In your medicine cabinet you may have a mix of prescription drugs and over-the-counter drugs to treat various conditions. Some of these medications are truly necessary, as people tend to have more health problems with age. But the more medicines you take, the greater your risk of suffering adverse reactions from the drugs.
When compared to younger people, seniors are more sensitive to drug interactions and side effects. Older people are especially susceptible to becoming confused, dizzy, or falling and breaking a hip. Medicine-related problems in older adults are often preventable.
The American Geriatric Society has identified drugs that may be inappropriate for persons aged 65 years and older. For these drugs, the risk of harm when used in older adults potentially outweighs their benefits.
This is not a complete list, though. There may be other medications that can be harmful to you. Talk to your doctor.
|Indomethacin (Indocin, Indocin SR)||Avoid|
|Oxybutynin (Ditropan)||Avoid unless there are no other alternatives|
|Meprobarnate (Miltown, Equanil)||Avoid|
|Lorazepam (>3 mg) (Ativan)||Avoid for treatment of insomnia, agitation, or delirium|
|Oxazepam (>60 mg) (Serax)||Avoid for treatment of insomnia, agitation, or delirium|
|Alprazolam (> 2 mg) (Xanax)||Avoid for treatment of insomnia, agitation, or delirium|
|Temazepam (>15 mg) (Restoril)||Avoid for treatment of insomnia, agitation, or delirium|
|Triazolam (>0.25 mg) (Halcion)||Avoid for treatment of insomnia, agitation, or delirium|
|Chlordiazepoxide (Librium)||Avoid for treatment of insomnia, agitation, or delirium|
|Chlordiazepoxide-arnitriptyline (Limbitrol)||Avoid for treatment of insomnia, agitation, or delirium|
|Clidinium-chlordiazepoxide (Librax)||Avoid for treatment of insomnia, agitation, or delirium|
|Diazepam (Valium)||Avoid for treatment of insomnia, agitation, or delirium|
|Quazepam (Doral)||Avoid for treatment of insomnia, agitation, or delirium|
|Chlorazepate (Tranxene)||Avoid for treatment of insomnia, agitation, or delirium|
|Disopyramide (Norpace, Norpace CR)||Avoid|
|Digoxin ( >0.125 mg/d, except if treating atrial arrhythmia) (Lanoxin)||Avoid|
|Short-acting dipyridamole (Persantine)||Avoid|
|Reserpine (>0.25 mg)||Avoid|
|Hyoscyamine (Levsin, Levsinex)||Avoid except in short time palliative care|
|Propantheline (Pro-Banthine)||Avoid unless no other alternatives|
|Belladonna alkaloids (Donnatal and others)||Avoid except in short time palliative care|
|Clidinium-chlordiazepoxide (Librax)||Avoid except in short time palliative care|
|Chlorpheniramine (Chlor-Trimeton)||Avoid unless no other alternatives|
|Diphenhydramine (Benadryl)||Avoid unless no other alternatives|
|Hydroxyzine (Vistaril, Atarax)||Avoid unless no other alternatives|
|Cyproheptadine (Periactin)||Avoid unless no other alternatives|
|Promethazine (Phenergan)||Avoid unless no other alternatives|
|Ergot mesyloids (Hydergine)||Avoid|
|Ibutilide||Avoid as first-line treatment of atrial fibrillation|
|All barbituates (except phenobarbital) except to control seizures||Avoid|
|Amphetamines and anorexic agents||Avoid|
|Naproxen (long-term use of full dosage) (Naprosyn, Avaprox, Aleve)||Avoid chronic use unless alternatives are not effective|
|Oxaprozin (long-term use of full dosage) (Daypro)||Avoid chronic use unless alternatives are not effective|
|Piroxicam (long-term use of full dosage) (Feldene)||Avoid chronic use unless alternatives are not effective|
|Sotalol||Avoid as first-line treatment of atrial fibrillation|
|Amiodarone (Cordarone)||Avoid as first-line treatment of atrial fibrillation|
|Nitrofurantoin (Macrodantin)||Avoid long-term use|
|Doxazosin (Cardura)||Avoid use as an antihypertensive|
|Methyltestosterone (Android, Virilon, Testrad)||Avoid unless indicated for severe hypogonadism|
|Short-acting nifedipine (Procardia, Adalat)||Avoid|
|Testosterone||Avoid unless indicated for severe hypogonadism|
|Amphetamines (excluding methylphenidate hydrochloride and anorexics)||Avoid|
|Estrogens with or without progestins (oral)||Avoid|
Note: For your own health and safety, do not stop taking any medication unless you have consulted with your doctor and have her approval.
When you are on a lot of medicine, how can you tell if you are taking more than you need? First of all, you need the help of your doctor to determine this. You and your doctor should be on a heightened state of alert for unnecessary medications. Follow these steps to reduce your risks for problems with your medicines:
The best way to fine-tune your medicines is to work with your doctor. After all, most doctors are experts in the drug treatment of disease. But your doctor can only help if you tell him or her about all the medicines you are taking, including prescription and over-the-counter drugs and supplements.
Thoroughly review your medicines with your doctor at least once a year. Write down a complete list, or better yet, bring all your medications into the office in a brown bag. And don’t forget to include those in your medicine chest or kitchen cupboard that you only take once in awhile.
Another key is to ask questions. Keep asking until you understand the dose, frequency, and purpose of the medicines you are taking. Finally, don’t be afraid to ask about nondrug options that can help you minimize your use of medicines.
FirstGov.gov for Seniors
National Council on the Aging
United States Administration on Aging
Public Health Agency of Canada
American Geriatrics Society updated Beers Criteria for potentially inappropriate medication use in older patients. American Geriatrics Society website. Available at: http://www.americangeriatrics.org/files/documents/beers/2012BeersCriteria_JAGS.pdf. Published 2012. Accessed September 24, 2012.
Medicines: use them safely. National Institutes of Health National Institute on Aging website. Available at: http://www.nia.nih.gov/health/publication/medicines-use-them-safely. Updated July 2011. Accessed September 24, 2012.
11/30/2010 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance: US Food and Drug Administration. Propoxyphene: withdrawal—risk of cardiac toxicity. US Food and Drug Administration website. Available at: http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm234389.htm. Published November 19, 2010. Accessed November 30, 2010.
Last reviewed September 2012 by Brian Randall, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
Copyright © 2012 EBSCO Publishing All rights reserved.
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