The more health problems people have, the more medications they are likely to take. While these medications can help reduce symptoms of the health problems, there is a downside when a medication list gets long.  Taking a lot of medications is called "polypharmacy," and it can be a tricky situation to manage.

Understanding Polypharmacy

Polypharmacy happens when someone has to take several medicines at the same time.  The "magic" number in healthcare is considered to be five or more medications, because this number is where risk starts to really increase.  Taking more than five medications is often necessary, but here is why pharmacists get concerned:

• Mistakes: A complicated list with several medications, all with different directions, increases the chance that they can be taken wrong or missed.

• Side Effects: More medicines mean a greater chance of side effects, and the chance the medications will impact each other in a bad way.

• Prescribing Cascade: described below

The prescribing cascade is a bit like a chain reaction. It begins when someone takes a medicine and experiences side effects from it. Sometimes, they don't know these side effects are from the medicine, so they go back to the doctor. The doctor then prescribes another medicine to deal with the new problem. This cycle can keep going, making things more complicated.

For example, let's say someone takes a pain medicine like ibuprofen, and it upsets their stomach. They might go back to the doctor again with this complaint, and the doctor could treat that stomach pain with a medication like omeprazole. Then omeprazole might lead to a new problem like low levels of calcium and magnesium, which can lead to more medications or new health problems.

Preventing the Prescribing Cascade

We can stop the prescribing cascade and make things simpler. Here are some ways to do it:

• Check Your Medicines: Make a list of your medicines and show it to your doctor. They can check if you're taking too many similar medicines.

• Ask Questions: If you don't understand something about your medicine, don't hesitate to ask your doctor or pharmacist. They can explain it in a way that makes sense to you.

• Stop Unneeded Medicines: Sometimes, you might not need all the medicines you're taking. Talk to your doctor about stopping the ones that aren't helping you anymore.

• Stay in Touch: Keep talking to your healthcare team. They need to know what's happening with your medicines and your health.

Taking many medicines can be complicated, but we can work together to make it easier and safer. By keeping a list of your medicines, asking questions, stopping medicines you don't need, and staying in touch with your healthcare team, we can make sure you get the right medicines to stay healthy without too many problems. It's all about finding the right balance to keep you feeling your best!