Older adults are more likely than any other age group to take multiple medications. Current estimates show that more than 40% of older adult Americans take five or more prescription medications, and 20% take 10 or more. Older adults are also more likely to see multiple medical providers who may not always check their other medications. Drug interactions can lead to dangerous side effects and consequences. Learning how to tell if your medications interact and how to discuss it with your provider is integral to your medical management. Here, we offer ways to check for and avoid harmful drug interactions.
What is a drug interaction?
Drug interactions occur when taking two or more medications or supplements that affect one another. They can occur in different ways, such as:
- One drug making another drug not work or be less effective.
- The drugs together causing unwanted side effects, also known as adverse events.
It is important to note that drug interactions can also occur with certain over-the-counter medications, vitamins, supplements, foods, and drinks. Not every drug interaction will have noticeable side effects, so you cannot rely on symptoms alone to know if your prescription drugs are interacting negatively.
Some common drug reaction symptoms that may occur or worsen with drug interactions include:
- Rashes.
- Unusual bruising (not from a known fall or injury).
- Bleeding.
- Swelling.
- Feeling dizzy or lightheaded.
- Nausea and vomiting.
- Diarrhea or constipation.
- New-onset confusion.
- Difficulty breathing or feeling short of breath.
- Tachycardia or an abnormal heartbeat.
Why are drug interactions more common and dangerous for seniors?
Drug interactions are more common in older adults due to an increased chance of having multiple chronic conditions and polypharmacy (taking five or more medications). Having chronic health conditions makes you more likely to see multiple health care providers who prescribe medications versus having one primary care provider who manages all of your medications.
Older adults are also more susceptible to dangerous interactions, as their bodies metabolize (break down and use) drugs differently than younger adults. This is due to increased body fat, less water stored in the body, and reduced muscle mass. Based on current estimates, older adults over the age of 70 have more body fat than younger adults, which impacts how drugs are stored and used in the body. Additionally, age-related changes in the liver and kidneys can also have an effect. These factors mean older adults may be more or less sensitive to medications and need a different dose to avoid side effects and interactions.
New or worsening symptoms related to drug interactions can increase the risk of falls, injury, and hospitalization among older adults. One study found that drug-to-drug interactions were a significant contributor to drug-related hospitalizations.
How to prevent drug interactions
There are some simple steps you can take to decrease the risk of experiencing drug interactions. If you manage your own medications, have help from friends or family, or live in a facility where they manage your medications for you, these tips will still apply:
- Always keep an updated list of prescription drugs, over-the-counter (OTC) medications, supplements, and vitamins with you. The list should include the drug name, reason you are taking it (e.g., high blood pressure), dosage, and how often you take it. Show this list to any providers you see.
- Have the pharmacist review your medication list when filling new or changed prescriptions.
- Promptly discuss any side effects or symptoms with your prescribing provider(s).
- Do not start or stop taking any medications, including those you can buy yourself at the store, without talking to your provider first.
How to check your medications for interactions
The safest option for checking drug-to-drug interactions is to speak directly with a health care provider or pharmacist. They can access the most up-to-date information and systems to check for interactions. However, some online resources are available to check or double-check your medications. These websites should not be used in place of medical advice or a medication review from your provider.
Online drug interaction checkers usually require you to enter medication names one at a time. They may also ask for the dosage and how often they are taken. After submitting your medications, you should receive a drug interaction report.
If there are interactions or warnings, the report should display them with details. Each drug checker will differ slightly, but they will generally categorize the drug-to-drug interaction on a scale of minor to major or severe. If you find potential interactions when using one of these tools, you can print out the report or write down the information to review with your provider.
What to do if you think you are experiencing an interaction
If you think you are experiencing a drug interaction due to a side effect or feeling like a medication is not working, you should contact the prescribing provider promptly. Based on the severity of your symptoms, you can call the after-hours number and speak with a provider directly. In general, you should not stop taking a prescribed medication without discussing it with your provider, as you may experience withdrawal or other dangerous symptoms. However, there are exceptions to this rule. If you think you are having an allergic reaction or a life-threatening emergency, you should seek emergency medical services immediately or call 911.
