Most therapeutics have no evidence on safety, efficacy and dose in the older age groups.
Changes in physiology with age and the added burdens of comorbidity and concomitant medications affect the way drugs are handled in the body.
These changes also affect how drugs work in the body.
Non-pharmacological interventions should be considered first, if possible.
Starting with the lowest dose possible and increasing only if efficacy has not been achieved and higher doses are tolerated.
A consideration of deprescribing (including dose reductions) should be undertaken at every visit of every doctor managing health problems in the older age groups.
KeywordsDeprescribing Adverse Drug Reactions (ADRs) Total Annual Direct Medical Cost Higher Free Fraction Postural Blood Pressure Drop
Adverse drug event
Adverse drug reaction
Proton pump inhibitor
Three times daily
Volume of distribution