5 Potentially Dangerous Medications in People 65 and Older

By Frieda Wiley, Pharm D.

It’s no secret that our bodies change over time, but what you may not realize is that these changes can affect the way some drugs work in our bodies. In fact, by the time we hit 65, some drugs—whether prescription or over-the-counter (OTC) — may act differently in your body, but you might actually think the side effects are just signs of getting older.

Keep reading for five drugs that may be in your medicine cabinet to ask your doctor about if you’re 65 years of age or older. But first, please understand that these are just some general tips to help guide your discussion with your doctor and should not to be taken as medical advice. Because everyone’s different, what works for you might not work for someone else, and vice versa.

1. Benzodiazepines: Doctors prescribe these drugs for conditions like sleeplessness, depression, to calm your nerves, and even shaky hands.  However, the effects of certain benzodiazepines— like chlordiazepoxide (Librium) and diazepam (Valium) — take longer to wear off than others.  This means some of the drugs’ benefits might turn into side effects like confusion and fall risk before their effects wear off. Yet some people age 65 and older may take either of these drugs without any problems. If you’re one of these people, you might be okay, but it’s still doesn’t hurt to ask your doctor — just in case. However, if you’ve fallen within the last several months, you should definitely talk to your doctor about switching to a different benzodiazepine or a different drug class.

2. Antihistamines: It wasn’t too long ago that antihistamines were considered a major risk for increasing falls. While falling is perhaps one of the more dangerous side effects, antihistamines can also cause dry mouth, dry eyes, increase trouble urinating, and even confusion. Taking diphenhydramine (Benadryl) for a few days should generally be okay for that runny nose or high pollen counts if you don’t notice any of these issues. However, as with benzodiazepines, if you already have trouble balancing, have fallen in the past, or have fallen recently, you might want to ask your doctor or pharmacist about other drugs that may be safer for your condition.

3. Tricyclic Antidepressants (TCAs): Even though we now have many other drug choices for depression, doctors still use TCAs such as amitriptyline (Elavil) or nortriptyline (Pamelor) to treat depression and other conditions. Like antihistamines, they can cause a lot of the same potentially dangerous side effects including dry mouth, dizziness, and confusion in older persons. These drugs might also make certain conditions worse. For example, they may decrease the ability to function in people with dementia and make it more difficult for people with bladder problems to use the bathroom.

4. Nonsteroidal Anti-Inflammatory Drugs (NSAIDs): NSAIDs don’t cause problems for everyone, but they might damage your stomach if you already struggle with acid reflux or ulcers — both of which can be pretty common as we get older. If over-the-counter NSAIDs like naproxen (Aleve) and ibuprofen (Motrin or Advil) or the prescription strengths of these and similar drugs are giving you grief, you might ask your doctor for a different NSAID or other treatment options. You might also ask your pharmacist to help you choose a good over-the-counter pain-relieving cream or gel that you can apply to that achy knee, as there are many different options. Prescription NSAID gels containing diclofenac like Voltaren or Solaraze are also options if you have aches and pains in one or two specific areas. For example, Salonpas comes in many different dosage forms containing a variety of differnet active ingredients in varying concentrations. Ditto Bengay, and others. Finally, NSAIDs can worsen heart failure, uncontrolled high blood pressure, and kidney disease, so please ask your doctor about NSAIDs if you have any of these conditions.

5. Senna: Constipation often becomes problematic with age. Some laxatives are safe to use on a daily basis for long periods of time, while others are not. The stimulant laxative senna, found over-the-counter in brands — like Senna and Sennakot-S — is generally safe to use for occasional constipation, but it shouldn’t be your go-to drug for constipation. Although uncommon, taking senna for long periods of time or in high amounts could alter potassium levels in your body, cause shakiness, dizziness, and even heart palpitations. Doctors may have some of their older patients take senna every day and at high doses, but these people are often people in nursing homes and/or people who don’t move around very much who need the extra help. If you have ongoing constipation, ask your pharmacist or doctor about drugs that are safe to take more frequently.  Many people find fiber supplements that contain psyllium such as Metamucil or wheat dextrin such as Benefiber very helpful.

Lastly, remember that everyone is different. This means that some people 65 years of age and older may take some or any of these drugs and not have any problems. Also, some people under 65 may have some of these side effects despite their age.  Regardless, if you’ve noticed any of the changes above after taking some of these drugs, talk to your doctor. And above all, listen to your body. It never lies.

Frieda Wiley, PharmD, CGP, RPh, is a freelance pharmacist writer based in the Piney Woods of East Texas. She loves to share her passion for empowering people with the information they need to live fuller, healthier lives. Frieda began her career in health care working as a consultant pharmacist in the community and telehealth settings. She has written for consumers, health care professionals, and scientists, and you can find her work in a variety of print and online publications. When she’s not writing, she can be found playing the piano or walking barefoot in the woods. For more about Frieda, feel free to check out her website and visit her blog at: http://www.medvonmediaandconsulting.com/blog/.