Medicines: The Good and the Bad

An expert panel convened by the Federal Agency for Healthcare Research and Quality recently identified 33 drugs, including the common ones listed below, that seniors should always, almost always, or usually avoid except in a hospital; for all those drugs, there are safer, often more effective alternatives. Those drugs can cause side effects, listed below, that are particular problems in seniors. If you are age 65 or older and take any of the drugs that seniors should avoid, call your doctor as soon as possible. If you take one of the other drugs, ask your doctor whether it is truly appropriate for you.

Following is the chart made by the expert panel.

DRUG CHIEF RISKS COMMENTS
ALWAYS AVOID
Anti-Anxiety Drug:
Meprobamate (Equanil, Meprospan, Probate, Trancot 		Confusion
Dizziness 		Risks always outweigh benefits
Antispasmodics:
Dicyclomine (Bentyl, Di-Spaz) Hyoscyamine (Anaspaz, Gastrosed, Levbid) 		Same as above Same as above
Pain Reliever:
Pentazocine (Talwin, Talwin-Nx 		Same as above Same as above
Sedatives:
Butabarbital (Butalan, Butisol Flurazepam (Dalmane) Pentobarbital (Nembutal) Secobarbital (Seconal) 		Same as above Same as above
ALMOST ALWAYS AVOID
Anti-Anxiety Drugs:
Chlordiazepoxide (Librium) Diazepam (Valium) 		Confusion, Falls Sedation May be used briefly to treat alcohol withdrawal, or, with diazepam, possibly muscle spasms.
Muscle Relaxants:
Carisoprodol (Soma, Vanadom) Cyclobenzaprine (Flexeril) Methocarbamol (Carbacot, Robaxin 		Constipation, sedation, urine retention May possibly be used briefly to treat acute back pain in otherwise healthy senior citizens.
Pain Reliever:
Propoxyphene (Cotanal-65, Darvon) 		Addiction
Sedation 		Not suitable to treat new pain can by used by those who've already taken it without problems.
USUALLY AVOID
Antiarrhythmia:
Disopyramide (Persantine) 		Constipation
Sedation
Urine Retention 		Suitable only when alternatives have failed.
Anticlotting Drug:
Dipyridamole (Persantine) 		Very low blood pressure, low white-blood-cell count. Dipyridamole sometimes suitable for people with artificial heart valves.
Antidepressants:
Amitriptyline (Elavil, Endep) Doxepin (Sinequan) 		Constipation
Sedation
Urine Retention 		Low doses of amitryptyline suitable for neuropathic pain and occasionally for urinary incontinence. Doxepin possibly suitable for agitated depression in otherwise healthy senior citizens.
Antihistamines:
Chlorpheniramine (Chlor-Trimeton Diphenhydramine (Benadryl Allergy, Sominex) Hydroxyzine (Atarax, Vistaril) Promethazine (Pentazine, Promet) 		Same as above. Suitable for allergic reaction but not sedation.
Antispasmodic:
Oxybutynin (Ditropan) 		Same as above. Possibly suitable for stress incontinence but not for stomach spasms.
Pain Reliever:
Indomethacin (Indocin, Indocin SR) 		Confusion
Dizziness
Fluid Retention 		Possibly suitable for gout, but there are better alternatives.


Source:  Consumer Reports on Health

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