OTC Medicines & Supplements for Older Australians

Why Medicines Affect Older Bodies Differently

As we age, the body changes how it handles medicines. Kidney and liver function gradually decline, so drugs are cleared more slowly and can build up. Body composition shifts too — there is usually less body water and more fat, which changes how some medicines are distributed and how long they last. The result is that a standard adult dose can have a stronger or longer effect in an older person.

Older adults are also more likely to be taking several regular medicines at once. Taking five or more medicines — known as polypharmacy — is common after 65 and raises the chance of side effects and interactions. Because many OTC products and supplements can interact with prescription medicines, an over-the-counter choice that is fine for a younger adult is not automatically safe later in life.

Bone Health: Calcium and Vitamin D

Bones naturally lose density with age, which increases the risk of osteoporosis — a condition where bones become fragile and break more easily. Adequate calcium and vitamin D support bone strength and, alongside weight-bearing exercise, may help reduce the risk of fractures. Healthy Bones Australia recommends most adults over 50 aim for around 1,300 mg of calcium a day, ideally from food such as dairy, tinned fish with bones and fortified alternatives.

Vitamin D helps the body absorb calcium, and deficiency is common in older Australians — particularly those who are housebound, live in residential care, cover up for cultural reasons or have darker skin, because the skin makes less vitamin D from sunlight with age. A supplement may help when sun exposure and diet are not enough. Your GP can order a blood test to check your vitamin D level and advise whether a supplement is worthwhile.

Common OTC Medicines and Safer Approaches

This table summarises OTC products that need extra care in older adults and a lower-risk alternative to discuss with your pharmacist. It is a general guide, not personal advice — your individual health and other medicines always matter.

Managing Multiple Medicines

When several medicines are involved, staying organised is one of the best ways to avoid mistakes and interactions. A few simple tools make a real difference for both older adults and the family members or carers who help them.

• radio_button_uncheckedKeep an up-to-date medicines list: Write down every prescription medicine, OTC product, vitamin and herbal supplement, with the dose and why you take it. Show it at every GP, specialist and pharmacy visit — this is one of the simplest ways to catch interactions.
• radio_button_uncheckedUse a dose administration aid: A Webster-pak or similar blister pack, prepared by your pharmacy, sorts tablets into days and times so it is easy to see whether a dose has been taken. This can be especially helpful for people managing many medicines or living with memory changes.
• radio_button_uncheckedAsk about a Home Medicines Review (HMR): Your GP can refer you for an HMR, where an accredited pharmacist reviews all your medicines — often at home — to check for interactions, duplication and medicines that may no longer be needed. It is subsidised for eligible people.
• radio_button_uncheckedUse one pharmacy where possible: Filling everything at the same pharmacy means the pharmacist has a full picture of what you take and can spot problems more easily.
• radio_button_uncheckedDo a regular clean-out: Return expired or unused medicines to any pharmacy for safe disposal through the free Return Unwanted Medicines (RUM) programme, rather than keeping or binning them.

Falls: How Medicines and Simple Aids Help

Falls are a leading cause of injury in older Australians, and medicines are part of the picture. Products that cause drowsiness, dizziness or a drop in blood pressure — including sedating antihistamines and some sleep and cold remedies — can make a fall more likely. Reviewing these with a pharmacist is a practical safety step.

• radio_button_uncheckedHave your eyesight and hearing checked regularly, as both affect balance and awareness.
• radio_button_uncheckedConsider simple home aids such as non-slip mats, grab rails, good lighting and removing loose rugs and clutter.
• radio_button_uncheckedStay active — gentle strength and balance exercises help maintain stability. Your GP can suggest suitable programmes.
• radio_button_uncheckedWear well-fitting, supportive footwear rather than loose slippers.
• radio_button_uncheckedAsk your pharmacist to review any medicine that makes you feel drowsy or unsteady.

Constipation, Fluids and Hydration

Constipation becomes more common with age, partly because of reduced activity, lower fluid intake and the side effects of some medicines (including certain pain relievers and sedating antihistamines). The first steps are usually more fibre, more fluids and gentle movement.

Older adults are also more prone to dehydration because the sense of thirst can fade with age, and dehydration can make some medicines act more strongly. Sipping fluids regularly through the day helps. If constipation is new, persistent or comes with pain, weight loss or bleeding, see your GP rather than relying on laxatives — and check with your pharmacist before using laxatives long term.

Hearing Aid Care Basics

Many older adults use hearing aids, and good day-to-day care keeps them working well and helps prevent ear problems. Pharmacies stock the everyday supplies you need, from batteries to cleaning tools and wax guards.

• radio_button_uncheckedWipe hearing aids daily with a dry cloth and use a cleaning brush to keep the sound outlet and microphone clear of wax.
• radio_button_uncheckedOpen the battery door overnight to let moisture escape, and store aids in a dry place — a drying kit can help in humid weather.
• radio_button_uncheckedReplace wax guards regularly to keep sound clear, following the manufacturer's instructions.
• radio_button_uncheckedIf ears feel blocked with wax, ask your pharmacist about softening drops rather than using cotton buds, which can push wax deeper.
• radio_button_uncheckedSee a doctor or audiologist for sudden hearing changes, pain or discharge.

Bone-Support Supplements Available in Australia

If your GP or pharmacist has advised a calcium or vitamin D supplement, these are widely stocked in Australian pharmacies. Prices vary between retailers, so check current pricing. A supplement should complement — not replace — a balanced diet and, where appropriate, prescribed osteoporosis treatment.

Frequently Asked Questions

Which OTC medicines should older adults be careful with?

The two groups that most often cause problems are sedating (older) antihistamines and anti-inflammatories (NSAIDs) such as ibuprofen. Sedating antihistamines — found in some night-time cold, allergy and sleep products — can cause confusion, drowsiness and an increased risk of falls. NSAIDs can affect the kidneys, raise blood pressure and cause stomach bleeding, and are riskier alongside blood thinners or heart and kidney conditions. Oral decongestants can also raise blood pressure. Paracetamol is often the preferred first choice for everyday pain, but always confirm what suits you with your pharmacist.

Do older adults need a vitamin D supplement?

Not everyone does, but vitamin D deficiency is common in older Australians — especially those who are housebound, in residential care, cover up outdoors or have darker skin, because the skin makes less vitamin D with age. Vitamin D helps the body absorb calcium and supports bone strength, so a supplement may help when sunlight and diet are not enough. The best way to know is a blood test: your GP can check your level and advise whether a supplement is worthwhile and at what dose.

What is a Home Medicines Review?

A Home Medicines Review (HMR) is a service where an accredited pharmacist reviews all the medicines you take — prescription, over-the-counter and supplements — usually in your own home. Your GP refers you, and the pharmacist checks for interactions, duplication, side effects and medicines that may no longer be needed, then reports back to your GP. It is subsidised for eligible people and is particularly useful if you take several medicines or have recently had a change to your prescriptions. Ask your GP or pharmacist whether you qualify.

Are sleeping tablets safe for older people?

OTC sleep products are generally not recommended as a first option for older adults. Most contain a sedating antihistamine, which can cause next-day drowsiness, confusion, dry mouth, constipation and an increased risk of falls. If sleep is a persistent problem, it is better to speak to your GP or pharmacist about the cause and non-medicine approaches first, rather than reaching for an over-the-counter sedative. Never combine a sleep product with alcohol or other sedating medicines without advice.

Can supplements interact with prescription medicines?

Yes. Supplements are not automatically safe just because they are sold over the counter. Calcium can reduce the absorption of some thyroid medicines and antibiotics; high-dose fish oil can add to the effect of blood thinners; and herbal products such as St John's Wort interact with many prescription medicines. This is why keeping an up-to-date list of everything you take — including vitamins and herbal products — and showing it to your pharmacist or GP is so important.

How can carers help manage medicines safely?

Carers can keep a single, current medicines list, arrange a dose administration aid such as a Webster-pak from the pharmacy, and use one pharmacy so the pharmacist sees the full picture. Watching for new drowsiness, confusion, dizziness or unsteadiness after any medicine change — and reporting it — helps catch problems early. Asking the GP about a Home Medicines Review is a good step when several medicines are involved. Any OTC product or supplement should be checked with the pharmacist before it is added.