Medication can help control symptoms or prevent adverse health events, but it can also cause potential harm due to drug interactions and potential side effects. Taking too many prescription medications can overload your system (known as polypharmacy) and cause confusion, memory issues, falls and fractures, and, in some cases, hospitalizations.

How many is too many?

Despite the risks, medication overload is on the rise in Canada. It’s not uncommon for individuals to be taking prescription medications in addition to other vitamins, over the counter products (OTCs), and herbal supplements. When combined, this can increase the potential for drug interactions, adherence issues (taking drugs as prescribed), and financial burden.

Who is at risk of medication overload?

In my experience, people with multiple chronic conditions such as hypertension, high cholesterol, and diabetes are at higher risk of medication overload. Other common situations involve individuals with mental health conditions that include element of chronic pain and sleep disorders. In addition, women are more at risk for potential drug interactions as they tend to live longer than men.

Whenever you begin a new treatment with prescription or non-prescription products, it should always be based on a diagnosed medical condition, or for the purposes of preventing future health complications or risk factors. It’s important to see your health care provider regularly, so they may evaluate these treatments and determine if ongoing therapy is meeting the desired goals, with as few side effects as possible.

Aren’t vitamins and herbal supplements harmless?

Although most vitamins and supplements are often safe to take in standard doses, there may be some situations where excessive or inappropriate use, when combined with specific prescription medications may lead to side effects, drug interactions, and unnecessary expenses.

In Canada, the regulation and quality control of some non-prescription products can vary greatly and result in unnecessary polypharmacy issues. Regardless of the products you choose to take, always discuss any potential changes with your pharmacist or health care provider.

Why should I review my medications?

Clinical studies in the elderly and those with chronic conditions have demonstrated that reducing the number of prescription medications has the potential to improve depression and other symptoms associated with mental health disorders, enhance physical function/mobility, prevent falls, while also reducing financial costs for individuals and families.

What can I do if I’m concerned about my medications?

Talk to your health care provider and ask for a review of your prescription and non-prescription medications to determine if a change in dosage or even a reduction in the number of medications is appropriate. If you are taking a medication that causes significant side effects, your health care provider may be able to recommend another prescription drug.

It’s also important to share any changes in medications or supplements with a pharmacist who is aware of your entire health and medication status. If you aren’t sure where to start with evaluating your medications, or if you don’t have a regular family doctor, a pharmacist can help you start this process.

Helpful questions to ask

Here are some questions from the Canadian Medication Appropriateness and Deprescribing Network to ask when starting a new medication or reviewing those you are already taking:

• Why am I taking this medication?
• What are the potential benefits and harms of taking this medication?
• Can it affect my memory and cause me to fall?
• Can I stop or reduce the dose of this medication?
• Who do I follow up with and when?