Guide on Medicine for Older Adults

Data To Support Social and Behavioral Research as Used by the Food and Drug Administration

Guide on Medicine for Older Adults

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Medicines and You:
A Guide for
Older Adults

Council on Family Health
Provided in cooperation with
U.S. Department of Health and Human Services
Food and Drug Administration
and the Administration on Aging

Table of Contents
Aging and Health: You and Your Medicines . . . . . . . . . . . . . . . . . . . . .1
Talk to Your Health Care Professionals . . . . . . . . . . . . . . . . . . . . . . . . . .3
What You Need to Know About Your Prescription Medicines . . . .7
Taking Prescription Medicines . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10
Taking Over-the-Counter Medicines . . . . . . . . . . . . . . . . . . . . . . . . . . .12
Cutting Medicine Costs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13
Tips for Seniors on Safe Medicine Use . . . . . . . . . . . . . . . . . . . . . . . . .14
My Medicine Record . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .16
Use the medicine chart on pages 16-17 to keep a written list of
your medicines and other important health information.

Council on Family Health
www.cfhinfo.org
Provided in cooperation with
U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES
Food and Drug Administration
www.fda.gov
and
Administration on Aging
www.aoa.gov

As you age, it is important to know
about your medicines to avoid
possible problems.

Aging and Health:
You and Your Medicines

A

s you get older you may be faced with more health
conditions that you need to treat on a regular basis. It is
important to be aware that more use of medicines and
normal body changes caused by aging can increase the chance
of unwanted or maybe even harmful drug interactions.
The more you know about your medicines and the more you
talk with your health care professionals, the easier it is to avoid
problems with medicines.
As you age, body changes can affect the way medicines are
absorbed and used. For example, changes in the digestive system
can affect how fast medicines enter the bloodstream. Changes in
body weight can influence the amount of medicine you need to
take and how long it stays in your body. The circulation system
may slow down, which can affect how fast drugs get to the liver
and kidneys. The liver and kidneys also may work more slowly,
affecting the way a drug breaks down and is removed from the
body.

1

Because of these body changes, there is also a bigger risk of
drug interactions for older adults.
Drug-drug interactions happen when two or more medicines
react with each other to cause unwanted effects. This kind of
interaction can also cause one medicine to not work as well or
even make one medicine stronger than it should be. For example,
you should not take aspirin if you are taking a prescription blood
thinner, such as warfarin, unless your health care professional tells
you to.
Drug-condition interactions happen when a medical condition
you already have makes certain drugs potentially harmful. For
example, if you have high blood pressure or asthma, you could
have an unwanted reaction if you take a nasal decongestant.
Drug-food interactions result from drugs reacting with foods or
drinks. In some cases, food in the digestive track can affect how
a drug is absorbed. Some medicines also may affect the way
nutrients are absorbed or used in the body.
Drug-alcohol interactions can happen when the medicine you
take reacts with an alcoholic drink. For instance, mixing alcohol
with some medicines may cause you to feel tired and slow your
reactions.
It is important to know that many medicines do not mix well with
alcohol. As you grow older, your body may react differently to
alcohol, as well as to the mix of alcohol and medicines. Keep in
mind that some problems you might think are medicinerelated, such as loss of coordination, memory loss, or irritability,
could be the result of a mix between your medicine and alcohol.
For more information about alcohol and medicines, visit the U.S.
Substance Abuse and Mental Health Services Administration at
http://www.samhsa.gov
2

Some medicines can interact
with other medicines, foods,
drinks or health conditions.

What Are Side Effects?
Side effects are unplanned symptoms or feelings you have when
taking a medicine. Most side effects are not serious and go away
on their own; others can be more bothersome and even serious.
To help prevent possible problems with medicines, seniors must
know about the medicine they take and how it makes them feel.
Keep track of side effects to help your doctor know how your
body is responding to a medicine. New symptoms or mood
changes may not be a result of getting older but could be from
the medicine you’re taking or another factor, such as a change
in diet or routine. If you have an unwanted side effect, call your
doctor right away.

Talk to Your Health Care Professionals
It is important to go to all of your medical appointments and to
talk to your team of health care professionals (doctors, pharmacists, nurses, or physician assistants) about your medical conditions, the medicines you take, and any health concerns you have.
It may help to make a list of comments, questions, or concerns
before your visit or call to a health care professional. Also, think
about having a close friend or relative come to your appointment
with you if you are unsure about talking to your health care
professional or would like someone to help you understand
and/or remember answers to your questions.

3

Tell your health professionals
about your medical history
and about all medicines or
supplements you take.

Here are some other things to keep in mind:
All Medicines Count: Tell your team of health care professionals
about all the medicines you take, including prescription and
over-the-counter medicines, such as pain relievers, antacids, cold
medicines, and laxatives. Don’t forget to include eye drops, dietary
supplements, vitamins, herbals, and topical medicines, such as
creams and ointments.
Keep in Touch with Your Doctors: If you regularly take a
prescription medicine, ask your doctor to check how well it is
working, whether you still need to take it, and, if so, whether there
is anything you can do (like lowering fats in your diet or exercising
more) to cut back or, in time, stop needing the medicine. Don’t
stop taking the medicine on your own without first talking with
your doctor.
Medical History: Tell your health care professional about your
medical history. The doctor will want to know if you have any
food, medicine, or other allergies. He or she also will want to know
about other conditions you have or had and how you are being
treated or were treated for them by other doctors. It is helpful to
keep a written list of your health conditions that you can easily
share with your doctors. Your primary care doctor should also
know about any specialist doctors you may see on a regular basis.
Eating Habits: Mention your eating habits. If you follow
or have recently changed to a special diet (a very low-fat diet, for
instance, or a high-calcium diet), talk to your doctor about this.
Tell your doctor how much coffee, tea, or alcohol you drink each
day and whether you smoke. These things may make a difference
4 in the way your medicine works.

A pill box can help you remember
when to take your medicines.

Recognizing and Remembering to
Take Your Medicines: Let your health care
professional know if you have trouble
telling your medicines apart. The doctor
can help you find better ways to recognize
your medicines. Also tell your doctor if you
have problems remembering when to take your medicines or how
much to take. Your doctor may have some ideas to help, such as a
calendar or pill box.
Swallowing Tablets: If you have trouble swallowing tablets, ask
your doctor, nurse, or pharmacist for ideas. Maybe there is a liquid
medicine you could use or maybe you can crush your tablets. Do
not break, crush, or chew tablets without first asking your health
professional.
Your Lifestyle: If you want to make your medicine schedule more
simple, talk about it with your doctor. He or she may have another
medicine or ideas that better fits your lifestyle. For example, if taking medicine four times a day is a problem for you, maybe the
doctor can give you a medicine you only need to take once or
twice a day.
Put It in Writing: Ask your health care professional to write out a
complete medicine schedule, with directions on exactly when
and how to take your medicines. Find out from your primary care
doctor how your medicine schedule should be changed if you
see more than one doctor.

5

Your pharmacist can help keep
track of your medicines.

Your Pharmacist Can Help Too
One of the most important services a pharmacist can offer is to talk
to you about your medicines. A pharmacist can help you understand how and when to take your medicines, what side effects you
might expect, or what interactions may occur. A pharmacist can
answer your questions privately in the pharmacy or over the
telephone.
Here are some other ways your pharmacist can help:

6

■

Many pharmacists keep track of medicines on their computer.
If you buy your medicines at one store and tell your pharmacist
all the over-the-counter and prescription medicines or dietary
supplements you take, your pharmacist can help make sure your
medicines don’t interact harmfully with one another.

■

Ask your pharmacist to place your prescription medicines
in easy-to-open containers if you have a hard time taking
off child-proof caps and do not have young children living in
or visiting your home. (Remember to keep all medicines out
of the sight and reach of children.)

■

Your pharmacist may be able to print labels on prescription
medicine containers in larger type, if reading the medicine label
is hard for you.

■

Your pharmacist may be able to give you written information to
help you learn more about your medicines. This information may
be available in large type or in a language other than English.

What You Need to Know About Your
Prescription Medicines
The following questions will help you get the information you
need when you visit your doctor and pharmacist.*
Before you leave the doctor’s office with a new prescription, ask:
■

What is the name of the medicine and what is it supposed to
do? Is there a less expensive alternative?

■

How and when do I take the medicine and for how long?

■

Whether to take it with water, food, or with a special medicine,
or at the same time as other medicines.

■

Can it be taken with over-the-counter medicines? If so, when?

■

What to do if you miss or forget a dose.

■

Whether you take it before, during, or after meals.

■

The timing between each dose. For example, does “four times a
day” mean you have to take it in the middle of the night?

■

What your doctor means by “as needed.”

■

Are there any other special instructions to follow?

■

What foods, drinks, other medicines, dietary supplements, or
activities should I avoid while taking this medicine?

■

Will any tests or monitoring be required while I am taking this
medicine? Do I need to report back to the doctor?

■

What are the possible side effects and what do I do if
they occur?

■

When should I expect the medicine to start working, and how
will I know if it is working?

■

Will this new prescription work safely with the other prescription
and over-the-counter medicines or dietary supplements I am
taking?
7

Keep an up-to-date list of all your
medicines, prescription and
over-the-counter.

At the pharmacy, or wherever you get your medicines, ask:
■

Do you have a patient profile form for me to fill out? Does it
include space for my over-the-counter drugs and my dietary
supplements?

■

Is there written information about my medicine? Ask the
pharmacist if it’s available in large print or in a language other
than English if you need it.

■

What is the most important thing I should know about this
medicine? Ask the pharmacist any questions that may not have
been answered by your doctor.

■

Can I get a refill? If so, when?

■

How and where should I store this medicine?
* These questions are based on information found on the
National Council on Patient Information and Education’s
web site at www.talkaboutrx.org.

8

Keep a Record of Your Medicines; Give Your Medicine Chest a
Yearly Check-Up
To help you organize information about your medicines, list
all the prescription and over-the-counter medicines, dietary
supplements, vitamins, and herbals you take. Bring this list with
you when you see your doctors and any other health care
professional. It is very important that each of them knows what
medicines you are taking.
The list should include: the name of the medicine, the doctor who
prescribed it, how much and how often to take, instructions on
how to take the medicine, what it is taken for and any expected
side effects. Use “My Medicine Record” in the back of this
booklet to help organize this information.
It is a good idea to take all your medicines to your doctor at least
once a year for a “medicine check-up.”That way your doctor
can see what you are taking and tell you if there might be any
interaction problems. This is also a good time to review dosage
information and ask other questions you might have about your
medicines. Remember to bring all over-the-counter medicines
you take as well as any dietary supplements, vitamins, and
herbals. It is also important to get rid of any expired medicines
you may have.

In the space below, list all medicines you take, including all prescription and OTC
medicines, dietary supplements, vitamins and herbals, remembering to cross off
medicines you are no longer using. Throw away any expired medicines.

My Medicine Record
Name of medicine

What it is for

Doctor who prescribed

How and when to take

How much to take

Color/shape

Side effects/ warnings

List all the prescription
and over-the-counter
medicines, dietary
supplements, vitamins,
and herbals you take.
Doctors’ names and phone numbers

Pharmacists’ names and phone numbers

Emergency Contact Information:

16

Name:___________________________________________________________________ Relationship: ______________________ 17
Phone number: _____________________________________________________

9

Before you travel,
discuss your medicine
schedule with your
doctor or pharmacist.

Taking Prescription Medicines
Follow your doctor’s instructions and read (and keep) the
package insert information, if available. Have your doctor write
down instructions if you don’t understand or are worried about
forgetting them.
Take your medicines for the whole time they are prescribed,
even if you feel better.
Take only your own medicines. Taking someone else’s medicine
may hide your symptoms and make diagnosing your illness more
difficult for your doctor.
Know about your medicines. If you take more than one
medicine, be able to tell them apart by size, shape, color, number
or name imprint, form (tablet or capsule), or container.
Plan for medicines you need to take during the night.
If you need to take more than one medicine, try not to keep them
by your bedside. If you must, and there are no small children or
pets in your home, place the pills you will need during the night
on your bedside table. Turn on the light and make sure you’re
taking the right medicine at the right time.
10

Organize your medicines at home. Many people use a chart or
written schedule to keep track of their medicines. Some find
containers with different colored caps, different sections or with
alarms that go off at set times helpful.
Keep medicines in a cool, dry place, away from bright light.
A kitchen cabinet or bedroom shelf may be good storage places.
Medicines should not be kept in places where heat and moisture
can alter their effectiveness. Do not keep medicines in the
refrigerator, unless your doctor or pharmacist, or the label,
tells you.
Before you travel, ask your doctor or pharmacist how to
adjust your medicine schedule to account for changes in time,
routine, and diet. Bring the phone numbers of your doctors and
pharmacists with you. When flying, carry your medicines with you;
do not pack them in your checked luggage. When traveling,
always keep medicines out of heat and direct sunlight.
If there are children in your home, remember to put medicines
out of their sight and reach, and don’t take medicines in front
of them.
Get prescriptions refilled early enough to avoid running out of
medicine, which may cause problems with your medicine schedule.
If you to buy medicines on the Internet, check the web site for
the Verified Internet Pharmacy Practice Sites (VIPPS) program
and seal of approval to make sure the site is properly licensed and
has been successfully reviewed and inspected by the National
Association of Boards of Pharmacy (www.nabp.net).
Always keeps medicines in their original containers, and never
put more than one kind of medication in the same container.

11

Taking Over-the-Counter Medicines
Today’s medicine cabinets contain a growing choice of over-thecounter, OTC, medicines to treat a growing number of health
problems. Common OTC medicines include pain relievers, laxatives,
cough and cold products, and antacids. Some OTC medicines,
however, can affect the way prescription medicines work or are
used by the body. Always talk with your doctor about all OTC
medicines you take. Here are some important tips to remember:
Always read and follow the directions on the medicine label.
OTC medicine labels give you all the information you need to take
the medicine the right way and tell you:
■ Active and inactive ingredients,
■ What the medicine is used for,
■ Interactions or side effects that could happen,
■ How and when (or when not) to take the medicine,
■ Other warnings.
Choose OTC medicines that have only the ingredients you
need. It is a good idea to only use medicines that treat the
problems or symptoms you have. Ask your pharmacist for help.
If you are taking more than one medicine, pay attention to the
“active ingredients” to avoid taking too much of the same
ingredient.
Check for package tampering and the expiration date.
Don’t buy medicines if the packaging has been broken or if the
expiration date has passed. The expiration date tells you the
date after which the product may not be as effective.
Talk to your doctor if taking an OTC medicine becomes a
regular habit. Most OTC medicines are only to be used for a
short time.

12

If you have questions about specific medicines, visit the National
Library of Medicine's web site at www.medlineplus.gov and
click on "Drug Information."

Cutting Medicine Costs
Medicines are an important part of treating an illness because
they often allow people to remain active and independent.
But medicine can be expensive. Here are some ideas to help
lower costs:
Tell your doctor if you are worried about the cost of your
medicine. Your doctor may not know how much your prescription
costs, but may be able to tell you about another less expensive
alternative.
Ask for a senior citizen’s discount.
Shop around. Look at prices at different stores or pharmacies.
Lower medicine prices may not be a bargain if you need other
services, such as home delivery, patient medicine profiles, or pharmacist consultation, or if you cannot get a senior citizen discount.
Ask for medicine samples. If your doctor gives you a prescription
for a new medicine, ask your doctor for samples you can try
before filling the prescription. (Make sure you know the right
way to use the sample medicine and ask for any other important
product information.)
Buy bulk. If you need to take medicine for a long period of time
and your medicine does not expire quickly, you may be able to
buy a larger amount of the medicine for less money.
Try mail order. Mail-order pharmacies can provide medications at
lower prices. However, it is a good idea to talk with your doctor
before using such a service since there may not be a health care
professional there to talk to and it may take a few weeks for medicine to get to you. Make sure to find a back-up pharmacy in case
there is a problem with the mail service.
Buy OTC medicines when they are on sale. Check the
expiration dates and use them before they expire. If you need
help choosing an OTC medicine, ask the pharmacist.
13

Tips for Seniors on Safe Medicine Use
✓Learn about your medicines. Read medicine labels and
❏
package inserts and follow the directions. If you have
questions, ask your doctor or other health care professionals.

✓Talk to your team of health care professionals about your
❏

medical conditions, health concerns, and all the medicines
you take (prescription and OTC medicines), as well as dietary
supplements, vitamins, and herbals. The more they know, the
more they can help. Don’t be afraid to ask questions.

✓Keep track of side effects or possible drug interactions
❏

and let your doctor know right away about any unexpected
symptoms or changes in the way you feel.

✓Make sure to go to all doctor appointments and to any
❏

appointments for monitoring tests done by your doctor or
at a laboratory.

✓Use a calendar, pill box or other things, to help you
❏

remember what you need to take and when. Write down
information your doctor gives you about your medicines or
your health condition.

✓Take along a friend or relative to your doctor’s
❏

appointments if you think you might need help to
understand or to remember what the doctor tells you.

✓Have a “Medicine Check-Up” at least once a year. Go through
❏
your medicine cabinet to get rid of old or expired medicines
and also ask your doctor or pharmacist to go over all of the
medicines you now take. Don’t forget to tell them about all
the OTC medicines or any vitamins, dietary supplements, and
herbals you take.

✓Keep all medicines out of the sight and reach of children.
❏
14

For more information contact:
U.S. Department of Health and Human Services
www.dhhs.gov
Administration on Aging
www.aoa.gov
202-619-0724
AoAInfo@aoa.gov
Agency for Healthcare Research and Quality
www.ahrq.gov
Food and Drug Administration
www.fda.gov
1-888-INFO-FDA
Substance Abuse and Mental Health Services Administration
www.samhsa.gov
www.findtreatment.samhsa.gov
1-800-662-HELP
National Institutes of Health
www.nihseniorhealth.gov
National Institute on Aging Information Center
www.niapublications.org
1-800-222-2225
1-800-222-4225 TTY
National Library of Medicine
www.medlineplus.gov

15

In the space below, list all medicines you take, including all prescription and OTC
medicines, dietary supplements, vitamins and herbals, remembering to cross off
medicines you are no longer using. Throw away any expired medicines.

My Medicine Record
Name of medicine

What it is for

Doctors’ names and phone numbers

Doctor who prescribed

How and when to take

How much to take

Color/shape

Side effects/ warnings

Pharmacists’ names and phone numbers

Emergency contact information:

16

Name:___________________________________________________________________ Relationship: ______________________
Phone number: _____________________________________________________

17

Council on Family Health
www.cfhinfo.org

Provided in cooperation with
U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES
Food and Drug Administration
www.fda.gov
and
Administration on Aging
www.aoa.gov
4/04


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