When it comes to using medicines wisely and safely – you are never too old to learn.
It is said that with age comes wisdom. It would seem for many of us, with age also comes the increased likelihood of taking medicines on a regular basis. Health problems become more common as you get older, so you may need to be treated with more medicines. In fact, Australian research suggests around half those aged 5-74 years and two thirds of those 75 and older are taking at least five medicines every day.
Being aware of the medicines we are taking and knowing how to use them wisely is important across all ages and life stages – and may be particularly relevant as we become older. This is highlighted by the fact that one in three unplanned hospital admissions involving older Australians are due to problems with medicines, and half of these medicine problems could be prevented.
What changes can occur with ageing?
In addition to taking more medicines to manage our health, as we get older the way our bodies handle and react to medicines changes. It’s not that we wake up and are suddenly different the day we turn 65, but rather that gradual changes affect a variety of body functions and can lead older bodies to respond or react differently to medicines compared with a younger body.
Age-related changes mainly affect:
- how medicines are removed (excreted) from your body by your kidneys — this may affect your body’s ability to efficiently get rid of medicines and their waste products (also known as metabolites) so they build up, or remain in the body for longer than usual.
- how medicines are broken down (metabolised) by your liver — this can mean less medicine is broken down by the liver, resulting in more of the medicine getting into your bloodstream and potentially increasing your risk of experiencing side effects or harmful medicine interactions.
- how and where a medicine is stored in your body — less water and muscle in your body can lead to higher concentrations of medicines in the blood stream, while increased fat deposits can mean some medicines stay in your body for longer.
What does this mean for me?
If your kidney or liver have changed their function, your doctor may need to lower the dose of some medicines you are taking. In some cases a medicine may need to be stopped, or avoided.
NPS MedicineWise clinical adviser Dr Andrew Boyden says, “You may need to have a kidney or liver function test before starting a medicine and while you are taking it. This can help your doctor to decide about a suitable dose or choice of medicine for you. You may also need to have other tests if you are taking certain medicines, to measure how much of the medicine is in your body”.
Be aware of medicine side effects
Age-related changes can also make some people more sensitive to the medicines they take, so they are likely to have stronger side effects and/or medicine interactions. For example, a dose of a medicine that would have made you slightly drowsy at a younger age could now make you more drowsy, confused, or unsteady on your feet, and consequently more prone to falls.
Dr Boyden says communication about your medicines is important as you get older. “Always keep your health professionals informed of any changes in how you feel, especially when taking new medicines or after a change in your dosage regime.”
Keep track of your medicines
When you take many medicines on a regular basis, it can be difficult to manage them all – from actually remembering to take them to ensuring you take the prescribed dose at the right time and in the correct way.
“Multiple medicines can mean a greater chance that you will have side effects, or that the medicines may interact, leading to unwanted side effects,” Dr Boyden says.
It is also important to remember that medicines don’t just come on prescription – they include over-the-counter medicines from a pharmacy or other store, as well as herbal remedies, vitamins and other supplements. Make sure to tell your doctor or pharmacist about all the medicines you take to avoid risky interactions and so they can help you find the best ways to manage multiple medicines.
“It’s not that we wake up and are suddenly different the day we turn 65, but rather that gradual changes affect a variety of body functions and can lead older bodies to respond or react differently.”
How to become more medicinewise
Although making decisions about medicines as you become older is not always straightforward, age should never be a barrier to being medicinewise.
Make sure to:
- ask your doctor or pharmacist to review your medicines
- keep a medicines list (keep a written record, or use the Medicines List+ app on a smartphone)
- talk to your health professional about any changes in how you feel, especially when taking new medicines or a different dose.
About
Where can I find more information?
Visit nps.org.au to find a wealth of information and resources on being medicinewise at all ages and life stages. If you have questions about your medicines, call the NPS Medicines Line on 1300 MEDICINE (1300 633 424) for the cost of a local call (mobiles may cost more), Monday to Friday 9am–5pm AEST (excluding public holidays).
Resources
1. Morgan TK, et al. Med J Aust 2012;196:50-3.http://www.ncbi.nlm.nih.gov/pubmed/22256935.
2. Chan M, et al. Intern Med J 2001;31:199-205.
3. McLean AJ, Le Couteur DG. Pharmacol Rev 2004;56:163-84.http://pharmrev.aspetjournals.org/content/56/2/163.full.pdf.
4. Le Couteur DG, et al. Aust Fam Physician 2004;33:777-81.
5. Turnheim K. Exp Gerontol 2003;38:843-53.
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