Many people may not know that prescribed medications have potential side effects. But knowing about the side effects of medications, as well as how they may interact with each other, is very important information – especially for boomers.
“Polypharmacy” refers to when an individual is taking multiple medications to treat a variety of acute or chronic conditions.
Boomers tend to take more medications than their younger counterparts. In fact, while boomers represent around 12 percent of the U.S. population, they account for more than a third of all prescription medication use.
The number of prescriptions we take can be staggering. The average American in her 60s may be taking over 10 prescription medications over the course of a year.
In addition to the increased potential side effects and interactions of the medications, polypharmacy may decrease physical and cognitive ability (increasing risk of confusing medications or taking them incorrectly).
Many older adults don’t take medications correctly, contributing to more than 100,000 deaths a year. It can increase risk of falls or accidents while doing even simple tasks such as cooking.
As we continue to age, the concern is we will take even more medications. One study suggested that over the course of 22 years, the number of prescriptions taken by adults over 65 doubled and the proportion of adults taking five or more medications tripled. One quarter of admissions among older patients to one New York hospital was attributable to polypharmacy.
Another side effect of taking multiple medications is a “prescribing cascade.” As the name implies, this happens when you take one medication to reduce the side effects of another which you may be taking to deal with the side effects of yet another. Often, these side effects are misdiagnosed as a new medical condition.
Let’s say you take a medication that makes sleep difficult, as can happen with nasal decongestants or depression medicines. You tell your doctor you are having trouble sleeping; she diagnoses insomnia and gives you sleeping pills.
You are now taking sleeping pills to counteract the insomnia caused by your decongestant. While the sleeping pill helped, it also caused constipation. Your doctor gives you something for constipation. You are now taking three medications.
Many of us are taking medications for ailments such as hypertension, depression, chronic pain, diabetes and arthritis and run a constant risk of falling into a “prescription cascade” – especially if we see multiple doctors. The risk increases if we use different pharmacies since such a cascade could go unnoticed if a pharmacist only knows of one or two prescriptions.
Another risk of polypharmacy is when two medications either magnify or reduce the effects of others. A good example of the former is taking aspirin at the same time as a blood thinner, such as warfarin or Coumadin. This may cause excessive bleeding.
Antacids, contrarily, may prevent blood-thinners, antibiotics and heart medications from being adequately absorbed into the bloodstream, rendering them less effective or even ineffective. Iron supplements may impact how well antibiotics work.
The risk for side effects and medication interactions is also increased by changes in how our bodies metabolize and eliminate medication with age. Some medications may build up quickly in our bodies while others may not have intended effects. This is one reason why doctors will usually start with lower doses to see how we react.
Knowing all of the above can be the beginning of paying better attention to our medications and how they affect our health. Here are some tips that can help prevent the “prescribing cascade.”
Don’t assume that it is the sole responsibility of our doctors and pharmacists to make us understand why we take medications, how to take them and what side effects we can expect.
One poll revealed that 11 percent of participants believed the pharmacist is responsible, 26 percent said the doctor and 63 percent said both. Interestingly, no one said “I have a responsibility” to understand these issues.
It is a good idea to always keep records of your medications. Jot down any side-effects you experience – and when experienced – so that you can discuss with your doctor. Use one pharmacy so that it has a record of all medications. This will help you anticipate, prevent, and manage possible side effects and interactions.
To help better prepare for conversations with either your doctor or pharmacist, research medications online. There are sites that explain medications in non-medical language.
Many medical professionals suggest an annual “brown bag” with your doctor. Rather than lunch, put all prescription and nonprescription medications and supplements in a bag and take it with you when you visit your doctor.
The doctor can see everything you are taking. This allows her to identify potential interactions and side effects as well as see if any can be eliminated (or dosage reduced).
Talk with your doctor about how to treat a condition with fewer medications. For example, high cholesterol or hypertension may respond to diet and exercise.
Be careful with alcohol consumption since it interacts with many medications, which can reduce effectiveness or increase risk of side effects.
Many medications may deplete your body of nutrients, which can cause inflammation, new health risks or worsening of symptoms. For example, Metformin (type 2 diabetes medicine), may deplete vitamin B12 and coQ10, which increases the risk for heart disease.
Certain hypertension medicines can reduce amount of water-soluble nutrients, such as B vitamins, in your body. Another common medicine taken by boomers for managing cholesterol, statins, can deplete coQ10 which may cause heart failure, mood swings and depression.
How well would you say you understand the possible side effects and interactions of the medicines you take? Why or why not? How often do you talk with your doctor about your medications? Do you ever talk with your pharmacist about your medications? Do you ever do your own research about your medications? Do you feel you may be taking more medications than you need? Please join the conversation.