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Prescription drug safety

Medications often play an increasingly important role in our lives as we grow older. As we age, we are more likely to be prescribed more than one kind of medication, and many older adults take five or more (polypharmacy). This increases the risk for side effects and for one drug to affect whether and how another drug works. What does the evidence say? Read more below.

Polypharmacy, part 1. Pitfalls of multiple medications: taking multiple drugs and risk of interactions.
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A closer look at opioids for chronic pain
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Got heartburn? Avoid these common acid-blocking drugs
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  • Evidence Summary

    Interventions to optimise prescribing for older people in care homes

    Rating 5 out of 5 stars
    Cochrane Database of Systematic Reviews (2016)
  • Evidence Summary

    Deprescribing can reduce the number of inappropriate medications taken by older patients, and may increase longevity

    Rating 5 out of 5 stars
    British Journal of Clinical Pharmacology (2016)
  • Evidence Summary

    Mobile phone text messages help people with chronic conditions take medications as prescribed

    Rating 5 out of 5 stars
    JAMA Internal Medicine (2016)
  • Evidence Summary

    Multimedia educational interventions for consumers about prescribed and over-the-counter medications

    Rating 5 out of 5 stars
    The Cochrane Database of Systematic Reviews (2013)
  • Evidence Summary

    Medication review in hospitalised patients to reduce morbidity and mortality

    Rating 5 out of 5 stars
    Cochrane Database of Systematic Reviews (2016)
  • Evidence Summary

    Behavioural support and pharmacotherapy improve smoking quit rates in adults

    Rating 5 out of 5 stars
    Annals of Internal Medicine (2015)
  • Evidence Summary

    In people with advanced non-small cell lung cancer, combined with other medications, carboplatin and cisplatin do not differ for overall or 1-year survival

    Rating 5 out of 5 stars
    Cochrane Database Syst Rev (2013)
  • Evidence Summary

    Interventions to improve the appropriate use of polypharmacy for older people.

    Rating 4 out of 5 stars
    Cochrane Database Syst Rev (2023)
  • Evidence Summary

    Medication errors and adverse drug events are common following hospital discharge

    Rating 4 out of 5 stars
    Drug Safety (2020)
  • Evidence Summary

    Long-term aspirin use does not decrease the incidence of cancer in people who have not previously had cancer, compared to no aspirin use

    Rating 4 out of 5 stars
    Journal of Cancer (2020)
  • Evidence Summary

    Non-medical prescribing versus medical prescribing for acute and chronic disease management in primary and secondary care.

    Rating 4 out of 5 stars
    Cochrane Database Syst Rev (2016)
  • Evidence Summary

    Patient/provider education, multidisciplinary teams and computer support lead to improvements in prescribing multiple medications

    Rating 4 out of 5 stars
    BMJ Open (2015)
  • Evidence Summary

    Psychosocial interventions for cannabis use disorder

    Rating 4 out of 5 stars
    Cochrane Database of Systematic Reviews (2016)
  • Evidence Summary

    Nurse-led clinics can lower the risk of death and myocardial infarction, and increase medication adherence in patients with cardiovascular diseases

    Rating 4 out of 5 stars
    Journal of Cardiovascular Nursing (2015)
  • Evidence Summary

    New anticoagulant pills reduce cardiovascular events and do not increase serious bleeding

    Rating 4 out of 5 stars
    J Am Geriatr Soc (2014)
  • Evidence Summary

    Bisphosphonates increase risk of serious atrial fibrillation by a small amount

    Rating 4 out of 5 stars
    Chest (2013)
  • Evidence Summary

    Aspirin reduces risk of death, heart disease or cancer, with some increase in the risk of stroke or major bleeding

    Rating 4 out of 5 stars
    Health Technol Assess (2013)
  • Evidence Summary

    Statins are not associated with cognitive impairment, dementia, or Alzheimer’s disease

    Rating 4 out of 5 stars
    Ann Intern Med (2013)
  • Evidence Summary

    Statins do not increase risk of serious or minor symptomatic side-effects

    Rating 4 out of 5 stars
    Eur J Prev Cardiol (2014)
  • Evidence Summary

    Older adults can reduce their benzodiazepine use if they receive withdrawal support in combination with psychotherapy

    Rating 4 out of 5 stars
    The British Journal of Psychiatry (2014)
  • Evidence Summary

    Stopping psychotropic medications can reduce falls and improve cognition

    Rating 4 out of 5 stars
    Age Ageing (2014)
  • Evidence Summary

    For acute bronchitis, antibiotics can reduce cough by about half a day but can cause side-effects

    Rating 4 out of 5 stars
    Cochrane Database Syst Rev (2014)
  • Evidence Summary

    In people with 2 to 4 diabetes risk factors, high-dose atorvastatin reduced cardiovascular risk but increased new-onset diabetes compared with low-dose statins

    Rating 4 out of 5 stars
    J Am Coll Cardiol (2013)
  • Evidence Summary

    NSAIDS, except naproxen, increase major coronary events; all NSAIDs increase heart failure and upper gastrointestinal complications

    Rating 4 out of 5 stars
    Lancet (2013)
  • Evidence Summary

    (a) In patients with atrial fibrillation, 2 tools are best for predicting risk for stroke; a third tool is best for predicting risk for bleeding

    Rating 4 out of 5 stars
    AHRQ Comparative Effectiveness Reviews (2013)
  • Evidence Summary

    In people with coronary artery disease, intensive blood pressure control is linked to reduced stroke and heart failure but increased risk for too low blood pressure

    Rating 4 out of 5 stars
    Heart (2013)
  • Evidence Summary

    For people prescribed antibiotics, probiotics (compared with no treatment or placebo) reduce the risk of getting C. difficile-associated diarrhea without causing important side effects

    Rating 4 out of 5 stars
    Ann Intern Med (2012)
  • Evidence Summary

    Delayed antibiotics for respiratory infections.

    Rating 4 out of 5 stars
    Cochrane Database Syst Rev (2013)
  • Evidence Summary

    A review of patient safety practices recommends the adoption of 22 practices

    Rating 4 out of 5 stars
    Evid Rep Technol Assess (Full Rep) (2013)
  • Evidence Summary

    ACE inhibitors for high blood pressure prevent kidney disease and death in people with diabetes and normal kidney function

    Rating 4 out of 5 stars
    Cochrane Database Syst Rev (2012)
  • Evidence Summary

    In people with chronic kidney disease, antiplatelet drugs reduce heart attacks but increase bleeding

    Rating 4 out of 5 stars
    Cochrane Database Syst Rev (2013)
  • Evidence Summary

    For people with atrial fibrillation, new “blood thinners” (factor Xa inhibitors) reduce strokes and clots more than warfarin

    Rating 4 out of 5 stars
    Cochrane Database Syst Rev (2013)
  • Evidence Summary

    For patients with COPD, combined long-acting beta2-agonists plus inhaled corticosteroids reduce worsening of condition but not hospitalization

    Rating 4 out of 5 stars
    Cochrane Database Syst Rev (2013)
  • Evidence Summary

    Unplanned hospital admissions among older adults with heart failure may be reduced by pharmacist-led education and follow-up interventions

    Rating 3 out of 5 stars
    Age and Ageing (2014)
  • Evidence Summary

    Medication reviews do not reduce mortality and hospitalization among nursing home residents

    Rating 3 out of 5 stars
    British Journal of Clinical Pharmacology (2014)
  • Evidence Summary

    Unnecessary medication use in frail older adults can be reduced through team-based care, providing education to providers and reviewing prescribing practices

    Rating 3 out of 5 stars
    Drugs and Aging (2013)
  • Evidence Summary

    Tamoxifen and raloxifene each reduce invasive breast cancer; neither reduces mortality rates in the particular group

    Rating 3 out of 5 stars
    Ann Intern Med (2013)
  • Evidence Summary

    Antibiotics for acute laryngitis in adults.

    Rating 3 out of 5 stars
    Cochrane Database Syst Rev (2013)
  • Blog Post

    High blood pressure in older adults: Let’s talk medication!

    Research highlights the benefits of blood pressure lowering medications.
  • Blog Post

    Antidepressants for anxiety: Where does the evidence stand?

    Research continues to support the effectiveness of certain medications in treating anxiety.
  • Blog Post

    Cause for concern? Medications and falls in people living with cognitive impairment

    Research addresses questions around side effects related to commonly prescribed cognitive enhancers.
  • Blog Post

    Testosterone treatment in men: What you need to know

    Research highlights the potential benefits and harms of testosterone treatment in men who have low testosterone levels without a related medical condition.
  • Blog Post

    Medicine cabinet check! Can we use aspirin to combat cancer?

    From fever reduction to pain relief, many of us use aspirin as a way to treat common conditions or illnesses that occur in our daily lives. But does the research support its use for cancer prevention?
  • Blog Post

    Are aspirin and other non-steroidal anti-inflammatory drugs effective for preventing dementia?

    If you’re interested in aspirin and other non-steroidal anti-inflammatory drugs as a dementia prevention strategy, you should know that current evidence doesn’t support their use for this purpose and raises red flags around potential health risks.
  • Blog Post

    Preventing heart attacks: Is aspirin a safe choice?

    Aspirin is one of the world’s most widely used drugs. Although for some time it was believed that aspirin helped prevent heart attacks, emerging research suggests that in adults without a history of heart disease, aspirin may do more harm than good.
  • Blog Post

    Abnormal heart rhythms: How do different medications stack up?

    For people with atrial fibrillation, newer blood thinners may be safer and more effective than older, more commonly prescribed medications.
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    The up-and-up on treating premature ejaculation

    Premature ejaculation is a frustrating experience that can bring any man down. On the up-side, there are many treatments that can help.
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    Is it just me, or is it hot in here? Take the heat out of menopause with these treatments

    Many women experience hot flashes and night sweats during menopause. If you are suffering from your own personal heat wave, find comfort in the fact that there are options available to help cool you down.
  • Blog Post

    Living with gout? Explore your treatment options

    A gout flare-up can be a very unpleasant and painful experience. Several treatment options are available, so speak with your healthcare provider about which treatment might work best for you.
  • Blog Post

    Do you have a hidden heart risk in your medicine cabinet?

    Many people will pop a nonsteroidal anti-inflammatory drug casually at the slightest pain. Make sure that you are aware of the risks, and review your medications with your doctor.
  • Blog Post

    Fighting the fungus among us: Treatment options for toenail fungus

    Dreading sandal season? Fungal infections are unpleasant to look at and difficult to treat, but research shows that oral antifungal medications can be effective, although they come with some side effects.
  • Blog Post

    Fact or fiction: research reveals the truth about common medications

    Based on the research evidence, some drugs are getting credit they don’t deserve! They may even be doing more harm than good.
  • Blog Post

    Treated and discharged: How to avoid repeat hospital visits

    Research evidence shows there are things we can do to avoid repeat hospital visits.
  • Blog Post

    6 research-based ways your smartphone can support your healthy aging goals

    Stay informed, engaged and on track to age well. Find out how your mobile phone can be a helpful tool to help keep you healthy.
  • Blog Post

    What works best for relieving back pain?

    Low back pain can be debilitating but it can be managed with non-drug therapies and medications if needed. What works best? Find out recommendations from recent research evidence.
  • Blog Post

    Digestive problems? Try probiotics

    Got probiotics? These “good for you” bacteria, found in certain foods and available as supplements, contribute to a healthy digestive system and improve gastrointestinal problems.
  • Blog Post

    3 alternative options for pain relief

    Alternative options for managing pain can bring relief without the risks associated with prescription drugs.
  • Blog Post

    Avoid falls with these 4 simple tips

    Many older adults experience a fall as they get older. But it doesn’t have to be that way! Here are four evidence-based tips to lower your falls risk and promote healthy aging.
  • Blog Post

    Got heartburn? Avoid these common acid-blocking drugs

    Proton pump inhibitors – a common type of stomach acid medication – are overprescribed and many people can safely reduce or stop this medication.
  • Blog Post

    Vaginal estrogen relieves common menopause symptoms

    Menopause may be a natural and inevitable phase in a woman’s life but it often comes with uncomfortable and irritating symptoms. Vaginal estrogen is an effective treatment option.
  • Blog Post

    Is it time for a medication review? Many people take unnecessary meds

    As we grow older, our collection of prescription pills tends to grow larger! A medication review can help you cut down on inappropriate or unnecessary medications.
  • Blog Post

    5 tips to stay healthy at home

    Research-based recommendations to stay in your home and community safely, independently and comfortably for as long as possible.
  • Blog Post

    When "good nights" are rare: Do sleeping pills help people with dementia?

    Do sleep aid medications help to improve sleep for people with dementia?
  • Blog Post

    Need help managing medications? Try text message reminders

    Text messaging can have health benefits, including helping people better manage their medications.
  • Blog Post

    A closer look at opioids for chronic pain

    Do the benefits of opioids outweigh the risks? Or, is it time to re-examine their role in relieving pain?
  • Blog Post

    5 tips to help you quit smoking for good

    Tried to quit smoking in the past and failed? Try again! These five evidence-based strategies can help you kick the nicotine habit.
  • Blog Post

    Erectile dysfunction treatment options

    Erectile dysfunction may be an awkward topic of discussion for some, but it’s a very common condition that affects up to half of all men over the age of 40. Find out what the research says about erectile dysfunction treatment options.
  • Blog Post

    3 simple ways to manage challenging behaviours associated with dementia

    What can caregivers do to help manage common behavior challenges among people with dementia? Three tips supported by research evidence.
  • Blog Post

    Weeding out the truth: Cannabis-based medications for cancer patients

    Cannabinoids are active chemicals found in cannabis (marijuana) that are approved for medical use. Research shows they may be a promising way to ease nausea and vomiting from cancer treatment.
  • Blog Post

    The shingles vaccine: Should you get it?

    Shingles is a painful condition that can attack anyone who has ever had chicken pox, but is most likely to strike older adults and others with weakened immune systems. Vaccines are available that cut the chance of getting shingles. Is vaccination worth it? Dr. Mark Loeb provides a professional view and shingles patient Jean shares her personal experience.
  • Blog Post

    Make it stop! Should patients manage their own pain after surgery?

    Most people experience pain after surgery and need to take pain killers for at least a few days. Being in charge of their own medications gives patients some control and may result in improved pain relief.
  • Blog Post

    Biologic drugs for rheumatoid arthritis: the rewards may come with risks

    A new type of drug may significantly improve rheumatoid arthritis progression and symptoms, but is associated with potentially serious side effects.
  • Blog Post

    Irregular heartbeat a possible side effect of osteoporosis medication

    Bisphosphonates are drugs that help increase bone strength in people with osteoporosis. They are effective, but may also contribute to irregular heartbeats (atrial fibrillation).
  • Blog Post

    New drug may be 'next big thing' in type 2 diabetes management

    A new drug may improve blood sugar control for people with Type 2 diabetes, while helping them avoid weight gain.
  • Blog Post

    New blood thinners prove to be safe and effective option for most

    New types of blood thinners are effective at preventing blood clots and are safe for most older adults.
  • Blog Post

    When it might be wise to stop taking certain medications

    Certain drugs can increase risk for falls or confusion in older adults. Regularly review your medication with your doctor to reduce these risks.
  • Blog Post

    Urinary incontinence in aging females: When can medications help?

    Urinary incontinence is a very common problem in aging women. When conservative measures (pelvic floor training, lifestyle changes) don't work some drugs can help for some types of incontinence.
  • Blog Post

    Treating behavioural problems of dementia: When confusion leads to controversy

    The majority of people with Alzheimer’s will develop behaviour problems over time and this causes much suffering and stress for patients and caregivers. There are solutions to manage this.
  • Blog Post

    Polypharmacy, part 4. Medication review encourages best use and reduces adverse effects.

    Periodically ask a healthcare provider to check your medications. This can ensure the least harm and most benefit overall, and reduce drugs taken and interactions in polypharmacy.
  • Blog Post

    Polypharmacy, part 3. Online drug interaction checkers to assess side effects.

    Online drug interaction checkers are useful, but have some problems with identifying adverse effects. Always talk to a healthcare provider to confirm your risk for side effects.
  • Blog Post

    Polypharmacy, part 2. Risk of drug effects with multiple medications in the elderly: aging changes.

    Aging may change the effects and risk profile of different drugs. Polypharmacy may increase, decrease, or cancel effects of different drugs, foods, and supplements.
  • Blog Post

    Polypharmacy, part 1. Pitfalls of multiple medications: taking multiple drugs and risk of interactions.

    Many older Canadians are taking multiple medications (polypharmacy) to manage their health conditions. Taking 5 or more medications can increase your risk of drug interactions.
  • Blog Post

    Recognize and prevent delirium (confusion and agitation) when in hospital.

    Simple interventions (family visits, familiar objects, clocks) may help to prevent or recover from acute delirium in hospital. Recognize confusion or agitation and inform staff.
  • Blog Post

    Multimorbidity: how to improve quality of life when managing several chronic health conditions

    If you have 3 or more health conditions, ask your family doctor about better ways to coordinate your care with other health professionals, and how you might decrease important health risks or improve key functional activities.
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