Medicine lists tend to grow one prescription at a time. A cardiologist adds one, a specialist up north adds another, a pharmacist suggests something for sleep, and a friend recommends a supplement. Each choice may make sense on its own. Together, they can add up to side effects nobody intended.

A full medication review is simply a careful look at everything a person takes, all at once, by a doctor who knows the rest of their health. This article explains why that matters more with age and how to prepare. It is general information; never stop or change a medicine without talking with the clinician who prescribed it.

Why medicines act differently as we age

The National Institute on Aging notes that older adults often manage several conditions and medicines at the same time, and that mixing prescriptions, over-the-counter drugs and supplements without guidance can cause problems.

Some side effects are easy to mistake for aging itself. NIA lists medication side effects among the treatable causes of memory problems. Dizziness, unsteadiness, constipation, poor appetite and daytime sleepiness are other complaints worth checking against the medicine list before assuming they are just part of getting older.

The Beers Criteria, briefly

The American Geriatrics Society publishes the AGS Beers Criteria, a list of medicines that are potentially inappropriate for many adults 65 and older. The most recent update was published in 2023. The list flags drugs that are often best avoided in older adults, drugs to use with caution, combinations that may interact, and medicines that should be avoided or dosed differently when kidney function is reduced.

The Beers Criteria are a tool for clinicians, not a rule for patients. A medicine on the list may still be the right choice for a particular person. What the list does well is prompt a question: is this still the best option, at this dose, for this patient today.

Kidney function and medicine doses

The kidneys clear many medicines from the body. When kidney function declines, as it often does with age, diabetes or high blood pressure, some drugs can build up. That is why kidney function is part of any careful medication review.

Pain relievers are a common example. The National Institute of Diabetes and Digestive and Kidney Diseases warns that nonsteroidal anti-inflammatory drugs (NSAIDs), including ibuprofen and naproxen, can damage the kidneys, and that NSAIDs appear in many headache, pain and cold products under different brand names. Our article on NSAID risks and side effects covers this in more detail.

Dr. Shtern is board-certified in both Internal Medicine and Nephrology, so kidney function is something she looks at as a matter of course. If you want to understand the numbers on your own lab report, see reading your kidney labs, and our kidney care page describes how the practice approaches kidney health.

How to prepare for a medication review

NIDDK advises telling your provider and pharmacist about everything you take, including over-the-counter medicines, vitamins and supplements. The simplest way is the “brown bag” approach:

  1. Put every prescription, over-the-counter product, vitamin, supplement, eye drop, inhaler and cream in a bag, in the original containers.
  2. Include anything you take only now and then, such as a sleep aid or allergy pill.
  3. Bring the names of every prescriber and pharmacy you use, in Florida and elsewhere.
  4. Write down how you actually take each one, especially if it differs from the label.
  5. Note any side effects you suspect, even small ones, and when they started.

Good questions to ask include: What is each medicine for? Is it still needed? Could any of these be causing the symptom I mentioned? Do any of them interact? Does my kidney function change anything? Is there a simpler schedule with fewer daily doses?

Why one doctor seeing the whole list helps

The most common gap is not a bad prescription but a missing view. Specialists focus on their own area, and seasonal residents may fill prescriptions in two states. A primary care doctor who keeps one current list, and has time in the visit to go through it, can catch duplicates and interactions that are easy to miss.

At Legacy Medical, visits are unhurried and labs are drawn in the office, so a review of the list and a check of kidney function can happen together. Changes are always made with you, and with the prescribing specialist when needed.

If you would like to bring your bag of bottles and meet the doctor first, the first visit is a complimentary meet and greet with Dr. Shtern.

This article is general information, not advice for your situation. Members can call the office with questions about their own care.