Are your medications increasing your fall risk?

Woman holding medication and looking at label

If you’re taking several prescription meds, there’s a chance they could interact and make you less steady on your feet. Here’s what to do.

The information in this article is for educational purposes only and is not intended to replace medical advice from your doctor.

When your doctor prescribes you a new medication, they’re doing it not only to treat a health problem but also to make you feel better. But sometimes that’s not what happens, especially with older adults.

More than 4 in 10 older adults take five or more prescription drugs every day, according to data from the Lown Institute. And sometimes those drugs don’t interact well with one another. That’s where side effects can make you feel unstable.

Here’s the truth: Side effects are common. Almost all prescription — and even some over-the-counter (OTC) — medications can cause side effects, states the National Institute on Aging (NIA). Most are mild, such as a headache or constipation.

But when it comes to side effects and adults ages 65 and up, things can get serious quickly, the NIA adds. Other common side effects include dizziness or drowsiness. And if you’re not steady on your feet, it could lead to a fall.

If you think you’re experiencing side effects from any of your medications — or have fallen because of them — talk to your doctor. (Don’t stop taking your medicine without consulting your doctor first.) They may be able to switch you to a new prescription or even find ways to lessen the side effects of your medications.

Here are some common prescription and OTC medications that can put you at risk of falling. (For more information about each medication and its side effects, please see “See our sources,” at the end of this article.)

12 medications that can increase your risk of falling

1. Anticholinergics

Prescription or OTC: prescription
Used to treat: chronic obstructive pulmonary disease (COPD), overactive bladder, gastrointestinal disorders, asthma, involuntary muscle movements
Fall risk/side effects: drowsiness (with long-term use)
Common anticholinergics: trihexyphenidyl, amitriptyline

2. Antidepressants

Prescription or OTC: prescription
Used to treat: anxiety, depression
Fall risk/side effects: low blood pressure (when standing after sitting/lying down)
Common antidepressants: sertraline, citalopram, duloxetine, venlafaxine, bupropion, mirtazapine

3. Antihistamines

Prescription or OTC: OTC
Used to treat: colds, allergies
Fall risk/side effects: drowsiness, blurred vision
Common antihistamines: diphenhydramine (Benadryl), fexofenadine (Allegra), cetirizine (Zyrtec). You may also find these ingredients in any OTC sleep aids labeled “PM.”

4. Antipsychotics

Prescription or OTC: prescription
Used to treat: bipolar disorder, schizophrenia 
Fall risk/side effects: agitation, constipation, dizziness, dry mouth, sedation, weight gain
Common antipsychotics: aripiprazole, clozapine, olanzapine, paliperidone, and risperidone, among others

5. Anxiety and insomnia medications

Prescription or OTC: prescription
Used to treat: anxiety, insomnia, seizures
Fall risk/side effects: dizziness, drowsiness
Common anxiety and insomnia meds: alprazolam (Xanax), diazepam (Valium), zolpidem (Ambien)

6. Blood pressure medications

Prescription or OTC: prescription
Used to treat: high blood pressure
Fall risk/side effects: dizziness
Common blood pressure meds: ACE inhibitors (benazepril, lisinopril), alpha-blockers (doxazosin, prazosin), beta-blockers (atenolol, labetalol)

7. Diabetes medication

Prescription or OTC: prescription
Used to treat: diabetes
Fall risk/side effects: dizziness, fainting
Common diabetes meds: biguanides (metformin), meglitinides (repaglinide, nateglinide)

8. Diuretics (water pills)

Prescription or OTC: prescription
Used to treat: high blood pressure
Fall risk/side effects: dizziness, headaches, impotence, muscle cramps, joint disorders (e.g., gout)
Common diuretics: thiazide (chlorthalidone, indapamide), loop (furosemide, torsemide), potassium-sparing (eplerenone, spironolactone)

9. Epilepsy and seizure medications

Prescription or OTC: prescription
Used to treat: anxiety, mood, seizure risk
Fall risk/side effects: drowsiness
Common epilepsy and seizure meds: carbamazepine, clonazepam, diazepam, lorazepam

10. Muscle relaxants

Prescription or OTC: prescription
Used to treat: back pain, muscle spasms
Fall risk/side effects: dizziness, drowsiness, low blood pressure, muscle weakness
Common muscle relaxants: carisoprodol, cyclobenzaprine, diazepam, methocarbamol

11. Narcotic pain medications

Prescription or OTC: prescription
Used to treat: chronic pain
Fall risk/side effects: dizziness, sedation
Common narcotic pain meds: codeine, morphine, oxycodone

12. Nonsteroidal anti-inflammatory drugs (NSAIDs)

Prescription or OTC: OTC (most of the time)
Used to treat: fever reduction, inflammation, pain, blood clots
Fall risk/side effects: dizziness, drowsiness
Common NSAIDs: ibuprofen, naproxen

What you can do to lessen your chance of falls from medication

If you’re taking one of the medications listed above, ask yourself:

Have I experienced side effects?
Have any of them led to me falling or feeling not like myself?

If you answered yes to either of these questions, contact your doctor as soon as possible.

At your appointment, you’ll want to bring a list of the other medications you’re taking — even OTC drugs or supplements, as they may be creating a harmful interaction.

If you’re dealing with interactions between prescription medications, your doctor may be able to help you find alternatives. Or they can advise you about lifestyle changes, such as diet and exercise, that can help reduce the negative effects of the drugs you’re taking.

Your in-home health and wellness assessment is another opportunity to review all your medications with a clinician. This yearly visit is available at no additional cost to you — and it gives you plenty of time to get all your questions answered with a Matrix Medical Network licensed clinician. Learn more about this visit here.

Even if you’re not taking one of the above drugs, there are tweaks you can make to your day-to-day lifestyle that can help you avoid falls. These include:

Addressing leg or foot injuries promptly. If you stub your toe and it stays black and blue for weeks, it’s probably a good idea to get it checked out by a health professional. Abnormal issues with your legs and/or feet could also be a sign of diabetic neuropathy.
Drinking more water. Being dehydrated can make you feel dizzy. It’s a good idea to drink at least four to six cups of water a day.
Exercising regularly. Strengthening your muscles and doing balance exercises can go a long way toward helping you avoid a fall.
Maintaining a healthy weight. Being underweight increases the risk of bone loss and broken bones if you do fall.
Maintaining stable blood sugar levels. You can do this by eating balanced meals.

The bottom line: If you’re 65 or older and taking multiple medications, it’s worth keeping tabs on yourself. Are you feeling woozy after taking a certain medication? Are you unsure about how the different medications you’re taking might interact? Whatever the case may be, it’s always a good idea to consult your doctor. They will be able to keep you in good health — and on your feet.

See our sources:

General information about medications, falls, and tips to help keep older adults safe:

Medication overload and older Americans: Lown Institute

Medication and older adults: National Institute on Aging

Taking medicines safely as you age: National Institute on Aging

Medications linked to falls: Centers for Disease Control and Prevention

Causes of falls and how to prevent them: National Institute on Aging

Falls and diabetes: American Diabetes Association

Falls and dehydration: Mayo Clinic Proceedings: Innovations, Quality & Outcomes

Finding and learning about side effects: U.S. Food and Drug Administration

Balance and avoiding falls: American Diabetes Association

Association between dehydration and falls: Mayo Clinic Proceedings: Innovations, Quality & Outcomes