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. |