The risk of chronic diseases increases with age which may result in an increased need for pharmacological treatment: polypharmacy. Polypharmacy to the elderly is particularly challenging due to altered pharmacokinetics and -dynamics, and is associated with numerous problems such as poor compliance/adherence, drug interactions, adverse drug reactions, increased mortality and hospitalization. Beers criteria and STOPP/START criteria are tools which can be used as guidance in medication of the elderly, but they cannot replace a structured medical review, which should be individualized.