The short answer
Polypharmacy is the use of multiple regular medications — commonly discussed from about five onward — where the combination itself becomes a risk. It is often entirely appropriate: several conditions genuinely need several treatments. The problem is drift: a medicine started for a short course that never stopped, two prescribers adding to the same list, or a dose that suited a body ten years ago. A review does not aim to cut the list; it aims to make every item defensible.
How the risk shows up
| Pattern | What it can look like |
|---|---|
| Additive sedation | Drowsiness, unsteadiness, falls, foggy thinking |
| Blood-pressure medicines stacking | Dizziness on standing, near-fainting |
| Kidney strain | Rising creatinine, swelling, a changed drug level |
| Anticholinergic load | Dry mouth, constipation, urinary retention, confusion |
| Blood sugar medicines and poor appetite | Low blood sugar episodes |
| Duplication | Two medicines doing the same job from two prescribers |
What a structured review does
Build the true list
From the bottles, not from memory or a portal: prescriptions, over-the-counter medicines, supplements, creams, inhalers and eye drops.
Attach a reason to each item
What is it for, who started it and when. Anything nobody can explain gets flagged for discussion with the prescriber.
Check the combination, not just the drugs
Interactions, additive effects, doses that need adjusting for kidney function, and anything that raises fall risk.
Ask what monitoring is due
Some medications need periodic laboratory monitoring — see common primary care blood tests.
Change one thing at a time, with a follow-up date
Safe deprescribing is gradual and is checked. Some medicines need a taper; stopping them abruptly is its own risk.
What to bring
Bring to the visit
- Every bottle and package, including supplements and over-the-counter products.
- Any medication list from a hospital stay or a specialist.
- Recent laboratory results if another practice ordered them.
- Home blood pressure and blood sugar readings, with dates.
- Your questions — especially 'do I still need this one?'
Where virtual care fits
Medication review is one of the best uses of a virtual visit: it needs time, the bottles and the history rather than an examination, and a family member can join. Symptoms that may be medication-related and involve balance, the heart or swelling usually need an in-person assessment as well. Refill visits are covered on refill visits; no visit guarantees a prescription.
General education only. Do not start, stop or change any medication because of this page — discuss it with the provider who prescribes for you.