How to manage multiple medications

Your medications are supposed to help you. But if you take more than one medication, they might harm you instead. This is especially true if you’re age 65 or older and don’t carefully manage your multiple medications.

According to the National Institute on Aging, adults 65 and older take more medications than any other age group. One-third of people in their 60s and 70s take five or more prescription drugs. And the use of several medications increases the risk for adverse reactions and drug interactions.

In fact, a 2017 study found that patients who took 10 or more medications had a more than 90% likelihood of having one or more harmful drug interactions. This is when two or more drugs taken at the same time or in the same period don’t mix well and cause unintended health problems.

These interactions can make medications less effective and cause unexpected side effects, such as drowsiness, dizziness, constipation, nausea, heart palpitations, rash and stomach irritation. They can also increase the action of a medication, which can also cause unexpected side effects. Drug disease interactions — when a medication prescribed to treat one condition negatively affects another or causes a new condition — are also an unfortunate possibility.

The importance of keeping a current list of medications
Due to the risk of adverse reactions when taking multiple medications, Shawn Mahal, PharmD, a pharmacist at the Sharp Grossmont Hospital Pharmacy, recommends keeping a list of your medications with you at all times. The list should include all current prescription medications as well as any over-the-counter creams, lotions, ointments, ear drops, eye drops, vitamins and supplements you take.

Having a comprehensive list of medications is important in case of a medical emergency, to help your doctors correctly assess and diagnose any medical issues you may have, and for your own knowledge and convenience. A current list of medications should include the name of every medication you take — prescription or otherwise — along with specific information for each, such as:

• How much is taken

• When it is taken (for example, in the morning or at bedtime)

• What it is taken for

• Date you started taking it

• Name of the doctor who prescribed the medication

• Directions for taking the medication (for example, with food or on an empty stomach)

“When someone is admitted to the hospital or comes to the emergency room unexpectedly, they frequently have difficulty remembering all of their medications,” Mahal says. “We’ve had patients who are very ill come in with no family with them and they are able to share only a small amount of information about the medicines they take.”

Depending on the situation, minimal information about a patient’s medications may limit how health care professionals can treat them, Mahal reports. What’s more, medication can be the cause of a hospital visit due to missing a dose, a medication side effect or taking it incorrectly. Health care providers need to know if the medication is a possible cause of a patient’s symptoms.

Medication management methods
Along with keeping a current list of all the prescriptions, over-the-counter medicines and supplements you take, Mahal recommends additional ways to safely manage your medications:

• Get organized. Pillboxes are useful for keeping your pills in order. They are easy to find at your local pharmacy, inexpensive and come in many sizes to hold several medications. When using a pillbox, always keep the original pill bottle until you have taken the last one.
   

• Use alarms or reminders. Set an alarm on your watch, phone or computer; use a digital app; or ask a friend or family member to remind you to take your medicine. Your loved one can also help you remember to order or pick up your refill at the pharmacy. And many pharmacies now offer patient reminder systems that will call or text you when it’s time to order your refill and when your refill is ready for pickup.
   

• Pair medications with regular routines. You may forget or skip doses because taking your medications is not part of your normal routine. To help you remember, try pairing doses with an activity you do regularly, such as eating a meal, brushing your teeth and going to bed. Pairing doses to a certain time of day may also be helpful.
   

• Keep a daily medication journal. Using either an app on a digital device or a written diary, track your medications and their doses and schedules. Check off each medication after you take it and jot down notes about how you feel and any side effects you experience while on the medication.
   

• Pick up all medications from one pharmacy. By sticking with one pharmacist, you can form a relationship so they are better able to understand your health needs. A dedicated pharmacist can watch for possible drug interactions, avoid drug duplication and simplify your drug options.

“Talk with your doctor and your pharmacist if you have questions or concerns about the medications you are taking,” Mahal says. “Doctors recognize the specialized knowledge pharmacists have when it comes to medications and will welcome the additional expert eye for your safety.”