Applied Evidence

Strategies to reduce and prevent polypharmacy in older patients

School of Pharmacy, University of Wyoming, Laramie

The authors reported no potential conflict of interest relevant to this article.




After applying Beers criteria10 and STOPP15, the pharmacist makes several recommendations:

  • Use aripiprazole and quetiapine with caution.
  • Consider discontinuing fluoxetine, hydrocodone–acetaminophen, lorazepam, pantoprazole, and ranitidine.
  • Reduce the dosage of gabapentin.
  • Clarify the indication for prazosin. Consider discontinuing if being used as an antihypertensive.

In addition, the pharmacist recommends holding metformin because lactic acidosis can develop (however rarely) when a person taking metformin experiences acute kidney injury.

Tracy Mahvan, PharmD, BCGP, University of Wyoming, School of Pharmacy, 1000 East University Avenue, Laramie, WY 82071;

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