The average older adult takes 4-5 prescription drugs and two over-the-counter drugs, and fills 12-17 prescriptions a year. 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 an adverse drug reaction.
When compared to younger people, seniors are more sensitive to drug interactions and side effects. And older people are especially susceptible to becoming confused, dizzy, or falling and breaking a hip.
Previous studies have found unnecessary drugs common in nursing homes, hospitals, doctors’ offices, and the home. Although medical providers have tried to address this issue, misuse of drugs remains a major problem for seniors.
In a study published in the
Journal of the American Medical Association, researchers analyzed a national sample of people age 65 years or older living at home. They found that 21.3%—nearly seven million community-dwelling seniors in the US—received 1 of 33 potentially inappropriate medications in 1996. Following are details from the study:
| Category of Drug Use | Percent of Seniors |
|---|
| Taking at least one drug that should never be used | 2.6 |
| Taking at least one drug that should rarely be used | 9.1 |
| Taking at least one drug that has some indications, but that is often misused | 13.3 |
| Total taking any type of potentially inappropriate drug | 21.3 |
In a 2003 publication of
Archives of Internal Medicine, researchers identified drugs that should be avoided by persons age 65 years and older.
Note:
For your own health and safety, however, do not stop taking any medication unless you have consulted with your doctor and have his or her approval.
| Drug Name | Severity Rating |
|---|
| Propoxyphene (Darvon, Darvon w/ASA, Darvon-N, Darvon-N) | Low |
| Indomethacin (Indocin, Indocin SR) | High |
| Pentazocine (Talwin) | High |
| Trimethobenzamide
(Tigan) | High |
| Methocarbamol (Robaxin) | High |
| Carisoprodol (Soma) | High |
| Chlorzoxazone (Paraflex) | High |
| Metaxalone (Skelaxin) | High |
| Cyclobenzaprine (Flexeril) | High |
| Oxybutynin (Ditropan) | High |
| Rurazepam (Dalmane) | High |
| Amitriptyline (Elavil) | High |
| Chlordiazepoxide-amitriptyline (Limbitrol) | High |
| Perphenazine-amitriptyline (Triavil) | High |
| Doxepin (Sinequan) | High |
| Meprobarnate (Miltown, Equanil) | High |
| Lorazepam (>3 mg) (Ativan) | High |
| Oxazepam (>60 mg) (Serax) | High |
| Alprazolam (> 2 mg) (Xanax) | High |
| Ternazepam (>15 mg) (Restoril) | High |
| Triazolam (>0.25 mg) (Halcion) | High |
| Chlordiazepoxide (Librium) | High |
| Chlordiazepoxide-arnitriptyline (Limbitrol) | High |
| Clidinium-chlordiazepoxide (Librax) | High |
| Diazepam (Valium) | High |
| Quazepam (Doral) | High |
| Halazepam (Paxipam) | High |
| Chlorazepate (Tranxene) | High |
| Disopyramide (Norpace, Norpace CR) | High |
| Digoxin ( >0.125 mg/d, except if treating atrial arrythmias) (Lanoxin) | Low |
| Short-acting dipyridamole (Persantine) | Low |
| Methyldopa (Aldomet) | High |
| Methyldopa-hydrochlorothiazide (Aldoril) | High |
| Reserpine (>0.25 mg) | Low |
| Chlorpropamide (Diabinese) | High |
| Dicyclomine (Bentyl) | High |
| Hyoscyamine (Levsin, Levsinex) | High |
| Propantheline (Pro-Banthine) | High |
| Belladonna alkaloids (Donnatal and others) | High |
| Clidinium-chlordiazepoxide (Librax) | High |
| Chlorpheniramine (Chlor-Trimeton) | High |
| Diphenhydramine (Benadryl) | High |
| Hydroxyzine (Vistaril, Atarax) | High |
| Cyproheptadine (Periactin) | High |
| Promethazine (Phenergan) | High |
| Tripelennamine | High |
| Dexchlorpheniramine (Polaramine) | High |
| Diphenhydramine (Benadryl) | High |
| Ergot mesyloids (Hydergine) | Low |
| Cyclandelate (Cyclospasmol) | Low |
| Ferrous sulfate (>325 mg/d) | Low |
| All barbituates (except phenobarbital) except to control seizures | High |
| Meperidine (Demerol) | High |
| Ticlopidine (Ticlid) | High |
| Ketorolac (Toradol) | High |
| Amphetamines and anorexic agents | High |
| Naproxen (long-term use of full dosage) (Naprosyn, Avaprox, Aleve) | High |
| Oxaprozin (long-term use of full dosage) (Daypro) | High |
| Piroxicam (long-term use of full dosage) (Feldene) | High |
| Daily fluoxetine (Prozac) | High |
| Bisacodyl (long-term use) (Dulcolax) | High |
| Casacara sagrada (long-term use) | High |
| Neoloid except in presence of opiate analgesic use (long-term use) | High |
| Amiodarone (Cordarone) | High |
| Orphenadrine (Norflex) | High |
| Guanethidine (Ismelin) | High |
| Guanadrel (Hylorel) | High |
| Cyclandelate (Cyclospasmol) | Low |
| Isoxsurpine (Vasodilan) | Low |
| Nitrofurantoin (Macrodantin) | High |
| Doxazosin (Cardura) | Low |
| Methyltestosterone (Android, Virilon, Testrad) | High |
| Thioridazine (Mellaril) | High |
| Mesoridazine (Serentil) | High |
| Short-acting nifedipine (Procardia, Adalat) | High |
| Clonidine (Catapres) | Low |
| Mineral oil | High |
| Cimetidine (Tagamet) | Low |
| Ethacrynic acid (Edecrin) | Low |
| Desiccated thyroid | High |
| Amphetamines (excluding methylphenidate hydrochloride and anorexics) | High |
| Estrogens only (oral) | Low |
When you’re on a lot of medicine, how can you tell if you’re 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 if any of the following risk factors apply to you:
- Taking multiple drugs, especially if filling over 14 prescriptions a year
- Using over-the-counter drugs and supplements
- Visiting a number of different doctors
- Having trouble understanding instructions
- Saving medications for later use
- Borrowing or sharing medication
- Being age 65 years or older
- Being female
- Having poor health status
The best way to fine-tune your medications 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’re taking, including prescription and over-the-counter drugs and supplements. A study in the
Journal of the American Geriatric Society
found that three out of four older adults take medications that their doctors don't know about.
Thoroughly review your medications 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 inquiring until you understand the dose, frequency, and purpose of the medicines you’re taking. Finally, don’t be afraid to ask about nondrug options that can help you minimize your use of medications.
