Medications Older Adults Should Avoid

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Health Editor’s Note: You might be on one of the drugs listed below.  It may be fine for you to be taking that drug.  If you are taking a medication listed here it would be prudent to discuss that medication with the healthcare provider who prescribed it for you.  It is always in your best interest to have your medications reviewed as some may no longer be necessary or may not be doing what they were intended to do for your health.  Keep a list of your medications in your wallet, along with dosage and how many times a day, so you can refer to that list if you need to remind someone what you are taking. Also, if you are being seen by more than one healthcare provider be sure that ALL know your medication list as well as herbals and vitamins that you are taking.  Some medications and herbals do not work together…..Carol


29 Medications Older Adults Should Avoid

by Barbara Brody

The risks of using certain prescription and OTC drugs change as you get older. Are you taking something you shouldn’t be?

Even if you’re as sharp and active as you were in your 20s, there’s no denying your body has changed over the years. And while some of those changes might be obvious, others are not as easily noticeable. One important example: how your body responds to the medication.

As you age, your kidney function changes, so it takes longer for many drugs to leave your system. Meanwhile, your body is less able to hold on to water, and your body fat percentage increases says Donna Marie Fick, Ph.D., R.N., director of the Center of Geriatric Nursing Excellence at Penn State College of Nursing.

These shifts, among others, mean a drug that worked well for you when you were younger might no longer do the trick—or, worse, it could leave you vulnerable to serious side effects or adverse events.

Benzodiazepines, for example, are often prescribed for anxiety and related conditions but can increase the risk for cognitive impairment, falls, and motor vehicle accidents—leading to fractures and other serious injuries. Despite these risks, six percent of men and more than 10 percent of women 65 to 80 years old use benzodiazepines, according to a study in JAMA Psychiatry.

In an effort to keep older adults and their doctors in the loop about these risks, the American Geriatric Society (AGS) maintains a list of drugs that might be dangerous in older patients. And you might very well be taking one or more of the drugs on this list.

Is Your Doctor Up to Speed?

If you’re thinking your doctor should already know which drugs are off-limits for seniors, don’t be so sure. Unless you’re seeing a geriatrician, your provider might not be an expert in treating older adults.

You should also know that the 2019 version of the AGS list—called the AGS Beers Criteria for Potentially Inappropriate Medication Use in Older Adults—just came out in late January 2019. The previous update was in 2015, so if your doctor is still relying on that version, their info could be outdated.

Another common issue: “You might have been put on a drug when you were 55 or 60, but now you’re 65 or 75 and still taking it,” says Fick, who was a panel co-chair for the 2019 update.

That could be problematic if a doctor hasn’t recently assessed all of the meds you’re taking. She recommends going over all your prescription and over-the-counter (OTC) drugs, as well as any dietary supplements you may be using, with a doctor at least every six months.

Fick adds that it’s a good idea to periodically ask your doctor if you still need to be taking everything that’s part of your current drug regimen, or if any of them can be stopped.

“There’s a big push now to do what’s called ‘deprescribing,’ because the sheer number of drugs you’re taking is the biggest risk factor for adverse events,” she says.

Whether you’re taking one pill or 10 (or more!), you and your doctor should consult the new AGS guide to help make sure it’s safe for you. The guide puts drugs into five categories:

  • Medications that are potentially inappropriate for most older adults
  • Medications that should typically be avoided in older adults with certain conditions
  • Medications to use with caution
  • Medications that can react negatively with other medications (drug-drug interactions)
  • Medications that may need a dosage adjustment based on your kidney function

You can get most of the highlights of the report by visiting HealthinAging.org. If your doctor hasn’t already seen the full version, point them to the AGS professional site or the January edition of the Journal of the American Geriatric Society.

In the meantime, here is a list of relatively common medications that older adults are now advised to avoid or use with caution.

Drugs Older Adults Should Avoid

  • Diabetes drugs: glyburide (DiaBeta or Micronase) and chlorpropamide (Diabinese)
  • Muscle relaxants: cyclobenzaprine (Flexeril), methocarbamol (Robaxin), carisoprodol (Soma), and similar medications
  • Anxiety drugs: benzodiazepines, such alprazolam (Xanax), lorazepam (Ativan), diazepam (Valium), and chlordiazepoxide (Librium)
  • Insomnia drugs: zaleplon (Sonata), zolpidem (Ambien), and eszopiclone (Lunesta)
  • Antidepressants: amitriptyline (Elavil) and imipramine (Tofranil)
  • Parkinson’s drug: trihexyphenidyl (Artane)
  • Irritable bowel syndrome drug: dicyclomine (Bentyl)
  • Prescription pain reliever: meperidine (Demerol)
  • Drugs for menopause symptoms: estrogen pills and patches
  • OTC antihistamines: diphenhydramine (Benadryl), except for the treatment of severe allergic reaction, and chlorpheniramine (Aller-Chlor and Chlor-Trimeton)
  • OTC sleep aids that contain antihistamines: Tylenol PM (contains diphenhydramine) and similar medications

Drugs Older Adults Should Use with Caution

  • Pain relievers in the NSAID class: celecoxib, aspirin, ibuprofen, and naproxen. Avoid them if you have heart failure with symptoms, and use them with caution if you have heart failure without symptoms. Also, consider avoiding aspirin, ibuprofen, and naproxen entirely if you’re older than 75, taking an oral steroid, or taking a prescription blood thinner.
  • Heart failure or irregular heartbeat medication: digoxin (Lanoxin). Ask about safer alternatives.
  • Antipsychotic medications, unless you are being treated for schizophrenia, bipolar disorder, or chemotherapy side effects: haloperidol (Haldol), risperidone (Risperdal), or quetiapine (Seroquel)

How to Use This List

Of course, there are exceptions to everything, and there are some cases in which one or more of the drugs listed above truly is best for an older adult.

“All drugs have risks,” Fink says. “Our panel—which included clinicians, research scientists, private practice providers, pharmacists, and nurses—really tried to weigh the risk and benefits to figure out which ones belong on this list.”

Your own doctor can take it a step further by factoring in your medical history, health conditions, current medications, and any personal risk factors. If you’re concerned about a medication you are taking, continue taking it as directed, but call your doctor as soon as possible. After reviewing your information, your doctor will decide if it’s best for you to continue, change, or stop your medication.

Biography
Carol graduated from Riverside White Cross School of Nursing in Columbus, Ohio and received her diploma as a registered nurse. She attended Bowling Green State University where she received a Bachelor of Arts Degree in History and Literature. She attended the University of Toledo, College of Nursing, and received a Master’s of Nursing Science Degree as an Educator.

She has traveled extensively, is a photographer, and writes on medical issues. Carol has three children RJ, Katherine, and Stephen – one daughter-in-law; Katie – two granddaughters; Isabella Marianna and Zoe Olivia – and one grandson, Alexander Paul. She also shares her life with husband Gordon Duff, many cats, and two rescue pups.

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4 COMMENTS

  1. I’ll be turning 80 this year and only take an NSAID Indomethacin for my arthritis. I do take supplements, like Xtendovite, COQ10, most vitamins, B, C D and E and maintain a diet with low fats and lots of fruit and veggies.
    I went from 260 down to 225 in about 6 months. In the morning I take garlic, ginger, cilantro mixed with apple cider vinegar and I do use chlorella with baking soda, ACV, organic cinnamon mixed with alkaline water. My blood pressure has gone down to 130/90 from 165/90. I exercise by playing golf everyday, depending on the weather. In a drier climate such as Az or NM or west texas, I don’t have to take the NSAID. When I was in Kurdistan, near Mosul, in one year I took probably 4 NSAID’s when a front came in and it rained – unusual. Diet and exercise, with plenty of garlic and ginger assists.

    • Oh, forgot, I never take flu shots either and haven’t been sick for years. Well, maybe a runny nose, once in 6 months, where I got the handle Dbooger.

  2. People go to healthcare providers because they do not feel well and feel something is wrong. It is not normal to be sick or to remain feeling that way. There are drugs that will help the various organs and physiological processes in your body to perform more nearly to normal. Insulin, blood pressure lowering medications, drugs that help the heart to pump more efficiently, and I could go on are here, should be used. People do need these drugs in order to live their lives to the fullest. The alternative to not taking these drugs is likely to be debilitation and death. That being said, life style changes such as getting at least 25 minutes of exercise (walking will do) daily and eating fresh fruits, vegetables, grains, less fats can only help how you feel and your body functions. Drinking lots of water is also important. I do not think that doctors prescribe drugs unless it is thought that there is a good chance that these drugs will help the patient.

  3. The doctor, of course, is the end of one of the tentacles from the Hydra known as Big Pharma. The purpose of Big Pharma is to make as much money as possible for itself. I wonder how many of the prescribed medication actually do any good. For sure, some do harm. For absolutely sure huge money is made.
    I am uneasy with such an article, medicines are for sick people, so many people taking so many medicines indicate a sick society. The article seems to be promoting the idea that it is normal to take lots of meds. In other words that it is normal to be sick. Should people be looking at life style changes not pills?

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