Multiple Medicines, Kidney Function and Supplement Burden

Why: NIA says to take a prescription medicine until it is finished or your doctor says it is all right to stop, and notes some medicines must be stopped slowly. If you stop early, you may not get its full effect or your condition could worsen.

Who it applies to: Anyone on prescription medicines, including when you feel better.

Try instead: Ask your doctor or pharmacist whether it is safe to stop and whether it can be stopped abruptly.

Why: NIA says not to take medicines prescribed for another person or give yours to someone else.

Who it applies to: Everyone.

Try instead: Ask a pharmacist or doctor if you think you need a medicine someone else uses.

Why: NIA warns that a larger dose could be very dangerous and even deadly, and not to skip or take half doses of a prescription drug to save money.

Who it applies to: People worried about cost.

Try instead: Tell your doctor if cost is a worry; NIA lists asking about generics, comparing prices and discount or assistance programs.

Why: NIDDK says regular use of NSAIDs (non-steroidal anti-inflammatory drugs), such as ibuprofen and naproxen, can damage the kidneys. The National Kidney Foundation says they can lower blood flow to the kidneys, especially at high doses or with long-term use.

Who it applies to: People with kidney disease or reduced kidney function, and anyone using these pain relievers often.

Try instead: Ask a pharmacist or doctor what is safe for you for pain.

Why: NIA gives the example that mixing a sedative with an antihistamine can slow reactions.

Who it applies to: People using sleep, allergy or cold products along with prescribed medicines.

Try instead: Ask a pharmacist to check any combination before you use it, and take care with falls.

Reduce Your Risk of Falls →

Why: NIA advises asking first before chewing, breaking or crushing tablets, and telling the pharmacist if swallowing is hard because liquid forms may exist.

Who it applies to: Anyone with swallowing difficulty.

Try instead: Ask the pharmacist for alternatives and see a clinician about the swallowing problem.

Why: NIA says not to buy dietary supplements with ingredients you do not need and not to assume more is better; taking too many supplements or very high concentrations can be harmful.

Who it applies to: Anyone adding vitamins, minerals or herbs to a long list.

Try instead: Ask your doctor, pharmacist or a registered dietitian whether a supplement is needed at all.

Supplements for Healthy Aging →

Why: NIA warns that medicines from a fake online pharmacy can be ineffective, unsafe or even dangerous, and says a legitimate pharmacy requires a valid prescription, is licensed in your state and has a pharmacist available to answer questions.

Who it applies to: People trying to save money by ordering online.

Try instead: Use your usual pharmacy, or check the pharmacy's licence before ordering.

Why: NIA says that something being called natural does not mean it is safe or good for you. It may have side effects, may make a prescribed medicine weaker or stronger and may be harmful with certain medical conditions.

Who it applies to: Herbal and supplement marketing.

Try instead: Treat every supplement as something to put on the shared list and check with a pharmacist.

How interactions work →

Why: NIA says advertisements may promise to make you feel better, prevent illness or even help you live longer, but there is often little, if any, science behind these claims.

Who it applies to: Adverts, online shops and social media.

Try instead: Check the claim against sources such as the Wellness claim checks, and ask your clinician.

NAD, NMN, Resveratrol and Longevity Claims →

Why: NIA says changes in the body with age can affect how well a medicine works, and that as an illness worsens its medicines may work less well. The sources read also say many medicines are needed.

Who it applies to: Anyone on the same medicines for years.

Try instead: Ask for a review and say if a medicine seems to work less well. Do not change it yourself.

Why: A systematic review found mixed evidence on whether polypharmacy itself causes harm, so the number alone does not decide whether a list is safe.

Who it applies to: People worried by the size of their list, and those who feel reassured by a short one.

Try instead: Review what each item is for, whether it is still needed and how the items fit together.

Why: NIA asks people to list over-the-counter medicines, vitamins, supplements and herbal remedies along with prescriptions, even those used only sometimes.

Who it applies to: Everyone.

Try instead: Add them to the written list and show it at every visit.

The data are mixed. Better-adjusted studies often linked polypharmacy to falls, adverse drug events, hospitalization and decline, but some did not, and many medicines are needed.

Against the evidence read: NIA says supplements can have unsafe interactions with prescription drugs and can make a medicine weaker or stronger.

A meta-analysis found a small, transient rise in serum creatinine but no significant change in GFR. It is not evidence of kidney damage, and it does not cover people with existing kidney disease.

Deprescribing is a supervised process of safely reducing or stopping medicines that may be unnecessary or inappropriate, and some need to be stopped slowly.

Against the evidence read: NIDDK says regular NSAID use can damage the kidneys, and the National Kidney Foundation says they can lower blood flow to the kidneys.