Are You Taking Drugs You Don't Need?

IMAGE 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 Name Recommendation
Indomethacin (Indocin, Indocin SR) Avoid
Pentazocine (Talwin) Avoid
Trimethobenzamide (Tigan) Avoid
Methocarbamol (Robaxin) Avoid
Carisoprodol (Soma) Avoid
Chlorzoxazone (Paraflex) Avoid
Metaxalone (Skelaxin) Avoid
Cyclobenzaprine (Flexeril) Avoid
Oxybutynin (Ditropan) Avoid unless there are no other alternatives
Brompheniramine Avoid
Amitriptyline (Elavil) Avoid
Chlordiazepoxide-amitriptyline (Limbitrol) Avoid
Perphenazine-amitriptyline (Triavil) Avoid
Doxepin (Sinequan) Avoid
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
Doxylamine Avoid
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
Methyldopa (Aldomet) Avoid
Scopolamine Avoid
Reserpine (>0.25 mg) Avoid
Chlorpropamide (Diabinese) Avoid
Dicyclomine (Bentyl) 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
Prazosin Avoid
Dexchlorpheniramine (Polaramine) Avoid
Diphenhydramine (Benadryl) Avoid
Ergot mesyloids (Hydergine) Avoid
Terazosin Avoid
Ibutilide Avoid as first-line treatment of atrial fibrillation
All barbituates (except phenobarbital) except to control seizures Avoid
Meperidine (Demerol) Avoid
Ticlopidine (Ticlid) Avoid
Ketorolac (Toradol) 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
Imipramine Avoid
Trimipramine Avoid
Butalbital Avoid
Amiodarone (Cordarone) Avoid as first-line treatment of atrial fibrillation
Orphenadrine (Norflex) Avoid
Meprobamate Avoid
Zolpidem Avoid
Isoxsuprine Avoid
Isoxsurpine (Vasodilan) Avoid
Nitrofurantoin (Macrodantin) Avoid long-term use
Doxazosin (Cardura) Avoid use as an antihypertensive
Methyltestosterone (Android, Virilon, Testrad) Avoid unless indicated for severe hypogonadism
Thioridazine (Mellaril) Avoid
Mesoridazine (Serentil) Avoid
Short-acting nifedipine (Procardia, Adalat) Avoid
Clonidine (Catapres) Avoid
Mineral oil Avoid
Cimetidine (Tagamet) Avoid
Testosterone Avoid unless indicated for severe hypogonadism
Desiccated thyroid Avoid
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.

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.

  • FirstGov.gov for Seniors

    http://www.seniors.gov/

  • National Council on the Aging

    http://www.ncoa.org/

  • United States Administration on Aging

    http://www.aoa.gov/

  • Public Health Agency of Canada

    http://www.phac-aspc.gc.ca/

  • Seniors

    Health Canada

    http://www.hc-sc.gc.ca/hl-vs/seniors-aines/index-eng.php/

  • 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%5FJAGS.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.