You can avoid dangerous drug interactions
To keep your medicines organized, use a pillbox. Some electronic pill dispensers will remind you of when to take your medication. (Fotolia.com / June 26, 2013)
Drugs are intended to treat medical conditions and help you feel better, but they can also have side effects and interactions. An estimated 100,000 Americans ages 65 and older are hospitalized each year for adverse drug reactions, according to a 2011 study in The New England Journal of Medicine (NEJM).
A more recent study in PLoS One found that about one out of every five drugs prescribed to seniors is inappropriate--it's prescribed even though it is likely to cause side effects and another drug is potentially just as effective or more effective.
"So it's important for people to be aware," says Dr. Suzanne Salamon, an instructor in medicine at Harvard Medical School and associate chief for clinical geriatrics at Beth Israel Deaconess Medical Center, Boston, Mass.
Any drug can have side effects or interact with other medications you're taking--even over-the-counter drugs and supplements. For example, aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) can slow the rate at which your body removes immune-suppressing drugs like cyclosporine and heart medicines such as digoxin.
Mixing vitamin E with warfarin can cause excess bleeding. The risk of interactions is compounded when you go to several specialists, and each one prescribes a different drug (or drugs), without knowing what else you're taking.
In addition, as we age, our bodies metabolize medications at a slower rate.
"The drug hangs around in your body longer. It accumulates in your body," Dr. Salamon explains. So the effects from your first pill can stay with you even after you've taken the next dose.
Several drugs require particular care when used in older adults. In the NEJMstudy, these were the drugs most likely to cause hospitalization:
1. Digoxin, a drug used to treat heart failure
2. Blood sugar-lowering drugs and insulin for diabetes
3. Opioid pain relievers
4. Warfarin (Coumadin), a blood thinner.
PREVENTING HARMFUL EFFECTS
How can you avoid drug interactions and side effects when you're taking so many different pills?
First, make sure your doctor knows exactly what you're taking, Dr. Salamon says. "My advice is to put your pills in a bag and bring them into the doctor's office," she notes. Let your primary care provider review all the drugs you're taking, including over-the-counter medicines, supplements, and medicines that were prescribed by other doctors.
Your doctor might find that some of the drugs you've been taking for years are potentially harmful, could interact with one another, or are entirely unnecessary.
"People will stay on pills for years and years because they were started for a particular condition and no one told them to get off," according to Dr. Salamon.