Medications that Older Adults Should Avoid or use with Caution

The 2023 Updated AGS Beers Criteria®

The AGS Beers Criteria® for Potentially Inappropriate Medication Use in Older Adults identifies medications with risks that may be greater than their benefits for older adults. It is one of the leading sources of this information.

The American Geriatrics Society (AGS) regularly reviews and updates the AGS Beers Criteria®  because new medications and research results become available all the time. The latest update was in 2023.

Why Experts Developed the AGS Beers Criteria®

The AGS Beers Criteria® was developed to reduce the use of medications that can result in more risks than benefits in older adults.

As people age, their bodies change. These changes can increase the risk of an older adult having side effects from taking certain medications. Also, older adults often have more health problems and take more medications than younger people.

One in six adults age 65 or older will have at least one side effect from their medicines.

What the 2023 Updated AGS Beers Criteria® Include

The AGS Beers Criteria®  expert panel reviewed over 7,300 high-quality research studies of medications in their latest update.

The experts updated lists of:

  • Medications and types of medications that are “potentially inappropriate” for older people. Healthcare professionals should consider avoiding giving medications on this list to older adults. These medications may have a higher risk of side effects and may not work as well in an older person.
    • Healthcare professionals can sometimes replace these medications with those that are safer or more effective. Or they can recommend treatments that do not rely on medications. 
  • Medications that are potentially inappropriate for older adults with certain common health problems. Older adults often have other specific diseases or disorders that some medications may make worse.
  • Types of medications that should be used with caution in older adults. Medications on this list can cause problems.  There is less agreement by the experts about the balance of benefits and harms of these medications in older adults.
    • Healthcare providers and older adults need to monitor the impact of these medications to make sure they are working and not causing harm.
  • A list of medication combinations that may result in harmful “drug-drug” interactions.  Medications for several conditions common in older adults may be harmful when taken at the same time. These medications interact with each other to put older adults at higher risk of serious side effects.
  • Medications that should be avoided or have their dose changed in people with poor kidney function.  Because the kidneys help to filter many medications from the body, people with poor kidney function may have harmful reactions to some medications.
To access the complete AGS Beers Criteria® and its related resources, please visit GeriatricsCareOnline.org.

How Health Professionals Are to Use this List

The AGS cautions that healthcare professionals and older adults should not make decisions about their medications based only on the AGS Beers Criteria® . 

The AGS Beers Criteria® don’t apply to all situations. For example, the AGS Beers Criteria® don’t apply if an older adult is getting palliative care (pain and symptom relief) or hospice care (end-of-life). 

The AGS Beers Criteria® are meant to be used as a resource for healthcare professionals, NOT as a replacement for their experience and knowledge. It’s also important to remember that for some people, the medications listed in the AGS Beers Criteria® will be the best choices.

Healthcare providers should not face penalties for prescribing a medication for an older person simply because it appears in the AGS Beers Criteria® lists. Different older adults respond differently to the same medication.

What Older Adults Can Do

To lower the chance of medication-related problems:

  • Keep a list of all medications and dose levels that you take. This includes prescriptions, over-the-counter medications (such as pain relievers or cough and cold products), and supplements, such as vitamins and herbal medications. Bring the list with you whenever you see a healthcare professional. This way, they will know what you are taking and can check for side effects.
  • Ask what side effects your medications can cause and watch for them. Report any bad reactions or ineffective medications to your healthcare provider as soon as possible. Don’t stop taking a medication without first checking with the provider.
  • Talk with your healthcare professional if a medication you are taking is in the AGS Beers Criteria® .  Ask if there might be a safer or more effective choice. If a medication you take is on the AGS Beers Criteria®, it still may be a reasonable choice for you. The way you respond to medications can differ from the way other older adults do.

This summary is from the full report titled American Geriatrics Society 2023 Updated AGS Beers Criteria® for Potentially Inappropriate Medication Use in Older Adults.
 

Last Updated May 2023

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