When it comes to risks from prescription drugs, seniors face triple jeopardy.

They’re more likely to take multiple meds and more susceptible to side effects due to physical changes that accompany aging. And they’re at a higher risk of drug interactions, partly because they tend to take more meds.

In Consumer Reports’ recent survey, for example, 40 percent of people ages 65 and older took five drugs or more, compared with just 17 percent of those ages 45 to 55.

Compounding the problem is that older people are less likely than younger ones to ask a doctor about drug safety. Barely half of the seniors in a recent Consumer Reports survey said they talked with their doctor about such concerns as drug side effects, but two-thirds of younger adults did.

It’s not surprising, then, that older adults are twice as likely to suffer a side effect serious enough to require a trip to an ER, and seven times more likely to be hospitalized as a result, according to the Centers for Disease Control and Prevention. To reduce those risks, ask your physicians these questions:

Is This Drug Safe for Someone My Age?

The American Geriatrics Society has identified dozens of medications that people 65 and older should almost always avoid because of the risk of serious side effects. They include the anti-anxiety drugs diazepam (Valium) and alprazolam (Xanax), and sleep drugs such as zolpidem (Ambien) and eszopiclone (Lunesta). For a complete list, go to http://www.healthinaging.org/medications-older-adults/.

Will a Lower Dose Work Just as Well?

Because older people are more susceptible to medication, a lower dose may be as effective and pose less risk. For example, a study of more than 200,000 patients ages 70 and older on levothyroxine (Synthroid) to treat an underactive thyroid found that those taking lower doses were two to three times less likely to suffer a fracture, one of the drug’s known risks. And our experts say a lower dose of the drug can work just as well for older patients.

Do I Need to Treat the Problem So Aggressively?

In some cases, it can make sense to treat conditions less aggressively as you age.

For example, high doses of diabetes medication can make blood sugar levels drop dangerously low in older people. One study found that certain diabetes drugs were responsible for 23 percent of emergency hospitalizations of seniors.

More on Drug Safety

Recognizing that problem, guidelines from the American Geriatrics Society and the American Diabetes Association now say that otherwise healthy older adults with diabetes should talk with their doctor about aiming for an HbA1c (a measure of long-term blood sugar levels) of 7.5 rather than 7, which is the goal for other adults.

Similarly, new guidelines from the American College of Physicians say that low-risk people older than 60 should consider treating high blood pressure only if their systolic, or upper, reading is over 150, rather than 140 — the traditional cutoff.

Even then, our experts say, if blood pressure is only moderately elevated (between 150 and 160), try several months of diet and lifestyle changes before resorting to medication.

Is This Prescription Still Necessary?

Sometimes the potential benefit of a drug declines with age.

For example, there’s little evidence that cholesterol-lowering statins reduce the risk of heart problems in most people older than 70, and even less that they benefit people in their mid-80s and older. That makes the risks of the drugs, which include muscle pain and possibly cognitive decline, of greater concern. For those reasons, the American College of Cardiology encourages older people to discuss with their doctor the limited benefits and potential risks of statins.

It makes sense to have an honest discussion with your doctor about how your age and overall health affect your need for specific medication, says Michael Hochman, M.D., of the Keck School of Medicine at the University of Southern California. “When someone’s life expectancy is less than 10 years,” he notes, “we should re-evaluate whether a medication’s benefits outweigh the potential downsides on quality of life.”

Editor's Note: This special report and supporting materials were made possible by a grant from the state Attorney General Consumer and Prescriber Education Grant Program, which is funded by a multistate settlement of consumer fraud claims regarding the marketing of the prescription drug Neurontin (gabapentin).

This article also appears in the September 2017 issue of Consumer Reports magazine.