Polypharmacy
The use of multiple medicines by one person, conventionally five or more.
What it means
Polypharmacy is the use of several medicines at once, conventionally defined as five or more.
The important distinction is between two kinds:
- Appropriate polypharmacy — every medicine has a current indication and the benefits outweigh the risks. Someone after a heart attack may legitimately take five.
- Problematic polypharmacy — medicines have accumulated over years, some no longer needed, some treating the side effects of others.
A prescribing cascade is the pattern where a drug's side effect is mistaken for a new condition and treated with another drug. It is common and largely invisible unless the whole list is reviewed at once.
In practice
Deprescribing is the planned, supervised reduction or withdrawal of medicines that are no longer of benefit. It is an active clinical process, not neglect.
Risk rises steeply with numbers: interactions, falls, confusion and hospital admissions all increase with the size of the list.
Why it matters
Anyone taking several regular medicines is entitled to a structured review covering what each is for, whether it is still needed, and whether the list makes sense as a whole.
Bringing every packet, including over-the-counter remedies and supplements, is more useful than a printed repeat list, which often does not match what is actually being taken.
Never stop a regular medicine on your own — several are dangerous to stop abruptly. The review is the place to change things.
Clinically reviewed by Dr Mohammad Zubair Khan, GMC 7563469
Last reviewed
August 30, 2026