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However, the increasing prevalence of polypharmacy in the predominantly older CLL population has emerged as a major challenge to the safe and effective delivery of these treatments. Multiple concomitant medications, particularly potentially inappropriate medications (PIMs), are associated with frailty, treatment\u2010related toxicity, hospitalization, poor adherence, and inferior survival. These risks are further exacerbated by clinically significant drug\u2013drug interactions with BTK inhibitors and venetoclax, as well as age\u2010related pharmacokinetic changes. Integrating medication stewardship into routine CLL care\u2014including medication reconciliation, interaction screening, adherence assessment, use of geriatric prescribing tools, and deprescribing of unnecessary or high\u2010risk medications\u2014may improve the safety and effectiveness of targeted therapies while reducing preventable treatment\u2010related complications. Although current recommendations are largely extrapolated from geriatric oncology rather than CLL\u2010specific studies, they may provide a practical framework for optimizing pharmacotherapy in this population.<\/jats:p>","DOI":"10.1111\/ejh.70265","type":"journal-article","created":{"date-parts":[[2026,7,12]],"date-time":"2026-07-12T22:40:20Z","timestamp":1783896020000},"page":"1198-1205","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Polypharmacy in Chronic Lymphocytic Leukemia in the Era of Targeted Agents: A Medication Stewardship Perspective"],"prefix":"10.1111","volume":"117","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2795-6507","authenticated-orcid":false,"given":"Stefano","family":"Molica","sequence":"first","affiliation":[{"name":"Department of Hematology Hull University Teaching Hospitals NHSTrust  Hull 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