Did you know that some medications can be harmful to people 65 years or older?

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1 Did you know that some medications can be harmful to people 65 years or older? What s the risk? Some medications can be dangerous to people 65 years of age or older. As we age, our bodies change. These changes can put us at a greater risk of experiencing serious, and sometimes even deadly, side effects. o Some of these side effects include confusion, weakness, sleepiness, impaired kidney and brain function, trouble with bladder control, and falling. Some medications also may not work as well in treating conditions for older adults. Many of these medications require prior approval or are not covered under your drug plan, causing you additional cost and effort. How do I know which medications can be harmful? The American Geriatrics Society has developed a list of medications that can be unsafe for people 65 years or older. This list is referred to as the Beers Criteria for Potentially Inappropriate Medication Use in Older Adults, or the Beers List. Some of the medications found on the Beers List are included in the table below. High Risk Medication Drug Class Safer, Formulary Alternatives Alora Hormones Dryness, itching, and burning of the vagina Amitriptyline mirtazapine, nortriptyline Nerve Pain or Pain: duloxetine, topical Benztropine Antiparkinson agents ropinirole, pramipexole, carbidopa/levodopa (+entacapone), selegiline Chlorzoxazone Skeletal Muscle Baclofen, tizanidine H0022_HRM16_Approved_

2 Climara Pro Hormones Dryness, itching, and burning of the vagina Clomipramine mirtazapine Nerve Pain or Pain: duloxetine, topical Cyclobenzaprine Skeletal Muscle Baclofen, tizanidine Cyproheptadine Antihistamines levocetirizine, azelastine nasal Diazepam Benzodiazepines Anxiety: buspirone, duloxetine Digoxin >0.125mg/day Cardiovascular agents Heart Failure: digoxin 0.125mg, lisinopril, enalapril, losartan, metoprolol XL Diphenhydramine-oral Antihistamines Allergies: levocetirizine, azelastine nasal Insomnia: trazodone, rozerem Nausea: meclizine, ondansetron oral tabs Dipyridamole Antithrombotics Low dose aspirin, clopidogrel Disopyramide Phosphate Antiarrhythmics Quinidine, Procainamide Doxepin >6mg/day mirtazapine Nerve pain or pain: duloxetine, topical Ergoloid mesylate Antidementias donepezil, galantamine, rivastigmine, Namenda Estradiol (oral tabs and topical patches) Hormones Dryness, itching, and burning of the vagina

3 Estropipate Hormones Dryness, itching, and burning of the vagina Glyburide, Glyburide Micronized, Glyburide/Metformin Oral Hypoglycemics glipizide (+metformin), glimepiride (+metformin) Guanfacine Antihypertensive lisinopril, losartan, felodipine ER, Hydroxyzine Oral tablets and solution Antihistamines Allergies: levocetirizine, azelastine nasal Anxiety: buspirone Nausea: meclizine, ondansetron oral tabs Indomethacin, ER Caps Analgesics acetaminophen, short acting non-steroidal Ketorolac tabs Analgesics acetaminophen, short acting non-steroidal Megestrol acetate suspension Hormones HIV/AIDS wasting syndrome only: Serostim (authorization required) Menest Hormones Dryness, itching, and burning of the vagina Meprobamate Antianxiety buspirone Methocarbamol Skeletal Muscle baclofen, tizanidine Methyldopa Antihypertensive lisinopril, losartan, felodipine ER, Nitrofurantoin Urinary Anti-infective Dependent on the infection: sulfamethoxazole/trimethoprim, ciprofloxacin, cephalexin Orphenadrine Skeletal Muscle baclofen, tizanidine Phenadoz Suppository 12.5 mg Antiemetics ondansetron, meclizine

4 Premarin, Premphase, Hormones Prempro Dryness, itching, and burning of the vagina Promethazine Antihistamines Nausea: meclizine, ondansetron oral tabs Allergies: levocetirizine, azelastine nasal Reserpine Antihypertensive lisinopril, losartan, felodipine ER, Talwin Analgesics acetaminophen, short acting non-steroidal Thioridazine Antipsyhotics, aripiprazole, olanzapine, quetiapine, conventional risperidone Ticlopidine Antithrombotics low dose aspirin, clopidogrel Trihexyphenidyl Antiparkinson agent ropinirole, pramipexole, carbidopa/levodopa (+entacapone), selegiline Trimethobenzamide Antiemetics ondansetron oral tabs Zaleplon Hypnotics trazodone, rozerem Zolpidem Hypnotics trazodone, rozerem Please note: This is not a complete list of all the medications that can be potentially harmful for people 65 years or older. Please talk to your doctor or pharmacist for more information about high risk medications. What should I do if I am taking one of the medications on this list? Please talk to your doctor. Your doctor can decide if the risk of your medication(s) outweigh(s) the benefits, and may prescribe a safer medication that works just as well. Safer options to potentially harmful medications are listed in the table above. o Remember, you should not stop taking any medication without speaking to your doctor first. What if I have questions about the safety of my medication(s)? If you have any questions about your medications or any of the high risk medications listed in the table above, please talk to your pharmacist. You can call Buckeye Health Plan - My Care Ohio Member Services. Member Services can be reached at or TTY 711. Member Service hours are

5 from 8 a.m. to 8 p.m., seven days a week. On weekends and federal holidays, you may be asked to leave a message. Your call will be returned within the next business day. Additional Resources For a flyer containing Frequently Asked Questions about the Beers List and information on how to speak with your doctor about high risk medications, visit: Also see: df Buckeye Health Plan - MyCare Ohio MMP is a health plan that contracts with both Medicare and Ohio Medicaid to provide benefits of both programs to enrollees. The List of Covered Drugs and/or pharmacy and provider networks may change throughout the year. We will send you a notice before we make a change that affects you. Benefits may change on January 1 of each year. Limitations and restrictions may apply. For more information, call Buckeye Member Services or read the Buckeye Member Handbook. You can get this information for free in other languages. Call from 8 a.m. to 8 p.m., seven days a week. TTY users call 711. On weekends and federal holidays, you may be asked to leave a message. Your call will be returned within the next business day. The call is free. Puede obtener esta información en otros idiomas gratis. Llame al de 8:00 a. m. a 8:00 p. m., los siete días de la semana. Los usuarios de TTY deben llamar al 711. Los fines de semana y los días feriados nacionales, es posible que se le pida que deje un mensaje. Le devolveremos la llamada durante el próximo día hábil. La llamada es gratuita.

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