Taking many medicines – keeping it safe
Every additional medicine raises the chance of an interaction, a side effect and a mistake. How to stay on top of a long list, and when to ask for a review.
More medicines, more risk
Taking several medicines is often entirely appropriate — someone with diabetes, high blood pressure and high cholesterol legitimately needs a few. But risk rises with each addition: more interactions, more side effects, more doses to remember, and more chance that a side effect of one gets treated with another.
Keeping the list straight
- Keep one written or app-based list: name, strength, when it is taken, and what it is for. 'What it is for' is the part people cannot answer and the part that matters most.
- Update it every time something changes, and take it to every appointment and hospital visit.
- Use one pharmacy so a single record sees everything.
- Use a weekly pill organiser, filled at the same time each week.
- Set alarms rather than relying on memory or routine.
- Keep the list where an ambulance crew or family member would find it.
- Never share medicines, and never take someone else's leftovers.
Asking for a medicines review
A medicines review means sitting down with a doctor or pharmacist and going through everything to ask what is still needed, what could be stopped and what could be simplified. It is one of the higher-value appointments available and it is rarely offered without being requested.
- Ask for one at least yearly if you take several regular medicines.
- Ask after any hospital admission, when lists frequently change without the original prescriber knowing.
- Ask specifically about medicines started long ago for a reason that may no longer apply — acid-suppressing medicines, sleeping tablets and some painkillers are the usual candidates.
- Ask which ones raise fall risk if you are older, and which should be paused during illness with vomiting or diarrhoea.
- Ask whether any doses can be combined or timed together to simplify the day.
Signs the list needs attention
- New confusion, drowsiness or unsteadiness, particularly in an older person.
- Falls.
- A new symptom that started within weeks of a new medicine.
- Not being able to say what a medicine is for.
- Being unable to afford or collect everything, and quietly rationing it — say this, because there are usually options.
- Doses being missed regularly because the schedule is unmanageable.
Common questions
- Is taking many medicines automatically bad?
- No. What matters is whether each one still has a clear purpose and whether the combination is safe. A regular review is what keeps a necessary list from quietly becoming an unnecessary one.
- Can I stop something I do not think is helping?
- Raise it rather than stopping. Some medicines produce no felt benefit while doing important work — blood pressure and cholesterol treatment most obviously — and several are dangerous to stop abruptly.
- What should I do with medicines I no longer take?
- Return them to a pharmacy for safe disposal. Do not keep them for later, do not give them to anyone else, and do not flush them or put them in household waste where children can reach them.
Sources
- Primary Healthcare Standard Treatment Guidelines and Essential Medicines ListNational Department of Health, South Africa
- Medication safety and clinical guidanceWorld Health Organization
Last reviewed 4 August 2026.