6 Medications Older Adults 75 and Up Should Reconsider, According to Doctors

A drug that seemed harmless for years can become riskier as people age. Slower kidney function, greater sensitivity to medications, and a growing list of prescriptions can all raise the odds of side effects that were once easier to tolerate. For adults over 75, those complications may include falls, confusion, internal bleeding, and unplanned hospital stays.

The American Geriatrics Society’s Beers Criteria highlights medications that can be more dangerous for adults 65 and older. The guidance does not mean every older person should stop taking these medicines, but it does offer a useful starting point for a discussion about medication safety.

Cost is part of the equation as well. A preventable drug-related injury can lead to emergency care, rehab, extra prescriptions, or even changes in living arrangements. Below are six medication categories worth reviewing with a healthcare professional.

1. Benzodiazepines Can Raise the Risk of Falls and Confusion

Benzodiazepines such as alprazolam (Xanax), diazepam (Valium), and lorazepam (Ativan) are often used for anxiety, panic disorders, and certain sleep issues. In older adults, these drugs can have stronger effects and may contribute to delirium, impaired thinking, falls, fractures, and car crashes. For example, a 78-year-old who gets dizzy after taking a nighttime anxiety pill could turn a simple trip to the bathroom into a serious injury. The resulting costs might include emergency treatment, physical therapy, and extra help at home. These medications can still be appropriate in some cases, but patients should talk with a prescriber about the risks and never stop them suddenly because withdrawal can be dangerous.

2. NSAID Pain Relievers Can Lead to Bleeding and Kidney Injury

Nonsteroidal anti-inflammatory drugs, or NSAIDs, include familiar options like ibuprofen (Advil), naproxen (Aleve), and prescription indomethacin. They can help ease arthritis and other painful conditions, but long-term oral use raises the risk of gastrointestinal bleeding, ulcers, and kidney damage. The danger is even greater for seniors who take blood thinners, corticosteroids, or other medications that increase bleeding risk. Someone relying on over-the-counter ibuprofen every day may not realize that a hospital stay for gastrointestinal bleeding could bring major out-of-pocket costs even with insurance. Depending on a patient’s history, doctors may suggest topical treatments, physical therapy, or other pain-management options instead.

3. Antipsychotics Carry Major Warnings for People With Dementia

Antipsychotic drugs such as risperidone (Risperdal), quetiapine (Seroquel), and olanzapine (Zyprexa) are sometimes used for severe behavioral symptoms in people with dementia. But in older adults with dementia, these medicines can raise the risk of stroke, worsening cognition, and death. They can also cause sleepiness, dizziness, and movement problems that make daily tasks harder and may increase the need for caregiving support. For families already dealing with the financial strain of dementia care, added falls, hospital visits, or drug complications can make matters worse. While antipsychotics may still be necessary for certain psychiatric conditions or dangerous behaviors, clinicians usually recommend trying nonmedication approaches first when possible.

4. Common Antihistamines Can Cause Confusion and Memory Trouble

One of the most overlooked risks comes from products sold without a prescription in many pharmacies and grocery stores. First-generation antihistamines such as diphenhydramine (Benadryl), doxylamine (found in some sleep aids), and hydroxyzine have strong anticholinergic effects that can lead to confusion, constipation, blurred vision, and trouble urinating. These drugs are potentially inappropriate for many older adults because their side effects can become more pronounced with age. Someone who takes a nighttime cold medicine along with a prescription sleep aid may unknowingly increase the risk of sedation and falls, which could lead to expensive medical care. For allergies, a clinician may recommend less sedating alternatives such as loratadine or fexofenadine, depending on the person’s health conditions and other medicines.

5. Muscle Relaxants Can Increase the Chance of Serious Injury

Muscle relaxers such as cyclobenzaprine (Flexeril), methocarbamol (Robaxin), and carisoprodol (Soma) are sometimes prescribed for back pain, muscle spasms, and other painful problems. Yet several commonly used skeletal muscle relaxants are considered potentially inappropriate for older adults because they can cause sedation, anticholinergic side effects, and a higher fracture risk. The concern grows when these drugs are combined with opioids, benzodiazepines, or other medicines that affect alertness and balance. For someone over 75, a medication-related fall could cause a hip fracture that requires surgery, rehab, and possibly short- or long-term help at home. Physical therapy, guided stretching, and other targeted treatments may be worth discussing with a healthcare professional.

6. Prescription Sleep Aids Can Trigger Dangerous Nighttime Behavior

Prescription sleep medications such as zolpidem (Ambien), eszopiclone (Lunesta), and zaleplon (Sonata) are part of a group often called Z-drugs. In older adults, they can cause side effects similar to benzodiazepines, including delirium, falls, fractures, and emergency room visits. Some people may also experience poor coordination or unusual nighttime behaviors, making simple activities like walking to the bathroom especially risky. Beyond the immediate health concerns, an injury or hospital stay can bring unexpected bills and disrupt independent living. Before depending on these drugs for long-term use, doctors may suggest cognitive behavioral therapy for insomnia, or CBT-I, along with other individualized sleep strategies.

Medicare Can Help You Review Risky Prescriptions

One of the most helpful steps older adults can take is asking for a full medication review before problems arise. According to Medicare.gov, Medicare Part B covers an annual Wellness visit that includes a review of current prescriptions, with no cost to eligible beneficiaries when the provider accepts assignment, though extra services may still be billed. Some people with Medicare prescription drug coverage also qualify for Medication Therapy Management, which offers medication reviews at no added cost for eligible participants. These reviews can uncover duplicate prescriptions, harmful interactions, and opportunities to talk about safer or less expensive alternatives. Seniors should bring a complete list of prescriptions, over-the-counter drugs, vitamins, and supplements so the care team can evaluate everything together.

Medication Safety Can Also Help Protect Retirement Savings

Medication safety becomes more important with age, especially for seniors managing several chronic conditions or getting prescriptions from multiple healthcare providers. The six medication categories discussed here are not automatically wrong for everyone over 75, but they deserve close attention because the potential complications can affect both health and finances. Preventing avoidable injuries, unnecessary hospital stays, and medication-related problems may help preserve independence while limiting surprise medical costs. Before making any changes, ask a doctor or pharmacist whether the benefits still outweigh the risks and whether safer alternatives fit your situation. A medication review now could help avoid a serious health problem and a costly setback later.