28051 Health Library | Health and Wellness | Wellmont Health System
  • 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.

    RESOURCES

    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/

    CANADIAN RESOURCES

    Public Health Agency of Canada http://www.phac-aspc.gc.ca/

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

    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%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.

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