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Adverse drug effects are common in elderly patients but can often be avoided. Judicious prescribing practices require the clinician to be aware of age-related changes in drug absorption, distribution, metabolism, and elimination. Clinicians may need to adjust drug dose, frequency, or the choice of drug altogether as they consider the physiologic changes of aging. This article reviews prescribing situations with elderly patients commonly encountered by the podiatric physician. Strategies for medication management are provided to minimize the risk of adverse drug events in the older patient. (J Am Podiatr Med Assoc 94(2): 90-97, 2004)