Are You Taking Drugs You Don’t Need?
En Español (Spanish Version)


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.

List of Inappropriate Drugs
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.

Drug NameRecommendationIndomethacin (Indocin, Indocin SR)AvoidPentazocine (Talwin)AvoidTrimethobenzamide (Tigan)AvoidMethocarbamol (Robaxin)AvoidCarisoprodol (Soma)AvoidChlorzoxazone (Paraflex)AvoidMetaxalone (Skelaxin)AvoidCyclobenzaprine (Flexeril)AvoidOxybutynin (Ditropan)Avoid unless there are no other alternativesBrompheniramineAvoidAmitriptyline (Elavil)AvoidChlordiazepoxide-amitriptyline (Limbitrol)AvoidPerphenazine-amitriptyline (Triavil)AvoidDoxepin (Sinequan)AvoidMeprobarnate (Miltown, Equanil)AvoidLorazepam (>3 mg) (Ativan)Avoid for treatment of insomnia, agitation, or deliriumOxazepam (>60 mg) (Serax)Avoid for treatment of insomnia, agitation, or deliriumAlprazolam (> 2 mg) (Xanax)Avoid for treatment of insomnia, agitation, or deliriumTemazepam (>15 mg) (Restoril)Avoid for treatment of insomnia, agitation, or deliriumTriazolam (>0.25 mg) (Halcion)Avoid for treatment of insomnia, agitation, or deliriumChlordiazepoxide (Librium)Avoid for treatment of insomnia, agitation, or deliriumChlordiazepoxide-arnitriptyline (Limbitrol)Avoid for treatment of insomnia, agitation, or deliriumClidinium-chlordiazepoxide (Librax)Avoid for treatment of insomnia, agitation, or deliriumDiazepam (Valium)Avoid for treatment of insomnia, agitation, or deliriumQuazepam (Doral)Avoid for treatment of insomnia, agitation, or deliriumDoxylamineAvoidChlorazepate (Tranxene)Avoid for treatment of insomnia, agitation, or deliriumDisopyramide (Norpace, Norpace CR)AvoidDigoxin ( >0.125 mg/d, except if treating atrial arrhythmia) (Lanoxin)AvoidShort-acting dipyridamole (Persantine)AvoidMethyldopa (Aldomet)AvoidScopolamineAvoidReserpine (>0.25 mg)AvoidChlorpropamide (Diabinese)AvoidDicyclomine (Bentyl)AvoidHyoscyamine (Levsin, Levsinex)Avoid except in short time palliative carePropantheline (Pro-Banthine)Avoid unless no other alternativesBelladonna alkaloids (Donnatal and others)Avoid except in short time palliative careClidinium-chlordiazepoxide (Librax)Avoid except in short time palliative careChlorpheniramine (Chlor-Trimeton)Avoid unless no other alternativesDiphenhydramine (Benadryl)Avoid unless no other alternativesHydroxyzine (Vistaril, Atarax)Avoid unless no other alternativesCyproheptadine (Periactin)Avoid unless no other alternativesPromethazine (Phenergan)Avoid unless no other alternativesPrazosinAvoidDexchlorpheniramine (Polaramine)AvoidDiphenhydramine (Benadryl)AvoidErgot mesyloids (Hydergine)AvoidTerazosinAvoidIbutilideAvoid as first-line treatment of atrial fibrillationAll barbituates (except phenobarbital) except to control seizuresAvoidMeperidine (Demerol)AvoidTiclopidine (Ticlid)AvoidKetorolac (Toradol)AvoidAmphetamines and anorexic agentsAvoidNaproxen (long-term use of full dosage) (Naprosyn, Avaprox, Aleve)Avoid chronic use unless alternatives are not effectiveOxaprozin (long-term use of full dosage) (Daypro)Avoid chronic use unless alternatives are not effectivePiroxicam (long-term use of full dosage) (Feldene)Avoid chronic use unless alternatives are not effectiveSotalolAvoid as first-line treatment of atrial fibrillationImipramineAvoidTrimipramineAvoidButalbitalAvoidAmiodarone (Cordarone)Avoid as first-line treatment of atrial fibrillationOrphenadrine (Norflex)AvoidMeprobamateAvoidZolpidemAvoidIsoxsuprineAvoidIsoxsurpine (Vasodilan)AvoidNitrofurantoin (Macrodantin)Avoid long-term useDoxazosin (Cardura)Avoid use as an antihypertensiveMethyltestosterone (Android, Virilon, Testrad)Avoid unless indicated for severe hypogonadismThioridazine (Mellaril)AvoidMesoridazine (Serentil)AvoidShort-acting nifedipine (Procardia, Adalat)AvoidClonidine (Catapres)AvoidMineral oilAvoidCimetidine (Tagamet)AvoidTestosteroneAvoid unless indicated for severe hypogonadismDesiccated thyroidAvoidAmphetamines (excluding methylphenidate hydrochloride and anorexics)AvoidEstrogens 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.

Reducing Your Risks for Problems with Drug Use
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:
  • Make a list of all your medicines. Update the list anytime your doctor prescribes a new medicine.
  • 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.

Talk to Your Doctor
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.




RESOURCES:
FirstGov.gov for Seniors

National Council on the Aging

United States Administration on Aging

CANADIAN RESOURCES:
Public Health Agency of Canada


References:
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 http://www.ebscohost.com/dynamed/what.php: 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



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