To identify the potential drug drug interactions of clinical significance and assess its relation with polypharmacy, the prospective observational study was conducted to identify drug-drug interactions according to severity and to show the relation between number of prescribed medications and actual DDIs in elderly patients in a tertiary care teaching hospital. Micromedex Healthcare Series 2.0. was used to identify actual and potential DDIs. Drug therapy details by medication chart review and

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... inical review of 120 elderly inpatients (52% male and 48% female) was carried out and analyzed for incidence of any actual and potential drug-drug interactions. Polypharmacy was observed in almost all cases, wherein 45% were prescribed 11-15 drugs and 32% patients were with 6-10 drugs per prescription. 256 no. of DDIs were encountered in the study, comprising of 32 actual and 224 potential DDIs. As per severity, 34.37% were major and 65.62% were moderate. Multiple object drug and precipitant drugs were involved in actual and potential DDIs. Most common outcome of these actual DDIs was found to be increased blood pressure and blood sugar level, electrolyte and fluid imbalance, decreased diuretic effect of drugs. Elderly patients taking multiple medications concurrently because of their comorbid and multimorbid health conditions have lead to polypharmacy. The actual and potential DDIs increase as per number of drugs in prescription.The management of clinically relevant DDIs can be improved by clinical pharmacist interventions. Advice on withdrawal or substituting the precipitant drug would be beneficial.