Your Medication Review Checklist for Multiple Scripts

Here's a number that should stop you mid-scroll: at least 250,000 hospital admissions in Australia every year are medication-related, costing the health system around $1.4 billion — and roughly two-thirds of them are potentially preventable, according to a major review published in *Drug Safety*. That's a quarter of a million hospital beds filled not by accidents or infections, but by medicines that were meant to help.

And it's not a niche problem. Research published in *Drugs & Aging* found that around two million Australians were taking five or more medicines at the same time in 2024 — a pattern clinicians call polypharmacy. The Australian Institute of Health and Welfare reports that about 40% of Australians aged 75 and over are dispensed more than five medications concurrently — noticeably higher than the OECD average of 32%.

If you're juggling a blood pressure tablet, a cholesterol tablet, a puffer, something for reflux, a contraceptive pill, a bit of magnesium your cousin swears by, and the occasional Nurofen for your back — congratulations, you already qualify as someone who'd benefit from a proper medication review.

Here's the reassuring part: most medication harm doesn't come from exotic drug reactions. It comes from very ordinary, very fixable things. Two doctors prescribing the same drug under different brand names. A medicine that was started "for two weeks" in 2019 and never stopped. A supplement quietly cancelling out a prescription. A dose that made sense when your kidneys were younger.

The single most powerful tool you have against all of that is preparation. So in this guide, we're going to walk you through a practical, Australian-specific medication review checklist — how to build a medicines list, how to record side effects properly, how to do a sensible medicine interaction check, and how to book the right kind of review (including the free ones most Australians don't realise they're entitled to). We'll also show you where telehealth fits in, because at NextClinic we help Australians manage scripts, referrals and consultations online every day, and we see how often a 15-minute conversation prevents a much bigger problem.

Grab a pen. Or your phone. This one's genuinely worth doing.

Why Multiple Prescriptions Change the Maths

One medicine is a decision. Five medicines is a system — and systems have interactions.

The reason multiple prescriptions safety deserves its own conversation is simple: risk doesn't add up in a straight line, it compounds. Every additional medicine introduces new possible interactions, new side effects that can be mistaken for new diseases, and new opportunities for a mix-up. The AIHW notes that while polypharmacy is often clinically necessary for people managing several chronic conditions, it increases the risk of medicine-related harm because of the greater chance of drug interactions and mistakes.

There's a particularly sneaky version of this called a prescribing cascade. It goes like this: a medicine causes a side effect. The side effect gets treated as a new problem with a second medicine. The second medicine causes its own side effect. A third medicine appears. Nobody did anything unreasonable at any single step — but three years later you're on eight medicines and you feel worse than when you started.

The other issue is fragmentation. Your GP starts one thing. A specialist starts another. The hospital changes a dose on discharge. You buy a supplement at the health food shop. A telehealth service renews a script you've had for years. Every one of those interactions is legitimate, but unless someone is looking at the whole picture, nobody is.

That someone can be your GP or pharmacist — but they can only review what they can see. Which is why the checklist starts with you.

Who Should Book a Medication Review?

You don't need to be elderly or seriously unwell. Consider a review if any of these apply:

• You take five or more medicines regularly (prescription or otherwise)
• You haven't had a proper medicines review in the last 12–24 months
• You've recently been discharged from hospital or had a significant health event
• You have a new diagnosis or have just started a new medicine
• You see more than one prescriber (GP plus specialists, or multiple clinics)
• You've noticed new symptoms — tiredness, dizziness, falls, confusion, nausea, low mood, poor sleep — since a medicine changed
• You're not sure what a medicine is for, or you suspect you're doubling up
• You're pregnant, planning pregnancy, or breastfeeding
• You use complementary medicines, herbal products or high-dose supplements
• You struggle to afford or remember your medicines

If you nodded at even one of those, keep reading.

The Medication Review Checklist (Do These Before Your Appointment)

Step 1: Build Your Master Medicines List

This is the backbone of the whole exercise. A good medicines list for Australia should capture everything that enters your body with a therapeutic purpose — not just the things on a PBS label.

For each item, write down:

• Brand name and active ingredient (e.g. Nexium / esomeprazole). This matters enormously, because the same active ingredient is sold under many brands and generic substitutions at the pharmacy are one of the most common causes of accidental double-dosing.
• Strength and dose (e.g. 20 mg, one tablet)
• How often, and what time of day you actually take it — not what the label says, what you do
• What it's for, in your own words
• Who prescribed it and roughly when it started
• Whether it's regular or "as needed" (PRN) — and if PRN, how many times you used it in the past month

Then make sure you've included the easy-to-forget categories:

• Inhalers and puffers (including the "preventer" you sometimes skip)
• Eye drops, ear drops, nasal sprays
• Creams, gels and patches
• Injections and pens, including weight-management and diabetes injectables
• Contraception — the pill, implants, IUDs, injections, rings
• Over-the-counter painkillers, antihistamines, laxatives, reflux tablets, sleep aids
• Vitamins, minerals, fish oil, protein powders and greens powders
• Herbal and traditional medicines, including St John's wort, turmeric, ginkgo and ginseng
• Medicinal cannabis, if prescribed
• Anything you take occasionally, seasonally, or "only when it flares"
• Nicotine products, vapes, alcohol intake and recreational substances (your clinician isn't judging — they're checking interactions)

Two practical shortcuts for Australians: your My Health Record contains prescription and dispensing records uploaded by prescribers and pharmacists, which you can view through myGov by selecting Medicines information and then Prescription and Dispense Record . It won't be perfect or complete, but it's an excellent memory jogger. Your regular pharmacy can also print a dispensing history for you if you ask.

Format tip: keep the list somewhere you'll always have it — a note on your phone, a photo of a handwritten page, or a printed card in your wallet. Then keep a duplicate for whoever helps with your care.

Step 2: Do the Brown Bag Test

Once your list is drafted, physically gather every medicine, supplement and half-used tube in the house — bathroom cabinet, kitchen drawer, handbag, glovebox, bedside table, gym bag — and put them in a bag or box.

This is the classic "brown bag review", and it's revealing every single time. You'll typically find at least one expired item, one duplicate under a different brand name, one medicine you completely forgot you had, and one you were told to stop months ago. Bring the bag (or clear photos of every label) to your appointment.

While you're there, check the expiry dates and note anything that looks degraded, discoloured or has been stored somewhere hot. Australian summers are brutal on medicines — a car glovebox in Brisbane in January is not a storage solution.

Step 3: Record Side Effects Properly for Two Weeks

"I've been feeling a bit off" is hard for a clinician to work with. A short, specific diary is gold.

For two weeks before your review, jot down:

• The symptom, described plainly (dizzy on standing, dry mouth, loose stools, bruising easily, vivid dreams, low mood, muscle aches)
• When it happens — morning, after a dose, at night, after food
• How long it lasts and how bad it is out of 10
• What makes it better or worse
• When it started relative to any medicine change

Pay particular attention to symptoms that are easy to write off as "just getting older" but are commonly medicine-related: unsteadiness or near-falls, memory fog, constipation, poor appetite, swollen ankles, persistent cough, sexual difficulties, and daytime drowsiness.

Also note what you've had to stop doing because of a symptom. "I don't walk the dog anymore because I get lightheaded" is far more clinically useful than a number.

If you experience a side effect you think others should know about, consumers in Australia can report it directly to the Therapeutic Goods Administration via its report a problem page. Consumer reports genuinely feed into national safety monitoring.

Step 4: Do a Preliminary Medicine Interaction Check

You are not expected to do a pharmacist's job. But arriving with a few flagged questions makes the review sharper — and helps you understand your own treatment.

Start with the Consumer Medicine Information (CMI) leaflet for each medicine. As healthdirect explains, the CMI comes with your medicine packaging or can be requested from your pharmacist, and it's designed to tell you how to take your medicine safely — including what to avoid. Read the "interactions", "before you take it" and "side effects" sections and highlight anything that applies to you.

Then think about these common categories:

• Doubling up on the same class. Two products both containing paracetamol. Two sedating antihistamines. An anti-inflammatory tablet plus an anti-inflammatory gel plus a cold-and-flu sachet.
• Complementary medicines with prescription medicines. This is a real and under-recognised issue. *Australian Prescriber* has documented how substances including St John's wort can alter warfarin's effect by influencing the cytochrome P450 pathway and lowering INR — which matters a great deal when the medicine in question prevents strokes. St John's wort is also well known for reducing the effectiveness of a range of other medicines, including hormonal contraception.
• Anti-inflammatories with blood pressure, kidney or heart medicines. Regular over-the-counter ibuprofen or naproxen is one of the most common causes of avoidable trouble in people on multiple scripts. Always flag it.
• Anything that makes you drowsy, stacked together. Sleep aids, strong painkillers, some antihistamines, muscle relaxants and alcohol all pull in the same direction.
• Timing and food rules. Some medicines must be taken on an empty stomach; some don't mix with dairy, calcium, iron or antacids; some interact with grapefruit juice. If two of your medicines have opposite rules, that's a great question for your pharmacist.
• Alcohol. Be honest about how much. It changes advice.

Write your suspicions as questions rather than conclusions — "Is my magnesium okay with my thyroid tablet?" — and let the clinician do the verifying. Don't stop a prescribed medicine based on your own internet research. That's a genuinely risky move, and it's the one part of self-diagnosis we'd ask you to resist.

Step 5: Know the "Why" Behind Every Medicine — and Ask About Deprescribing

For each item on your list, try to answer: what is this doing for me, and how would we know if it's working?

If you can't answer for a particular medicine, star it. Those stars are the most valuable part of your list.

Then have the courage to ask the question clinicians increasingly welcome: "Is there anything here I could safely stop or reduce?" This is called deprescribing, and as *Australian Prescriber* explains, quality use of medicines includes not just starting drugs and adjusting doses but discontinuing those that are no longer beneficial.

Good candidates for that conversation are usually medicines started for a short-term problem that never got reviewed, sedatives and sleeping tablets taken long-term, long-running acid-suppressing tablets, or medicines whose benefit depends on a time horizon that has changed. Importantly, deprescribing is a supervised process — usually one medicine at a time, often with a gradual dose reduction and a plan for what to watch for. It is not the same as quitting.

Step 6: Bring Your Numbers and Your History

A medication review is much better with data. Bring:

• Recent blood pressure readings (home readings over a week are ideal — note the time of day)
• Weight, and any recent significant change
• Blood glucose readings if relevant
• Any recent pathology results (kidney function, liver function, cholesterol, INR, thyroid, vitamin D)
• Your allergies and previous adverse reactions, with a description of what actually happened — "rash" and "throat swelling" lead to very different decisions
• Whether you have difficulty swallowing tablets, opening packaging, or reading labels
• Any cost pressures — if you're skipping doses to stretch a script out, say so. There are often cheaper alternatives, 60-day dispensing options for some medicines, or safety net considerations that can help.

Step 7: Write Down Your Top Three Questions

Appointments compress time. If you only get to ask three things, make them count. Popular high-value questions:

• "Which of these medicines matter most if I ever have to prioritise?"
• "What should I do about my medicines if I get a vomiting bug, a heatwave, or can't eat normally?"
• "Which side effects mean I should call someone urgently versus wait and see?"
• "Can any of these be simplified into fewer tablets or fewer doses per day?"
• "What's the plan for reviewing this again?"

Step 8: Book the Right Kind of Review

Australia has several distinct options, and knowing the difference saves time and money.

A longer GP appointment. If you're on multiple scripts, book a long consultation and say explicitly when booking that it's for a medicines review. A standard appointment for "a script" won't give either of you room to think.

A MedsCheck at your pharmacy. This is a structured, in-pharmacy medication review with your pharmacist. According to the Pharmacy Programs Administrator, MedsCheck and Diabetes MedsCheck services are government-funded, with eligibility requirements including being a current Medicare or DVA cardholder and not having received a MedsCheck, Diabetes MedsCheck, HMR or RMMR in the previous 12 months. One service can be provided per eligible patient per 12 months, and the patient consent information confirms the pharmacy doesn't charge you a fee for the service itself.

A Home Medicines Review (HMR). This is the deep dive. As healthdirect describes it, an HMR is when a credentialled pharmacist reviews the medicines you're taking at home, checking that your regimen is safe and appropriate, and involving your doctor and your preferred community pharmacy. The Australian Government Department of Health, Disability and Ageing explains that under the program a pharmacist visits the patient's home to help them understand all the medicines they take and makes recommendations so patients and health practitioners can develop a medicine management plan — the aim being better quality use of medicines and fewer adverse events. Your GP makes the referral, so ask for it. Diabetes Australia notes that if you take five or more medications and haven't had a review in the last two years, you may be eligible.

A telehealth consultation. For many people, the barrier isn't willingness — it's time, distance, mobility or a full GP appointment book. This is where online care earns its place, particularly for the follow-up conversations that a review generates.

Step 9: Set Up Systems Before You Leave the Appointment

A review is only as good as what happens next. Before you finish:

• Ask for a written, updated medicines list and check it against yours
• Confirm what's stopping, what's changing, and what's staying the same
• Ask when to expect improvement and what to do if you don't
• Agree on one change at a time where possible, so you can tell what did what
• Consider a dose administration aid (a weekly blister pack from your pharmacy) if timing is your weak point
• Set phone alarms with the medicine name in the label
• Nominate a regular pharmacy so one team sees everything you're dispensed
• Book the next review date now
• Take unwanted or expired medicines back to a pharmacy for safe disposal — never the bin or the toilet
• Share the updated list with a family member or carer

Step 10: Repeat It Seasonally

Medication lists drift. A useful Australian rhythm is to review your list at the start of the year and again heading into winter, when respiratory season, flu vaccination and cold-and-flu products enter the picture.

Seasonal traps worth knowing: hay fever season brings sedating antihistamines and steroid nasal sprays into an existing mix; cold-and-flu products often contain decongestants that can nudge blood pressure up; summer heat and dehydration can change how diuretics, blood pressure medicines and lithium behave; and gastro season means vomiting and diarrhoea can affect absorption of everything from the contraceptive pill to blood thinners. If you're on multiple scripts and you're heading into a heatwave or a long flight, that's a legitimate reason to ask for advice.

Special Situations Worth Flagging

Sexual and reproductive health. Hormonal contraception is a medicine like any other and belongs on your list. Some medicines and herbal products — St John's wort being the classic example — can reduce contraceptive effectiveness, and vomiting or severe diarrhoea can too. If you're on multiple scripts and using the pill, ask explicitly about interactions and about backup contraception rules. Our guide to online birth control prescriptions in Australia covers how this works through telehealth.

Mental health medicines. Never stop antidepressants or antipsychotics abruptly on your own — withdrawal effects can be significant and are often mistaken for relapse. Bring them to the review and discuss any tapering as a supervised plan.

Chronic conditions with several prescribers. If you have diabetes, heart disease, asthma or an autoimmune condition, you may have a cardiologist, an endocrinologist and a GP all making changes. Ask your GP to be the coordinator, and make sure every specialist letter includes an updated medicines list.

Older Australians and carers. If you manage someone else's medicines, healthdirect makes the point plainly: medicines need to be managed very carefully, because not taking them properly or mixing the wrong ones can have serious consequences. A written list, a dose administration aid and an annual HMR are three of the highest-value interventions available.

Don't Wait for the Review If You Notice These

Seek urgent medical care — or call 000 — for signs such as difficulty breathing, swelling of the face, lips or tongue, a spreading rash with blistering, chest pain, fainting, confusion, bleeding that won't stop, black or bloody stools, severe abdominal pain, yellowing of the eyes or skin, or thoughts of self-harm. For advice at any hour, healthdirect (1800 022 222) connects you with a registered nurse, and the Poisons Information Centre (13 11 26) is available nationally, 24/7, if you've taken the wrong dose or the wrong medicine.

A medication review is preventive care. It's not a substitute for emergency care.

How We Help at NextClinic

We built our service around the friction points Australians actually hit — and "I need to sort out my scripts but I can't get in to see anyone" is near the top of the list.

Through NextClinic you can request repeat prescriptions online, with electronic scripts delivered to your phone as an eScript token — you can read how the process works in our post on Instant Scripts and in our overview of our online prescription service. If you've ever put off dealing with a medicine because the logistics felt impossible, our guide on renewing your scripts from the couch is a good place to start, and you can see the full service details on our online prescriptions page.

We also provide telehealth consultations when your list raises questions that need a doctor's judgement, specialist referrals when a review reveals something that deserves expert input, and medical certificates for the days when your health simply doesn't allow work or study. There are limits to what's appropriate online — we don't prescribe Schedule 8 medicines, and some situations genuinely need hands-on examination or pathology — and we'll always tell you when that's the case rather than issue something inappropriate.

What we'd love you to take from this article, though, is bigger than any one service: the list is the intervention. Whether you bring it to us, to your regular GP, or to the pharmacist down the road, the act of writing everything down is where safety starts. You'll find more practical guides across our blog.

The Recap — and Your Challenge for This Week

Let's pull the thread back together. Around two million Australians take five or more medicines at once, and medication-related problems drive roughly 250,000 hospital admissions a year — two-thirds of them potentially preventable. The gap between those two facts is filled by something remarkably low-tech: organised information.

The pivotal insights worth remembering:

1. Build one master medicines list covering prescriptions, over-the-counter products, supplements, herbals, patches, drops and PRN medicines — and keep it on your phone.
2. Do the brown bag test to surface duplicates, expired items and forgotten medicines.
3. Record side effects for two weeks with timing and severity, because patterns beat impressions.
4. Run a preliminary interaction check using the CMI leaflets and flag your suspicions as questions — never as unilateral decisions to stop a medicine.
5. Know the "why" for every medicine, star the ones you can't explain, and ask openly about deprescribing.
6. Bring your numbers — blood pressure, weight, recent pathology, allergies.
7. Book the right review: a long GP appointment, a government-funded MedsCheck at your pharmacy, or a Home Medicines Review via GP referral if you're on five or more medicines.
8. Set up systems afterwards — one change at a time, one pharmacy, alarms, a shared list, and a date for the next review.

Now here's your challenge, and it's deliberately small enough to actually do.

This week, pick one step from the checklist above and complete it. Just one. Open your notes app and type out your full medicines list. Or tip everything into a bag and check the expiry dates. Or start a two-week side effect diary tonight. Or ring your pharmacy and ask three words: "Am I eligible for a MedsCheck?"

Then tell us about it in the comments: which step did you choose, and what surprised you? Did you find a duplicate? An expired inhaler? A supplement you'd never mentioned to your GP? Your discovery might be exactly the nudge another reader needs — and we read and reply to every comment.

Because the best time to review your medicines isn't when something goes wrong. It's on an ordinary Tuesday, with a pen, before anything does.

This article is general information only and isn't a substitute for personalised medical advice. Never start, stop or change a prescribed medicine without speaking to a doctor or pharmacist. For health advice at any time, call healthdirect on 1800 022 222; for suspected poisoning or a medication error, call the Poisons Information Centre on 13 11 26; in an emergency, call 000.

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