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Managing your health and medications can be challenging. As you get older, your medication list may get longer, which increases the risk of interactions and adverse effects. Here are some suggestions to empower you to be an expert on your medication list and ensure you are on the right regimen. Collaborating with your doctors, pharmacists and loved ones will be essential to achieving these goals.
Rule 1: Know Your Medication List.
It’s very important that you know your list of medications and what each drug is treating. Sometimes the medications that a patient is taking are different from what is listed in the electronic medical record or how your doctor thinks you are taking them. Every year during your annual wellness exam (also called a physical exam or preventive visit), you should gather all your prescriptions, over-the-counter medications and dietary supplements and bring them to the doctor to review together. This allows everyone involved in your care to ensure that you are taking the correct medications and review for possible drug interactions.
To assist with knowing your medications, you should have a drug list. You can ask your doctor to print one from the electronic medical record, you can create your own or you can use this Drug Worksheet.
The purpose of the Drug Worksheet is for you and your team of doctors to keep an ongoing record of all drugs you are using, what each medication is treating, whether the drug is working, and other information essential for the safest and most effective use of these products. This form also allows you to track changes to the doses and log possible adverse effects.
Ahead of your visit, start to fill out the Drug Worksheet with any information you know, especially over-the-counter medications and dietary supplements, because your doctor may not know what you are taking. Then, with your doctor(s), you can review and fill out the remaining parts of the Drug Worksheet together to make sure everyone knows these important details about your medications. If you have multiple specialists involved in your care, it may be that your specialist assists with filling out the Drug Worksheet for the medications they are prescribing and your primary care doctor can review the entire form to make sure it is complete and appropriate.
Whatever form you choose to log your medication list, your family members or caregivers should have a copy. It is also helpful if you have a paper copy of your medication list in your wallet and a digital copy in your phone in case of an emergency.
Rule 2: Stay Organized With Your Medications.
If you are prescribed multiple medications, an organization system is essential to make sure you are taking the drugs correctly. For each medication, you should know at what time it should be taken, how many times per day, and whether it should be taken on an empty stomach or with a meal.
Some people find it helpful to create a schedule that they keep in a visible place, such as the fridge door or the bathroom mirror, and near where the medications are kept. You can also organize all your medications for the week in a pill box. Upon request, some pharmacies will create “blister packs” of pills that should be taken together. For example, they would create a pack of all your morning pills, midday pills and evening pills together. Finally, phone alarms or medication-reminder applications can help create reminders to take your medications on time.
Rule 3: Make Sure a New Drug Therapy Is Really Needed.
When discussing a medical issue with your doctor, ask about nondrug approaches to treat the problem. For example, for mild high blood pressure and cholesterol, diet change and weight loss can be as effective as taking medication.[1],[2],[3],[4] For certain musculoskeletal problems, physical therapy and exercise can avoid the need for prolonged pain medication.[5],[6] For constipation, increasing intake of natural fiber from whole foods and drinking more water is preferable to using laxatives. Not only will this approach help you avoid starting a new medication, potential added cost and adverse effects, but these lifestyles changes can also have a positive effect on other aspects of your health. In certain cases, your doctor will recommend a trial period of lifestyle changes, such as diet or exercise, before considering starting a new medication.
Drugs should rarely be prescribed for occasional anxiety or difficulty sleeping, particularly in older adults, because they can lead to confusion, falls and cognitive decline. Whenever possible, nondrug approaches to these problems should be tried. However, these situational problems are different from clinical depression, anxiety or insomnia, which often require a combination of therapy and medication treatment.
If you develop adverse effects from a medication, before taking a new medication to counteract these undesirable symptoms, consider with your doctor causes of these adverse effects, an alternative medication or a different dosing regimen. Make sure that you are not prescribed drugs for adverse events of another medication if that drug is not necessary. However, some essential drugs, such as chemotherapy agents, cause adverse events, and physicians will prescribe other drugs to mitigate these symptoms.
The guiding principle is to use as few drugs as possible in order to reduce adverse reactions and increase the odds of properly taking the drugs that are necessary. In addition, be wary of pharmaceutical advertising that may present misleading information or downplay the possible adverse effects of a medication.
Rule 4: If Drug Therapy Is Indicated, Start With a Low Dose.
More generally, start with as low a dose as possible. This is especially recommended in older adults. In other words, “start low and go slow,” increasing the dose gradually and only if necessary to get the desired effect. Because the rate of adverse effects is often dose dependent, a lower dose may cause fewer adverse effects.[7],[8]
Rule 5: When Adding a New Drug, See If It Is Possible To Discontinue Another Drug.
If your doctor is considering adding a new drug, this is an opportunity to reevaluate existing drugs and eliminate those that are not essential. The possibility of adverse drug interactions increases with the addition of each new drug.[9]
Rule 6: Understand How To Take a New Drug, and for How Long.
When prescribed a new medication, make sure you understand why this drug is being prescribed and how to take it before leaving the doctor’s office. This includes the time of day to take the pill, whether it should be on an empty stomach or with food, whether it interacts with certain foods or alcohol, if it impairs your ability to drive, whether its administration needs to be spaced out with other medications, possible adverse effects, and how to store the medication safely (for example, in the fridge or at room temperature).
You should also have a sense of how long you will be taking this medication to avoid the continuation of medications past necessary use. For example, antacid medications are often prescribed to treat reflux and are continued for years without reevaluation or discontinuation. For any drug, new or old, you should assume that it should be used for as short a time as possible unless there is evidence that its continued use is necessary. Do not stop a prescription drug without speaking to your clinician first.
Rule 7: Monitor for Adverse Effects.
Before you leave your doctor’s office, make sure you ask about and understand possible side effects of a new drug. In one study, researchers found that adverse effects of a prescribed medication were only mentioned 44% of the time by the prescriber. When the prescriber did not mention an adverse effect, 55% of patients reported that the medication did not have possible adverse effects.[10]
Once you start a new medication, monitor for possible adverse effects. If family members or friends are involved in your care, make sure they are aware of the new drug and possible adverse effects. Older adults may not notice a change and may be inclined to blame many of their problems on aging. Loved ones are often the first to notice adverse drug reactions, especially related to cognition or mood.
If you develop new concerning symptoms, report them to your doctor. These could be caused by the new drug. It is also possible that these adverse effects could resolve with time as your body adjusts to the medication. Discuss with your doctor to determine the best course of action.
Rule 8: Use a Single Pharmacy.
If possible, it is helpful to use one pharmacy consistently so that the pharmacy team can be aware of all your prescription medications and provide information on possible interactions. When receiving a new medication at the pharmacy, you should be given an instruction sheet with additional information on the medication. You can ask your pharmacist to explain it to you.
Be wary of automatic refill requests that are generated by your pharmacy to your doctor. If you receive a prescription that you did not discuss with your doctor or a refill past the agreed-upon treatment duration, reach out to your provider’s office to discuss this further.
It can be challenging to know your cost for a drug prior to filling a prescription. To know the exact cost, have your doctor prescribe the medication and the pharmacy process the order with your most up-to-date insurance information, if you are insured. If the drug is too costly for you, talk to your doctor about less-expensive alternatives. Always ask for a generic prescription whenever possible. For brand-name drugs, if you have health insurance, ask your doctor to prescribe the drug that is least expensive in your plan if it is the best drug for you. Regardless of insurance status, your clinician’s office may be able to help you find coupons or patient-assistance programs to lower the price. However, if you need to take the drug for the long term and the coupons only lower the price for a few months, talk to your doctor about a more sustainable solution.
Rule 9: Stopping a Drug Is as Important as Starting It.
Regularly review with your doctor your drug list and the need to continue each one. Adverse drug reactions can be caused by continuing to use drugs long after they are needed, especially in older adults as they metabolize drugs differently over time. Drugs that are prescribed for an acute problem are not needed beyond a short period and can cause risks without providing benefits in the long term.
If you and your doctor decide to stop a drug, talk to them about a plan for how to discontinue it safely. Do not stop a medication without first discussing it with your doctor. In certain cases, it is very important to have a slow and careful wean to reduce adverse effects or withdrawal symptoms. In addition to considering whether to stop the drug, you and your doctor should discuss the possibility of lowering the dose.
Rule 10: Store and Discard Drugs Carefully.
If there are young children or pets living or visiting your house, ensure that all of your prescription medications, over-the-counter drugs and supplements are safely locked in a place that is inaccessible to the child or pet.
Many people are tempted to keep and reuse drugs obtained in the past. Restarting old drugs may make the other prescribed drugs more dangerous or worsen certain health conditions. In addition, do not give your prescription drugs, including antibiotics, to a friend or relative who you believe may benefit from them. You may not know all of their medical conditions and medications, so it is not safe to share prescriptions.
Discard discontinued drugs safely by dropping off the pill bottle with the label removed at a “drug take-back” location. These are often found in pharmacies, hospitals and law-enforcement facilities. If you are unable to safely dispose of your drug at a drug take-back location, you can obtain prepaid drug mail-back envelopes from a pharmacy or website. If this is not an option for you, most medicines can be discarded in the trash by removing the drug from the original bottle and mixing them with unappealing substances such as dirt or coffee grounds.
Finally, for certain medications with dangerous effects, if you cannot bring them to a drug take-back location or mail them back, the FDA recommends flushing these medications down the toilet to avoid accidental exposure to humans. In this case, the benefits of avoiding human toxicity and death outweigh the risk to the environment. Visit the FDA’s website to see which medications are on this list.[11]
References:
[1] Writing Committee Members*; Jones DW, Ferdinand KC, et al. 2025 AHA/ACC/AANP/AAPA/ABC/ACCP/ACPM/AGS/AMA/ASPC/NMA/PCNA/SGIM Guideline for the prevention, detection, evaluation and management of high blood pressure in adults: A report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. 2025 Sep 16;152(11):e114-e218.
[2] Carey RM, Moran AE, Whelton PK. Treatment of hypertension: A review. JAMA. 2022 Nov 8;328(18):1849-1861.
[3] Blumenthal RS, Morris PB, Gaudino M, et al. 2026 ACC/AHA/AACVPR/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the management of dyslipidemia: A report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. J Am Coll Cardiol. 2026 May 19;87(19):2624-2757.
[4] Mohr AE, Hatem C, Sikand G, et al. Effectiveness of medical nutrition therapy in the management of adult dyslipidemia: A systematic review and meta-analysis. J Clin Lipidol. 2022 Sep-Oct;16(5):547-561.
[5] Martin S, Tallian K, Nguyen VT, et al. Does early physical therapy intervention reduce opioid burden and improve functionality in the management of chronic lower back pain? Ment Health Clin. 2020 Jul 2;10(4):215-221.
[6] Sun E, Moshfegh J, Rishel CA, et al. Association of early physical therapy with long-term opioid use among opioid-naive patients with musculoskeletal pain. JAMA Netw Open. 2018 Dec 7;1(8):e185909. doi: 10.1001/jamanetworkopen.2018.5909.
[7] Coleman JJ, Pontefract SK. Adverse drug reactions. Clin Med (Lond). 2016 Oct;16(5):481-485.
[8] Böhm R, Cascorbi I. Pharmacogenetics and predictive testing of drug hypersensitivity reactions. Front Pharmacol. 2016 Oct 21;7:396.
[9] Gutiérrez-Valencia M, Izquierdo M, Cesari M, et al. The relationship between frailty and polypharmacy in older people: A systematic review. Br J Clin Pharmacol. 2018 Jul;84(7):1432-1444.
[10] Ho T, Campos BS, Tarn DM. Post-visit patient understanding about newly prescribed medications. J Gen Intern Med. 2021;36(11):3307-3310.
[11] U.S. Food & Drug Administration. Where and How to Dispose of Unused Medicines. April 16, 2025. https://www.fda.gov/consumers/consumer-updates/where-and-how-dispose-unused-medicines. Accessed September 15, 2026.
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