A medication regimen isn’t something you can set and forget. You and your doctor need to keep tabs on what you’re taking and how it’s affecting your health. “We are required to do a medication ‘check-up’ at every visit, regardless of the specialty, which means that every clinician who sees you is supposed to review your medications and check off a box,” says geriatrician Dr. Suzanne Salamon, an assistant professor at Harvard Medical School.

Sometimes things change between visits, and adjustments need to be made. It’s up to you to schedule an appointment. Here are seven reasons why that may need to happen.

1. You take a lot of pills

It’s estimated that more than a third of older adults take five or more prescription medications, over-the-counter drugs, or dietary supplements. If your regimen is too complicated or confusing, it increases the risk that you will forget to take your medicine (and develop medical problems as a result), take too much of a particular medicine (causing adverse effects), or have a dangerous drug interaction. Your doctor may be able to subtract a medication or a supplement to simplify your routine.

2. You’re experiencing side effects

You might think to call your doctor about an obvious side effect, such as nausea. But sometimes side effects such as drowsiness are chalked up to lifestyle. They may actually indicate that the dose of your medication needs adjustment. For example, taking 50 milligrams (mg) of a selective serotonin reuptake inhibitor (SSRI) for depression may make you sleepy all day. Cutting back to 25 mg may control symptoms without causing drowsiness.

3. You’re self-prescribing

Many medications that were once prescription-only are now available over the counter, such as the antihistamine loratadine (Claritin) or the heartburn medication famotidine (Pepcid). When you take over-the-counter drugs without consulting your doctor, you may be risking an adverse interaction with your other medications.

4. You just got out of the hospital

If you received new medications during your stay, it’s important to see how they’re working and if they need to be adjusted. “We recommend a visit to the primary care physician within two weeks after a discharge from the hospital,” says Dr. Salamon.

5. You’re seeing other doctors

Maybe you’re a snowbird with doctors in other states, or maybe you’re seeing a number of specialists in your own town. “Patients often assume that their doctors all know what the other ones are doing, but we don’t all share the same computers,” Dr. Salamon points out. “A cardiologist may change a blood pressure regimen, and the primary care physician may not know about it.”

6. You don’t need the drug anymore

If you’re self-prescribing at the drugstore, or if your doctor has given you a prescription with refills but hasn’t provided clear instructions about how long to take it, you may be taking a pill unnecessarily. For example, some medications, like heartburn drugs known as proton-pump inhibitors, are not intended for long-term use.

7. Your symptoms aren’t controlled

Your doctor may start you on the lowest medication dose possible. But if you’re still having symptoms, the dose may need to be increased. That’s common with drugs for heart failure, such as diuretics or ACE inhibitors. Or if you’ve been taking medication for a while and your symptoms are no longer controlled, that may indicate your condition has worsened and you need a stronger dose or a different drug.

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