In your medicine cabinet you probably 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 or their interactions.
When compared to younger people, seniors are more sensitive to drug interactions and side effects. Older people are especially susceptible to becoming confused, lightheaded or falling and breaking a hip. Medicine-related problems in older adults are often preventable.
As you age and develop more medical problems, the number of doctors you see may also increase. This may lead to medications from different doctors may not be not aware of all the ones you are taking.
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.
According to the AGS, these are the top ten medications or types of medication that older adults should avoid or use with caution. There may be other medications that can be harmful to you. Talk to your doctor.
- Nonsteroidal anti-inflammatory drugs (NSAIDs)
- Digoxin, a medication used to treat heart failure and irregular heartbeats
- Certain diabetes drugs, such as glyburide
- Muscle relaxants such as cyclobenzaprine
- Certain medications used for anxiety and/or insomnia such as diazepam and zaleplon
- Certain anticholinergenic drugs such as amitriptyline and oxybutynin
- Meperidine, a pain reliever
- Certain over-the-counter products such as diphenhydramine and chlorpheniramine
- Antipsychotics if you are not being treated for psychosis
- Estrogen pills and patches
For your own health and safety, do not stop taking any medication unless you have consulted with your doctor and have their 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 primary care doctor to determine this. You and your doctor should be on a heightened state of alert for unnecessary medications, especially after seeing specialists. Follow these steps to reduce your risks for problems with your medicines:
- Make a list of all your medicines. Update the list anytime your doctor prescribes a new medicine or stops and old one. Always bring the list when you are seeing specialists.
- Read and save all the written information that comes with your medicines.
- Take medicines exactly as your doctor prescribes.
- Do not skip doses or take half doses to save money. If you need help paying for your medicines, talk to your doctor.
- Use a memory aid (such as a calendar, chart, or weekly pill box) to remember to take your medicines on time.
- Avoid mixing alcohol and medicines.
- Take all of the medicine your doctor prescribes unless the doctor says it is okay to stop.
- Do not take medicines prescribed to another person or share your medicines.
- Check the expiration dates on your medicines. Dispose of expired medicines properly.
- Store all medicines safely out of reach of young children.
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
the medicines you are taking, including prescription medications from other doctors, and over-the-counter drugs and supplements.
Thoroughly review your medicines with your doctor at least once a year or when changes are being made. 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. Ask if you still need all your medications and how they may interact. Keep asking until you understand the dose, frequency, and purpose of all the medications you are taking. Finally, don’t be afraid to ask about non-drug options that can help you minimize your use of medicines.
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 October 22, 2014.
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 April 17, 2014. Accessed October 22, 2014.
Ten medications older adults should avoid or use with caution. American Geriatrics Association website. Available at: http://www.americangeriatrics.org/files/documents/beers/FHATipMEDS.pdf. Published April 2012. Accessed October 22, 2014.
11/30/2010 DynaMed's Systematic Literature Surveillance
http://www.ebscohost.com/dynamed: US Food and Drug Administration. Propoxyphene: withdrawal—risk of cardiac toxicity.
US Food and Drug Administration website. Available at:
Published November 19, 2010. Accessed October 22, 2014.
Last reviewed October 2014 by Michael Woods, 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.
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