Avoiding adverse reactions. Effective lower-dose drug therapies for older patients

Adverse drug reactions (ADRs) are a leading cause of morbidity and mortality, with the highest incidence occurring in patients age 60 and older. Prescribing the lowest effective doses of medications to older patients can help avoid ADRs, minimize bothersome side effects, and increase rates of compliance. For many drugs, clinical experience and published studies demonstrate the effectiveness of doses substantially lower than those recommended in standard references. This article examines the problem of ADRs in older patients, discusses pharmacokinetic data regarding older versus younger adults, and provides effective lower doses for many common drugs.