High Risk Medications and the Elderly

Use of High-Risk Medication in the Elderly

The Healthcare Effectiveness Data and Information Set (HEDIS®) measure “Use of High-Risk Medications in the Elderly” targets safe use of medications in patients ages 65 and older.

 

Medications on the list are based on the Beer’s list, the recognized consensus standards for medication use in older adults.

 

The medications listed below have been determined to be harmful, regardless of medication dose, frequency, or patient’s underlying health status:

 

Therapeutic Class

Medication Name

Antianxiety

▪ meprobamate  

▪ aspirin-meprobamate

Antiemetic

▪ trimethobenzamide                                                          

▪ scopolamine

Analgesic

▪ ketorolac                                                                          

▪ acetaminophen-diphenhydramine

▪ diphenhydramine-magnesium salicylate                                       

Antihistamines

▪ APAP/dextromethorphan/diphenhydramine                   

▪ promethazine

▪ APAP/diphenhydramine/phenylephrine                         

▪ diphenhydramine

▪ APAP/diphenhydramine/pseudoephedrine                     

▪ hydroxyzine hydrochloride

▪ acetaminophen-diphenhydramine                                   

▪ diphenhydramine-tripelennamine

▪ codeine/phenylephrine/promethazine                             

▪ diphenhydramine-phenylephrine

▪ diphenhydramine-pseudoephedrine                               

▪ cyproheptadine

▪ dexchlorpheniramine/guaifenesin/PSE                           

▪ dextromethorphan-promethazine

▪ dexchlorpheniramine-pseudoephedrine                           

▪ codeine-promethazine

▪ dexchlorpheniramine/dextromethorphan/PSE                

▪ phenylephrine-promethazine

▪ dexchlorpheniramine/methscopolamine/PSE                 

▪ dexaclropheniramine 

▪ diphenhydramine-magnesium salicylate                         

▪ tripelennamine

▪ diphenhydramine/hydrocodone/phenylephrine               

▪ hydroxyzine pamoate

▪ atropine/CPM/hyoscyamine/PE/PPA/scolpolamine        

▪ carbetapentane/diphenhydramine/

▪ dexachlorpheniramine/hydrocodone/phenylephrine           

▪ phenylephrine

Antipsychotics, typical

▪ thioridazine                             

▪ mesoridazine                

Amphetamines

▪ dexmethylphetamine              

▪ benzphetamine              

▪ methylphenidate 

▪ pemoline                                 

▪ phendimetrazine            

▪ phentermine

▪ dexmethylphenidate               

▪ diethylpropion               

▪ methamphetamine                   

▪ amphetamine-dextroamphetamine           

Barbiturates

▪ amobarbital                             

▪ secobarbital                   

▪ amobarbital-secobarbital  

▪ butabarbital                             

▪ mephobarbital               

▪ phenobarbital

▪ pentobarbital                 

Long-acting

benzodiazepines

▪ chlordiazepoxide                     

▪ flurazepam                    

▪ amitriptyline-chlordiazepoxide

▪ diazepam                                                                           

▪ chlordiazepoxide-clidinium                                

Calcium channel

blockers

▪ nifedipine –short acting only

GI antispasmodics

▪ propantheline                           

▪ dicyclomine

Belladonna alkaloids

▪ belladonna/ergotamine/phenobarbital                               

▪ atropine                                              

▪ atropine/hyoscyamine/PB/scopolamine                            

▪ atropine–difenoxin

▪ butabarbital/hycosycamine/phenzopyridine                      

▪ atropine-diphenoxylate

▪ digestive enzymes/hyoscyamine/phenyltoloxamine         

▪ hyosycamine

▪ belladonna/caffeine/ergotamine/pentobarbital                  

▪ belladonna  

▪ atropine/CPM/hyoscyamine/PE?scoplamine                    

▪ atropine-edrophonium             

▪ hyoscyamine/methenam/m-blue/phenyl salicyl                 

▪ hyosycamine-phenobarbital                                               

Skeletal muscle relaxants

▪ ASA /caffeine/orphenadrine   

▪ aspirin-methocarbamol   

▪ carisprodol

▪ ASA/carisoprodol/codeine      

▪ aspirin-carisoprodol       

▪ chlorzoxazone

▪ aspirin –meprobamate             

▪ cyclobenzaprine             

▪ metaxalone                             

▪ methocarbamol                        

▪ orphenadrine

Oral estrogen

▪ esterified estrogen-methyltestosterone                              

▪ conjugated estrogen

▪ estropipate                               

▪ esterified estrogen          

▪ conjugated estrogen-medroxyprogesterone

Oral hypoglycemics

▪ chlorpropamide

Narcotics

▪ ASA/caffeine/propoxyphene   

▪ meperidine                  

▪ meperidine-promethazine

▪ propoxyphene napsylate         

▪ pentazocine                  

▪ naloxone-pentazocine   

▪ acetaminophen-pentazocine    

▪ belladonna-opium        

▪ propoxyphene hydrochloride  

▪ acetaminophen-propoxyphene                

Vasodilators

▪ cyclandelate  

▪ ergot mesyloid 

▪ isoxsuprine                  

▪ dipyridamole-short acting only 

Others

▪ methyltestosterone                   

▪ thyroid desiccated        

▪ nitrofurantoin macrocrytals

▪ nitrofurantoin                           

▪ nitrofurantoin macrocrystals-monohydrate             

 

Quick Links

 Download List of High Risk Medications in the Elderly

 

 


 

 

This list is promulgated by Optima Health as recommendations for the clinical management using specific medications in the elderly. Clinical data in a particular case may necessitate or permit deviation from these recommendations. The list of High Risk Medications in the Elderly is institutionally endorsed and is not intended as a substitute for clinical judgment. 9/08

 

Last Updated September 23, 2008 8:25:36 AM