Whether you're settling into your sixties or heading into your nineties, be careful when taking prescription and over-the-counter medicines, herbal preparations, and supplements. And if you're caring for older loved ones, help them stay safe too.
Why the particular concern? The older you get, the more likely you are to use additional medicines, increasing the chance of harmful side effects, including interactions. And, as you age, physical changes can affect the way drugs are handled by your body, leading to potential complications. For instance, your liver and kidneys may not work as well, which affects how a drug breaks down and leaves your body.
"No matter how hard we fight it, our body changes over time. For example, we tend to lose muscle and gain fat. This changes the way medicine works in our body," said Lt. Cmdr. Zachary Oleszczuk who has a doctorate in pharmacy and is a board-certified geriatric pharmacist and team leader in the FDA's Division of Drug Information. "This means that medicines may need to be adjusted or changed later in life, even if they have worked very well for you for years or even decades."
Read on for important safety tips.
1. Take Medicine as Prescribed
With Input from Your Health Care Provider. Take your medicine regularly and according to your health care provider's instructions. If you're having bothersome side effects or have other questions, talk to your provider. Don't take prescription medication your health care provider has not prescribed for you. Taking someone else's prescription medication can be very dangerous. If you have a symptom like pain and take another person's prescription pain medication instead of seeing a doctor, your medical problem could get worse. Misuse of medications, such as taking someone else's prescription opioids, may lead to addiction. Doctors consider many factors, such as allergies and drug interactions, before prescribing medication for a patient. Taking unprescribed medication can have unexpected side effects or cause serious reactions. Conversely, don't skip doses or stop taking a prescribed medication without first consulting your provider – even if you're feeling better or if you think the medicine isn't working. Many antibiotics must be taken even after an infection stops bothering you in order to work. Not taking your medicine as prescribed by a doctor or as instructed by a pharmacist could lead to your disease getting worse, hospitalization, or even death. The Centers for Disease Control and Prevention estimates that in the United States, 125,000 deaths occur every year because of medicines not being taken correctly.
"The best medicine in the world won't work unless you take it correctly," Oleszczuk said. "For instance, medicines that treat chronic conditions such as high blood pressure, high cholesterol, and diabetes only work when taken regularly and as directed. It's important to keep taking these medications even though you don't feel sick. High blood pressure, high cholesterol, and diabetes can cause damage to your body before you notice something is wrong. These medicines work best when you take them regularly."
Dosing for medications is based on clinical trials. "Every medicine is different and is dosed according to what's been tested," Oleszczuk said, "which is one reason why you shouldn't select or change a dose yourself."
If you are having trouble remembering how and when to take your medicine, talk with your pharmacist or other health care provider. They may have tools such as prefilled pillboxes, automated reminders attached to pill bottles, and other options to help you take the right medicine at the correct dose and at the right time.
2. Store your Medicines Properly and Check the Expiration Date
Proper storage is one way to help make sure your medicines remain safe and effective. Medications that are not appropriately stored may not work as well or may cause harm, even if they are not expired.
Be sure to read the information you were provided to find specific storage instructions for your medicine. Certain medicines need to be stored in the refrigerator, while others cannot be exposed to high temperatures. Most medicines are best stored up and away in a cool, dry place such as a high dresser drawer, storage box, closet shelf, or kitchen cabinet, keeping them away from hot appliances and sinks. Storing medicines in the bathroom can expose it to wide heat and humidity fluctuations, even if the medicine is stored in a cabinet. For these reasons, it is best not to store any medicines in your bathroom. When storing medicine in a busy area of your home, like the kitchen, care should be taken to keep all medicines up and away from children. Children are especially at risk of accidental poisoning and may take a medicine because it looks like candy. If you have questions about storing your medicines safely, contact your pharmacist or health care provider. Especially for those medicines, you don't use every day, check your current medication list and the medicine's expiration date before using them. Some people may still have that bottle of aspirin they bought years ago, which is now expired. It is easy to find ourselves with old, expired prescription and OTC medicines on the shelf throughout our lifetime. If your medicine is expired, do not use it. It's essential to be aware that several potential harms may occur from taking an expired medicine. If medicine has degraded, it might not provide the intended benefit. In addition, when medicine degrades, it may yield toxic compounds that could cause unwanted side effects. Those with serious and life-threatening diseases may be particularly vulnerable to potential harm from expired medicines. You should also throw away medicine you no longer need. "By keeping unneeded medicine, you end up with an even more crowded selection of medicines which may cause confusion and lead you to take the wrong medicine," Oleszczuk said. Finally, expired medicines and medicines you no longer need are not just a risk to you but can also cause harm to your children, grandchildren, and pets if taken by mistake.
3. Be Aware of Potential Medication Interactions and Side Effects
Interactions can occur when:
Your task? Learn about possible interactions and the potential side effects of your medications. You can do this by carefully reading drug facts labels on over-the-counter (OTC) medications and the information that comes with your prescription medications and by reviewing any special instructions with your health care provider.
For instance, nitroglycerin, which treats angina, should not be taken with many erectile dysfunction medications, including Viagra and Cialis, because serious interactions can occur. Likewise, some medications should not be taken with alcohol, as problems such as loss of coordination, memory problems, sleepiness, and falls can result. Even common foods and drinks can cause serious interactions with medications. One example is grapefruit juice, which can affect how well some medicines work and may cause dangerous side effects. In addition, some medications can cause side effects that mimic other health problems occurring in older adults, such as memory difficulties, dizziness, and sleepiness. Ask your healthcare provider if any new health problems you are experiencing could be due to your medications.
4. Keep a Medication List
Write down what you're taking and keep the list with you. Make sure your medication list is up-to-date and includes any changes made by your health care provider. Consider giving a copy to a friend or loved one you trust, which is especially important in case of emergency and when traveling. If you carry a cell phone, you can store your medication list using the electronic note function or an app.
A medication list should include:
If you're seeing more than one health care provider, share your medication list with each one, so they know all the prescription and OTC medications, herbal preparations, and supplements you take, even if you don't take them every day. Your pharmacist can advise you about potential medication interactions and side effects. Ideally, you should discuss prescription and over-the-counter medications, herbal preparations, and supplements that you take with your health care provider at each visit. This will confirm if the medications are still necessary, if the supplements are appropriate, and determine which ones you can stop taking, if any. Schedule at least one annual review with your primary care provider if it's not possible to review medications during each visit. If a specific medication seems out of your budget, ask your health care provider if there is a less expensive, effective alternative. Additionally, tell your health care provider if you think a medication isn't working well, for example, if a medication is not relieving pain like you think it should.
Bottom line – a medication review with your health care provider can help you avoid medication interactions, reduce your risk for side effects, and lessen costs.
"Sometimes, especially if you're seeing multiple providers, certain questions can fall through the cracks," Oleszczuk said. "There is no such thing as a stupid question. Medication is an amazing technological advancement that helps us live longer and have a higher quality of life, but all medications have risks. To get the most out of them, you should ask questions and take your medications according to directions."