Allergy: Levocetirizine (Xyzal) (F) Desloratadine (Clarinex) (NF) OTC Cetirizine (Zyrtec) (NF) OTC Loratadine (Claritin) (NF) Dexchlorpheniramine
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1 Anticholinergics Brompheniramine Carbinoxamine Chlorpheniramine Clemastine Cyproheptadine Highly anticholinergic, clearance reduced with advanced age, and tolerance develops when used as hypnotic; greater risk of confusion, dry mouth, constipation, and other anticholinergic effects and toxicity. Note: Use of diphenhydramine in special situations such as acute treatment of severe Allergy: Levocetirizine (Xyzal) (F) Desloratadine (Clarinex) (NF) OTC Cetirizine (Zyrtec) (NF) OTC Loratadine (Claritin) (NF) Dexchlorpheniramine allergic reaction may be appropriate. Diphenhydramine OTC Fexofenadine (Allegra)(NF) (oral only) Cough: Doxylamine OTC Guaifenesin (NF) Hydroxyzine OTC Dextromethorphan (NF) Promethazine Triprolidine Nausea/Vomiting: Ondansetron (Zofran, ODT) (PA) Granisetron (Kytril) (PA) Antiparkinson Agents Benztropine (oral only) (Cogentin) Trihexyphenidyl (Artane) Not recommended for prevention of extrapyramidal symptoms with antipsychotics; more effective agents available for treatment of Parkinson s disease. Extrapyramidal symptoms (EPS): Amantadine (Symmetrel) (F) Parkinson s: Ropinirole (Requip; XL) (IR F) Pramipexole (Mirapex; ER) (IR F) Carbidopa/Levodopa (Sinemet; CR) (F) Bromocriptine (Parlodel) (F) Selegiline (Eldepryl) (F) Rasagiline (Azilect) (F) Anti-thrombotics Dipyridamole (oral short acting) Note: Does not apply to the extendedrelease combination with aspirin May cause orthostatic hypotension; more effective alternatives available. Aspirin/Dipyridamole (Aggrenox) (F) Ticlopidine Safer effective alternatives available. Clopidogrel (Plavix) (F) Prasugrel (Effient) (F) Ticagrelor (Brilinta) (F) 1
2 Anti-infective Nitrofurantoin Note: If cumulative day supply is > 90 days. Potential for pulmonary toxicity; safer alternatives available; lack of efficacy in patients with CrCl <60 ml/min due to inadequate drug concentration in the urine. Acute infections in CrCl < 60 ml/min: TMP-SMX (F) (Trimethoprim/Sulfamethoxazole) dose by 1/2 in CrCl 15 30; avoid in CrCl < 15 Fluroquinolone (e.g., ciprofloxacin) For prophylaxis: Trimethoprim (F) TMP-SMX (F) Methenamine hippurate (F) Cardiovascular Digoxin (for doses > mg/day only) Disopyramide (Norpace; CR) In heart failure, higher dosages associated with no additional benefit and may increase risk of toxicity; slow renal clearance may lead to risk of toxic effects. Disopyramide is a potent negative inotrope and therefore may induce heart failure in older adults; strongly anticholinergic; other antiarrhythmic drugs preferred. Digoxin 0.125mg/day (F) Beta-blockers Calcium channel blockers Flecainide (Tambocor) (F) Guanfacine Methlydopa Reserpine (for doses > 0.1 mg/day only) High risk of adverse CNS effects; may cause bradycardia and orthostatic hypotension; not recommended as routine treatment for hypertension. Hypertension: Thiazides ACEIs ARBs Beta-blockers Calcium channel blockers Combinations Nifedipine (Procardia) (immediate release only) Potential for hypotension; risk of precipitating myocardial ischemia. Hypertension: Nifedipine ER ACEIs ARBs Beta-blockers Calcium channel blockers 2
3 Central Nervous System Amitriptyline Clomipramine Imipramine Trimipramine Highly anticholinergic, sedating, and cause orthostatic hypotension Depression: SSRIs SNRIs (venlafaxine) Bupropion (Wellbutrin) (F) Desipramine (Norpramin) (F) Mirtazapine (Remeron) (F) Nortriptyline (Pamelor) (F) Trazodone (F) Doxepin (doses > 6mg/day only) Highly anticholinergic, sedating, and cause orthostatic hypotension; safety profile of low-dose doxepin (< 6mg/day) is comparable with that of placebo. Neuropathic pain associated with diabetes neuropathy: Duloxetine (Cymbalta) (F) Pregabalin (Lyrica) (F) Gabapentin (Neurontin) (F) Venlafaxine ER (Effexor XR) (F) Migraine prophylaxis: Propranolol (F) Topiramate (Topamax) (F) Divalproex sodium (Depakote; ER; Sprinkles) (F) Thioridazine Highly anticholinergic and risk of QT interval prolongation. Aripiprazole (Abilify) (F) Lurasidone (Latuda) (F) Haloperidol (Haldol) (F) Quetiapine (Seroquel) (F) Risperidone (Risperdal) (F) Ziprasidone (Geodon) (F) Asenapine (Saphris) (F) Paliperidone (Invega) (F) Iloperidone (Fanapt) (ST) 3
4 Central Nervous System (continued) Amobarbital Butabarbital Butalbital Pentobarbital Secobarbital High rate of physical dependence; tolerance to sleep benefits; risk of overdose at low dosages. Phenobarbital Chloral hydrate High rate of physical dependence; tolerance to sleep benefits; risk of overdose at low dosages. Tolerance occurs within 10 days, and risks outweigh benefits in light of overdose with doses only 3 times the recommended dose. Seizure: Levetiracetam (F) Ethosuximide (F) Gabapentin (F) Divalproex sodium (F) Valproic acid (F) Lamotrigine (F) Topiramate(F) Felbamate (F) Carbamazepine(F) Phenytoin(F) Oxcarbazepine(F) Meprobamate High rate of physical dependence; very sedating. Anxiety: SSRIs SNRIs Buspirone (F) Eszopiclone Zolpidem ZaleplonNote: If cumulative day supply is > 90 days. Ergoloid mesylates Isoxsuprine Benzodiazepine-receptor agonists that have adverse events similar to those of benzodiazepines in older adults (e.g., delirium, falls, fractures); minimal improvement in sleep latency and duration. Lack of efficacy. Alzheimers/Dementia: Donepezil (Aricept; ODT) (F) Memantine (Namenda; XR) (PA) Rivastigmine (Exelon) (F) 4
5 Endocrine Desiccated thyroid Concerns about cardiac effects; safer alternatives available. Levothyroxine (F) Estrogens with or without progesterone Note: Oral and topical patch/transdermal products only. Evidence of carcinogenic potential (breast and endometrium); lack of cardioprotective effect and cognitive protection in older women. Hot flashes: SSRIs Venlafaxine ER (F) Desvenlafaxine (Pristiq) (F) Bone density: Bisphosphonates (alendronate) (F) Raloxifene (Evista) (F) Megesterol Chlorpropamide Minimal effect on weight; increases risk of thrombotic events and possibly death in older adults. Prolonged half-life in older adults; can cause prolonged hypoglycemia; causes syndrome of inappropriate antidiuretic hormone section. Vaginal symptoms: Estrace vaginal cream (F) OTC lubricants (NF) Dronabinol (Marinol) (PA ) Oxandrolone (Oxandrin) (PA) Glipizide (Glucotrol; XL) (F) Glimepiride (Amaryl) (F) Glyburide Greater risk of severe prolonged hypoglycemia in older adults. Glipizide (Glucotrol; XL) (F) Glimepiride (Amaryl) (F) Gastrointestinal Trimethobenzamide One of the least effective antiemetic drugs; can cause extrapyramidal adverse effects. Ondansetron (Zofran; ODT) (PA) Granisetron (Kytril) (PA) Pain Meperidine Pentazocine Not an effective oral analgesic in dosages commonly used; may cause neurotoxicity; safer alternatives available. Opioid analgesic that causes CNS adverse effects, including confusion and hallucinations, more commonly than other narcotic drugs; is also a mixed agonist and antagonist; safer alternatives available. Mild to moderate pain: NSAIDs (short-term) Topical NSAID: Voltaren Gel (F) Moderate to moderately severe pain: Hydrocodone/APAP (F) Oxycodone/APAP (F) Morphine sulfate ER (F) 5
6 Pain (continued) Indomethacin Ketorolac Note: Oral and injectable formulations. Increases risk of GI bleeding and peptic ulcer disease in high risk groups, including those aged >75 or taking oral or parenteral corticosteroids, anticoagulants or antiplatelet agents. Of all the NSAIDs, indomethacin has most adverse effects. Mild to moderate pain: Celecoxib (F) NSAIDs (short-term) Topical NSAID: Voltaren Gel (F) Gout: Colchicine (Colcrys) (F) Skeletal Muscle Relaxants Carisoprodol Chlorzoxazone Cyclobenzabrine Metaxalone Methocarbamol Orphenadrine Most muscle relaxants are poorly tolerated by older adults because of anticholinergic adverse effects, sedation, risk of fracture; effectiveness at dosages tolerated by older adults is questionable. Spasticity: Tizanidine tablets (F) Baclofen (F) This table is for use as a guide only. (F)= Formulary; (NF)= Non-formulary; (PA)= Formulary with Prior Authorization *Use generics when available. For full and up-to-date formulary coverage details, please visit Source: The American Geriatrics Society 2012 Beers Criteria Update Expert Panel (2012), American Geriatrics Society Updated Beers Criteria for Potentially Inappropriate Medication Use in Older Adults. Journal of the American Geriatrics Society, 60: doi: /j x 6
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