Medications to avoid in the elderly
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1 Medicationstoavoidintheelderly Description Medicationstoavoid 1 (nonformularyin2016) Adversesideeffects/concerns Formularyalternatives 2,3 Alphaagonists, central Analgesics Androgen Anti anxiety guanabenz guanfacine indomethacin ketorolac methyltestosterone aspirin meprobamate meprobamate Highriskofcentralnervous system methyldopa (CNS)effects;maycause bradycardia reserpine andorthostatichypotension;not (dosesgreaterthan 0.1 recommendedfor routinetreatment mg/day) ofhypertension Potentialforgastrointestinal bleeding,renalfailure,highblood pressureandheartfailure Prostatichypertrophyandcardiac concerns Addictiveandsedatinganxiolytic lisinopril*,enalapril*,losartan**, felodipine***, nifedipinelong acting (nifedipineer)***, amlodipine*,atenolol* acetaminophen(notincombination product),trisalicylate(trilisate),topicals (capsaicin) danazol*** Anxiety:buspirone**,duloxetine***, escitalopram**,fluvoxamine**,sertraline*, venlafaxine* Insomnia:Seethenonbenzodiazepine hypnoticsectionforinsomniaalternatives. *=Tier1;**=Tier2;***=Tier3;+=Tier4; =OTCmedication, =genericistier1for Note:Tierinformationisbasedonformularies:[16342(PuertoRico) 16364(6 Tierclosed[MedicareAdvantagePrescriptionDrugprogram]. $=Selectiveserotoninreuptakeinhibitorscanbeconsideredaclinicalalternativeforpatientsolderthan65yearsoldonahigh riskmedication(hrm),butshouldnotbe consideredanalternativeorusedinpatientswithahistoryoffallsordementia. GHHH1R5HH ALL1115 1
2 Description Medicationstoavoid 1 Adversesideeffects/concerns Formularyalternatives 2,3 Depression:Selectiveserotoninreuptake inhibitors(ssris) $ escitalopram**, amitriptyline fluvoxamine**,sertraline*;serotoninand clomipramine Antidepressants, Highlyanticholinergiceffects;may norepinephrinereuptakeinhibitors(snris) doxepin(dosesgreaterthan6mg/day) tricyclic causeorthostatichypotension duloxetine***,venlafaxine* imipramine Insomnia:Seethenonbenzodiazepine trimipramine hypnoticsectionforinsomniaalternatives. Neuropathicpain:gabapentin* Anti emetics trimethobenzamide Extrapyramidaladverseeffects ondansetron***,prochlorperazine* Antihistamines (includessingle entityoraspart ofacombination product) brompheniramine diphenhydramine carbinoxamine(oral) chlorpheniramine doxylamine clemastine hydroxyzine cyproheptadine hydrochloride dexbrompheniramine hydroxyzinepamoate dexchlorpheniramine promethazine triprolidine Highlyanticholinergiceffects, sedation,weakness,bloodpressure changes,drymouth,urinary retention;clearancereducedin advancedage(tolerancedevelops whenusedas hypnotic.) Pruritus/urticaria:fexofenadine, levocetirizine**,loratadine, cetirizine syrup** Nausea/vomiting:ondansetron*** Allergicrhinitis:fexofenadine, levocetirizine**,loratadine, cetirizine syrup **,azelastine***, fluticasone** Insomnia:Seethenonbenzodiazepine hypnoticsectionforinsomniaalternatives. Over the counteroption:melatonin,if appropriate;regardedassafeinrecommended doses(upto15mgdaily)foruptotwoyears *=Tier1;**=Tier2;***=Tier3;+=Tier4; =OTCmedication, =genericistier1for Note:Tierinformationisbasedonformularies:[16342(PuertoRico) 16364(6 Tierclosed[MedicareAdvantagePrescriptionDrugprogram]. $=Selectiveserotoninreuptakeinhibitorscanbeconsideredaclinicalalternativeforpatientsolderthan65yearsoldonahigh riskmedication(hrm),butshouldnotbe consideredanalternativeorusedinpatientswithahistoryoffallsordementia. GHHH1R5HH ALL1115 2
3 Description Medicationstoavoid 1 Adversesideeffects/concerns Formularyalternatives 2,3 Anti infectives (whencumulative days supply greaterthan 90days) nitrofurantoin nitrofurantoinmacrocrystals Potentialforpulmonarytoxicity, hepatotoxicityandperipheral neuropathy;nitrofurantoincauses renal impairment;avoidinpersons witha CrCllessthan60mL/mindue toinadequate drugconcentrationin theurine Dependentontheinfection: sulfamethoxazole/trimethoprim*, ciprofloxacin*,cephalexin* Anti Parkinson agents Antipsychotics benzatropine(oral) trihexyphenidyl thioridazine Notrecommendedforprevention ofextrapyramidalsymptomswith antipsychotics Highlyanticholinergic;Central nervoussystemand extrapyramidal effects;greater riskofqtinterval prolongation; associatedwith tremors,slurred speech, bradykinesia,dystonia, muscle rigidityandakathisia ropinirole(requip)**,amantadine +, pramipexole(mirapex)** olanzapine(zyprexa)***,quetiapine (Seroquel)**, risperidone(risperdal)** Note:Allantipsychoticshavebeenassociated withincreasedmortalitywhenusedtotreat psychosisrelatedtodementia. Anti thrombotics dipyridamole,oralshort actingonly ticlopidine Dipyridamolemaycauseorthostatic hypotension;moreeffective alternativesareavailable low doseaspirin,clopidogrel**, cilostazol** *=Tier1;**=Tier2;***=Tier3;+=Tier4; =OTCmedication, =genericistier1for Note:Tierinformationisbasedonformularies:[16342(PuertoRico) 16364(6 Tierclosed[MedicareAdvantagePrescriptionDrugprogram]. $=Selectiveserotoninreuptakeinhibitorscanbeconsideredaclinicalalternativeforpatientsolderthan65yearsoldonahigh riskmedication(hrm),butshouldnotbe consideredanalternativeorusedinpatientswithahistoryoffallsordementia. GHHH1R5HH ALL1115 3
4 Description Medicationstoavoid 1 Adversesideeffects/concerns Formularyalternatives 2,3 Barbiturates amobarbital pentobarbital butabarbital phenobarbital butalbital secobarbital mephobarbital Highrateofphysicaldependence; Anxiety:SSRIs $ (escitalopram**, patientsdeveloptolerance,which fluvoxamine**,sertraline*);snris reducessleepbenefits;riskof overdoseatlowdosagedueto (duloxetine***, venlafaxine*);buspirone** toleranceandpatientchoiceto overmedicatetoachieve therapeuticeffect Insomnia:Seenonbenzodiazepinehypnotic sectionforinsomniaalternatives. Belladonna alkaloids(includes single entityoras partofa combination product) Calciumchannel blockers atropine/hyoscyamine/phenobarbital/ scopolamine belladonna/phenobarbital butabarbital/hyoscyamine/phenazopyridine nifedipine short actingonly Anticholinergiceffects Potentialforhypotension;riskof causingmyocardialischemia Constipation:psyllium,polyethyleneglycal, stoolsoftener,lubiprostone(amitiza)*** Diarrhea:loperamide**,aluminumhydroxide Uselong actingformulationtoavoidadverse effects:felodipine***,nifedipinelong acting (nifedipineer)*** *=Tier1;**=Tier2;***=Tier3;+=Tier4; =OTCmedication, =genericistier1for Note:Tierinformationisbasedonformularies:[16342(PuertoRico) 16364(6 Tierclosed[MedicareAdvantagePrescriptionDrugprogram]. $=Selectiveserotoninreuptakeinhibitorscanbeconsideredaclinicalalternativeforpatientsolderthan65yearsoldonahigh riskmedication(hrm),butshouldnotbe consideredanalternativeorusedinpatientswithahistoryoffallsordementia. GHHH1R5HH ALL1115 4
5 Description Medicationstoavoid 1 Adversesideeffects/concerns Formularyalternatives 2,3 Cardiovascular Endocrine digoxin(dosesgreaterthan0.125mg/day) disopyramide megestrol Heartfailure:Angiotensin converting enzyme inhibitors(acei)(lisinopril,quinapril, enalapril)* Digoxin:inheartfailure,higher doses orangiotensinreceptorblockers (ARB) haveincreasedriskoftoxicity; (losartan)*and/orabetablocker(metoprolol decreasedrenalclearance succinatexl**,bisoprolol**, carvedilol*) Disopyramide:potentnegative inotrope insteadofdigoxin,aldosterone antagonist thatmayinduceheart failureinolder (spironolactone**)anddigoxin0.125 mg. adults;anticholinergiceffects OptimizeACEI/ARB,betablockerand/or aldosteroneantagonistpriortodigoxinuse. Digoxindoesn tdecreasemorbidity/mortality. Increasesriskofthromboticevent and possiblydeathinolderadults Considernutritionalsupportandtreatment of potentialcause(e.g.,depression,certain medications);considerdronabinol***for anorexia associatedwithweightlossinpatients withaidsorfornauseaandvomitingin chemotherapypatientswhofailedtorespond adequatelytoconventionaltreatments. *=Tier1;**=Tier2;***=Tier3;+=Tier4; =OTCmedication, =genericistier1for Note:Tierinformationisbasedonformularies:[16342(PuertoRico) 16364(6 Tierclosed[MedicareAdvantagePrescriptionDrugprogram]. $=Selectiveserotoninreuptakeinhibitorscanbeconsideredaclinicalalternativeforpatientsolderthan65yearsoldonahigh riskmedication(hrm),butshouldnotbe consideredanalternativeorusedinpatientswithahistoryoffallsordementia. GHHH1R5HH ALL1115 5
6 Description Medicationstoavoid 1 Adversesideeffects/concerns Formularyalternatives 2,3 Narcotics acetaminophen pentazocine belladonna opium meperidine meperidine promethazine naloxone pentazocine pentazocine Meperidine:Maynotbeeffective at commonlyprescribeddoses; sideeffects includeconfusion, falls,fractures, dependencyand withdrawal Pentazocine:Producescentralnervous systemadverse effects,including confusionandhallucinationsandisa mixedagonist andantagonist;safer alternativesareavailable hydrocodone*,morphine***,oxycodone***, fentanyl transdermalpatch +,acetaminophen (notin combinationproduct),tramadol** *=Tier1;**=Tier2;***=Tier3;+=Tier4; =OTCmedication, =genericistier1for Note:Tierinformationisbasedonformularies:[16342(PuertoRico) 16364(6 Tierclosed[MedicareAdvantagePrescriptionDrugprogram]. $=Selectiveserotoninreuptakeinhibitorscanbeconsideredaclinicalalternativeforpatientsolderthan65yearsoldonahigh riskmedication(hrm),butshouldnotbe consideredanalternativeorusedinpatientswithahistoryoffallsordementia. GHHH1R5HH ALL1115 6
7 Nonbarbiturate or nonbenzodiazepine hypnotic (whencumulative days supplyis greaterthan90 days) chloralhydrate Lunesta(eszopiclone) Sonata(zaleplon) Ambien(zolpidem) Chloralhydrate:Tolerancedevelops within10days;risksoutweigh benefits: delirium,overdose(narrow therapeutic window) Allothers:Benzodiazepine receptor agonistshaveadverseeventssimilar to thoseofbenzodiazepinesinolder adults (e.g.,delirium,falls,fractures); they produceminimalimprovement insleep latencyandduration 1 Consideronlyshort termorintermittentuse (lessthan90daysperyear). Discusssleephygieneandavoidanceof caffeine,alcohol,nicotineandmedications thatcauseinsomnia. Evaluatefordepression,acommoncause ofinsomniaintheelderly.secondary insomniacanbetreatedwithtrazodone* 50 mg(maycauseorthostatichypotension), ordoxepin**(lessthan6mgperday). + Over the counteroption:melatonin, if appropriate;regardedassafein recommendeddoses(upto15mgdaily)for uptotwoyears. Description Medicationstoavoid 1 Adversesideeffects/concerns Formularyalternatives 2,3 Oralestrogens andestradiol transdermalpatch conjugatedestrogen esterifiedestrogen conjugatedestrogen methyltestosterone medroxyprogesterone estropipate drospirenone estradiol estradiol esterifiedestrogen estradiol norethindrone levonorgestrel Cardio protectivepropertiesare absent;highcarcinogeniceffects (breastcancerand endometrial cancer) Hotflashes:nondrugcomforttherapy SSRIs $ :citalopram*,escitalopram**, fluvoxamine**, sertraline*;snris: venlafaxine* Vaginaldryness:Premarinvaginal cream*** Bonedensity:calcium,vitaminD, alendronate**,raloxifene*** *=Tier1;**=Tier2;***=Tier3;+=Tier4; =OTCmedication, =genericistier1for Note:Tierinformationisbasedonformularies:[16342(PuertoRico) 16364(6 Tierclosed[MedicareAdvantagePrescriptionDrugprogram]. $=Selectiveserotoninreuptakeinhibitorscanbeconsideredaclinicalalternativeforpatientsolderthan65yearsoldonahigh riskmedication(hrm),butshouldnotbe consideredanalternativeorusedinpatientswithahistoryoffallsordementia. GHHH1R5HH ALL1115 7
8 Oral hypoglycemics chlorpropamide glyburide Prolongedhalf lifecausing prolonged hypoglycemia;also causessyndrome ofinappropriate anti diuretic hormonesecretion(siadh) glimepiride*,glipizide* Skeletalmuscle relaxants ASA/caffeine/ cyclobenzaprine orphenadrine metaxalone ASA/carisoprodol/ methocarbamolcodeine orphenadrine aspirin carisoprodol carisoprodolchlorzoxazone Anticholinergiceffects,sedation, weaknessandincreasedriskof fractures Poorlytolerated;effectivenessat dosestoleratedbyolderadultsis questionable baclofen**,tizanidine** Nonpharmacologictreatmentformuscle spasms:heat,massage,stretching/exercise Thyroid thyroiddesiccated Cardiacconcerns levothyroxine* Description Medicationstoavoid 1 Adversesideeffects/concerns Formularyalternatives 2,3 Vasodilators dipyridamole short actingonly ergotmesyloid isoxsuprine Orthostatichypotension Strokeprevention:low doseaspirin, clopidogrel** Alzheimer sdisease/dementia:galantamine +, rivastigmine +,donepezil**. References: 1. TheAmericanGeriatricsSociety2012BeersCriteriaUpdateExpertPanel.AmericanGeriatricsSocietyUpdatedBeersCriteriaforPotentiallyInappropriateMedicationUsein *=Tier1;**=Tier2;***=Tier3;+=Tier4; =OTCmedication, =genericistier1for Note:Tierinformationisbasedonformularies:[16342(PuertoRico) 16364(6 Tierclosed[MedicareAdvantagePrescriptionDrugprogram]. $=Selectiveserotoninreuptakeinhibitorscanbeconsideredaclinicalalternativeforpatientsolderthan65yearsoldonahigh riskmedication(hrm),butshouldnotbe consideredanalternativeorusedinpatientswithahistoryoffallsordementia. GHHH1R5HH ALL1115 8
9 OlderAdult. 2. Source:PLDetail Document,PotentiallyHarmfulDrugsintheElderly:BeersList.Pharmacist sletter/prescriber sletter.june STARTingandSTOPPingMedicationsintheElderly.Pharmacist sletter/prescriber sletter.(2011): TheAmericanGeriatricsSociety2015BeersCriteriaUpdateExpertPanel(2015).AmericanGeriatricsSociety2015UpdatedBeersCriteriaforPotentiallyInappropriate MedicationUseinOlderAdults.JournaloftheAmericanGeriatricsSociety.DOI: /jgs AccessedOct.23,2015. *=Tier1;**=Tier2;***=Tier3;+=Tier4; =OTCmedication, =genericistier1for Note:Tierinformationisbasedonformularies:[16342(PuertoRico) 16364(6 Tierclosed[MedicareAdvantagePrescriptionDrugprogram]. $=Selectiveserotoninreuptakeinhibitorscanbeconsideredaclinicalalternativeforpatientsolderthan65yearsoldonahigh riskmedication(hrm),butshouldnotbe consideredanalternativeorusedinpatientswithahistoryoffallsordementia. GHHH1R5HH ALL1115 9
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