Are you or a loved one over the age of 65? If so, you might be surprised to learn that some of the most commonly prescribed medications could be doing more harm than good. As someone who’s seen the effects of these drugs firsthand, I’m here to pull back the curtain and share which medications I most frequently see causing problems — and what you should be watching out for. Don’t worry, I’m not anti-medication, but I do want you to be informed and empowered to make the best choices for your health. (Based on the insights of Dr. Suneel Dhand)
- Certain medications are linked to serious side effects and complications in older adults.
- Always consult with your doctor before making any changes to your medication regimen.
- Being informed helps you advocate for your own health, and sometimes there are safer alternatives.
1. Hydrochlorothiazide (HCTZ): The Common Blood Pressure Diuretic
If you’ve been prescribed Hydrochlorothiazide — or its UK equivalent, Bendrofluazide — for blood pressure, take note. This diuretic is notorious for causing dehydration and especially low potassium, a condition called hypokalemia. Over the years, I’ve seen too many patients wind up in the hospital because their potassium dropped dangerously low, often after just a mild illness. While supplements or dietary advice are sometimes given, other blood pressure medications are available that carry fewer risks, especially for those over 65.
What to Do: If you or someone you care about is on HCTZ and experiences fatigue, muscle cramps, or confusion, mention it to your doctor. Don’t stop it on your own, but do ask if a safer alternative might be appropriate.
2. Gabapentin (Neurontin): For Nerve Pain, But at What Cost?
Gabapentin is commonly prescribed for nerve pain, but here’s the catch: in older adults, the side effects can be severe. Drowsiness is a big problem. I’ve lost count of the times I’ve seen someone on high doses of gabapentin who is barely awake, only to become alert again after the dose is reduced in hospital. Over-sedation isn’t just an inconvenience — it can lead to falls, cognitive changes, and even hospitalizations.
What to Do: Watch for signs of excessive sleepiness or confusion. Talk to your doctor if you’re concerned about drowsiness or the medication’s effectiveness — sometimes a dose reduction or a different approach to pain management can make all the difference.
3. High-Dose NSAIDs: The Silent Attack on Your Stomach and Kidneys
Non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen, naproxen, and diclofenac are easily available and often used long-term for chronic pain or arthritis. However, regular high doses can cause stomach ulcers — sometimes leading to serious gastrointestinal bleeding — and can impair kidney function.
I’ve seen far too many older adults admitted with stomach bleeding or new kidney issues after using NSAIDs for months or years. While they can reduce inflammation, they’re not without risk, especially in seniors.
What to Do: If you rely on NSAIDs, ask your doctor about safer pain management options — and always use the lowest effective dose for the shortest possible time. Lifestyle changes and targeted physical therapy can sometimes provide much safer relief.
4. Flexeril (Cyclobenzaprine): The Muscle Relaxant That Can Increase Falls
Muscle spasms can be bothersome, but Flexeril can make things worse in older adults. Over-sedation is once again a primary danger. Multiple times, I have seen serious falls linked directly to Flexeril use — often confirmed by family who notice increased sleepiness after the medication starts.
Remember, muscle spasms can sometimes be due to nutrient deficiencies, such as low magnesium. Exploring the root causes and natural remedies may help.
What to Do: If you or someone you care for starts Flexeril and seems groggy or has difficulty with balance, discuss alternatives or supplements like magnesium with your doctor. A personalized approach always beats a “one-size-fits-all” prescription.
5. Benadryl (Diphenhydramine): The Sleepy Antihistamine to Avoid
Benadryl is a sedating antihistamine frequently used for allergies or itching. In seniors, it’s far more likely to cause drowsiness, confusion, and even dangerous falls. I’ve even felt the profound fatigue myself after taking Benadryl — imagine how much worse it is in someone older!
Non-sedating antihistamines are available and equally effective for most allergy issues, so there’s rarely a good reason for an older adult to use Benadryl.
What to Do: Before you reach for Benadryl, ask your doctor or pharmacist about non-sedating antihistamines. If you must use something, always weigh the pros and cons and monitor for changes in alertness or balance.
Why Are Older Adults at Higher Risk?
As we age, our bodies process medications differently. Kidneys and liver may work a little slower, and there are often more medications interacting together (the so-called “polypharmacy” problem). That means side effects can be amplified, and what’s safe at 40 might be risky at 70.
What If You’re Worried About a Medication?
Never stop or change your medications without consulting your doctor — but do bring up your concerns. Ask if there are non-drug alternatives, or safer medications for people in your age group. If you notice sudden changes in alertness, memory, or balance after starting a new medication, speak up!
Advocating for yourself — or your loved ones — is crucial. Seek out health professionals who are willing to have holistic conversations about wellness, not just hand you a prescription.
Conclusion: You Deserve More Than a “Band-Aid” Prescription
It’s so important as we age to really take stock of what we’re putting in our bodies. The five medications above aren’t always inappropriate, but they often have better, safer alternatives for people over 65. Educate yourself, ask questions, and build a healthcare team that treats the root causes — not just the symptoms.
Remember, your good health is a partnership between you and your medical team. You’re not just a “patient” — you’re an active participant in creating a better, safer care plan. Stay informed, stay empowered, and remember: knowledge really is the best medicine at any age.
Source: Dr. Suneel Dhand