast medicines enter the bloodstream. Changes in body weight can influence the amount of medicine you need to take and how long it stays in your body. The circulatory system may slow down, which can affect how fast drugs get to the liver and kidneys. The liver and kidneys also may work more slowly, affecting the way a drug breaks down and is removed from the body.

Drug Interactions

Because of these body changes, there is also a bigger risk of drug interactions among older adults. Therefore, it's important to know about drug interactions.

• Drug-drug interactions happen when two or more medicines react with each other to cause unwanted effects. This kind of interaction can also cause one medicine to not work as well or even make one medicine stronger than it should be. For example, you should not take aspirin if you are taking a prescription blood thinner, such as warfarin, unless your health care professional tells you to.
• Drug-condition interactions happen when a medical condition you already have makes certain drugs potentially harmful. For example, if you have high blood pressure or asthma, you could have an unwanted reaction if you take a nasal decongestant.
• Drug-food interactions result from drugs reacting with foods or drinks. In some cases, food in the digestive tract can affect how a drug is absorbed. Some medicines also may affect the way nutrients are absorbed or used in the body.
• Drug-alcohol interactions can happen when the medicine you take reacts with an alcoholic drink. For instance, mixing alcohol with some medicines may cause you to feel tired and slow your reactions.

It is important to know that many medicines do not mix well with alcohol. As you grow older, your body may react differently to alcohol, as well as to the mix of alcohol and medicines. Keep in mind that some problems you might think are medicine-related, such as loss of coordination, memory loss, or irritability, could be the result of a mix between your medicine and alcohol.

What Are Side Effects?

Side effects are unplanned symptoms or feelings you have when taking a medicine. Most side effects are not serious and go away on their own; others can be more bothersome and even serious. To help prevent possible problems with medicines, seniors must know about the medicine they take and how it makes them feel.

Keep track of side effects to help your doctor know how your body is responding to a medicine. New symptoms or mood changes may not be a result of getting older, but could be from the medicine you're taking or another factor, such as a change in diet or routine. If you have an unwanted side effect, call your doctor right away.

Talk to Your Health Care Professionals

It is important to go to all your medical appointments and to talk to your team of health care professionals (doctors, pharmacists, nurses, or physician assistants) about your medical conditions, the medicines you take, and any health concerns you have. It may help to make a list of comments, questions, or concerns before your visit or call to a health care professional. Also, think about having a close friend or relative come to your appointment with you if you are unsure about talking to your health care professional or would like someone to help you understand and remember answers to your questions. Here are some other things to keep in mind:

• All medicines count. Tell your team of health care professionals about all the medicines you take, including prescription and over-the-counter (OTC) medicines, such as pain relievers, antacids, cold medicines, and laxatives. Don't forget to include eye drops, dietary supplements, vitamins, herbals, and topical medicines, such as creams and ointments.
• Keep in touch with your doctors. If you regularly take a prescription medicine, ask your doctor to check how well it is working. Check to see whether you still need to take it and, if so, whether there is anything you can do to cut back. Don't stop taking the medicine on your own without first talking with your doctor.
• Medical history. Tell your health care professional about your medical history. The doctor will want to know whether you have any food, medicine, or other allergies. He or she also will want to know about other conditions you have or had and how you are being treated or were treated for them by other doctors. It is helpful to keep a written list of your health conditions that you can easily share with your doctors. Your primary care doctor should also know about any specialist doctors you may see on a regular basis.
• Eating habits. Mention your eating habits. If you follow or have recently changed to a special diet (a very low-fat diet, for instance, or a high-calcium diet), talk to your doctor about this. Tell your doctor about how much coffee, tea, or alcohol you drink each day and whether you smoke. These things may make a difference in the way your medicine works.
• Recognizing and remembering to take your medicines. Let your health care professional know whether you have trouble telling your medicines apart. The doctor can help you find better ways to recognize your medicines. Also tell your doctor if you have problems remembering when to take your medicines or how much to take. Your doctor may have some ideas to help, such as a calendar or pill box.
• Swallowing tablets. If you have trouble swallowing tablets, ask your doctor, nurse, or pharmacist for ideas. Maybe there is a liquid medicine you could use or maybe you can crush your tablets. Do not break, crush, or chew tablets without first asking your health care professional.
• Your lifestyle. If you want to make your medicine schedule more simple, talk about it with your doctor. He or she may have another medicine or other ideas. For example, if taking medicine four times a day is a problem for you, maybe the doctor can give you a medicine you only need to take once or twice a day.
• Put it in writing. Ask your health care professional to write out a complete medicine schedule, with directions on exactly when and how to take your medicines. Find out from your primary care doctor how your medicine schedule should be changed if you see more than one doctor.
• Keep a record of your medicines. List all prescription and OTC medicines, dietary supplements, vitamins, and herbals you take.

Your Pharmacist Can Help, Too

One of the most important services a pharmacist can offer is to talk to you about your medicines. A pharmacist can help you understand how and when to take your medicines, what side effects you might expect, or what interactions may occur. A pharmacist can answer your questions privately in the pharmacy or over the telephone.

Here are some other ways your pharmacist can help:

• Many pharmacists keep track of medicines on their computer. If you buy your medicines at one store and tell your pharmacist all the OTC and prescription medicines or dietary supplements you take, your pharmacist can help make sure your medicines don't interact harmfully with one another.
• Ask your pharmacist to place your prescription medicines in easy-to-open containers if you have a hard time taking off child-proof caps and do not have young children living in or visiting your home. Remember to keep all medicines out of the sight and reach of children.
• Your pharmacist may be able to print labels on prescription medicine containers in larger type, if reading the medicine label is hard for you.
• Your pharmacist may be able to give you written information to help you learn more about your medicines. This information may be available in large type or in a language other than English.

What to Ask Your Doctor or Pharmacist

• What is the name of the medicine and what is it supposed to do? Is there a less expensive alternative?
• How and when do I take the medicine and for how long?
• Should it be taken with water, food, or with a special medicine, or at the same time as other medicines?
• What do I do if I miss or forget a dose?
• Should it be taken before, during, or after meals?
• What is the proper dose? For example, does "four times a day" mean you have to take it in the middle of the night?
• What does your doctor mean by "as needed"?
• Are there any other special instructions to follow?
• What foods, drinks, other medicines, dietary supplements, or activities should I avoid while taking this medicine?
• Will any tests or monitoring be required while I am taking this medicine? Do I need to report back to the doctor?
• What are the possible side effects and what do I do if they occur?
• When should I expect the medicine to start working, and how will I know if it is working?
• Will this new prescription work safely with the other prescription and OTC medicines or dietary supplements I am taking?
• Do you have a patient profile form for me to fill out? Does it include space for my OTC drugs and any dietary supplements?
• Is there written information about my medicine? Ask the pharmacist to review the most important information with you. (Ask if it's available in large print or in a language other than English if you need it.)
• What is the most important thing I should know about this medicine? Ask the pharmacist any questions that may not have been answered by your doctor.
• Can I get a refill? If so, when?
• How and where should I store this medicine?

Cutting Medicine Costs

Medicines are an important part of treating an illness because they often allow people to remain active and independent. But medicine can be expensive. Here are some ideas to help lower costs:

• Tell your doctor if you are worried about the cost of your medicine. Your doctor may not know how much your prescription costs, but may be able to tell you about another less expensive medicine, such as a generic drug or OTC product.
• Ask for a senior citizen's discount.
• Shop around. Look at prices at different stores or pharmacies. Lower medicine prices may not be a bargain if you need other services, such as home delivery, patient medicine profiles, or pharmacist consultation, or if you cannot get a senior citizen discount.
• Ask for medicine samples. If your doctor gives you a prescription for a new medicine, ask your doctor for samples you can try before filling the prescription.
• Buy bulk. If you need to take medicine for a long period of time and your medicine does not expire quickly, you may be able to buy a larger amount of the medicine for less money.
• Try mail order. Mail-order pharmacies can provide medications at lower prices. However, it is a good idea to talk with your doctor before using such a service. Make sure to find a backup pharmacy in case there is a problem with the mail service.
• Buy OTC medicines when they are on sale. Check the expiration dates and use them before they expire. If you need help choosing an OTC medicine, ask the pharmacist for help.

If you decide to buy medicines on the Internet, check the Web site for the Verified Internet Pharmacy Practice Sites (VIPPS) program seal of approval to make sure the site is properly licensed and has been successfully reviewed and inspected by the National Association of Boards of Pharmacy.

Why is a medicine I've taken for years no longer working?

As you age, changes in your body can affect how well medicines work. For example, the body may become less able to absorb the medicine. Older adults often have multiple medical conditions or take several medications at the same time, which can also affect how medicines work. And as an illness worsens, the medicines used to treat it might not be as effective as they once were. Talk to your doctor if you think your medicine is not working as well as it should be.

Why do I need to pay attention to the active ingredients in my medications?

Learn which active ingredients are in the prescription drugs, OTC medicines, and supplements you take so that you don’t take more than one that contains the same active ingredient. For example, if your cough syrup contains acetaminophen, don’t take it at the same time as a pain reliever that also contains that ingredient. Taking more than one medication or supplement with the same active ingredient could damage your liver or lead to other serious health problems.

What do the abbreviations in my prescription mean?

Doctors and pharmacists often use abbreviations or terms that may not be familiar to you. Here is an explanation of some of the most common abbreviations you will see on labels of your prescription medications:

• Rx means “prescription”
• prn means “as needed”
• qd means “every day,” bid means “twice a day,” tid means “three times a day,” qid means “four times a day”
• ac means “before meals,” pc means “after meals”
• hs means “at bedtime”
• po means “by mouth”
• ea means “each”

Ask your pharmacist to explain any terms or abbreviations on your prescription medication label that you don’t understand.

What does it mean to take medicines on an empty stomach?

Some medications need to be taken when your stomach is empty because food or drink can affect how they work. Taking medicines on an empty stomach generally means that you should take your pills at least two hours before you eat or two hours after you eat. However, this is only a rough guideline. Be sure to follow the instructions from your pharmacist about exactly when to take your medications.

Is it okay to stop taking my medicine if I start to feel better?

No. Even if you are feeling better, you should not stop taking your prescription drug unless your doctor says it’s okay. If you stop taking your medicine before you are supposed to, you may not get its full effect, or your condition could worsen. Some medicines need to be stopped slowly, and others (such as antibiotics) need to be taken until they are gone. Talk with your doctor or pharmacist if you are unsure about when you can stop taking a medication.

Medicines, often referred to as drugs, are used to prevent or treat diseases and other health conditions. Medicines can be obtained by a prescription or over the counter (OTC). Prescription drugs are medicines that you can get only with a doctor’s order; for example, pills to lower your cholesterol or an asthma inhaler. OTC medications can be purchased without a prescription; for example, aspirin or lubricating eye drops.

Dietary supplements are not considered drugs because they are not intended to prevent or treat diseases. Rather, these products are intended to maintain or improve health, and they may help you meet your daily requirements for essential vitamins and minerals. For example, calcium and vitamin D can help build strong bones.

It can be dangerous to combine certain prescription drugs, OTC medicines, dietary supplements, or other remedies. For example, you should not take aspirin if you take warfarin for heart problems. To avoid potentially serious health issues, talk to your doctor about all medicines you take, including those prescribed by other doctors, and any OTC drugs, vitamins, supplements, and herbal remedies. Mention everything, even ones you use infrequently.

Talk with your health care provider before starting any new prescription, OTC medicine, or supplement, and ensure that your provider knows everything else you are taking. Discuss any allergies or problems you have experienced with other medicines. These might include rashes, trouble breathing, indigestion, dizziness, or mood changes. Make sure your doctor and pharmacist have an up-to-date list of your allergies so they don’t give you a medicine that contains something that could cause an allergic reaction.

You will also want to find out whether you’ll need to change or stop taking any of your other prescriptions, OTC medicines, or supplements while using this new medicine. Mixing a new drug with medicines or supplements you are already taking might cause unpleasant and sometimes serious problems. For example, mixing a drug you take to help you sleep (a sedative) and a drug you take for allergies (an antihistamine) can slow your reactions and make driving a car or operating machinery dangerous.

When starting a new medication, be sure to write down the name of the drug, the dose, and why it’s being prescribed for you. Also, make note of any special instructions for how to take the medicine. For many drugs, this information is included on the bottle or prescription label.

Before you start a new medicine, your doctor or pharmacist can provide important information and answer any questions.

Ask your doctor:

• What is the name of the medicine and why am I taking it?
• Is there a less expensive alternative?
• What medical condition does this medicine treat?
• When should I expect the medicine to start working? How will I know if it’s working?
• What type of side effects might I expect, if any? What should I do if I experience serious side effects?
• Will this drug cause problems if I am taking other prescriptions, OTC medicines, or supplements?
• What should I do if I want to stop taking this medicine? Is it safe to stop abruptly?
• Will I need a refill? If so, will I need a follow-up appointment or other testing before I can refill the medication?

Ask your pharmacist:

• Is it safe for me to drive while taking this medication?
• Should I take the medicine with food or not? Is there anything I should not eat or drink when taking this How much medicine should I take?
• How many times a day should I take it? At what time(s)? If the bottle says take “four times a day,” does that mean four times in 24 hours or four times when I am awake?
• What does “as needed” mean?
• If I forget to take my medicine, what should I do?

Each time you visit one of your health care providers, tell them about any new prescription drugs, OTC medicines, and supplements you’re taking and be sure to ask if you still need to be on all your medications.

When you get your prescriptions filled, the pharmacist can answer many of your questions about prescription drugs, OTC medicines, and supplements. Try to have all your prescriptions filled at the same pharmacy so your records are in one place. This will help alert the pharmacist if a new drug might cause a problem with something else you’re taking. If you’re unable to use just one pharmacy, share your list of medicines and supplements with the pharmacist at each location when you drop off your prescription.

When you have a prescription filled:

• Ask your pharmacist if there is a patient profile you can fill out, so the pharmacy is aware of all drugs and OTC medications, vitamins, and supplements you take.
• Tell the pharmacist if you have trouble swallowing pills. There may be liquid medicine available. Do not chew, break, or crush tablets without first asking if this will change the way the drug works.
• Make sure you can read and understand the name of the medicine as well as the directions on the container and on the color-coded warning stickers on the bottle. If the label is hard to read, ask your pharmacist to use larger type.
• Read all the information about your medication carefully. Many prescription medicines come with paper handouts, called medication guides, that contain information to help patients avoid serious side effects.
• Check that you can open the container. If not, ask the pharmacist to put your medicines in bottles that are easier to open.
• Ask about special instructions on where to store a medicine. For example, should it be kept in the refrigerator or in another climate-controlled place?
• Check the label on your medicine before leaving the pharmacy. It should have your name on it and the directions provided by your doctor. If it doesn’t, don’t take it, and talk with the pharmacist.

The image below points out information typically present on a prescription label. Please note that your prescription label may have a different format than the one shown. The prescription number is usually printed in the upper left corner of the label.

Talk with your doctor or pharmacist if you have questions about the written information that comes with your prescription.

When you travel, your health care provider may recommend that you adjust your medicine schedule to account for changes in time zones, routine, and diet. Ask your doctor or pharmacist about these changes before you depart. Carry a list of all the prescription drugs, OTC medicines, and supplements you take and the phone numbers of your doctors and pharmacists. When flying, carry your medicines with you; do not pack them in your checked luggage. Take enough medication with you in case you need to stay longer. Always keep medicines out of heat and direct sunlight both at home and when traveling.

Unwanted or unexpected symptoms or feelings that occur when you take medicine are called side effects. Side effects can be relatively minor, such as a headache or a dry mouth. They can also be life-threatening, such as severe bleeding or damage to the liver or kidneys. The side effects of some medications can also affect your driving.

Some side effects may appear when you start taking a medicine but get better with time. Others occur once in a while. But some side effects may be ongoing while you’re on the medication. If you have uncomfortable side effects, don’t stop taking your medicine before you talk with a health care provider. Write them down so you can report them to your doctor or pharmacist accurately. Call your doctor right away if you have any problems with your medicines or if you are worried that the medicine might be doing more harm than good. Your health care provider may be able to prescribe a different medicine or help you deal with side effects in other ways.

A generic drug is a medication created to work the same way and have the same effects as an already marketed brand-name drug. Generic drugs and their brand-name equivalents contain the same active ingredients, which are the parts of the medicine that make it work. A generic drug is just as safe, and is of equal strength and quality, as a brand-name drug. You take a generic drug the same way as a brand-name drug. Generic drugs are usually less expensive than their brand-name counterparts, and they are more likely to be covered by health insurance.

Many older people take multiple medications, and it can be challenging to keep track of everything. Here are some tips that can help:

• Make a list. Write down all medicines you take, including OTC drugs. Also include any vitamins or dietary supplements. The list should include the name of each medicine or supplement, the amount you take, and time(s) you take it. If it’s a prescription drug, also note the doctor who prescribed it and the reason it was prescribed. Show the list to all your health care providers, including physical therapists and dentists. Keep one copy in a safe place at home and one in your wallet or purse.
• Get familiar with your medicines. If you take more than one medicine, make sure you can tell them apart by size, shape, color, or the number imprinted on the pill.
• Create a file. Save all the written information that comes with your medicines and keep it somewhere you can easily refer to it. Keep these guides for as long as you’re taking the medication.
• Check expiration dates on bottles. Don’t take medicines that are past their expiration date. Your doctor can tell you if you need a refill.
• Secure your medicines. Keep your medicines out of the reach of children and pets. If you take any prescription pain medicines (for example, morphine, other opioids, or codeine), keep them in a locked cabinet or drawer. If your medicines are kept in bottles without safety caps because those are hard for you to open, be extra careful about where you store them.
• Dispose of your medicines safely. Check the expiration dates on your medication bottles and discard any unused or expired medicines as soon as possible. Timely disposal of medicines can reduce the risk of others taking them accidentally or misusing the medications on purpose. Check with your doctor or pharmacist about how to safely discard expired or unneeded medications, or review the FDA’s guidance on Where and How To Dispose of Unused Medicines.

Get more tips for managing your medications.

The use of multiple drugs to treat diseases and other health conditions — called polypharmacy — is a growing concern for older adults. People age 65 and older tend to take more medicines than those in any other age group, often because they have several diseases or other health problems at the same time. Managing multiple medications can be expensive and difficult to track, especially for those who are homebound or who live in rural areas. Check out these tips for taking multiple medications safely.

Taking many medications can also increase the risk for side effects and other unintended problems. Researchers are studying deprescribing, an approach to safely reduce or stop medications that are potentially inappropriate or unnecessary.

If you are concerned that you might be taking too many medications, have a conversation with your health care provider about whether there are any you could safely reduce or stop.

Here are some tips to help you take your medicines safely:

• Follow instructions. Read all medicine labels and be sure to follow instructions. Don’t take a larger dose of a medicine, thinking it will help you more. This could be very dangerous and even deadly. And don’t skip or take half doses of a prescription drug to save money. Talk with your doctor or pharmacist if you can’t afford the medicine. There may be financial assistance or less expensive options available. Read Saving Money on Medicines for more information.
• Take medicine on time. Some people use meals or bedtime as reminders to take their medicine. Other people use charts, calendars, or weekly pill boxes. You can also set timers and write reminders to take your medication. Medication reminder apps for smartphones are becoming more popular; these apps can help you remember when and how to take your medications each day.
• Turn on a light. Don’t take medicine in the dark; you might make a mistake.
• Report problems. Call your doctor right away if you have any trouble with your prescriptions, OTC medicines, or supplements. There may be something else you can take.
• Tell your doctor about alcohol, tobacco, and drug use. Alcohol, tobacco, and other drugs can affect how well your medicines work. Be honest with your doctor about how much you use.
• Ask your loved ones for help. Take a friend or relative with you to your doctor’s appointments if you think you may need help understanding or remembering what the doctor tells you.
• Check before stopping. Take prescription medicine until it’s finished, or your doctor says it’s all right to stop. Note that some medicines are supposed to be taken only “as needed.”
• Don’t share. Do not take medicines prescribed for another person or give yours to someone else.