Side Effects of Common Medications & How They Affect the Aging Body

Last month we discussed how our bodies change as we age. Aging also makes us more prone to having side effects from medications. So what medications should be avoided in the elderly?

Dr. Mark Beers, writing in the Archives of Internal Medicine in 1997 and in 2003, identified medications that are potentially inappropriate for older adults. The Beers Criteria are now widely used by physicians and pharmacists to identify medications that require special monitoring in the elderly. Following is a list of the most common medicines listed in the Beers Criteria that may cause problems for older adults.

Type of Drug

Brand Names

Side Effects or Dangers

Tricyclic Antidepressants

Elavil® and Sinequan®

Dry mouth, urinary retention, constipation, dry eyes and confusion.

Gastrointestinal Antispasmodic Drugs

Bentyl®, Levsin®, Pro-Banthine®, Donnatal® and Librax®

Dry mouth, urinary retention, constipation, dry eyes and confusion.

Antidiabetic Drugs


Serious low blood sugar and increased fluid retention and low sodium (hyponatremia). Symptoms include nausea/vomiting, irritability, headache, disorientation, muscle cramps, weakness and delirium.

Antihypertensive Drugs


May lower the heart rate and increase depression.



May cause low blood pressure when rising. Also central nervous system effects such as drowsiness or dizziness.

Antiarrhythmic Drugs


Dry mouth, urinary retention, constipation, dry eyes and confusion. May induce heart failure.


Dalmane®, Librium® and Valium®

Prolonged sedation and increased risk of falls and fractures.

Narcotic Analgesics


Causes more confusion and hallucinations than other narcotic agents and does not have pure pain-blocking effects.


Can cause central nervous system stimulation and seizures in individuals with reduced kidney function.


Seconal®, Nembutal®

Highly addictive. May cause prolonged sedation and increased risk of falls and fractures.

Antiplatelet Drugs

Ticlid® More toxic than other alternatives such as aspirin.

Cardiac Drugs

Digoxin for heart failure (doses greater than 0.125mg daily)

Kidney clearance of the drug may be decreased, increasing the potential for toxicity.

Medications That Require Special Monitoring

Among patients 65 years and older, three drugs that typically require ongoing monitoring are insulin, warfarin, and digoxin. These were implicated in one in every three estimated adverse drug events treated in emergency departments and 41.5% of estimated hospitalizations. This was described in the October 2006 publication of the Journal of the American Medical Association. If you or a family member is taking one of the medications mentioned, watch for possible side effects. Discuss any changes with your doctor and pharmacist.

Stay active in both mind and body...take care!

Dr. Joe Woelfel