Actuality. Patients of elderly and senile age are often faced with the problem of polypharmacy due to the significant development of age-associated diseases. However, it is necessary to take into account the degree of polypragmasia and the presence of side effects from the drugs used, as well as the significant contribution to the development of polymorbidity of cardio-metabolic diseases, which are the most common among patients of older groups. We have studied the pleitropic effects of substances that are often used in gerontological practice in diseases of the cardiovascular system, metabolic disorders and premature aging syndrome in order to develop promising programs to reduce the development of polypragmasia syndrome. Purpose. To study the pleiotropic effects of drug therapy in gerontological practice. Material and methods. The patients included in the study had their biological age determined using the Voitenko method and compared with the chronological age. A prospective study was conducted to study the somatic status of 350 patients aged 45 to 74 years (average age 58.5+2.5 years, men-85 or 24.3%, women-265 or 75.7%), who turned to internists for various reasons. The study was conducted for 2 years. Homogeneous groups were selected to objectify the research data. To objectify the data obtained, we divided patients into 2 groups based on age criteria: 45 – 59 years, which made up a group of middle - aged patients in the amount of 189 people (average age 49.6+1.9 years, men – 45 or 23.8%, women – 144 or 76.2%), and 60 – 74 years, which made up an elderly group in the amount of 161 people (average age 68.9+2.1 years, men – 29 or 18.0%, women – 132 or 82.0%). Further, we determined the pleiotropic effects of the substance L-arginine and the substance-thioctic acid, which are often used in gerontological practice, since according to the first part of the study, cardio-metabolic diseases made a significant contribution to the development of polymorbidity. Results. With age, the level of polypragmasia significantly increases, which corresponds to General gerontological patterns. When assessing the degree of chronic immune inflammation in patients with cardiovascular diseases, metabolic disorders and premature aging syndrome, we noted that there is an increase in the level of Pro-inflammatory interleukins (IL -1 and IL-6) and a decrease in anti-inflammatory interleukins (IL-10), and the maximum in elderly patients. When assessing the biochemical parameters and cardiovascular risk of complications, we found that in both middle-aged and elderly patients, when using drugs containing L-arginine and thioctic acid, the level of total cholesterol, the level of glycosylated hemoglobin decreased, and in elderly patients it reached normal reference values, and the level of cardiovascular risk, and in elderly patients it decreased from high to medium, from 6.8 ± 0.2% to 4.9 ± 0.1%, respectively. Conclusions. We have obtained data that indicate a positive pleiotropic effect of drugs containing L-arginine and thioctic acid on reducing the level of chronic immune inflammation, especially in the elderly. Drugs containing L-arginine and thioctic acid have a positive pleiotropic effect in patients with diseases of the cardiovascular system, metabolic disorders and premature aging syndrome, having hypolipidemic properties, reducing the degree of impaired glucose tolerance and the risk of cardiovascular complications. Another pleitotropic effect can be considered a decrease in the volume of cardio-metabolic therapy in patients who took drugs containing L-arginine and thiotic acid.