Toxicity of the polymeric excipients in geriatric polypharmacy

Geriatric polypharmacy is already a complicated issue in pharmacotherapy as multiple biological and pharmaceutical factors are involved. Given the fact that the geriatric population, in general, takes more than five medications for multiple diseases and most likely takes several supplements, there is a hidden issue with the types and amounts of the pharmaceutical inactive ingredients (polymers in particular) as they, as well as their impurities, may build up in an ill-performing body beyond their safety levels. In this commentary, we impart on biological factors, the importance of polymers, and the types and amounts of the impurities within each polymeric excipient that can potentially lead to severe pharmacological and biological impacts. Given the complex safety and toxicity issues in polypharmacy, we may need to revisit the safety standards and regulations on the inactive materials that are widely used in geriatric medications.