Drugs Not Recommended For Seniors - The Beers List
The aging body often reacts differently to prescription drug therapy. On the whole, most drugs are processed less efficiently by the older body, which means it takes the body longer to eliminate them. This can result in an unanticipated build-up of the drug. Our seniors also tend to take more medications than younger people. The chance of two or more drugs acting together to cause more problems increases with each drug added into the mix.
In 1991 a geriatric physician by the name of Mark Beers published a list of medications that were most likely to cause serious side effects when used by elderly patients. This list of drugs that are potentially inappropriate for seniors, now known as the "Beers List" or the "Beers Criteria" has since been updated twice, most recently in 2003.
Psychotropics, some antidepressant drugs, and muscle relaxants make up a substantial portion of the list because they tend either to be less effective in the older body, or there are safer alternatives available. However, even such innocuous-sounding things as mineral oil are also listed.
The medical journal "Archives of Internal Medicine," where the original study and follow-up information has been published, offers a list of the classes of medications which they believe should be avoided by all older adults.
There are also some medications that the Beers researchers recommend should be avoided particularly by persons with certain health conditions. The "Archives of Internal Medicine" offers a list of these drugs by category.
When a drug is included on the Beers Criteria list, it does not mean that your senior should never, ever be taking this drug. It means that there have been problems identified, and there may be better choices for someone over the age of 65. There are certainly times when a listed drug may be the best choice for a patient because of factors that are not considered by the Beers Criteria. You, your elder, and your senior's doctor should make this decision together.
Carry a copy of the Beers Criteria with you when you and your senior visit the doctor. Before you leave the office with a prescription, check it against the criteria list. If you see the prescription listed, just ask (nicely) about the drug, the potential for side effects, and whether there might be a drug with fewer risks. Some doctors do get huffy when you ask. Blame it on us if yours seems miffed, but stick to your guns about wanting an answer before you full the prescription.
Below, in alphabetical order, is a list of the drugs presently on the Beers Criteria list, with links - where available - to more information from the National Institutes of Health:
| Adalat |
Ismelin |
| Aldomet |
isoxsuprine (Vasodilan) |
| Aldoril |
ketorolac (Toradol) |
| Aleve |
Lanoxin |
| alprazolam (Xanax) |
Levsin, Levsinex |
| amiodarone (Cordarone) |
Librax |
| amitriptyline (Elavil) |
Librium |
| amphetamines |
Limbitrol |
| Android |
lorazepam (Ativan) |
| anorexic agents |
Mellaril |
| Atarax |
meperidine (Demerol) |
| Ativan |
meprobamate (Miltown, Equanil) |
| Avaprox |
mesoridazine (Serintil) |
| barbiturates |
metaxalone (Skelaxin) |
| belladonna alkaloids (Donnatal) |
methocarbamol (Robaxin) |
| Benadryl |
methyldopa (Aldomet) |
| Bentyl |
methyldopa-hydrochlorothiazide (Aldoril) |
| bisacodyl (Dulcolax) |
methyltestosterone (Android, Virilon, Testrad) |
| Cardura |
Microdantin |
| carisoprodol (Soma) |
Miltown |
| cascara sagrada |
mineral oil |
| Catapres |
Mitran |
| chlordiazepoxide (Librium, Mitran) |
Naprosyn |
| chlordiazepoxide-amitriptyline (Limbitrol) |
naproxen (Naprosyn, Avaprox, Aleve) |
| chlorpheniramine (Chlor-Trimeton) |
Neoloid |
| chlorpropamide (Diabinese) |
nifedipine (Procardia, Adalat) |
| chlorzoxazone (Paraflex) |
nitrofurantoin (Microdantin) |
| Chlor-Trimeton |
Norflex |
| cimetidine (Tagamet) |
Norpace, Norpace CR |
| clidinium-chlordiazepoxide (Librax) |
orphenadrine (Norflex) |
| clonidine (Catapres) |
oxaprozin (Daypro) |
| clorazepate (Tranxene) |
oxazepam (Serax) |
| Cordarone |
oxybutynin (Ditropan) |
| cyclandelate (Cyclospasmol) |
Paraflex |
| cyclobenzaprine (Flexeril) |
Paxipam |
| Cyclospasmol |
pentazocine (Talwin) |
| cyproheptadine (Periactin) |
Periactin |
| Dalmane |
perphenazine-amitriptyline (Triavil) |
| Darvon |
Persantine |
| Daypro |
Phenergan |
| Demerol |
piroxicam (Feldene) |
| dessicated thyroid |
Polaramine |
| dexchlorpheniramine (Polaramine) |
Pro-Banthine |
| Diabinese |
Procardia |
| diazepam (Valium) |
promethazine (Phenergan) |
| dicyclomine (Bentyl) |
propantheline (Pro-Banthine) |
| digoxin (Lanoxin) |
propoxyphene (Darvon) |
| diphenhydramine (Benadryl) |
Prozac |
| dipyridamole (Persantine) |
quazepam (Doral) |
| disopyramide (Norpace, Norpace CR) |
reserpine (Serpalan, Serpasil) |
| Ditropan |
Restoril |
| Donnatal |
Robaxin |
| Doral |
Serax |
| doxazosin (Cardura) |
Serintil |
| doxepin (Sinequan) |
Serpalan |
| Dulcolax |
Serpasil |
| Edecrin |
Sinequan |
| Elavil |
Skelaxin |
| Equanil |
Soma |
| ergot mesyloids (Hydergine) |
Tagamet |
| estrogens |
Talwin |
| ethacrynic acid (Edecrin) |
temazepam (Restoril) |
| Feldene |
Testrad |
| ferrous sulfate (iron) |
thioridazine (Mellaril) |
| Flexeril |
Ticlid |
| fluoxetine (Prozac) |
ticlopidine (Ticlid) |
| flurazepam (Dalmane) |
Tigan |
| guanadrel (Hylorel) |
Toradol |
| guanethidine (Ismelin) |
Tranxene |
| halazepam (Paxipam) |
|
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