ALPRAZOLAM (use lowest effective dose)
AMIODARONE (may cause arrhythmias; questionable efficacy
in older adults)
AMITRIPTYLINE (anticholinergic effects and sedation)
AMPHETAMINES (may cause dependence, hypertension, angina,
MI, CNS stimulation)
ANOREXIC AGENTS (may cause dependence, hypertension,
angina, and MI)
BARBITURATES, except phenobarbital or for seizures (highly
addictive, cause more adverse effects in elderly than most other hypnotic/sedatives)
BELLADONNA ALKALOIDS (anticholinergic effects and
questionable effectiveness; avoid its use, esp. long-term)
BISACODYL (bowel dysfunction with long-term use; may be
appropriate with opiate analgesics)
CARISOPRODOL (poorly tolerated due to anticholinergic
effects and possibly less effective at tolerated doses)
CASCARA SAGRADA (bowel dysfunction with long-term use; may
be appropriate with opiate analgesics)
CHLORAZEPATE (prolonged sedation; short-acting
benzodiazepines are preferred)
CHLORDIAZEPOXIDE (prolonged sedation; short-acting
benzodiazepines are preferred)
CHLORDIAZEPOXIDE-AMITRIPTYLINE (anti-cholinergic effects
and prolonged sedation; short-acting benzodiazepines preferred)
CHLORPHENIRAMINE (causes anticholinergic effects;
non-anticholinergic antihistamines preferred for treating allergic reactions)
CHLORPROPAMIDE (may cause prolonged hypoglycemia and/or
SIADH)
CHLORZOXAZONE (poorly tolerated by elderly due to
anticholinergic effects and possibly less effective at tolerated doses)
Cimetidine (may cause confusion, other CNS adverse
effects)
CLIDINIUM-CHLORDIAZEPOXIDE (anticholinergic effects,
prolonged sedation; shortacting benzodiazepines preferred) clidinium is of questionable
effectiveness; avoid its use, esp. long-term)
Clonidine (may cause orthostatic hypotension, adverse CNS
effects)
Cyclandelate (uncertain efficacy at doses studied)
CYCLOBENZAPRINE (poorly tolerated by elderly due to
anticholinergic effects and possibly less effective at tolerated doses)
CYPROHEPTADINE (causes anticholinergic effects;
non-anticholinergic antihistamines preferred for treating allergic reactions)
DEXCHLORPHENIRAMINE (causes anticholinergic effects;
non-anticholinergic antihistamines preferred for treating allergic reactions)
DIAZEPAM (prolonged sedation; short-acting benzodiazepines
preferred)
DICYCLOMINE (causes anticholinergic effects and is of
questionable effectiveness; avoid its use, esp. long-term)
Digoxin (increased risk of toxic effects with decreased
renal function; use low doses except when treating atrial arrhythmias)
DIPHENHYDRAMINE (causes anticholinergic effects and
sedation; non-anticholinergic antihistamines preferred for treating allergic reactions; should
be used only at lowest effective dose if used for allergic reactions; should not be used as a
hypnotic)
Dipyridamole, short-acting (may cause ortho-static hypotension)
DISOPYRAMIDE (may cause heart failure and anticholinergic effects; avoid its use)
Doxazosin (hypotension, dry mouth, urinary problems)
DOXEPIN (anticholinergic effects and sedation)
Ergot mesyloids (uncertain efficacy at doses studied)
Estrogens only, oral forms (carcinogenicity and lack
of cardioprotective effect in older women)
Ethacrynic acid (may cause hypertension,
fluid/electrolyte imbalances; use safer alternatives)
Ferrous sulfate (doses over 325mg/day are not
reliably absorbed but may cause constipation)
FLUOXETINE, daily use forms (may cause excessive CNS
stimulation, agitation, sleep disturbances; use safer
alternatives)
FLURAZEPAM (prolonged sedation may result in
falls/fractures; medium or short-acting benzodiazepines
preferred)
GUANADREL (orthostatic hypotension)
GUANETHIDINE (orthostatic hypotension)
HALAZEPAM (prolonged sedation; shortacting
benzodiazepines preferred)
HYDROXYZINE (causes anticholinergic effects;
non-anticholinergic antihistamines preferred for treating allergic
reactions)
HYOSCYAMINE (causes anticholinergic effects and is
of questionable effectiveness; avoid its use, esp. long-term)
INDOMETHACIN (causes the most CNS side effects among
NSAIDs)
Isoxsurpine (uncertain efficacy)
KETOROLAC (avoid immediate and longterm use in
elderly, because they may have asymptomatic pathological GI
conditions)
LORAZEPAM (use lowest effective dose)
MEPERIDINE (may cause confusion; is of questionable
efficacy at commonly used oral doses)
MEPROBAMATE (very addicting and sedating; slow
withdrawal needed after prolonged use)
MESORIDAZINE (CNS and extrapyramidal adverse
effects)
METAXALONE (poorly tolerated by elderly due to
anticholinergic effects; possibly less effective at tolerated
doses)
METHOCARBAMOL (poorly tolerated by elderly due to
anticholinergic effects; possibly less effective at tolerated
doses)
METHYLDOPA and METHYLDOPA-HCTZ (may
cause bradycardia and worsen depression in elderly)
METHYLTESTOSTERONE (may cause prostatic hypertrophy,
cardiac problems)
MINERAL OIL (potential for aspiration and other
adverse effects; use safer alternatives)
NAPROXEN (avoid long-term, full-dose use due to
potential to cause GI bleed, renal failure, high BP, heart
failure)
NEOLOID (bowel dysfunction with long-term use; may
be appropriate with opiate analgesics)
NIFEDIPINE, short acting (may cause hypotension,
constipation)
NITROFURANTOIN (may cause renal impairment; use
safer alternatives)
ORPHENADRINE (sedation, anticholinergic effects; use
safer alternatives)
OXAPROZIN (avoid long-term, full-dose use due to
potential to cause GI bleed, renal failure, high BP, heart
failure)
OXAZEPAM (use lowest effective dose)
OXYBUTYNIN (poorly tolerated by elderly due to
anticholinergic effects; possibly less effective at tolerated doses;
do not consider extended-release form)
PENTAZOCINE (may cause more CNS adverse effects than
other narcotics)
PERPHENAZINE-AMITRIPTYLINE (anticholinergic effects,
sedation)
PIROXICAM (avoid long-term, full-dose use due to
potential to cause GI bleed, renal failure, high BP, heart
failure)
PROMETHAZINE (causes anticholinergic effects;
non-anticholinergic antihistamines preferred for treating allergic
reactions)
PROPANTHELINE (causes anticholinergic effects and is
of questionable effectiveness; avoid its use, esp. long-term)
Propoxyphene and combination products (risks may
outweigh benefits)
QUAZEPAM (prolonged sedation; short-acting
benzodiazepines preferred)
RESERPINE (may cause depression, impotence,
sedation, and orthostatic hypotension at doses over 0.25mg)
TEMAZEPAM (use lowest effective dose)
THIORIDAZINE (greater potential for CNS and
extrapyramidal adverse effects)
THYROID, DESSICATED (possible cardiac effects; use
safer alternatives)
TICLOPIDINE (aspirin, or other alternative drugs,
may be preferable due to efficacy and safety)
TRIAZOLAM (use lowest effective dose)
TRIMETHOBENZAMIDE (less effective, and may cause
extrapyramidal symptoms)
TRIPELENNAMINE (causes anticholinergic effects;
non-anticholinergic antihistamines preferred for treating allergic
reactions) |