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Prescriber Checkup

Prescriber Checkup » Risky Drugs

Risky Drugs for Elderly Adults

Under Medicare, thousands of health providers are giving seniors prescriptions for drugs the American Geriatrics Society says should
be avoided.

Drug Prescriptions in 2010* Providers who wrote them Risks for older adults AGS recommendation
Treats Type 2 diabetes
2,619,631 13,964 Can cause dangerously low blood sugar and other side effects. Safer medications are available. Avoid
Antidepressant
1,937,522 7,628 Increases the chance of dizziness, fainting and falling and may cause a slowed heartbeat. Avoid
Estrogen replacement
1,642,327 6,504 May increase risks of breast cancer and cancer of the uterine lining. It does not appear to protect women from heart disease or loss of cognitive (thinking) ability in later life. Avoid pills and skin patches. Vaginal creams can be used at low doses to relieve some symptoms.
Muscle relaxant
1,565,131 5,641 Most muscle relaxants have questionable effectiveness and can cause side effects such as sleepiness and increased risks of bone fractures. Avoid
Treats Type 2 diabetes
1,081,362 4,878 Contains Glyburide, which can cause dangerously low blood sugar and other side effects. Safer medications are available. Avoid
Antihistamine
782,648 2,326 May cause many side effects, including confusion, drowsiness, blurred vision, difficulty urinating, dry mouth and worsened constipation. Safer medications are available. Avoid unless no alternatives are available.
Antihistamine
776,383 2,976 May cause many side effects, including confusion, drowsiness, blurred vision, difficulty urinating, dry mouth and constipation. May also worsen symptoms of Parkinson's disease. Safer medications are available. Avoid
Estrogen replacement
619,320 1,559 May increase risks of breast cancer and cancer of the uterine lining. It does not appear to protect women from heart disease or loss of cognitive (thinking) ability in later life. Avoid pills and skin patches. Vaginal creams can be used at low doses to relieve some symptoms.
Increases appetite
609,039 2,440 Not very effective and may increase the chance of blood clots and, possibly, death. Avoid
Muscle relaxant
502,221 1,745 Most muscle relaxants have questionable effectiveness and can cause side effects such as sleepiness and increased risk of bone fractures. Avoid
Muscle relaxant
332,327 1,059 Most muscle relaxants have questionable effectiveness and can cause side effects such as sleepiness and increased risk of bone fractures. Avoid
Parkinson's disease
318,905 1,083 Other medications are usually more effective for ParkinsonÕs disease and related disorders. The drugs should not be used for other conditions, such as side effects from other medications (for example, the movement side effects of antipsychotic drugs). Avoid
Pain and inflammation
289,066 1,473 This drug is an non-steroidal anti-inflammatory, which increases the chance of stomach and intestinal bleeding and ulcers or other harmful effects. Avoid
Prevents blood clots from forming
199,644 577 The short-acting form of this drug may cause a drop in blood pressure upon standing. It also can cause dizziness and lead to falls. More effective alternatives are available. The injected form of dipyridamole, however, can be used during a heart stress test. Avoid unless injected for a stress test.
Antihistamine
185,000 463 May cause many side effects, including confusion, drowsiness, blurred vision, difficulty urinating, dry mouth and worsened constipation. Safer medications are available. Avoid unless no alternatives are available.
Antidepressant
161,078 315 Potential side effects include: confusion, drowsiness, blurred vision, difficulty urinating, dry mouth and constipation. They can also cause a drop in blood pressure upon standing. Safer medications are available. Avoid
Treats Type 2 diabetes
160,236 452 May cause dangerously low blood sugar and other side effects. Safer medications are available. Avoid
Treats pain and inflammation
155,792 146 This drug is an non-steroidal anti-inflammatory, which increases the chance of stomach and intestinal bleeding and ulcers or other harmful effects. Avoid
Estrogen replacement
147,053 142 May increase risks of breast cancer and cancer of the uterine lining. It does not appear to protect women from heart disease or loss of cognitive (thinking) ability in later life. Avoid pills and skin patches. Vaginal creams can be used at low doses to relieve pain during sex, and help prevent urinary tract infections, and related vaginal problems.
Relieves symptoms of allergic reactions and constipation
134,212 383 May cause many side effects, including confusion, drowsiness, blurred vision, difficulty urinating, dry mouth and worsened constipation. Safer medications are available. Avoid unless no alternatives are available.

Notes: * Includes refills. Prescriptions totals include dispensed refills for providers who wrote more than 10 prescriptions for a listed drug in 2010. Provider counts only include those who wrote 50 or more prescriptions to patients 65 and older.

Source: ProPublica, from Medicare Part D data; American Geriatric Society, from Beers list of potentially inappropriate medications for seniors.