The "Fall Risk" Medication Checklist: 3 Drug Groups Elderly Caregivers Must Watch

Compiled by: Pharmacist Krongthong Puttipokin

Falls in the elderly are dangerous and can be life-threatening. But did you know that the daily medications your loved ones take could be a hidden cause increasing this risk? Certain drugs have side effects that cause drowsiness, dizziness, or loss of balance.

Pharmacist Krongthong Puttipokin has compiled a checklist of medications that pose a high risk of causing falls. We have categorized them into 3 major groups so caregivers and family members can easily check and monitor them.

Group 1: Nervous System Medications (Highest Risk)

Drugs in this group depress the central nervous system, leading to drowsiness, confusion, dizziness, or slowed reaction times—the primary causes of losing balance.

• Sleeping Pills & Anti-Anxiety Meds (Benzodiazepines & Hypnotics):

  • Examples: Alprazolam, Diazepam, Lorazepam, Zolpidem.

  • Effect: Severe drowsiness, confusion ("brain fog"), and muscle weakness.

• Antidepressants:

  • Examples: Fluoxetine, Sertraline, Amitriptyline.

  • Effect: May cause a drop in blood pressure when standing up, dizziness, or confusion.

• Antihistamines (Allergy Meds):

  • Examples: Chlorpheniramine (CPM), Diphenhydramine.

  • Effect: Especially the "drowsy" types, these cause blurred vision, urinary retention, and heavy sedation.

• Opioid Pain Relievers (Narcotics):

  • Examples: Tramadol, Morphine, Fentanyl.

  • Effect: Causes significant dizziness and fainting spells.

• Anticonvulsants & Muscle Relaxants:

  • Examples: Gabapentin, Pregabalin, Baclofen, Tolperisone.

Group 2: Cardiovascular Medications

These medications often lower blood pressure or temporarily reduce blood flow to the brain, leading to Orthostatic Hypotension (dizziness or blacking out when standing up quickly).

• Antihypertensives (Blood Pressure Meds):

  • Examples: Amlodipine, Enalapril, Losartan, Prazosin.

  • Beta-blockers: Atenolol, Propranolol.

• Diuretics (Water Pills):

  • Examples: Furosemide, HCTZ.

  • Effect: Frequent urination, fatigue from electrolyte loss, and hypotension due to dehydration.

• Heart Vasodilators (Nitrates):

  • Examples: Isosorbide dinitrate.

  • Effect: Can cause a severe drop in blood pressure and bradycardia (slow heart rate).

Group 3: Other High-Risk Medications

• Diabetes Medications (Hypoglycemics):

  • Examples: Glipizide, Gliclazide.

  • Effect: If blood sugar drops too low (Hypoglycemia), it causes palpitations, dizziness, and fainting.

• Anti-Inflammatory Painkillers (NSAIDs):

  • Examples: Ibuprofen, Diclofenac, Naproxen.

  • Effect: May cause dizziness and confusion in some elderly patients.

• Acid Reflux Medication (PPIs):

  • Examples: Omeprazole.

  • Effect: Long-term use increases the risk of Osteoporosis and bone fractures if a fall occurs.

• Steroids:

  • Examples: Prednisolone, Dexamethasone.

  • Effect: Can cause confusion, agitation, or muscle weakness (myopathy).

⚠️ Important Advice for Caregivers

If the elderly person in your care is taking any of these medications: DO NOT stop the medication on your own.

Sudden withdrawal can be dangerous. Instead, please consult a doctor or pharmacist. They can evaluate the risk, adjust the dosage, or recommend specific fall prevention strategies to keep your loved ones safe.

Source: https://www.rama.mahidol.ac.th/fammed/th/article/patient/28jul2020-1244