Background. Chronic heart failure (CHF) is one of the most common pathologies, especially in patients of older age groups. In the treatment of patients with CHF, doctors strive to prescribe therapy in accordance with modern clinical guidelines. However, age-related patients with CHF have many concomitant pathologies, suffering from diseases that, in turn, require the appointment of additional medications. Thus, the risk of polypragmasia and undesirable drug interactions in older age groups increases. Given the increase in the number of drugs prescribed to elderly and senile patients with CHF, an assessment of both the total number of drugs and the risk of undesirable drug interactions in this group of patients is required. Purpose of the study. Analysis of the compliance of prescribed therapy with clinical guidelines and standards of care, as well as the risk of polypragmasia and undesirable drug interactions in older age groups with CHF. Method. A prospective study was conducted. A total of 1,518 people (583 men, 935 women) who were admitted to the hospital on a planned and urgent basis with a diagnosis of CHF were examined. The examined persons were divided into 3 subgroups: 35-59 years old (average age) – 187 people; 60-74 years old (elderly age) – 638 people; 75-94 years old (senile age) – 693 people. The inclusion criteria were age over 18 years, a preliminary diagnosis “Congestive heart failure”. The Charlson comorbidity index was calculated for all patients as part of the examination during hospitalization; taking into account the number of medications taken and assessing the risk of adverse drug reactions according to the BADRI and GerontoNet scales. Results. When evaluating the therapy of patients included in the study, it turned out that it was 95% consistent with clinical guidelines. In addition, it was shown that 66.5% of the elderly and 62% of senile patients receive more than 8 drugs at the same time, which increases the risk of polypragmasia and adverse drug reactions by 45%. When assessing the risk of adverse reactions on the BADRI scale, 74% of elderly patients and 71.5% of senile patients had a risk of adverse reactions of 25% or higher, and almost 12% of senile patients and 7.5% of elderly patients had a 100% risk of adverse reactions on this scale. When assessing the risk of adverse reactions, data were obtained that the majority of patients in older age groups with CHF had a high (12%) risk of adverse reactions on the GerontoNet scale, and 4% of patients aged 65-74 and 5% of patients over 75 had a very high risk of adverse events – 22-28%. Conclusion. In the treatment of patients of older age groups with CHF, in order to reduce the risk of adverse drug reactions, it is necessary to take into account not only the total number of drugs, but also use scales that allow assessing the risks of drug interactions, which will allow timely optimization of drug therapy in such patients, taking into account age characteristics.