Medications Associated With Falls in the Elderly

The table below lists some medications that have been associated with falls in the elderly.

Medication Potential adverse effects of medication contributing to falls Antidepressants e.g. amitriptyline, Drowsiness, dizziness, confusion, postural clomipramine, dosulepin, imipramine, hypotension, visual disturbances fluoxetine, citalopram (SSRIs are less sedating and are associated with fewer antimuscarinic and cardiotoxic side effects than tricyclic antidepressants) Antipsychotics e.g. haloperidol, Postural hypotension, drowsiness, unsteady gait, risperidone, quetiapine, clozapine confusion Antimuscarinic (anticholinergic) drugs Drowsiness, dizziness, confusion, blurred vision e.g. atropine, hyoscine, orphenadrine, procyclidine, trihexyphenidyl Benzodiazepines e.g. diazepam, Drowsiness, unsteady gait, confusion temazepam, nitrazepam Non-benzodiazepine hypnotics Drowsiness, unsteady gait, confusion (Z Drugs) e.g. zopiclone, zolpiderm Dopaminergic drugs used in Parkinson’s Sudden onset of sleep, postural hypotension, disease e.g. co-beneldopa, confusion co-careldopa, bromocriptine, ropinirole, pramipexole, rotigotine Angiotensin-converting enzyme (ACE) Dizziness, postural hypotension inhibitors e.g. captopril, ramipril, enalapril, lisinopril Angiotensin-II receptor antagonists e.g. Dizziness, postural hypotension candesartan, irbesartan, losartan Alpha-blockers e.g. doxazosin, prazosin Dizziness, postural hypotension Anti-arrhythmics e.g. digoxin, Bradycardia, arrhythmias, dizziness amiodarone, flecainide

Antiepileptic drugs e.g. phenytoin, Dizziness, drowsiness, confusion, visual carbamazepine disturbances (confusion, visual disturbances and ataxia may be signs of phenytoin toxicity)

Page 1 of 2

Beta-blockers e.g. propranolol, atenolol, Dizziness, postural hypotension sotalol Diuretics e.g. furosemide, bumetanide, Dizziness, postural hypotension bendroflumethiazide Opioid analgesics e.g. morphine, Drowsiness, dizziness, confusion, postural codeine, dihydrocodeine, tramadol hypotension, visual disturbances Sedating antihistamines (including those Confusion, dizziness, drowsiness, blurred vision in OTC medicines) e.g. promethazine, chlorphenamine Calcium-channel blockers e.g. Dizziness, postural hypotension amlodipine, felodipine, nifedipine, diltiazem, verapamil

Nitrates e.g. glyceryl trinitrate, isosorbide Dizziness, postural hypotension mononitrate, isosorbide dinitrate

Page 2 of 2