Polypharmacy: What To Do
Taking several long-term medicines at once, and the interactions and side effects that accumulate.
Last revised
Each additional medicine raises the risk of interactions, falls and confusion, and some become unnecessary without anyone noticing.
Key takeaways
- Structured medication review: available on request from a GP or pharmacist
- Medicines contributing to falls: sedatives, some blood pressure medicines, anticholinergics
- Most useful single change: Ask for a structured medication review at least annually.
- Commonest mistake: Stopping medicines yourself without discussion.
- See a doctor if any of the signs under "When to get help" below apply to you.
Do
- Ask for a structured medication review at least annually
- Keep one up-to-date list of everything you take, including over-the-counter items
- Use one pharmacy so interactions are more likely to be spotted
- Ask what each medicine is for and whether it is still needed
Do not
- Stopping medicines yourself without discussion
- Adding over-the-counter or herbal products without checking interactions
- Assuming a long-standing prescription is still appropriate
The figures behind the list
Each item above follows from these, published in the guidance named at the foot of the page.
| Measure | Figure |
|---|---|
| Structured medication review | available on request from a GP or pharmacist |
| Medicines contributing to falls | sedatives, some blood pressure medicines, anticholinergics |
| Anticholinergic burden | associated with confusion and falls |
| Deprescribing | a legitimate and planned part of good care |
Where to go next
- Polypharmacy: Just the Figures
- Polypharmacy: Sorting the Evidence From the Noise
- Polypharmacy — the reference entry
- The Evidence on Vaccination in Older Adults, Without the Hype
- The Evidence on Frailty, Without the Hype
When to get help
Seek prompt assessment for new confusion, dizziness on standing, unexplained falls, or increasing drowsiness — these are commonly medication-related and reversible. Never stop steroids, beta blockers or anticonvulsants abruptly. Seek urgent help for black stools, vomiting blood, or unusual bruising.
Where this comes from
How this page was put together
Every figure, recommendation and warning above is taken from the guidance named in Where this comes from. Nothing on this page is inferred, summarised or generalised beyond what those bodies publish: where they give a number, it is their number, and where they are silent, so are we. Pages are rebuilt whenever the underlying record changes. Sign-off by a named clinician, where it has happened, is shown at the top of the page along with the date.
Medical disclaimer
This article is general information, not medical advice. It cannot account for your own history, medication or circumstances. Always speak to a GP, pharmacist or another qualified health professional before making changes that affect your treatment, and never delay seeking medical advice because of something you have read here. In an emergency, call 999.