Purpose The world’s aging population has led to a greater use of prescription and non-prescription medication by the elderly. Besides, older drinkers consume alcohol often regardless of the medication they consume. The purpose of this paper is to examine the intake of medication and alcohol simultaneously in a group of elderly in the community of Madrid, and the possible differences in consumption between men and women. Design/methodology/approach An observational cross-sectional study of 342 elderly in Madrid, aged 65–96 years was conducted, including the collection of anthropometric data (weight, height, waist circumference, BMI), information about the quantity of daily alcohol intake and medication taken from each subject. Findings A high percentage of the sample used medication, especially women. A smaller percentage of the sample consumed alcohol, being more frequent among men and decreasing with age. In addition, almost half of the sample (46.4 percent) combined medication intake with alcohol, especially men. High alcohol consumption was observed simultaneously in those subjects taking medication; in addition to the non-perception of the real risk to health. Statistically significant sex differences were observed, since men drank more, including when taking medication; although women may be more vulnerable to harm derived from alcohol. Originality/value This study contributed to estimate the risk to the public health of old people, and the integrity of their health, by observing the consumption of both medication and alcohol, given that medication taken in conjunction with alcohol can cause adverse side effects.