Abstract

Geriatric pharmacotherapy presents unique challenges arising from the complex interplay of age-related physiological changes, multimorbidity, and polypharmacy. Elderly patients—typically defined as those aged 65 years and above—represent a rapidly growing segment of the global population, and their pharmaceutical care demands a specialized, individualized approach. Age-associated alterations in pharmacokinetics (PK) and pharmacodynamics (PD), including reduced hepatic metabolism, declining renal function, altered body composition, and heightened receptor sensitivity, fundamentally change how drugs are absorbed, distributed, metabolized, and eliminated. These changes increase vulnerability to adverse drug reactions (ADRs), drug-drug interactions (DDIs), and potentially inappropriate medication (PIM) use. This article aims to provide a clinically focused review of pharmaceutical strategies for optimizing drug therapy in geriatric patients. Key strategies discussed include individualized dose adjustment based on renal and hepatic function, structured medication review using validated tools such as the STOPP/START criteria and Beers Criteria, evidence-based deprescribing, and multidisciplinary pharmaceutical care interventions. Patient-friendly drug delivery systems—including modified-release formulations, orally disintegrating tablets, and transdermal patches—are highlighted as important approaches for improving adherence and therapeutic outcomes. Clinical applications across common geriatric conditions, including cardiovascular disease, neurodegenerative disorders, and chronic metabolic diseases, are also addressed. Collectively, optimized pharmaceutical care in geriatrics requires integration of clinical pharmacology, patient-centered counseling, and advanced drug delivery strategies to ensure safe, effective, and individualized therapy in older adults.