Can You Safely Stop Taking Daily Medications? What To Know About Deprescribing

Maybe it started in childhood with an asthma medication. In your 20s, perhaps you added an antidepressant or an acid-reflux drug. As you reached middle age, your blood pressure and cholesterol were creeping up, so now you take medicine for those. One way or another, you find yourself with a plastic pillbox filled with medicine you take every day.

While medicines are prescribed to improve health and well-being, long-term use of too many can have the opposite effect, decreasing quality of life and increasing the risk of death, disability and frailty.

What Is Deprescribing and Polypharmacy?

About 16% of U.S. adults take five or more prescription medicines each day, which is known as polypharmacy. It occurs in health-compromised younger people and spikes to 40% of adults 65 and older, who tend to develop chronic health conditions. But almost every medicine comes with possible side effects, which can lead to a prescribing cascade when new medicines are added to treat the side effects of an older one.

Is there any way out of this? The answer is sometimes. But you should never make a change without discussing it with your healthcare provider first to be sure you continue managing chronic conditions and avoid adverse effects of sudden withdrawal. It’s called “deprescribing,” and the goal is maintaining or improving your overall health while reducing your medical burden.

How To Reduce or Stop Long-Term Medications Safely

Medicine is the cornerstone of the U.S. healthcare system, and the past focus has been on starting treatment rather than stopping it. That’s quickly changing with a growing awareness of the dangers of polypharmacy.

The term “deprescribing” was first used in 2003, but it took a while for research to establish a firm definition and guidelines for its practice. Today, it is considered an essential part of prescribing, and national and international organizations have developed deprescribing schedules, patient information pamphlets and tools to help healthcare providers recognize and respond when it’s safe for a patient to reduce or quit taking a medicine.

Research shows most patients are not just open to deprescribing but eager to reduce or end some medications entirely. Maybe it’s the cost. Maybe it’s the unwanted side effects. Maybe you’ve made big lifestyle changes and believe your medicine is no longer needed. No matter your reason, do not act alone because it can be dangerous to end some medications abruptly.

Instead, be prepared for your next primary care doctor visit. Bring all your prescription and over-the-counter medicines so you can discuss with your healthcare provider whether deprescribing is safe for you.

Medications That May Be Candidates for Tapering

While you should never reduce or quit any daily medication without talking to your healthcare provider, together you may find it’s safer to do so with some medicines than others.

• Asthma medications can usually be tapered to the lowest effective dose once your disease is under control.
• Some acid-reflux medications can be safely stepped down and then stopped although rebound symptoms are possible.

Can You Stop Taking Blood Pressure or Cholesterol Medications?

Eight of the 10 most-prescribed drugs in the U.S. treat either high cholesterol or high blood pressure, which are risk factors for cardiovascular disease, the leading cause of adult deaths in the United States.

Because of their effectiveness in preventing heart attacks and strokes, reducing or getting off these medications requires particular caution and should never be undertaken without medical supervision.

If you take one and your blood pressure or cholesterol levels are now normal, it may be tempting to think you no longer need medication. However, in many cases those healthy numbers are a result of the medication doing its job, and stopping it could cause your blood pressure or cholesterol to rise again, often without symptoms.

That doesn’t mean everyone needs these medications forever. To decide if it’s safe for you to reduce or eliminate a blood pressure or cholesterol drug, you and your healthcare provider should consider these factors:

• Has your blood pressure or cholesterol level been normal and stable for a long time?
• Are you taking only one blood pressure or cholesterol medicine?
• Have you lost a significant amount of weight?
• Have you made permanent healthy changes to your diet and exercise habits?
• Have you identified and resolved an underlying medical issue that caused high blood pressure or cholesterol?

If the answer to all or most is “yes,” your healthcare provider may be able to schedule a reduction of your medication – done gradually to avoid a dangerous spike in cholesterol or blood pressure that could lead to a heart attack or stroke – and followed by regular monitoring.

If you are not there yet, you can still work toward reducing or ending your medication by making consistent, healthy lifestyle changes including losing weight or maintaining a healthy weight, getting regular physical activity, eating a heart-healthy diet, limiting sodium and alcohol consumption, and ending tobacco use.

Together, your doctor can help you decide if a lower dose or no dose at all is best for you, then help you taper off slowly. With caution and care, you could find that less is more – you could feel better on fewer medications.

This content is not AI generated.