Maintenance Medications 101

Maintenance medications are prescription medications that help treat chronic health conditions such as high blood pressure, heart disease, diabetes, and depression. They are frequently taken on a daily basis at the same dose, either for years or a life-time. 

Chronic conditions are very common among adult Americans. Approximately 60% of adult Americans have at least 1 chronic condition, and 42% have more than 1 condition.  Something is considered a chronic condition if it lasts longer than a year and requires ongoing medical attention.  

What isn’t a maintenance medication? 

Certain prescription medications treat “acute” conditions, for a short period of time. This type of medication commonly treats temporary conditions such as bacterial infections, diarrhea, colds, fevers, and body aches. 

For example, antibiotics are considered an acute prescription medication because you usually take them for a short time. Over-the-counter flu medications such as DayQuil are another example—you only take them while you have the flu. Your flu goes away eventually, and then you stop taking the medication.

Maintenance medications, on the other hand, are taken for chronic conditions that do not resolve within a matter of days, weeks, or even months. 

Treatment for chronic conditions usually begins with a starting dose. Then, that dose is gradually adjusted until the right dose is achieved—in other words, the dose that maximizes the benefits of the medication while minimizing the side effects. This is considered the “stable dose,” which is the dose you use to manage your chronic condition.

What are some popular maintenance medications?

Three of the most common chronic conditions in the U.S. are hypertension (high blood pressure), hyperlipidemia/hypercholesterolemia (high cholesterol), and mental health conditions (such as anxiety, depression, and bipolar disorder). In this figure, you can see the top ten chronic conditions in the U.S.: 

Below, we’ve broken down the most popular maintenance medications for the three most popular chronic conditions. 

High Blood Pressure

High blood pressure (hypertension) is a chronic condition that nearly 65 million adults in the U.S. currently have. Prescription medication taken daily can be used to control high blood pressure and reduce the risk of complications such as kidney problems, stroke, heart failure, blindness, and heart attacks. Hypertension affects more men than women and more black adults than any other racial group. Additionally, your risk increases as you age. Here are five common high blood pressure maintenance medications: 

*Data was sourced from the Medical Expenditure Panel Survey 2017 and can take months to find the correct maintenance dose for high blood pressure medications. For example, patients on lisinopril (Zestril) often start with a 5 mg/day dose and then work their way up to a 40 mg/day dose over 1 – 2 months. 

High Cholesterol 

High cholesterol (hypercholesterolemia/hyperlipidemia) is a condition where fatty deposits form in your blood vessels, restricting or blocking the flow of blood. Left untreated, this condition increases your risk of stroke or heart attack. More than 102 million American adults currently have high cholesterol levels, and your risk increases as you age

In addition to lifestyle changes, high cholesterol is often managed with the following maintenance medications: 

Cholesterol medications can also take months for a patient to reach the optimal maintenance dose. For example, some patients are prescribed a 20 mg/day dose of atorvastatin (Lipitor) to start, and then slowly increase that dose over 1 – 2 months. However, not all patients take increased doses, and the goal is always just to find the optimal level of the medication for each individual patient. 

Mood disorders

Mood disorders, also known as mental health conditions, affect your general emotional state or mood. This includes disorders such as depression, bipolar disorder, seasonal affective disorder, and anxiety. These disorders can range in severity and they can increase your risk of suicide. Overall, there appear to be higher rates of mood disorders among women (11.6%) compared to men (7.7%). 

There are many ways of managing mood disorders, including the following popular maintenance medications: 

Like with cholesterol and high blood pressure medications, mental health medications are no different and take time for patients to reach their stable dose. For example, for patients taking sertraline (Zoloft), it’s common to start at 50 mg/day and then work up to 100 or 150 mg/day over 1 – 2 months. It then takes some time to assess whether it’s best to adjust the dose further (either by raising or lowering it), add another drug to the regimen, or switch to another drug altogether.

How to make sure you take your medicine correctly

Medication adherence means whether or not you are taking your medications correctly—including the right dose, at the right time of day, consistently. With maintenance medications, it is very important to take them consistently in order to effectively manage your chronic condition. 

However, if you struggle to do this, you’re not alone. A government study found that around 50% of patients have a hard time keeping up with their maintenance medications. Here are a few helpful tips for remembering from the FDA

  • Take your meds at the same time every day so that you build up a routine
  • Attach the act of taking your medication to some other daily routine as a reminder, such as brushing your teeth (always check first if your medication should be taken with or without food)
  • Have a tracking system where you record each time you take your medication

Tips for saving on maintenance medications

Maintenance medications are often taken long-term, over the course of years or a lifetime. For many Americans, this becomes a significant financial burden. 

Nearly 25% of Americans taking prescription drugs report that they struggle to pay for their medications, and nearly 30% report that their drug prices rose in 2019. As a consequence, as many as 50% of patients  can’t afford to take their meds as prescribed.  

We wrote a series of blog posts on how you can save money on maintenance medication. Some examples include switching to a 90-day supply and switching to an online pharmacy.

Dr. Jessica Nouhavandi