At Any Age, It Does Matter:
Substance Abuse and Older Adults (for Professionals)

Supplements

Medications To Avoid in Older People, If Possible, When Certain Diagnoses Are Present

Condition
Generic
Brand Names*
Reason To Avoid
Heart failure Disopyramide Norpace, Norpace CR Weakens the pumping of the heart and may worsen heart failure.
  Drugs with high sodium content Various Causes fluid retention. May worsen heart failure.
Diabetes Beta blockers Inderal, Lopressor, Sectral, Tenormin, Toprol-XL, Visken May block hypoglycemic symptoms in diabetics being treated with insulin or oral hypoglycemic drugs.
  Corticosteroids Cortastat, Decadrol, Depopred, Dexamethasone Intensol, Hexadrol, Hydrocortone, Kenacort, Meprolone, Prednisone Intensol, Primethasone, Sterapred, Triamolone May worsen diabetic control.
Hypertension Diet pills; amphetamines Various, including Acutrim, Dexatrim, Dexedrine May elevate blood pressure.
Chronic obstructive pulmonary disease Beta blockers Inderal, Lopressor, Sectral, Tenormin, Toprol-XL, Visken May worsen respiratory function.
  Sedative-hypnotics Ambien, Ativan, Centrax, Dalmane, Doral, Doriden, Halcion, Klonopin, Librium, Noctec, Paxipam, ProSom, Restoril, Serax, Tranxene, Valium, Xanax, May slow respiration and increase carbon dioxide retention.
Asthma Beta blockers Inderal, Lopressor, Sectral, Tenormin, Toprol-XL, Visken May worsen respiratory function.
Ulcers Nonsteroidal anti-inflammatory drugs Advil, Aleve, Anaprox, Celebrex, Dolobid, Motrin, Nuprin, Tylenol May worsen ulcer disease, gastritis, and gastroesophageal reflux disease (GERD).
  Acetylsalicylic acid (ASA) in doses above 325 mg Anacin, Bayer, Bufferin, Lortab ASA May worsen ulcer disease, gastritis, and gastroesophageal reflux disease (GERD).
  Potassium supplements Cena-K, Effer-K, Gen-K, Glu-K, Kaon, Kato, Kay Ciel, Kaylixir, K-G Elixir, K-Lor, Klor-Con, K-Lyte, K-Norm, Kolyum, K-Sol, K-Tab, Micro-K, Potasalan, Slow-K, Tri-K, Twin-K May cause gastric irritation with symptoms similar to ulcer disease.
Seizures/epilepsy Clozapine
Chlorpromazine
Thioridazine
Chlorprothixene		 Clozaril
Thorazine
Mellaril
Taractan		 May make seizures more likely.
  Metoclopramide Metoclopramide Intensol, Octamide, Reglan
 May worsen blood flow through small arteries and precipitate claudication.
Peripheral vascular disease Beta blockers Inderal, Lopressor, Sectral, Tenormin, Toprol-XL, Visken May worsen blood flow through small arteries and precipitate claudication.
Blood clotting disorders (only for those on anticoagulant therapy) Acetylsalicylic acid (ASA) Anacin, Bayer, Bufferin, Lortab ASA May cause bleeding.
  Nonsteroidal anti-inflammatory drugs Advil, Aleve, Anaprox, Celebrex, Dolobid, Motrin, Nuprin, Tylenol May cause bleeding.
  Dipyridamole
Ticlopidine		 Dipridacot, Persantine
Ticlid		 May cause bleeding.
Benign prostatic hyperplasia Anticholinergic antihistamines Benadryl, Clistin, Tavist, Chlor-Trimeton, Dimetane Anticholinergic drugs may impair urination and cause obstruction.
  Gastrointestinal antispasmodics Bentyl, Donnatal, Levsin Anticholinergic drugs may impair urination and cause obstruction.
  Muscle relaxants Antiflex, Banflex, Cogentin, Flexeril, Flexoject, Myolin, Myotrol, Norflex, Orfro, Orphenate Anticholinergic drugs may impair urination and cause obstruction.
  Narcotics Codeine, Darvon, Demerol, Dilaudid, Dolophine, Lortab, Methadose, Orlaam, Percocet, Percodan, Vicodin May impair urination and cause obstruction.
  Flavoxate
Oxybutynin		 Urispas
Ditropan		 Bladder relaxants impair the ability to urinate in people with BPH.
  Bethanechol Duvoid, Urabeth, Urecholine
 Anticholinergic bladder relaxants impair the ability to urinate in people with BPH.
  Anticholinergic antidepressants Adapin, Elavil, Endep, Sinequan May impair the ability to urinate.
Incontinence Alpha blockers Cardura, Hytrin, Yovital Alpha blockers relax the external bladder sphincter and may cause incontinence.
Constipation Anticholinergics Antiflex, Atrovent, Banflex, Benadryl, Bentyl, Clistin, Cogentin, Dimetane, Donnatal, Duvoid, Flexeril, Flexoject, Levsin, Myolin, Myotrol, Norflex, Orfro, Orphenate, Tavist, Urabeth, Urecholine Will worsen constipation.
  Narcotics Codeine, Darvon, Demerol, Dilaudid, Dolophine, Lortab, Methadose, Orlaam, Percocet, Percodan, Vicodin Will worsen constipation.
  Tricyclic antidepressants Asendin, Aventyl, Elavil, Norpramin, Pamelor, Pertofrane, Sinequan, Tofranil, Wellbutrin May worsen constipation.
Fainting or falls Beta blockers Inderal, Lopressor, Sectral, Tenormin, Toprol-XL, Visken Slows the heart and weakens the pumping action of the heart. May precipitate syncope (fainting) in susceptible people.
  Long-acting benzodiazepines Dalmane, Doral May contribute to falls due to sedation, confusion, and other side effects.
Arrhythmias Tricyclic antidepressants Asendin, Aventyl, Elavil, Norpramin, Pamelor, Pertofrane, Sinequan, Tofranil, Wellbutrin May induce arrhythmias.
Insomnia Decongestants† Actifed, Dimetane, Dimetapp, Sudafed May cause or worsen insomnia.
  Theophylline Accurbron, Aerolate SR, Aquaphyllin, Asmalix, Bronkodyl, Chloledyl, Duraphyl, Elixophyllin, Labid, Lanophyllin, Lixolin, Respbid, Somophyllin, Sustaire, Theobid, Theolair, Theovent, Truxophyllin, Uniphyl May cause or worsen insomnia.
  Despiramine Norpramin May cause or worsen insomnia.
  Selective serotonin reuptake inhibitors Celexa, Paxil, Prozac, Zoloft May cause or worsen insomnia.
  Methylphenidate Ritalin May cause or worsen insomnia.
  Monoamine oxidase inhibitors Nardil, Parnate May cause or worsen insomnia.
  Beta agonists Alupent, Brethaire, Brethine, Bricanyl, Isuprel, Maxair, Medihaler-Iso, Metaprel, Norisodrine, Proventil, Serevent, Tornalate, Ventolin May cause or worsen insomnia.

*These are common brand names, but there may be others. Anyone with one of the conditions listed should discuss potential medication problems with a physician. In some cases, the type of drug, such as beta blocker, is the key information. The specific drug name is less important. For example, a patient with chronic obstructive pulmonary disease should alert the physician if he or she is taking beta blockers, even if the specific drug is not listed here.

†Some decongestants contain phenylpropanolamine (PPA), which is being pulled from the market. Products containing PPA have been linked to stroke in some people and could be dangerous for older adults.

<< Previous Page