General Warnings

Are There Drugs Seniors Should Not Take?

The number of medications elderly people take can vary depending on their health status and medical conditions. According to a study published in the Journal of the American Medical Association, about 40% of people aged 65 and older take five or more prescription medications, and 18% take ten or more medications. This is known as polypharmacy and is a concern because it increases the risk of adverse drug interactions and side effects.

Older adults may be more susceptible to medication-related problems due to age-related changes in their body’s metabolism, increased sensitivity to medications, and the presence of multiple chronic medical conditions. Furthermore, taking multiple medications can be challenging for older adults, who may experience difficulties with medication management and adherence.

Therefore, it is important for healthcare providers to carefully evaluate the medication regimen of older adults to minimize the risks associated with polypharmacy. This may include reviewing the necessity of each medication, identifying potential drug interactions, and optimizing dosages and administration schedules. Additionally, medication management strategies, such as medication reminders and pill organizers, can help older adults adhere to their medication regimen and avoid medication-related problems.

Are There Drugs Seniors Should Not Take?

The benefit-to-risk ratio is usually considered by doctors and healthcare providers when prescribing medications for seniors. This may involve assessing the potential benefits of a medication against the risks, considering alternative treatment options, and adjusting the dosage or frequency of medication as needed.

It’s important for seniors to work closely with their healthcare providers to manage their medications and make informed decisions about their treatment options. This may involve discussing the potential benefits and risks of different medications, reporting any adverse reactions or side effects, and following the prescribed dosage and instructions for use.

Generally, it is always recommended that seniors consult with their doctors before taking any medications or supplements, especially if they have pre-existing health conditions or take other medications. That being said, some drugs that are commonly considered potentially risky for seniors include:

1.      Benzodiazepines: These are a class of drugs used to treat anxiety, insomnia, and other conditions. While these drugs can be effective for some patients, they can also pose risks, particularly for older adults.

One reason why benzodiazepines are risky for the elderly is that they can cause excessive sedation and impaired coordination, leading to an increased risk of falls and other accidents. Older adults are already at a higher risk of falls due to age-related changes in balance and mobility, so the sedative effects of benzodiazepines can exacerbate this risk.

Additionally, benzodiazepines can interact with other medications commonly used by older adults, such as opioids and certain antidepressants, which can further increase the risk of sedation, respiratory depression, and other adverse effects.

Furthermore, as people age, their bodies may process medications more slowly, leading to an increased risk of accumulation and toxicity. This means that the same dose of benzodiazepines that might be safe for a younger person could potentially cause adverse effects in an older adult.

Finally, benzodiazepines can also affect cognitive function, which can be particularly problematic for older adults who may already be experiencing age-related cognitive decline. Some examples of benzodiazepines include alprazolam (Xanax), diazepam (Valium), lorazepam (Ativan), clonazepam (Klonopin), temazepam (Restoril), midazolam (Versed), flurazepam (Dalmane), oxazepam (Serax), and chlordiazepoxide (Librium).

2.      Non-steroidal anti-inflammatory drugs (NSAIDs): NSAIDs like ibuprofen and naproxen are commonly used to treat pain and inflammation. However, in older adults, NSAIDs can increase the risk of side effects such as gastrointestinal bleeding, ulcers, and kidney damage.

The risk of these side effects increases with age, especially in those with a history of ulcers or gastrointestinal bleeding. In addition, certain types of NSAIDs, such as ibuprofen and naproxen, can interact with other medications commonly used by the elderly, such as blood thinners and diuretics, leading to an increased risk of side effects. Therefore, it is essential for healthcare providers to review all medications taken by the elderly to identify potential drug interactions and to adjust dosages as necessary to avoid adverse effects. Some examples of NSAIDs include aspirin, ibuprofen, naproxen, and diclofenac.

3.      Anticholinergic drugs: These are a class of drugs used to treat a variety of conditions, including allergies, Parkinson’s disease, and urinary incontinence. However, Anticholinergic drugs can have a cumulative effect on the elderly due to changes in their body’s ability to metabolize and eliminate these medications. Additionally, many older adults are taking multiple medications for various medical conditions, increasing the risk of drug interactions and adverse effects.

Several studies have linked anticholinergic drug use in older adults with a higher risk of cognitive decline, dementia, and even death. Examples of anticholinergic drugs include diphenhydramine (Benadryl), used to treat allergies and as a sleep aid; atropine, used to dilate pupils and treat certain heart conditions; scopolamine, used to treat motion sickness and nausea; oxybutynin and tolterodine, used to treat overactive bladder and urinary incontinence; and trihexyphenidyl, used to treat Parkinson’s disease. While these drugs can be effective for treating certain conditions, they can also have negative effects on older adults, including cognitive impairment, increased risk of falls, constipation, urinary retention, and delirium.

4.      Opioids: Opioids are a class of drugs that are commonly used to manage pain. While they can be effective in treating acute pain, they can have negative effects on the elderly population. Here are some of the negative effects of opioids on the elderly. Opioids can cause dizziness, confusion, and sedation, which can increase the risk of falls, especially in elderly patients who are already at risk due to age-related changes in balance and mobility.

Opioids can also depress the respiratory system, leading to slowed breathing, shallow breathing, or even stopped breathing. This can be particularly dangerous in elderly patients who may already have compromised lung function due to other health conditions.

In addition, opioids can slow down bowel movements and lead to constipation. This can be particularly problematic in elderly patients who may already have bowel issues or take medications that affect bowel function. Some common examples of opioids include morphine, oxycodone, hydrocodone, codeine, and fentanyl.

Finally, opioids can cause confusion, dizziness, and other cognitive impairments that can impact an elderly patient’s ability to perform daily tasks or make decisions.

How To Safely Use Medications As a Senior

As a senior, it’s important to use medications safely to avoid adverse reactions or interactions with other drugs. Here are some tips to help you use medications safely:

1.      Keep a record of all your medications: Make a list of all the medications you take, including over-the-counter drugs, supplements, and herbal remedies. Include the name of the medication, the dose, and the frequency.

2.      Stick to your prescribed dosage: Follow your doctor’s instructions for how much medication to take and how often. Do not change the dosage without consulting your doctor.

3.      Ask questions: If you have any questions about your medications, ask your doctor or pharmacist. They can provide you with information about potential side effects, drug interactions, and the best time to take your medication.

4.      Use one pharmacy: Fill all your prescriptions at the same pharmacy to avoid confusion or potential drug interactions.

5.      Be aware of potential side effects: Read the label carefully and be aware of potential side effects. If you experience any adverse reactions, contact your doctor or pharmacist.

6.      Store medications safely: Keep your medications in a cool, dry place out of reach of children and pets. Do not store medications in the bathroom or in direct sunlight.

7.      Don’t share medications: Do not share your medications with others or take someone else’s medication. Only take medications prescribed by your doctor.

8.      Check for interactions: Be aware of potential drug interactions. Let your doctor know if you are taking any other medications or supplements.

9.      Be cautious with alcohol: Avoid drinking alcohol while taking medications, as it can increase the risk of adverse reactions.

10.    Take medications as directed: Take your medications at the same time every day and follow the instructions on the label. If you miss a dose, do not double up on your medication. Contact your doctor or pharmacist for guidance.


Dr. Oche Otorkpa PG Cert, MPH, PhD

Dr. Oche is a seasoned Public Health specialist who holds a post graduate certificate in Pharmacology and Therapeutics, an MPH, and a PhD both from Texila American University. He is a member of the International Society of Substance Use Professionals and a Fellow of the Royal Society for Public Health in the UK. He authored two books: "The Unseen Terrorist," published by AuthorHouse UK, and "The Night Before I Killed Addiction."
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