June 01, 2021

Potentially inappropriate medications for older adults

Regularly taking multiple medications can be complicated and costly. But there are also certain drugs that — even when taken alone — may potentially do more harm than good in older adults.

As people age, their bodies are affected by and metabolize drugs differently, in part due to age-related changes in the liver and kidneys. This can result in bothersome side effects, such as constipation, or an increase in your risk of serious harm, such as with confusion or falling. The American Geriatrics Society publishes a list of potentially inappropriate medications (PIMs) for older adults known as the Beers Criteria.

A recent study in the Journal of the American Geriatrics Society estimated that 34% of adults age 65 and older received a prescription for one or more PIMs. Older adults prescribed PIMs were more likely to be hospitalized and visit the emergency room. They also had higher overall health care costs.

PIMs include products containing the antihistamines chlorpheniramine and diphenhydramine, antidepressants such as paroxetine (Paxil), benzodiazepines such as lorazepam (Ativan) and diazepam (Valium), long-acting sulfonylureas used to treat diabetes such as glimepiride (Amaryl), and oral or patch-applied estrogen. Proton pump inhibitors such as omeprazole (Prilosec) and esomeprazole (Nexium) when taken long term also make the list. Learn more at www.healthinaging.org/ medications-older-adults.

Mayo Clinic experts recommend discussing any PIMs you take with your doctor — don't quit a prescribed drug on your own. The risk of taking a PIM is sometimes outweighed by the benefit, such as if other available medications are not an option for you....