Medication as risk factor for falls

Many drugs can increase the risk of falls. The more drugs one takes, the greater the chance that one or a combination of them will make a fall more likely to happen. Some medications are well known for side effects that increase a person's risk of falling.

Anti-hypertensive medications are prescribed to keep blood pressure under control and decrease the risk of stroke and heart failure. However, these drugs can cause blood pressure to get too low when one stands up from a lying or sitting position (orthostatic hypotension). This happens commonly in elderly. The result is lightheadedness and feeling faint, which can easily lead to a fall.

Medications that suppress the central nervous system are among those most likely to contribute to falling, as they reduce alertness and cause slower reactions and movements. These include:

Anti-anxiety drugs, such as diazepam (Valium) and lorazepam (Ativan)
Diphenhydramine (Benadryl), an older antihistamine. Because it causes drowsiness, it is the most popular ingredient in over-the-counter sleep aids like Nyquil, Sominex, and Unisom. It is often combined with pain medications, such as acetaminophen (Tylenol PM), ibuprofen (Motrin PM, Advil PM), and naproxen (Aleve PM).
Prescription medications to treat overactive bladder, such as oxybutynin (Ditropan) and tolterodine (Detrol).
Tricyclic antidepressants, such as amitriptyline (Elavil), to help relieve chronic pain, especially nerve pain.
Prescription sleep drugs, including zolpidem (Ambien), zaleplon (Sonata), and eszopiclone (Lunesta).
Narcotics (opioids), such as codeine, hydrocodone (Vicodin), oxycodone (Percodan, Percocet), hydromorphone (Dilaudid), and fentanyl (Duragesic).

Author

Paddy Kalish OD, JD and B.Arch

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