Are You Taking Drugs You Don’t Need?

Are You Taking Drugs You Don't Need?
by Elizabeth Smoots, MD

In your medicine cabinet you may have a mix of prescription drugs and over-the-counter drugs to treat various conditions. Some of these medications are truly necessary, as people tend to have more health problems with age. But the more medicines you take, the greater your risk of suffering adverse reactions from the drugs.
When compared to younger people, seniors are more sensitive to drug interactions and side effects. Older people are especially susceptible to becoming confused, dizzy, or falling and breaking a hip. Previous studies have found unnecessary drugs common in nursing homes, hospitals, doctors' offices, and the home. Although medical providers have tried to address this issue, misuse of drugs remains a major problem for seniors.
List of Inappropriate Drugs
In the journal, Archives of Internal Medicine, researchers identified drugs that may be inappropriate for persons aged 65 years and older.
This is not a complete list, though. There may be other medications that can be harmful to you. Talk to your doctor.

Drug Name	Severity Rating
Indomethacin (Indocin, Indocin SR)	High
Pentazocine (Talwin)	High
Trimethobenzamide (Tigan)	High
Methocarbamol (Robaxin)	High
Carisoprodol (Soma)	High
Chlorzoxazone (Paraflex)	High
Metaxalone (Skelaxin)	High
Cyclobenzaprine (Flexeril)	High
Oxybutynin (Ditropan)	High
Rurazepam (Dalmane)	High
Amitriptyline (Elavil)	High
Chlordiazepoxide-amitriptyline (Limbitrol)	High
Perphenazine-amitriptyline (Triavil)	High
Doxepin (Sinequan)	High
Meprobarnate (Miltown, Equanil)	High
Lorazepam (>3 mg) (Ativan)	High
Oxazepam (>60 mg) (Serax)	High
Alprazolam (> 2 mg) (Xanax)	High
Ternazepam (>15 mg) (Restoril)	High
Triazolam (>0.25 mg) (Halcion)	High
Chlordiazepoxide (Librium)	High
Chlordiazepoxide-arnitriptyline (Limbitrol)	High
Clidinium-chlordiazepoxide (Librax)	High
Diazepam (Valium)	High
Quazepam (Doral)	High
Halazepam (Paxipam)	High
Chlorazepate (Tranxene)	High
Disopyramide (Norpace, Norpace CR)	High
Digoxin ( >0.125 mg/d, except if treating atrial arrythmias) (Lanoxin)	Low
Short-acting dipyridamole (Persantine)	Low
Methyldopa (Aldomet)	High
Methyldopa-hydrochlorothiazide (Aldoril)	High
Reserpine (>0.25 mg)	Low
Chlorpropamide (Diabinese)	High
Dicyclomine (Bentyl)	High
Hyoscyamine (Levsin, Levsinex)	High
Propantheline (Pro-Banthine)	High
Belladonna alkaloids (Donnatal and others)	High
Clidinium-chlordiazepoxide (Librax)	High
Chlorpheniramine (Chlor-Trimeton)	High
Diphenhydramine (Benadryl)	High
Hydroxyzine (Vistaril, Atarax)	High
Cyproheptadine (Periactin)	High
Promethazine (Phenergan)	High
Tripelennamine	High
Dexchlorpheniramine (Polaramine)	High
Diphenhydramine (Benadryl)	High
Ergot mesyloids (Hydergine)	Low
Cyclandelate (Cyclospasmol)	Low
Ferrous sulfate (>325 mg/d)	Low
All barbituates (except phenobarbital) except to control seizures	High
Meperidine (Demerol)	High
Ticlopidine (Ticlid)	High
Ketorolac (Toradol)	High
Amphetamines and anorexic agents	High
Naproxen (long-term use of full dosage) (Naprosyn, Avaprox, Aleve)	High
Oxaprozin (long-term use of full dosage) (Daypro)	High
Piroxicam (long-term use of full dosage) (Feldene)	High
Daily fluoxetine (Prozac)	High
Bisacodyl (long-term use) (Dulcolax)	High
Casacara sagrada (long-term use)	High
Neoloid except in presence of opiate analgesic use (long-term use)	High
Amiodarone (Cordarone)	High
Orphenadrine (Norflex)	High
Guanethidine (Ismelin)	High
Guanadrel (Hylorel)	High
Cyclandelate (Cyclospasmol)	Low
Isoxsurpine (Vasodilan)	Low
Nitrofurantoin (Macrodantin)	High
Doxazosin (Cardura)	Low
Methyltestosterone (Android, Virilon, Testrad)	High
Thioridazine (Mellaril)	High
Mesoridazine (Serentil)	High
Short-acting nifedipine (Procardia, Adalat)	High
Clonidine (Catapres)	Low
Mineral oil	High
Cimetidine (Tagamet)	Low
Ethacrynic acid (Edecrin)	Low
Desiccated thyroid	High
Amphetamines (excluding methylphenidate hydrochloride and anorexics)	High
Estrogens only (oral)	Low

Note: For your own health and safety, do not stop taking any medication unless you have consulted with your doctor and have her approval.
Risks for Inappropriate Drug Use    
When you are on a lot of medicine, how can you tell if you are taking more than you need? First of all, you need the help of your doctor to determine this. You and your doctor should be on a heightened state of alert for unnecessary medications if any of the following risk factors apply to you:

• Taking multiple drugs, especially if filling over 14 prescriptions a year
• Using over-the-counter drugs and supplements
• Visiting a number of different doctors
• Having trouble understanding instructions
• Saving medications for later use
• Borrowing or sharing medication
• Being age 65 years or older
• Being female
• Having poor health status
  Talk to Your Doctor    

The best way to fine-tune your medications is to work with your doctor. After all, most doctors are experts in the drug treatment of disease. But your doctor can only help if you tell him or her about all the medicines you are taking, including prescription and over-the-counter drugs and supplements.
Thoroughly review your medications with your doctor at least once a year. Write down a complete list, or better yet, bring all your medications into the office in a brown bag. And don't forget to include those in your medicine chest or kitchen cupboard that you only take once in awhile.
Another key is to ask questions. Keep inquiring until you understand the dose, frequency, and purpose of the medicines you are taking. Finally, don't be afraid to ask about nondrug options that can help you minimize your use of medications.

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