The average Canadian over 65 takes between five and seven prescription medications. By age 80, that number often reaches ten or more. Each one was prescribed for a reason, but medications prescribed years apart by different doctors can interact with each other in ways nobody planned for. Falls, confusion, fatigue, and stomach problems that get blamed on aging are often medication side effects that a pharmacist can fix. At Acme Drug Mart, medication reviews for seniors are one of the most important things we do.
What polypharmacy actually means
Polypharmacy is the clinical term for taking five or more medications at the same time. It is not inherently bad, some conditions require multiple drugs. But every additional medication increases the risk of drug interactions, side effects, and dosing errors. Research consistently shows that patients on five or more medications have roughly a 50 percent higher risk of an adverse drug event compared to patients on fewer drugs.
The problem compounds when medications are prescribed by different providers who do not have a complete picture of what else you are taking. A cardiologist prescribes one drug, a rheumatologist another, and your family doctor a third. Each prescription makes sense individually. Together, they may cause low blood pressure, dizziness, or kidney strain that none of the prescribers anticipated.
Your pharmacist sees the complete picture. Every prescription from every doctor flows through the pharmacy, which is why a pharmacist-led medication review catches problems that individual prescribers miss.
Medications that increase fall risk
Falls are the leading cause of injury-related hospitalization in Canadians over 65. Medications are a contributing factor in roughly 40 percent of falls in seniors. The drug classes most commonly involved are:
- Blood pressure medications. These can cause orthostatic hypotension, a sudden drop in blood pressure when you stand up that makes you lightheaded. This is especially common when doses are too aggressive or when multiple blood pressure drugs are combined.
- Sedatives and sleep aids. Benzodiazepines (lorazepam, clonazepam) and Z-drugs (zopiclone) impair balance, slow reaction time, and increase fall risk for up to 24 hours after a dose. In seniors, these drugs stay in the body longer than in younger adults.
- Antidepressants. Both older tricyclics and newer SSRIs can cause dizziness, drowsiness, and low sodium levels that affect balance. The risk is highest in the first few weeks after starting or increasing a dose.
- Opioid pain medications. Even moderate doses affect coordination, alertness, and reaction time. If you are on a long-term opioid for chronic pain, ask your pharmacist about safer alternatives.
- Over-the-counter antihistamines. Diphenhydramine (Benadryl) is particularly problematic in seniors. It causes sedation, confusion, dry mouth, urinary retention, and blurred vision. Newer antihistamines like cetirizine or loratadine are much safer choices.
- Muscle relaxants. Cyclobenzaprine and methocarbamol cause significant drowsiness and are generally not recommended for long-term use in older adults.
If you are taking any of these and have noticed unsteadiness, dizziness, or near-falls, do not stop anything on your own. Come see us at Acme Drug Mart and we will review the full picture and work with your doctor on safer alternatives or dose adjustments.
Deprescribing: when less is more
Deprescribing is the planned, supervised process of reducing or stopping medications that may no longer be needed or may be causing more harm than benefit. It is not about taking away treatment. It is about making sure every drug you take is still earning its place.
Common candidates for deprescribing in seniors include:
- Proton pump inhibitors (PPIs). Often started for a short-term reason and continued indefinitely. Long-term PPI use in seniors has been linked to increased fracture risk, magnesium deficiency, and certain infections. If you have been on omeprazole or esomeprazole for years, a gradual step-down is often possible.
- Sleeping pills. Zopiclone and benzodiazepines lose effectiveness with long-term use while maintaining their side effects. Tapering off, combined with sleep hygiene strategies, often leads to better sleep than the medication was providing.
- Cholesterol medications. In patients over 80 with no history of heart attack or stroke, the benefit of statins becomes less clear and the side effects (muscle pain, fatigue) may reduce quality of life. This is a conversation worth having with your pharmacist and doctor.
- Bladder medications. Anticholinergic drugs for overactive bladder (oxybutynin, tolterodine) cause dry mouth, constipation, confusion, and have been linked to cognitive decline in seniors. Newer alternatives or non-drug approaches may work better.
Deprescribing is always gradual. Stopping medications abruptly can cause withdrawal effects or rebound symptoms. Your pharmacist creates a tapering plan and monitors you through the process.
Organizing multiple medications
Taking six or eight medications at different times of day with different food requirements is genuinely complicated. Missed doses and double doses are common, and both can have serious consequences. Here is what works:
- Compliance packaging (blister packs). We pre-sort your medications into labelled compartments by day and time. You tear open one compartment at breakfast, one at lunch, one at dinner, one at bedtime. No counting, no sorting, no guessing. Acme Drug Mart provides compliance packaging at no extra charge.
- A written medication schedule. A printed card listing each drug, what it is for, when to take it, and whether it needs food. Keep one on the fridge and one in your wallet. We create these during medication reviews.
- Synchronizing refills. If you are picking up different medications at different times throughout the month, we can align your refill dates so everything comes due at once. One trip, one package, less confusion.
- Free delivery. If getting to the pharmacy is difficult, we deliver for free anywhere in Edmonton. Same-day delivery for orders placed before 3 PM.
What happens during a medication review
A comprehensive medication review at Acme Drug Mart takes 20 to 30 minutes. Bring everything you take, prescriptions, over-the-counter drugs, vitamins, and supplements. Here is what we do:
- Check every medication for interactions with every other medication
- Identify drugs that may no longer be needed
- Flag medications that are high-risk in seniors
- Review doses, some drugs need lower doses in older adults because the kidneys and liver process them more slowly
- Look for gaps, conditions that should be treated but are not
- Create a clear medication schedule
- Contact your doctor with recommendations if changes are needed
The review is covered by Alberta Health at no cost to you. You do not need a doctor's referral. Seniors taking five or more medications should have a review at least once a year, and after any hospital stay or major medication change.
Signs your medications need a review
Many seniors attribute medication side effects to normal aging. If any of these apply to you, a medication review may help:
- You feel drowsy, foggy, or confused during the day
- You have had a fall or a near-fall in the past six months
- You feel dizzy when you stand up
- You have trouble sleeping despite taking a sleep aid
- You have unexplained nausea, constipation, or loss of appetite
- You recently left the hospital and your medications changed
- You see more than one doctor and are not sure they know about each other's prescriptions
- You have medications in your cabinet that you are not sure you still need
Book a medication review
Walk into Acme Drug Mart or call (780) 443-0202 to book a medication review. Bring your pill bottles, blister packs, vitamins, and any supplements. We will go through everything, simplify where possible, and make sure nothing is working against you. If you are a caregiver for a parent or spouse, you are welcome to attend the review with them, two sets of ears are better than one.