Vitamins, blood pressure pills, cholesterol drugs -- how many pills do you take every day?
According to a 2009 national survey conducted by Express Scripts, formerly Medco, more than half of the 1,000 people older than 65 who were surveyed said they take "at least five different prescription drugs regularly and one in four takes between 10 and 19 pills each day."
Some of these pills could be a few daily doses of one medication, such as a morning and an evening dose of a high blood pressure drug, but often seniors are taking many different medications for various ailments.
"A lot of diseases are treated now that we've never treated before," says Robert S. Gold, a clinical hospital pharmacist and affiliate instructor of clinical pharmacy at Purdue University, who is also the author of "Are Your Meds Making You Sick? A Pharmacist's Guide to Avoiding Dangerous Drug Interactions, Reactions and Side Effects."
Gold says patients are often encouraged to take medicine.
"TV ads definitely increase awareness," explains Gold, who has 30 years of experience. "Sometimes it's appropriate, sometimes it's not."
For example, he says a diabetic may take diabetes medication, a multivitamin and pain relievers, as well as medications for depression, eye problems and a thyroid condition.
The patient, the doctor and the pharmacist have to figure out what's the best treatment.
*Know Your Medications
"It would help if everyone keeps a list of medications you're taking," says Matthew Grissinger, director of error reporting programs at the Institute for Safe Medication Practices.
List prescriptions, including patches (nicotine, for example), as well as all over-the-counter medications, such as acetaminophen and heartburn remedies.
He says it's also smart to keep a list of meds you aren't taking anymore, as well as why you're not taking them. Plus, it's important to track your drug allergies and the reaction you get when exposed to those medications.
Give the list to every doctor and pharmacist you use so they know what you're taking and can prevent any problems.
Whether you're taking a few pills or a lot, you probably worry about what the prescriptions are doing for your health. So how can you tell if you're overmedicated?
"It would be good to have a critical review of your medications," says Grissinger, who recommends doing that review at your annual exam with your primary care doctor.
Tell the doctor all the medications you're taking and why you're taking them. Talk about the dosage and side effects, too.
Don't forget to talk about how long you'll be taking the medication.
"We're taking drugs chronically that are best taken short term," says Gold. He explains that depression medications can be helpful short term in the case of the death of a spouse or losing a job, for example. But those depression meds aren't necessarily intended for long-term use. Gold says some patients could wean off of depression medicine by taking corrective actions like exercise and talk therapy.
Many prescription drugs can have very dangerous side effects. Gold explains how a blood thinner can cause bleeding, opiates can cause a bowel obstruction, and many types of meds, including over-the-counter cold and allergy medications, as well as anti-anxiety pills, can make you lose your balance and fall.
Nonprescription drugs can be problematic, too. Too much ibuprofen, for example, can hurt your stomach; too much acetaminophen can damage your liver.
"Just because it's over-the-counter, doesn't make it safe," says Grissinger. "They all interact."
Herbal medicines may be natural, but when combined with other medications, especially prescription drugs, "they may interact and may make things worse," says Grissinger.
*Be Your Own Advocate
"When you go to the pharmacy, ask questions," advises Grissinger, who says patients shouldn't shop different pharmacies, because "all those pharmacies don't know what you're taking."
While doctors and pharmacists aim to be helpful, you need to take charge of your own health.
Consumers "need to be aggressive," says Gold. "People have to ask. People have to be aggressive, and they have to learn."
That means avoiding generalities and getting specific. Ask for more details about a medicine's side effects to find out which ones are likeliest to happen versus those that could happen.
Find out the best ways to take your medications, too. With a full glass of water? With food?
Keep a routine so you take your pills every day at the same time. Without a routine, you could forget the meds.
Always talk to your doctor about your concerns regarding prescription and nonprescription drugs. Your health could suffer if you stop taking a medication or change your dosage.