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, clomipramine, dosulepin, imipramine, fluoxetine, citalopram |
Drowsiness, dizziness, confusion, postural hypotension, visual disturbances (SSRIs are less sedating and are associated with fewer antimuscarinic and cardiotoxic side effects than tricyclic antidepressants) |
|
Antipsychotics e.g. haloperidol, risperidone, quetiapine, clozapine |
Postural hypotension, drowsiness, unsteady gait, confusion |
|
Antimuscarinic (anticholinergic) drugs e.g. atropine, hyoscine, orphenadrine, procyclidine, trihexyphenidyl |
Drowsiness, dizziness, confusion, blurred vision |
|
Benzodiazepines e.g. diazepam, temazepam, nitrazepam |
Drowsiness, unsteady gait, confusion |
|
Non-benzodiazepine hypnotics (Z Drugs) e.g. zopiclone, zolpiderm |
Drowsiness, unsteady gait, confusion |
|
Dopaminergic drugs used in Parkinson’s disease e.g. co-beneldopa, co-careldopa, bromocriptine, ropinirole, pramipexole, rotigotine |
Sudden onset of sleep, postural hypotension, confusion |
|
Angiotensin-converting enzyme (ACE) inhibitors e.g. captopril, ramipril, enalapril, lisinopril |
Dizziness, postural hypotension |
|
Angiotensin-II receptor antagonists e.g. candesartan, irbesartan, losartan |
Dizziness, postural hypotension |
|
Alpha-blockers e.g. doxazosin, prazosin |
Dizziness, postural hypotension |
|
Anti-arrhythmics e.g. digoxin, amiodarone, flecainide |
Bradycardia, arrhythmias, dizziness |
|
Antiepileptic drugs e.g. phenytoin, carbamazepine |
Dizziness, drowsiness, confusion, visual disturbances (confusion, visual disturbances and ataxia may be signs of phenytoin toxicity) |
|
Beta-blockers e.g. propranolol, atenolol, sotalol |
Dizziness, postural hypotension |
|
Diuretics e.g. furosemide, bumetanide, bendroflumethiazide |
Dizziness, postural hypotension |
|
Opioid analgesics e.g. morphine, codeine, dihydrocodeine, tramadol |
Drowsiness, dizziness, confusion, postural hypotension, visual disturbances |
|
Sedating antihistamines (including those in OTC medicines) e.g. promethazine, chlorphenamine |
Confusion, dizziness, drowsiness, blurred vision |
|
Calcium-channel blockers e.g. amlodipine, felodipine, nifedipine, diltiazem, verapamil |
Dizziness, postural hypotension |
|
Nitrates e.g. glyceryl trinitrate, isosorbide mononitrate, isosorbide dinitrate |
Dizziness, postural hypotension |