If you're taking more than three medications, your GP should review them regularly. Many patients accumulate drugs that are no longer needed, interact badly, or are causing side effects that get mistaken for new conditions.
What a proper medication review includes
A proper review asks: Is each drug still needed? Are you actually taking it as prescribed? Is it working? Are you having side effects? Could any symptoms actually be medication side effects rather than new illness?
This takes time—at least 20 minutes for someone on multiple drugs. It requires your GP to know your full medical history, not just what's in front of them. Rushed reviews are common and often miss problems.
A good review may reduce your medications. This isn't negligence—it's best practice. Deprescribing (removing drugs that aren't needed) improves quality of life for many older patients, reduces falls, and decreases drug interactions.
The polypharmacy problem
Polypharmacy (taking many medications) creates compound problems. Each drug can interact with others. Side effects multiply. Your brain becomes sluggish. Your blood pressure drops. You fall more easily. Each new symptom gets treated with another drug, creating a spiral.
Example: You're on a statin for cholesterol, an antihypertensive for blood pressure, a benzodiazepine for anxiety, and acetaminophen as needed. The benzodiazepine causes dizziness. Your GP adds blood pressure medication, thinking your BP is too high. It drops further. You have a fall. Now you're on pain medication. The painkillers cause constipation—so now you're on a laxative. You're now on 5+ drugs, and three are because of side effects from the original two.
This is common. About 40% of medications in older patients are for treating side effects of other medications.
What to ask your GP at medication review
Ask each drug: Why am I on this? For how long? How do I know if it's working? What side effects should I expect? Can it interact with anything else I'm taking?
Ask specifically: Are there any drugs here I can stop? If you're on a blood pressure drug with readings consistently lower than target, ask about reducing. If you're on a statin and living well past your life expectancy at baseline, ask if it's still needed.
If your GP seems reluctant to discuss stopping any drugs, request a second opinion from another GP or a pharmacist. Many GP practices have clinical pharmacists who specialize in deprescribing.
Specific drugs to reconsider
Benzodiazepines (diazepam, lorazepam, temazepam) for anxiety or insomnia should be stopped after 2-4 weeks. Longer-term use causes dependence, cognitive impairment, and increased falls. If you've been on them years, stopping should be very gradual, but starting the process is important.
Proton pump inhibitors (omeprazole, lansoprazole) for reflux are commonly used long-term but increase fracture risk, cause B12 deficiency, and may increase dementia risk. If you're on one, ask if you still need it or could switch to lower-dose or as-needed treatment.
Low-dose aspirin for primary prevention (preventing first heart attack when you've had no prior cardiac event) is increasingly questioned. NICE now recommends against routine aspirin for primary prevention in older adults due to bleeding risk. If you're on it "for heart health" without previous heart disease, discuss stopping.
Pharmacy access for medication reviews
Community pharmacists can often provide medication reviews for free on the NHS. They're sometimes more thorough than rushed GP appointments. Ask your pharmacist: "Can you review my medications for interactions and side effects?" This is a standard service many pharmacies offer.
Private medication reviews cost £50-150 and are thorough. If your NHS GP review is insufficient, a pharmacist review identifies interactions and deprescribing opportunities your GP might miss.