Preventing Falls in Older Adults Who Take High-Risk Medicines

Preventing Falls in Older Adults Who Take High-Risk Medicines

Topic Overview

What does "high-risk" mean?

High-risk means that a medicine can cause serious health problems or
accidents. High-risk doesn't always mean "do not use." It can mean "use with
care" when a medicine is more likely to help you than harm you.

If you take a medicine that may make you feel
confused, drowsy, or dizzy, pay attention to how
it affects your balance and how it makes you feel. Take extra care to prevent a
fall. A fall can lead to serious problems that can change your quality of life.

Examples of high-risk medicines include:

  • Antipsychotics, such as haloperidol, quetiapine, and
  • Muscle relaxants, such as carisoprodol, cyclobenzaprine, and methocarbamol.
  • Anxiety medicine, such as alprazolam, lorazepam, and oxazepam.
  • Sleep medicine, such as zaleplon and zolpidem.
  • Antidepressants, such as amitriptyline and paroxetine.
  • Over-the-counter allergy and cold medicines that contain ingredients that may cause drowsiness, such as chlorpheniramine or diphenhydramine. Some medicines for sleep or pain also use diphenhydramine.

How can you prevent falls when you take high-risk medicine?

Be prepared for side effects

As you
age, your body changes. When you take a medicine, you may get a stronger effect
now than when you were younger. For example, you may get more dizzy or
drowsy. And you may be more likely to have dangerous side effects when you take more than one medicine.

To help avoid serious side effects, talk to your doctor and pharmacist about your medicines.

  • Make a list of everything you take. Include the dose and when
    you take it. Keep a copy with you, and take it to each doctor visit. Ask if
    there are any medicines that you don't need or shouldn't take. And ask if you could lower your dose of any of the medicines.
  • Find out if a treatment without medicine might work for you.
  • Use one drugstore, if possible. Before filling a new prescription,
    give the pharmacist your list of medicines. Ask about possible interactions
    with anything you are taking. If you use more than one drugstore, make sure
    each one has your list.
  • Talk to your
    doctor about all side effects you have. Your doctor may want to change your
    dose or your medicine. Be sure to tell your doctor that you only want to take medicines that you really need, and at the lowest possible dose.

Learn to move wisely

  • Stand up slowly. After you stand up, stay still for a few seconds before you move. If you feel dizzy, don't try to walk.
  • If you have a
    problem with balance, walk carefully. Wear low-heeled shoes that fit well and
    give your feet good support. Use footwear with nonskid soles.
  • If
    you are very weak, have someone help you get up, walk, and bathe.
  • If one of your legs is stronger than the other, get into a tub or
    shower with your weaker leg first. Get out with your stronger side first.
  • Use extra care if you use a cane, a walker, or crutches. They can
    slip out from under you on smooth, wet surfaces.
  • If you have
    glasses, hearing aids, or both, be sure to use them.

Make changes to stay safe at home

  • Keep walking paths clear. Remove throw rugs and clutter. Place furniture and electrical
    cords out of the way.
  • Repair loose carpet or uneven flooring.
  • Keep your living space well lit. At night, use night-lights. Keep a cordless phone and a
    flashlight by your bed.
  • Install sturdy handrails on stairways. Put grab bars and nonskid
    mats in your shower or tub and near the toilet. Use a shower chair or bath
    bench when you bathe.
  • Store items within easy reach. Avoid reaching
  • If you have ice and snow during the winter, have a family member or friend sprinkle salt or sand on slippery steps and sidewalks.

Take care of yourself

  • Before you take any prescription or over-the-counter medicine,
    ask your doctor or pharmacist if it might make you sleepy, less alert, or less aware of how you're moving. It's important to know ahead of time if you're going to be at risk for losing your balance and
  • When you are alone at home or outdoors, carry a phone or
    personal medical alert device with you. Then you can quickly call for help if
    you need it.
  • Have
    your vision and hearing checked each year, or anytime you notice a change.
    Sight or hearing problems can cause falls.
  • Talk to your doctor or physical therapist about exercises for
    improving your strength and balance. Exercise regularly.

When should you call your doctor?

Call 911 anytime you think you may need emergency care. For
example, call if:

  • You passed out (lost
  • You cannot get up after a fall.
  • You
    believe you have serious or life-threatening injuries.
  • You are
    having chest pain or trouble breathing.
  • You are having trouble
    speaking, or you have new weakness or numbness on one side of your body.

Call your doctor now or seek medical
care right away if:

  • You feel faint.
  • You develop severe
  • You think you may have passed out but aren't
  • You hit your head or think you may have hit your head but aren't sure.
  • You think your medicine may have caused you to

Watch closely for changes in your health, and be sure to
contact your doctor if you have fallen, even if you aren't hurt.

Don't feel embarrassed to let your doctor know that you have fallen. Your
doctor may be able to adjust your medicine or give other advice so you can
prevent more falls.

Other Places To Get Help


American Geriatrics Society Health in Aging Foundation:

Related Information


Other Works Consulted

  • American Geriatrics Society 2015 Beers Criteria Update Expert Panel (2015). American Geriatrics Society 2015 updated Beers Criteria for
    potentially inappropriate medication use in older adults. Journal of the American Geriatrics Society, 63(4): 2227–2246. DOI: 10.1111/jgs.13702. Accessed March 31, 2016.

  • Hartikainen S, et al. (2007). Medication as a risk factor for falls: Critical systematic review. Journal of Gerontology, 62(10): 1172–1181.


ByHealthwise StaffPrimary Medical Reviewer Anne C. Poinier, MD - Internal Medicine Kathleen Romito, MD - Family Medicine Martin J. Gabica, MD - Family Medicine Elizabeth T. Russo, MD - Internal Medicine Specialist Medical Reviewer Elizabeth A. Phelan, MD, MS - Geriatric Medicine

Current as ofFebruary 7, 2018

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