Do You Know What's in Your Medicine Cabinet?

Do your medications increase your risk of falls? Listed in this Health Alert are 33 medications with side effects that are more dangerous to people over 65, like memory impairment, dizziness, drowsiness, and blurred vision. These medications should be avoided unless no other options exist.

A recent review by the Agency for Healthcare Research and Quality (AHRQ) found that older adults are still using many of the risky medications listed here. According to the AHRQ, 13% of adults over 65 used "always inappropriate" medications. This percentage was higher (25%) among older adults with disabilities.

Now researchers from the University of North Carolina (UNC) at Chapel Hill compiled a second list of dangerous medications. This new list includes medications that increase the risk of falls in people over 65 who take more than four medications.

Patients shouldn't avoid the medications on the UNC-Chapel Hill list, but if they're taking one of the UNC-Chapel Hill medications, they should talk to their doctors about reducing their risk of falling. To view the UNC–Chapel Hill list, go to:
uncnews.unc.edu/images/stories/news/ health/2008/drugslist.pdf

33 Medications To Avoid if You're Over 65

Always Inappropriate Medications

• Barbiturates (amobarbital, butabarbital, pentobarbital, phenobarbital, secobarbital)
• Flurazepam (Dalmane, Somnol, Novo-Flupam, Apo-Flurazepam)
• Meprobamate (Equanil, Meprospan 200, Meprospan 400, Probate, ApoMeprobamate)
• Chlorpropamide (Diabinese, Novo-Propamide, Apo-Chlorpropamide)
• Meperidine (Demerol) • Pentazocine (Talwin, Talwin Nx)
• Trimethobenzamide (Benzacot, Stemetic, Tebamide, Tigan, Tribenzagan, Trimazide)
• Dicyclomine (Bentyl, Bentylol, Spas- moban, Formulex)
• Hyoscyamine (Anaspaz, A-Spas-S/L, Cystospaz, Levbid, Levsin, Levsinex Timecaps, Symax SL)
• Propantheline (Pro-Banthine)
• Belladonna alkaloids/phenobarbital (Barbidonna, Donnatal)

Rarely Appropriate Medications

• Chlordiazepoxide (Librium)
• Diazepam (Valium)
• Propoxyphene (Darvon, Darvon-N)
• Carisoprodol (Soma)
• Chlorzoxazone (Remular-S, Paraflex, Parafon Forte DSC)
• Cyclobenzaprine (Flexeril)
• Metaxalone (Skelaxin)
• Methocarbamol (Robaxin)

Sometimes Appropriate Medications

• Amitriptyline (Elavil)
• Doxepin (Sinequan)
• Indomethacin (Indocin)
• Dipyridamole (Persantine)
• Ticlopidine (Ticlid)
• Methyldopa (Aldomet)
• Reserpine (Serpasil, Serpalan, Novoreserpine)
• Disopyramide (Norpace, Norpace CR)
• Oxybutynin (Ditropan, Ditropan XL)
• Chlorpheniramine (Aller-Chlor, Chlorate, ChloAmine, ChlorTrimeton)
• Cyproheptadine (Periactin)
• Diphenhydramine (Benadryl)
• Hydroxyzine (Atarax, Rezine, Vistaril)
• Promethazine (Phenergan)

Reported in the Journal of the American Medical Association, vol. 286, p. 2823