The Medications You May Not Need Anymore

YOUR HEALTH — Issue No. 2

The Medications You May Not Need Anymore

Why "I've been on it for years" isn't always a reason to stay on it — and how to start that conversation with your provider.

Something I hear almost every week in my exam room:

"I've been on this medication for years. I have to have it."

I understand why patients feel that way. A medication was prescribed for a reason. It helped. Life moved on. The prescription kept getting refilled.

But here's what most patients don't know: many of the most commonly prescribed medications in adults over 50 can be safely reduced or stopped — with the right conversation and the right supervision.

The problem isn't the medications. The problem is that nobody ever goes back and asks whether you still need them.

Here's why that happens.

Your provider genuinely wants to help you. But a standard appointment is 15-20 minutes. There are new symptoms to address, lab results to review, referrals to write. Going back through every medication on your list — evaluating whether each one is still necessary, whether the dose is still appropriate, whether two medications are working against each other — takes focused time that a routine visit simply doesn't allow.

So the medications stay. Refill after refill. Year after year. Not because you need them all. Because nobody has had the time to look.

The medications I see continued longer than necessary most often:

PPIs (omeprazole, pantoprazole, Prilosec) — prescribed for heartburn, often continued for years when they were only needed for weeks or months.

NSAIDs (ibuprofen, naproxen) — long-term use carries real risks for your kidneys, stomach, and heart that most patients aren't aware of.

Blood pressure medications — often stacked over years without anyone reassessing whether all of them are still needed or whether the doses are still appropriate.

Antidepressants — started during a difficult season of life and never revisited, even when that season has passed.

Benzodiazepines (Xanax, Valium, Ativan) — prescribed for anxiety or sleep, often continued for years despite significant risks for older adults including falls and cognitive changes.

Sleep medications (Ambien/zolpidem) — prescribed for short-term use and continued for years, despite significant fall risk and dependency concerns in adults over 50.

The one appointment that changes everything:

Call your provider's office and request a medication review appointment.

Not a sick visit. Not a routine follow-up. A medication review — where the entire focus of the appointment is going through your medication list together and asking: do I still need this? Is this dose still right? Are any of these working against each other?

Most practices will schedule this. Most providers welcome it. But they need you to ask for it by name — because the system won't create that space automatically.

Next week: How to read an Explanation of Benefits — the document your insurance sends after every visit that almost nobody understands.

“The Member deep-dive this week covers the safer alternative to PPIs, exactly what to say to get a blood pressure medication reduced, the sleep research that outperforms Ambien, and a breakdown of what stopping unnecessary medications could save you annually”.

Plain Medicine is published for educational purposes only and does not constitute medical advice or establish a patient-provider relationship. Always consult your healthcare provider before making medical decisions.

— Kyle