Medications Seniors Should Use With Caution
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Why Age Makes a Difference
It's no secret that when you get older, your body doesn't work the way it used to. And that's true for how you react to medicine. Your digestive system might not absorb medications as quickly. Liver problems might mean the drug builds up in the bloodstream or doesn't get into it as fast as it should. And kidney trouble could affect how well medicine moves out of your body as waste. Ask your doctor about the impact of your meds as you age.
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Over-the-Counter Painkillers
Non-steroidal anti-inflammatory drugs (NSAIDs), like ibuprofen, aspirin, and naproxen, can keep some prescription medications you take from working the way they should. They're often not a good combo with blood thinners, diabetes drugs, diuretics, or blood pressure drugs. NSAIDs are also rough on major organs when your body gets older, such as your kidneys, liver, heart, and the digestive system.
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Muscle Relaxants
Your doctor may suggest these drugs to ease muscle spasms. Muscle relaxants like cyclobenzaprine (Flexeril), methocarbamol (Robaxin), and carisoprodol (Soma) can have side effects like feeling woozy and confused. That could raise your chances of falling and hurting yourself.
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Certain Diabetes Drugs
Long-acting sulfonylurea drugs for diabetes, such as chlorpropamide (Diabinese) and glyburide (DiaBeta, Glynase), can cause low blood sugar, a condition called "hypoglycemia." You might get confused, shaky, sweaty, hungry, and tired. If the condition is severe or long-lasting, it can cause seizures and, in rare cases, could be life-threatening.
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Antihistamines
If you have hay fever, your doctor may suggest over-the-counter drugs called antihistamines. They can keep you from sneezing, but some come with more side effects than others. Some antihistamines may leave older adults extra drowsy and confused, which raises your chances of a taking a tumble.
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Certain Sleep Aids
Drugs that help you go to sleep can cause problems when you wake up. You might feel groggy and have trouble with balance when you get out of bed in the morning. Your ability to think clearly might be affected. Diphenhydramine, the main ingredient in many sleeping pills, can also lead to dry mouth, blurred vision, and bladder problems.
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Anxiety Medication
Benzodiazepines are drugs that treat anxiety. They include diazepam (Valium), alprazolam (Xanax), and chlordiazepoxide (Librium). Some of these medications stick around in your system a lot longer than others. Their side effects, like confusion, can last past the day you take them and raise your chances of falling.
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Anticholinergics
Your doctor may prescribe these drugs to help treat conditions like Parkinson's disease, irritable bowel syndrome, and depression. But anticholinergics can cause confusion, dry mouth, and blurry vision, especially in older adults. In older men, they are more likely to cause problems with peeing. In addition, common medications with anticholinergic properties include antihistamines, tricyclic antidepressants, cimetidine, muscle relaxants, and some cold medications.
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Tricyclic Antidepressants
They're an older class of drugs that doctors don't prescribe often. But if you take tricyclics, such as amitriptyline and imipramine, keep in mind they have side effects that can be worse in older adults. These include problems like constipation, irregular heartbeat, blurry vision, confusion, memory trouble, and dry mouth. Men could have problems with peeing.
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Antipsychotics
These drugs treat mental disorders, such as schizophrenia and bipolar disorder, and are risky for some older adults. Taking antipsychotics raises your chances of a life-threatening heart problem or a brain bleed if you have dementia.
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Cimetidine (Tagamet)
It's an over-the-counter treatment for heartburn, indigestion, and ulcers. If you're an older adult and take this medicine, it can have side effects like confusion, even at regular doses.
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Combination Drugs
Look carefully at the labels of over-the-counter medicines to see if they have more than one active ingredient. Some cold and sinus medications, for example, have decongestants along with antihistamines. The combination can make you confused, drowsy, and groggy. It can also raise your blood pressure and cause problems going to the bathroom.
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Laxatives
A lot of older folks take medications to help ease constipation. But it isn't wise to take some medicine, like bisacodyl (Dulcolax), as long-term, regular treatment. Over time, laxatives can cause permanent problems with your bowels.
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SOURCES:
Medscape: "Older Adults and NSAIDS: Avoiding Adverse Reactions," "Prevalence of Meperidine Use in Older Surgical Patients."
HealthinAging.org: "Ten Medications Older Adults Should Avoid Or Use With Caution."
UpToDate: "Treatment of type 2 diabetes mellitus in the older patient."
Mayo Clinic: "Hypoglycemia."
Cleveland Clinic: "Top Prescription Drugs Older Adults Should Avoid."
Harvard Health: "5 medications that can cause problems in older age."
FDA: "As You Age: You and Your Medicines."
Consumer Reports: "Muscle Relaxants: What You Should Know."
American Diabetes Association: "Hypoglycemia (Low Blood sugar)."
American Geriatrics Society: "2019 Updated AGS Beers Criteria for Potentially Inappropriate Medication Use in Older Adults."