As we age, our bodies process medications differently, and many older adults end up taking more prescriptions than they truly need. According to the American Geriatrics Society, more than 88% of older adults use at least one prescription drug, and over 66% take three or more in any given month. With numbers like that, it is no surprise that some medications become overused, continued long after the original problem has resolved, or prescribed when safer alternatives exist. This guide walks through the most common drugs older adults tend to overuse, the risks involved, and what you can do to take medications more safely.
1. Proton Pump Inhibitors (PPIs)
PPIs like omeprazole (Prilosec), esomeprazole (Nexium), and lansoprazole (Prevacid) are among the most widely used medications in the United States. They are highly effective for short-term treatment of acid reflux and stomach ulcers, but millions of older adults take them for years, often without a clear ongoing medical reason.
Long-term PPI use has been linked to increased risks of bone fractures, magnesium and vitamin B12 deficiencies, kidney disease, and serious infections such as Clostridioides difficile. The AGS Beers Criteria specifically flags prolonged PPI therapy as a concern in adults 65 and older, advising clinicians to use the lowest effective dose for the shortest possible duration.
If you have been taking a PPI for more than eight weeks without a clear reason, ask your doctor whether a step-down approach, such as switching to an H2 blocker or trying lifestyle changes, might work for you. The National Institute on Aging offers plain-language guidance on safely managing heartburn and other common conditions.
2. Benzodiazepines
Benzodiazepines such as lorazepam (Ativan), alprazolam (Xanax), diazepam (Valium), and temazepam (Restoril) are prescribed for anxiety, insomnia, and muscle spasms. In older adults, however, they carry steep risks. The body clears these drugs more slowly with age, allowing them to accumulate and cause lingering sedation, confusion, unsteady gait, and falls.
The Beers Criteria strongly recommends avoiding benzodiazepines in older adults for the treatment of insomnia, agitation, and delirium because the risks consistently outweigh the benefits. Long-term use is also associated with a higher risk of motor vehicle accidents and, when stopped abruptly, can trigger dangerous withdrawal symptoms.
The NIA’s guide on taking medicines safely as you age notes that cognitive behavioral therapy for insomnia, sleep hygiene improvements, and addressing underlying issues like pain or sleep apnea often work as well as or better than medication. If you or a loved one has been on a benzodiazepine for months or years, do not stop cold turkey; ask your clinician about a slow taper schedule that minimizes withdrawal.
3. NSAIDs and Other Pain Medications
Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil, Motrin), naproxen (Aleve), and prescription celecoxib (Celebrex) are go-to remedies for arthritis, back pain, and headaches. Many older adults take them daily for months or years without realizing the cumulative dangers.
Chronic NSAID use significantly raises the risk of stomach bleeding, ulcers, kidney injury, and high blood pressure, all of which become more common with age. The Beers Criteria recommends chronic NSAID use be avoided in older adults, particularly those with a history of peptic ulcer disease, heart failure, or chronic kidney disease. Acetaminophen is generally safer for ongoing pain, though it must be kept under 3,000 milligrams per day in older adults to protect the liver. For chronic pain, topical NSAIDs, physical therapy, exercise, heat and cold, and complementary approaches such as acupuncture can reduce reliance on oral pain medications.
The FDA’s five medication safety tips for older adults remind seniors to keep a current list of every prescription, over-the-counter drug, and supplement they take and share it at every visit so hidden NSAID use does not slip through.
4. Anticholinergic Medications
Anticholinergic drugs block the neurotransmitter acetylcholine and are found in many older allergy pills (diphenhydramine, or Benadryl), over-the-counter sleep aids, motion sickness drugs, and bladder control medications such as oxybutynin. They are notorious in geriatric medicine because they can cause dry mouth, blurred vision, urinary retention, constipation, and, most alarmingly, confusion and delirium. Long-term cumulative exposure to strong anticholinergics has been linked to a higher risk of dementia, a finding highlighted in multiple large cohort studies and reviewed in a PMC article on geriatric medication safety.
Many older adults are unaware that the sleep aid or allergy pill they reach for is on a list of drugs experts recommend avoiding. Newer alternatives exist for nearly every anticholinergic use: second-generation antihistamines such as cetirizine for allergies, non-anticholinergic sleep strategies, and bladder medications like mirabegron that work through a different mechanism.
Reading labels carefully and asking a pharmacist whether a product has anticholinergic effects is a simple way to avoid one of the most easily preventable sources of medication-related harm in older adults.
5. Statins in Frail Older Adults
Statins such as atorvastatin (Lipitor), rosuvastatin (Crestor), and simvastatin (Zocor) reduce cholesterol and lower cardiovascular risk, and for many older adults they are genuinely lifesaving. The debate over statin overuse in this population centers less on the drug itself than on whether it should be continued indefinitely in people who are very old or frail, particularly those with limited life expectancy.
The American College of Physicians and other experts suggest that for adults over 75 without existing cardiovascular disease, the benefit of starting a statin is less clear and should be weighed against the risks of muscle pain, weakness, drug interactions, and pill burden. Mayo Clinic Press coverage of polypharmacy in older adults emphasizes that deprescribing decisions must be individualized, considering each person’s goals, life expectancy, and other conditions.
Rather than viewing statins as automatically lifelong, older adults and their clinicians should revisit the decision at least annually, asking whether the original reason for the prescription still applies.
A Safer Path Forward
Medications are powerful tools, but more is not always better, especially as we age. The five classes above, PPIs, benzodiazepines, NSAIDs, anticholinergics, and sometimes statins, account for a large share of preventable medication-related harm in older adults. The good news is that most overuse is reversible.
Bring a complete medication list, including over-the-counter drugs and supplements, to every appointment. Ask whether each medication is still needed, whether the dose is appropriate for your age and kidney function, and whether a safer alternative exists.
A brown-bag check with your pharmacist, the AGS Beers Criteria, and resources from the NIA and FDA can guide those conversations.
Thoughtful deprescribing, done gradually and with clinical support, can protect independence, cognition, and quality of life for years to come.
Frequently Asked Questions (FAQs)
Q1. What is the AGS Beers Criteria?
The Beers Criteria is a regularly updated list published by the American Geriatrics Society that identifies medications potentially inappropriate for most adults 65 and older. The 2023 update reviewed more than 1,500 studies and flags drugs that should usually be avoided, used with caution, or dosed differently in older adults. It is a guide for clinicians, not a strict rulebook, and it encourages shared decision-making between patients and providers.
Q2. How can I tell if I am taking too many medications?
Polypharmacy is generally defined as taking five or more prescription medications. Signs of overuse include new confusion, falls, dizziness, unexplained fatigue, or a medication list that has not been reviewed in over a year. The NIA recommends an annual medication review with your doctor or pharmacist, ideally a brown-bag visit where you bring every bottle, including over-the-counter drugs and supplements.
Q3. Should I stop an overused medication on my own?
No. Some drugs, including benzodiazepines, certain antidepressants, opioids, and even PPIs after long-term use, must be tapered gradually to avoid withdrawal or rebound symptoms. Always work with a clinician to develop a deprescribing plan that specifies the taper schedule, monitoring, and warning signs to watch for.
Q4. Are over-the-counter drugs and supplements a concern?
Yes. Many OTC sleep aids and allergy pills contain anticholinergic ingredients, and NSAIDs are widely available without a prescription. Supplements can also interact with prescription drugs, sometimes dangerously. Always include OTC drugs and supplements on the medication list you share with your doctor and pharmacist.
Q5. Where can I learn more about medication safety for older adults?
The FDA, the National Institute on Aging, and Mayo Clinic Press all publish consumer-friendly guides, and your local pharmacist is often the most accessible expert for a personalized medication review.