The figures and the medication-management steps below come from the US National Institute on Aging (NIA) and the NIH Office of Dietary Supplements (ODS). The number that stands out most: about a third of people in their 60s and 70s take five or more prescription drugs.
“83% of U.S. adults in their 60s and 70s had used at least one prescription drug in the previous 30 days,” and “about one-third used five or more prescription drugs.”
“The use of multiple drugs to treat diseases and other health conditions is known as polypharmacy.”
— National Institute on Aging, The dangers of polypharmacy and the case for deprescribing in older adults (August 24, 2021)
So this is not a story about unusual patients.
1. How common is it. 83% of US adults in their 60s and 70s used at least one prescription drug in the past 30 days, and about a third used five or more. One in three reads much closer to “my household” than to “someone else's.”
2. Where the risk is. The same drug behaves differently as you age. And supplements, alcohol and tobacco belong on the list of things you take — they are the items most often left out at the appointment.
3. What to do. “Can we reduce this?” is a legitimate thing to raise first. Deprescribing means reducing or stopping medications that may be inappropriate or unnecessary — it is treatment in its own right. But it is done with your clinicians, not by stopping on your own.
Why the same drug lands differently with age
People describe this as a medicine “hitting harder.” NIA describes something else.
“As you age, changes in your body can affect how well medicines work. For example, the body may become less able to absorb the medicine.”
— National Institute on Aging, Taking Medicines Safely as You Age (reviewed September 22, 2022)
The drug did not change — the body did. Which means a dose that fit well a few years ago carries no guarantee of fitting now.
| Risk | What NIA links to polypharmacy |
|---|---|
| Drug interactions | “Harmful drug interactions” and adverse drug effects |
| Falls | Falls and cognitive impairment sit together on the risk list |
| Drug–disease interactions | A medication that worsens one condition while treating another |
| Hospitalization | Increased hospitalization rates |
| Mortality | Higher mortality rates |
| Breathing | Respiratory suppression with opioids combined with certain medications |
Notice that falls are filed as a medication problem. When someone gets dizzy and goes down, the explanation reached for is usually age or weak legs — but medication is near the top of this list. For the fall side see fall prevention; for the strength side, sarcopenia.
Deprescribing — taking drugs away is also treatment
The goal of deprescribing is “reducing or stop[ping] medications that are potentially inappropriate or unnecessary,” thereby lowering risk while “improving health outcomes and decreasing management burdens for patients and families.”
— NIA, The dangers of polypharmacy and the case for deprescribing in older adults (August 24, 2021)
This is not permission to stop things on your own. It is a clinician-led process. What it does give you is standing to raise the question — “do I still need all of these?” is a legitimate thing to ask first.
What to bring up in the appointment
| Step | What NIA says | Basis |
|---|---|---|
| ① Say all of it | Everything you are taking, including “prescription drugs, OTC medicines, and supplements” | NIA text |
| ② Past trouble | “Any allergies or problems you have experienced with other medicines” | NIA text |
| ③ Put it on paper | “Write down all medicines you take, including OTC drugs. Also include any vitamins or dietary supplements” | NIA text |
| ④ What the list holds | “The name of each medicine or supplement, the amount you take, and time(s) you take it” | NIA text |
| ⑤ Report side effects | From minor (headache, dry mouth) to “severe bleeding or damage to the liver or kidneys” — report promptly | NIA text |
| ⑥ Storage | “Keep your medicines out of heat and direct sunlight” | NIA text |
| ⑦ Disposal | “Check with your doctor or pharmacist about how to safely discard expired or unneeded medications” | NIA text |
The third row is the one that matters. “Also include any vitamins or dietary supplements” is explicit in the source. Supplements are the item most often left out of the conversation — because they do not feel like drugs — and they are exactly what collides with prescriptions.
What “supplements interact with drugs” actually means
If that phrase sounds abstract, here are the specific pairs printed in the NIH Office of Dietary Supplements fact sheets.
| Supplement | Collides with | What ODS says |
|---|---|---|
| Calcium | Levothyroxine (thyroid hormone) | Named among medicines calcium supplements can affect |
| Calcium | Quinolone antibiotics, lithium, dolutegravir | On the same list |
| Iron | Levothyroxine | Iron “interferes with levothyroxine absorption” |
| Iron | Levodopa (Parkinson's) | Iron “reduces levodopa effectiveness” |
| The other direction | Proton pump inhibitors → iron | PPIs “decrease non-heme iron absorption” |
Levothyroxine appears twice — once under calcium, once under iron. Taking a thyroid medication while adding calcium for bones and iron for fatigue is a common enough combination, and all three interfere with one another. How to space them is a question for the prescriber and pharmacist. The background is in thyroid signs and iron-deficiency anemia.
Alcohol and tobacco belong on the list too
“Alcohol, tobacco, and other drugs can affect how well your medicines work.”
“It can be dangerous to combine certain prescription drugs, OTC medicines, dietary supplements, or other remedies.”
— NIA, Taking Medicines Safely as You Age (reviewed September 22, 2022)
“Other remedies” covers herbal and traditional preparations. They are awkward to bring up and therefore routinely omitted — which is presumably why NIA spells them out.
Questions this raises
How many counts as “too many”?
NIA defines polypharmacy as the use of multiple drugs and does not fix a number. “Five or more” is simply where the quoted statistic draws its line. The source's emphasis is on combinations, not counts.
Can I cut back on my own?
No. Deprescribing is described as a process done with clinicians. What the concept gives you is the standing to ask the question first.
Should I bring all the boxes?
What NIA asks for is a list — name, amount, and time for each medicine and supplement. In practice a single sheet of paper works better than a bag of packaging.
Do supplements really need mentioning?
NIA says explicitly: “also include any vitamins or dietary supplements.” As the calcium and iron rows above show, they collide with real prescriptions.
Past five medicines, the problem stops being any single drug and becomes the combination. What to bring to the appointment is not the bag of boxes but one sheet of paper — name, dose, timing, supplements included.
Sources
- National Institute on Aging — The dangers of polypharmacy and the case for deprescribing in older adults (August 24, 2021). Source for “83% of U.S. adults in their 60s and 70s… about one-third used five or more,” the definition of polypharmacy, the risk list (interactions, falls, cognitive impairment, drug–disease interactions, hospitalization, mortality, opioid respiratory suppression), and the definition of deprescribing.
- National Institute on Aging — Taking Medicines Safely as You Age (reviewed September 22, 2022). Source for “changes in your body can affect how well medicines work… less able to absorb,” what to tell the provider, the instruction to include “vitamins or dietary supplements” on the list and what the list should contain, the range of side effects, alcohol and tobacco, and storage and disposal.
- NIH Office of Dietary Supplements — Calcium (updated September 14, 2023). Source for the levothyroxine, quinolone, lithium and dolutegravir interactions.
- NIH Office of Dietary Supplements — Iron (updated August 17, 2023). Source for iron interfering with levothyroxine absorption, reducing levodopa effectiveness, and PPIs decreasing non-heme iron absorption.
Where to check further
- The list of “medications potentially inappropriate in older adults.” Such lists exist but were not on the NIA pages we opened, so none is reproduced. Whether anything you take is on one is fastest answered by your regular pharmacist — they work from those lists.
- Polypharmacy figures and medicine disposal outside the US. The 83% and one-third are US population data, and other national statistics could not be reached. Unused medicines go to a pharmacy or public health centre take-back bin; local authorities publish the procedure.
- A safe interval between medication and alcohol. NIA states that alcohol interacts but gives no timing. This is drug-specific, so ask “can I drink on this?” at the point of prescribing.
Written as of July 2026. The statistics and management steps come from NIA; the supplement–drug interactions from ODS. If dizziness and falls are the worry, see fall prevention as well. This is general health information and does not replace medical diagnosis or treatment. Do not adjust your own medications — talk to a clinician or pharmacist.
