If you (or a loved one) take several prescriptions, you’re not alone. Polypharmacy, often defined as taking five or more medications, has become increasingly common as people live longer with multiple chronic medical conditions. But more pills aren’t always better: higher medication counts are consistently linked with more adverse effects, falls, hospitalizations, and even higher mortality.
Why too many medicines can be dangerous
As the number of medications rises, so does the risk of drug–drug interactions, drug–disease interactions, delirium, dizziness and falls, and trouble adhering to complex regimens. These harms are especially pronounced in older adults, whose bodies metabolize medicines differently and who often live with several conditions treated by different specialists. The American Academy of Family Physician’s guidance emphasizes that regularly reviewing medication lists and deprescribing (safely tapering or stopping drugs that no longer help or may cause harm) lowers pill burden, reduces adverse drug events, and decreases costs.
The evidence base keeps growing. Reviews and practice recommendations in leading journals link polypharmacy to cognitive and functional decline, more emergency visits and hospital stays, and higher health care spending. In community settings, nearly half of older adults may meet criteria for polypharmacy and the majority are exposed to at least one potentially inappropriate medication (PIM).
What the American Geriatrics Society (AGS) recommends
To make prescribing safer, the American Geriatrics Society publishes the AGS Beers Criteria®, a rigorously updated list of medications that older adults should generally avoid or use with caution because risks often outweigh benefits. The most recent comprehensive update (2023) refined several categories (including anticoagulants and anticholinergics) and remains a go-to tool for clinicians and patients. AGS also released an “Alternatives List” in 2025 to help clinicians quickly identify safer options when a Beers-listed drug is on a patient’s list.
How our practice gets multiple prescriptions under control
In our concierge primary care practice, we’ve built a detailed, patient-centered process to tame complex medication lists:
- Comprehensive medication reconciliation: We review every prescription, over-the-counter product, vitamin, and supplement—including doses and how you actually take them. We also verify allergies and what has (and hasn’t) worked for you.
- “Brown bag” review: Bring all pill bottles to your visit. We check for duplications (like two drugs from the same class), unnecessary refills, and expired or mismatched directions.
- Interaction and risk screening: Using tools informed by the AGS Beers Criteria®, we flag medicines with high anticholinergic burden, sedatives that raise fall risk, and combinations that can harm kidneys, cognition, or balance.
- Deprescribing plan you agree with: We prioritize which drugs to taper first, set monitoring checkpoints, and watch for withdrawal or symptom return. We’ll substitute safer alternatives when appropriate.
- Team-based coordination: We communicate with your specialists and pharmacist so everyone is aligned, and we update your medication list across settings to prevent prescribing cascades or duplicate therapies.
- Follow-through: We schedule follow-ups (in person or virtual) to track blood pressure, blood sugars, sleep, pain, and other outcomes as we simplify your regimen.
When should you ask for a review?
- You’re taking five or more medicines—or you’ve recently had a hospital stay.
- You’ve had new dizziness, confusion, falls, or “brain fog.”
- You started a new drug to treat a side effect of another.
- Your pill burden feels unmanageable or too costly.
Polypharmacy isn’t inevitable. The right care plan balances benefits and risks, prioritizes what matters to you, and keeps your medication list as simple and safe as possible. If you (or a family member) are concerned about too many prescriptions, schedule a visit with us—we’re ready to help you streamline safely and feel your best.
References: American Geriatrics Society (2023 Beers Criteria and 2025 Alternatives List),
AAFP recommendations on deprescribing, and recent reviews on polypharmacy risks and outcomes.
AGS JournalsAmerican Geriatrics Societyhealthinaging.orgAAFPBMJ