10 Medication Safety Across Patient Groups
Learn how age, pregnancy and breastfeeding, kidney or liver function, and medication-taking practices affect medication benefits, risks, and safe use.
Core principles of medication safety
Medication effects depend on more than the prescribed dose. Age, pregnancy, kidney or , other medicines, and a person’s ability to take medicine correctly can all change benefits and risks.
Safe care involves checking the person, medicine, dose, route, and timing; confirming allergies and relevant health conditions; following product-specific instructions; and monitoring for intended effects and harm. Never change or stop a prescribed medicine without consulting the prescriber or pharmacist.
Medication safety for children
Children are not simply small adults. Their ability to absorb, distribute, metabolize, and eliminate medicines changes as they grow, and some medicines are unsuitable at particular ages. A child’s dose may depend on weight, age, the specific medicine, and the product concentration. Use the prescribed or labeled dose; do not estimate or scale an adult dose.
For liquid medicines, check the and concentration each time. Measure in milliliters (mL) using the supplied or pharmacist-recommended or dosing device, never a kitchen spoon. Check combination cold or pain products for duplicate active ingredients; for example, two products may both contain acetaminophen.
Store medicines locked away and out of sight and reach. If a child may have taken too much or an unknown medicine, contact emergency services or poison control promptly.
For example, if a liquid prescription is labeled per dose, measure that volume with an appropriately sized and follow the prescribed interval.
Medication safety for older adults
Older adults are more likely to have several conditions and take multiple prescription medicines, over-the-counter products, and supplements. Interactions and unwanted effects may therefore be harder to recognize. Age-related changes in body composition and kidney or can affect how long some medicines remain in the body; the degree of change varies by person and medicine.
Dizziness, sleepiness, confusion, or low blood pressure can impair daily activities and increase fall risk. Regularly reconcile the full , including supplements and occasional-use products. Ask whether each medicine is still needed, whether doses fit current kidney and , and whether monitoring is due.
A written schedule or pill organizer may be useful when appropriate, but keep medicines in labeled containers when identification is important. Report new symptoms rather than assuming they are a normal part of aging. Do not stop a medicine abruptly without advice.
Medication use during pregnancy and breastfeeding
During pregnancy, medication decisions balance the risks of the medicine against the risks of untreated illness. Risk can depend on the medicine, dose, duration, and timing in pregnancy. Prescription labels use narrative pregnancy information—including risk summaries, clinical considerations, and available data—rather than the former A, B, C, D, and X letter categories.
Check current prescribing information and consult the pregnancy care team or pharmacist before starting, stopping, or changing prescription medicines, over-the-counter products, vitamins, or herbal supplements. A product described as “natural” is not necessarily safe.
When breastfeeding, check the medicine’s lactation information and consider possible effects on the infant and milk production. Do not stop an essential medicine or breastfeeding solely out of concern without getting individualized advice. Where available, a may collect information about outcomes after exposure to a particular medicine.
Medication safety with impaired
The kidneys clear many medicines and drug metabolites. Reduced can cause some medicines to build up and increase adverse effects; other medicines can further injure the kidneys.
Before prescribing or administering a medicine that requires , review the patient’s kidney-function information and the medicine’s current label. The appropriate measure or estimating equation can depend on the specific drug and patient. A dose change may involve a smaller dose, a longer interval, or both. Do not assume every medicine needs adjustment or that one kidney-function estimate fits every drug.
, such as ibuprofen and naproxen, can harm the kidneys, particularly with prolonged use or during dehydration. A person with kidney disease should ask a clinician or pharmacist before using them.
Medication safety with impaired
The liver metabolizes many medicines. Liver disease can alter drug breakdown, protein binding, or clearance, but the effect differs among people and medicines. Some drugs require a reduced dose, closer monitoring, or avoidance; there is no single adjustment that applies to all liver conditions.
Check the specific drug label and consult the prescriber or pharmacist. Review nonprescription medicines and supplements too, since they may cause liver injury or interact with treatment. In advanced liver disease, some medicines may worsen complications such as confusion, fluid retention, bleeding, or kidney problems.
Putting safe medication practices together
Use age- and condition-appropriate prescribing and administration: verify a child’s exact dose and liquid concentration; review and reconcile medicines for older adults; assess pregnancy or breastfeeding information with the care team; and check drug-specific guidance for kidney or liver impairment.
Monitor for expected benefit and adverse effects, communicate concerns promptly, and avoid medication changes without professional advice.