What is a common rule for prescribing medications to the elderly?

Starting at a lower dose than commonly prescribed for adults is a widely accepted practice when prescribing medications to the elderly. This guideline recognizes the physiological changes that occur with aging, including declines in renal function, hepatic metabolism, and changes in body composition. Older adults are often more sensitive to medications, leading to a higher risk of adverse drug reactions and toxicity. By initiating treatment at a lower dose, healthcare providers can minimize the risk of complications while still achieving the desired therapeutic effect. This approach allows for careful monitoring and dose adjustments as needed based on the patient's response and tolerance.

While other practices, such as performing a creatinine clearance test for older patients, may be appropriate in specific situations, they are not universally required for all elderly patients. Similarly, medication timing and taking medications with a full glass of water may not directly relate to safety and efficacy concerns in the same way as adjusting the dose. Lowering the starting dose is a fundamental principle that aligns with the goals of providing safe and effective medication management in the geriatric population.