MEDICATIONS LINKED TO FALLS Certain medications can increase your risk for falls. It is important to review your prescription, over-the- counter medications and herbal supplements that cause dizziness, sedation, blurred vision or low blood pressure with your physician and/or pharmacist if you are 65 years of age or older. Common prescriptions medications that may increase your risk of falls:

 Anticonvulsants (medications for seizures or mental health)

 Antidepressants (medications for mood or anxiety)

 Antipsychotics (medications for hallucinations or delusions)

 Benzodiazepines or sedative-hypnotics (“Pam” drugs for sleep or nerves)

 Opioids (or narcotics that are strong pain medications)

Common over-the counter medications that increase your risk for falls:

 Antihistamines for colds (diphenhydramine, chlorpheniramine)

 Muscle relaxants (methocarbamol)

 Sleep Aids (Nytol, Sominex- containing dimenhydrinate) Medication management can reduce interactions and side effects that may lead to falls. If you are falling, please notify your doctor to develop a plan to reduce your risk for falls. Options include:

STOP the medications that my be causing falls Switch to medications that may cause less risk of falls Reduce the dose of some medications

Turn over For a list of specific medication, please see the back of this page. Medications and the Risk of Falling Examples of drugs that can increase YOUR risk of falling.

ACE Inhibitors (3) Antidepressants (1,2,3,6) Pipotiazine NSAIDS Benazepril Amitriptyine Prochlorperazine ASA/acetylsalicylic acid (8) Captopril Bupropion Quetiapine Cilazapril Citalopram Risperidone Opiates/narcotics (1,2,3) Enalapril/enalaprilat Clomipramine Thioproperazine Alfentanil Fosinopril Desipramine Thiothixene Butorphanol Lisinopril Doxepin Trifluoperazine Codeine Escitalopram Zuclopenthixol Fentanyl Perindopril Quinapril Fluoxetine Hydromorphone Fluvoxamine Corticosteroids, oral (7) Meperidine Ramipril Corticosteroids, Methadone Trandolapril Imipramine inhaled, high-dose (7) Maprotiline Morphine Beclomethasone Oxycodone Alcohol (1,5) Mirtazapine Betamethasone Moclobemide Budesonide Oxymorphone Nortriptyline Cortisone Nalbuphine Alpha Receptor Blockers (2,3 Paroxetine Dexamethasone Pentazocine especially initial doses) Phenelzine (1,2,3) Fludrocortisone Propoxyphene Alfuzosin Sertraline Fluticasone Sufentanil Doxazosin Tranylcypromine(2,3) Methylprednisolone Prazosin Trazodone Prednisolone Protein Pump Inhibitors (9) Tamsulosin Trimipramine Prednisone Triamcinolone Esomeprazole Terazosin Venlafaxine Lansoprazole

Digoxin Omeprazole Anticoagulants (8) Antihistamines, sedating (1) (side-affects unknown) Pantoprazole Cold medications that contain Dalteparin Rabeprazole sedating antihistamines (1) Eye drops (6) Danaparoid Azatadine Sedative/hypnotics Benzodi- Enoxaparin Brompheniramine Herbal and Natural health azepines Barbiturates (1,2,5) Heparin Cetirizine products Nadroparin Chlorpheniramine Natural sleep aids Alprazolam Nicoumalone Clemastine Natural products for sexual Bromazepam Tinzaparin Cyproheptadine enhancement (possible adul- Chloral hydrate Warfarin Diphenhydramine teration with undeclared Clorazepate Hydroxyzine drugs) Diazepam Meclizine Diphenhydramine Anticonvulsants (1,2,5,6,7) Metoclopramide (1,2,4) Carbamazepine (1,2,6) Promethazine Doxylamine Trimeprazine Ethosuximide (1,2,5) Muscle Relaxants (1,2) Flurazepam Fosphenytoin (1,2,5,7) Baclofen Lorazepam Gabapentin (1,2,5,6) Antipsychotics (1,3,4) Carisoprodol Midazolam Lamotrigine (1,2,6) Chlorpromazine Chlorzoxazone Nitrazepam Levetiracetam (1,2,5) Clozapine Cyclobenzaprine Oxazepam Methsuxumide (1,2,5) Flupenthixol Dantrolene Pentobarbital Fluphenazine Methocarbamol Phenobarbital Oxcarbazepine (1,2,5,6) Haloperidol Temazepam Phenobarbital (1,2) Orphenadrine Loxapine Tizanidine Triazolam Phenytoin (1,2,5,7) Methotrimeprazine Zophiclone Primidone (1,2) Olanzapine Nitrates (2,3) Topiramate (1,2) Paliperidone Isosorbide dinitrate Thiazolidinediones (7) Valproic acid (1,2,5) Perphenazine Isosorbide mononitrate Pioglitazone Vigabatrin (1,2) Pimozide Nitroglycerin Rosiglitazone

Index of Side-effects that are outlined above Drugs are listed by generic (chemical) name  Drowsiness  Dizziness under each drug group. This list only includes  Hypotension those drugs for which there is evidence of  Parkinsonian effects increased risk of falls or their consequences.  Ataxia/gait disturbance There may be other drugs that increase risk in  Vision disturbance certain patients. See your pharmacist for a  Osteoporosis or reduced bone mineral density complete Medication Review. increase the fracture risk if a fall occurs

 Risk of serious bleeding if a fall occurs Handout provided by Lambton Seniors Association Fall Prevention Committee Source: Barbara Cadario & BC Falls and Injury Prevention Coalition