Too Many Medications? How Internal Medicine Reviews and Simplifies Your Prescriptions

It usually happens gradually. A medication for blood pressure gets added one year. A cholesterol medication the next. Something for acid reflux, a sleep aid, an over-the-counter pain reliever taken daily, a supplement a friend recommended. None of it feels dramatic in the moment — but a few years in, many patients look at their daily pill organizer and wonder how it got this full, and whether all of it is still actually necessary.

This situation has a name in medicine: polypharmacy, generally meaning the regular use of multiple medications at once. It’s extremely common, especially as people manage more than one chronic condition over time, and it’s one of the most important — and most overlooked — things an internal medicine physician reviews at a checkup.

Why More Medications Means More Risk of Interactions

Each individual medication is usually prescribed thoughtfully, often by different providers at different times, for a specific and valid reason. The issue is that medications don’t exist in isolation once they’re in your system together. One drug can change how your body processes another. A supplement can blunt or intensify a prescription’s effect. A medication added for a new symptom can sometimes be treating a side effect of a medication you’re already taking — without anyone realizing that’s what’s happening.

As the number of medications grows, so does the mathematical chance that two of them interact in a way that causes fatigue, dizziness, confusion, stomach upset, or falls — symptoms that are easy to attribute to “getting older” rather than to the medication list itself.

Why This Becomes More Important With Age

The way your body processes medications changes over time. Kidney and liver function, body composition, and metabolism all shift gradually with age, which means a medication dose that worked well for years can start to behave differently in the body without the prescription itself ever changing. This is part of why periodic medication reviews matter more, not less, as you get older — not because anything was done wrong, but because your body is a moving target and your medication list should be reviewed with that in mind.

What a Medication Review Actually Looks Like

A thorough medication review with your internal medicine physician typically involves:

• Going through every prescription, over-the-counter medication, and supplement you take — including things you might not think to mention, like occasional pain relievers or sleep aids
• Checking for overlapping or duplicate medications, especially if you’ve seen multiple specialists
• Looking for known interactions between what you’re currently taking
• Asking whether each medication is still treating an active, necessary purpose
• Considering whether any medication could reasonably be reduced, consolidated, or tapered off under medical supervision — a process sometimes called deprescribing

The goal isn’t to arbitrarily cut medications — plenty of long-term prescriptions remain exactly right for the person taking them. The goal is making sure every medication on your list is earning its place, and that none of them are quietly working against each other or against you.

What You Can Do Before Your Next Visit

Bring a complete, current list to your appointment — including supplements and anything prescribed by another provider — rather than relying on memory. If you’ve noticed new symptoms like fatigue, dizziness, or stomach issues since starting something, mention it specifically, even if it seems minor. And never stop or change a medication on your own; adjustments to a medication regimen should always be made with your physician, who can weigh the full picture safely.