Older Adults
Older adults and supplements: more medicines mean more chances of interaction, kidney and swallowing issues, narrow-range drugs, and what to bring to appointments.
Content last updated . This page has not been medically reviewed.
If you take several prescription medicines, ask your pharmacist or prescriber before adding any herb or supplement, and never stop a prescribed medicine on your own. This page is information only and gives no amounts. In a poisoning or emergency in the United States, call 911 or Poison Help at 1-800-222-1222.
Why older adults are a focus
Two things change with age in many people: the number of medicines taken, and how the body clears them. MedlinePlus says people prescribed 5 or more medicines have a higher chance of interactions or side effects, that older adults' bodies process medicines differently as they age, and that kidneys may not work as well as they used to, so more medicine can stay in the body longer. [1] It also lists an increased risk of falls with certain medicines. [1]
What research found
| Question | What the source found | Population | Type of evidence |
|---|---|---|---|
| How common is supplement use? | Dietary supplement use among US adults aged 62 to 85 rose from 51.8% to 63.7% between 2005-06 and 2010-11. [2] | Nationally representative US sample | Observational |
| How common are potential interactions? | About 15.1% of those older adults were at risk for a potential major drug-drug interaction in 2010-11, and most interacting combinations involved medicines and supplements whose use was rising. [2] | Same sample, interactions flagged by a drug-information database | Potential, not confirmed harm |
| What goes wrong in emergency rooms? | Among supplement-related emergency visits, swallowing problems, often tied to micronutrients, stood out for older adults. [3] | US emergency department surveillance, 2004 to 2013 | Observational |
"Potential" means the combination can interact on paper. The study did not follow each person to see whether harm occurred.
Narrow-range medicines: ask before adding anything
NCCIH says interactions are of special concern for medicines with a narrow therapeutic range, where a level only a little too high or low can cause serious reactions. Its examples include carbamazepine, cyclosporine, digoxin, phenytoin and warfarin. [4] If you take one of these, ask the prescriber or pharmacist before adding any supplement. See Narrow-range medicines and supplements.
Blood thinners and bleeding
FDA gives an example: warfarin, ginkgo biloba, aspirin and vitamin E can each thin the blood, and taking them together may raise the potential for internal bleeding or stroke. [5] NCCIH says ginkgo may increase bleeding risk for people taking anticoagulants such as warfarin. [6] Read Supplements and blood thinners.
FDA also notes that St. John's wort can make medicines for HIV/AIDS, heart disease, depression, organ transplants and birth control less effective. [5] See St. John's wort interactions.
Swallowing and large pills
In the US emergency department study, among adults aged 65 and over, swallowing problems were a leading reason for supplement-related visits, and micronutrients were most often involved. [3] NIH likewise reports emergency visits by older adults with swallowing problems from large vitamin pills. [7] If swallowing is hard, ask a pharmacist about other forms of a product.
Memory and "brain" claims
NCCIH says ginkgo has not been shown to be beneficial for preventing or slowing the progression of dementia. [6] See ginkgo for evidence by use.
A practical habit that sources agree on
MedlinePlus advises keeping a list of all medicines, noting that over-the-counter products include vitamins, supplements and herbal products. [1] FDA advises bringing the list to every visit. [5] A printable form is at A printable medicine and supplement list. More: Older adults: falls, kidney function and keeping a medicine list, and Vitamins and supplements for older adults.
Before an operation, see Supplements before surgery.
What we could not verify
Proper evidence not found in the sources we read for an age-specific list of herbs that older adults should avoid. We searched NCCIH, MedlinePlus, NHS and PubMed, and the National Institute on Aging page we tried was not available. We publish no such list.
Frequently asked questions
Are supplements safer for older adults because they are natural?
No. FDA says natural does not always mean safe. [5]
Why do interactions matter more with age?
People tend to take more medicines, and MedlinePlus says kidneys may clear medicines less well with age. [1]
Can I take ginkgo to prevent dementia?
NCCIH says ginkgo has not been shown to prevent or slow dementia progression. [6]
What should I bring to appointments?
A complete list of medicines, vitamins, supplements and herbal products. [1][5]
Should I stop a supplement if I take many medicines?
Ask your pharmacist or prescriber what makes sense for you. Do not change prescribed medicines without them. [1]
References
- MedlinePlus (US National Library of Medicine). Taking multiple medicines safely. Read 2026-10-23.
- Qato DM, et al. Changes in Prescription and Over-the-Counter Medication and Dietary Supplement Use Among Older Adults in the United States, 2005 vs 2011. JAMA Intern Med. 2016. Read 2026-10-23.
- Geller AI, et al. Emergency Department Visits for Adverse Events Related to Dietary Supplements. N Engl J Med. 2015. Read 2026-10-23.
- National Center for Complementary and Integrative Health (NIH, US). Know the Science: Some Medication-Supplement Interactions Can Be Serious. Read 2026-10-23.
- U.S. Food and Drug Administration. Mixing Medications and Dietary Supplements Can Endanger Your Health (consumer update, content current as of 2022). Read 2026-10-23.
- National Center for Complementary and Integrative Health (NIH, US). Ginkgo: Usefulness and Safety. Page last updated February 2025. Read 2026-10-23.
- National Center for Complementary and Integrative Health (NIH, US). Using Dietary Supplements Wisely. Page last updated January 2019. Read 2026-10-23.