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Polypharmacy

Poly (many) pharmacy (medicines)

Key points about polypharmacy

Polypharmacy is the term used to describe taking a large number of medicines (usually more than 5) regularly.
Some people may need to take a large number of medicines, but sometimes the use of many medicines may not be appropriate.
Read about polypharmacy and what you can do to make sure the medicines you are taking are appropriate for you.

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Polypharmacy is the term used to describe taking a large number of medicines (usually more than 5) regularly.

People with many health conditions often need to take more medicines. This is why older adults are more likely to experience polypharmacy, as they tend to have more long-term conditions and are often prescribed many medicines.

Other factors contributing to polypharmacy are:

Availability of medicines: The development of new medicines for different conditions has benefited many people, but it can also lead to overuse and inappropriate use of medicines.
Side effects: Medicines can cause side effects that may need to be managed or that appear similar to symptoms of another illness. You may be prescribed another medicine to treat these symptoms, creating the chance of more side effects and interactions between medicines.
Self-prescribed medicines: Over-the-counter medicines and supplements can also be inappropriately used when they are taken without advice from a healthcare provider, or overused if they're taken when they're not necessary.

Some people may need to take a large number of medicines to help them manage their health conditions, but sometimes the use of many medicines may not be appropriate.

Appropriate polypharmacy

This is where you have many illnesses or a complex medical condition that's being treated with several medicines, and where the benefits of the medicines outweigh the potential harms. For example, a person with heart failure, high blood pressure and atrial fibrillation (irregular heart beat) will be prescribed a range of heart medicines, all of which are likely to improve their health.

Inappropriate polypharmacy

This is where you're treated with many medicines and the harms outweigh the benefits.

Some examples of a medicine not being appropriate are when:

you no longer need the medicine because your condition has changed
the medicine may interact with another medicine you're taking
you aren't getting the full benefit of the medicine
the side effects of the medicine outweigh the benefits of taking it
you were prescribed a new medicine to treat a side effect of a medicine instead of the first medicine being changed to one that doesn’t cause that side effect.

Reducing unnecessary polypharmacy often improves safety and quality of life, while also reducing waste.

A major concern with polypharmacy is that it increases your risk of experiencing adverse effects from your medicines. The more medicines you take, the greater the chance of side effects and interactions between these medicines.

In older adults, polypharmacy has been associated with serious risks including:

more falls and fractures
dehydration and kidney problems
delirium and confusion
low blood glucose (hypoglycaemia)
malnutrition.

Taking lots of medicines means that you have to remember to take them all properly. This can be difficult:

when you're taking them every day over a long period of time
if you don't feel they are giving you any benefit
when you're away from home or travelling
if they're causing side effects.

If you're having trouble remembering to take your medicines, try a medicine reminder app to help with this or read some tips for remembering to take your medicine(external link).

Medicine reviews

Talk to your healthcare provider about having a medicine review. This involves your healthcare provider gathering information about your medicines from you and your records. This information is used to check that you're taking the most appropriate medicines. You'll also be able to ask questions about your medicines and raise any concerns you have.

Get to know your medicines

Learn your medicines by name, what they're for and how to take them.
When you're prescribed a new medicine, ask your doctor or nurse prescriber:
- what the medicine is for
- how long you need to use it
- whether there are other medicines or foods you should avoid while taking this medicine
- If there are any side effects that might happen, and how to manage these.
Make a list of all your medicines, including each tablet's strength and dose, as well as herbal products, vitamins, homeopathic remedies, supplements, Rongoā Māori and over-the-counter drugs.
Carry your medicine list everywhere, and bring it to every healthcare provider visit, along with the pill bottles.
Update your medicine list after every visit.
If you have more than 1 doctor, make sure each one knows what the other has prescribed for you, eg, your GP knows what your specialist has prescribed.
Read your medicine labels – they have advice on what to avoid when taking the medicine to reduce the chance of unwanted interactions. For example you may need to avoid products containing iron.
Never take a new medicine without asking your pharmacist about its side effects and interactions with other medicines.

Other things you can do

Check the ingredients of any medicines that have more than 1 active ingredient so you’re not taking the same medicine twice, eg, cold and cough products often contain paracetamol. If you're already taking paracetamol regularly, you may end up taking too much.
Use lifestyle measures to improve your health whenever possible. For example:
- If you have sleep problems, there are many lifestyle tips you can try, before using medicine. Read about tips for sleep(external link).
- For muscle sprains, use rest, ice, compression and elevation (R.I.C.E.) together with pain relief.