Medications and the Risk of Falling Which drugs can increase the risk of falls?
In theory ANY drug that causes one of the following effects can increase the risk of falling:
As well, theoretically ANY drug that causes the following effects can increase the risk of a serious outcome if an individual falls:
• Osteoporosis or reduced bone mineral density: Increased risk of fracture if a fall
• Bleeding risk: Increased risk of a cerebral hemorrhage if a fall occurs
What can be done if you are taking a drug that can increase the falls risk?
Individualize treatment. Drugs are just one of many factors that can increase the risk of falling.
Assessment: Are you at high risk? Have you had a slip, trip, near fall or fall in the last 6 months? taking a drug that can cause the effects listed above
Are you taking a high dose of the drug? displaying any of the adverse effects listed above, such as
Are you over the age of 65? Elderly patients may be more sensitive to adverse
drug effects because of alterations in the way that the body absorbs, distributes or eliminates the drug.
taking more than one drug that increases the falls risk?
Are you at high risk of falling for other, non-drug reasons? difficult for you or your doctor to monitor for an adverse drug effect?
Consider intervention, especially if you have assessed the patient as high risk:
• Consider risk/benefit ratio: Does the benefit of the drug outweigh a possible risk
• Is there a safer drug or non-drug alternative?
• Is it possible to minimize the dose without losing the benefit of the drug?
Medications and the Risk of Falling Examples of drugs that can increase the risk of falling, or of a serious outcome if a fall occurs (and possible mechanisms)
ACE Inhibitors (3) Eye drops (6) Herbal and Antipsychotics Natural health products Natural sleep aids Natural products Alcohol (1,5) Antidepressants for sexual Proton Pump enhancement Inhibitors (9) Alpha Receptor Blockers Metoclopramide Sedative/ hypnotics Muscle Relaxants Benzodiazepines Barbiturates Anticoagulants (8) Corticosteroids, Nitrates (2,3) Anticonvulsants Antihistamines, sedating (1) Opiates/narcotics Thiazolidinediones Possible mechanisms (often unclear): (1) Drowsiness; (2) Dizziness; (3) Hypotension; (4)
Parkinsonian effects; (5) Ataxia/gait disturbance; (6) Vision disturbance; (7) Osteoporosis or reduced bone mineral density increases the fracture risk if a fall occurs; (8) Risk of serious bleeding if a fall
occurs. Drugs are listed by generic (chemical) name under each drug group. For Brand
(manufacturer’s) names, check in the CPS to find the generic name. This list includes only those drugs for which there is evidence of increased risk of falls or their consequences. There may be other drugs
that increase this risk in certain patients.
Barbara Cadario and BC Falls and Injury Prevention Coalition. Drugs and the Risk of Falling: Guidance Document. Revised August 2011.
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Using Natural Progesterone and Still Having Hot Flushes? Here's why. Day one of your menstrual cycle is the day you start your period. That's when the pituitary gland in your head sends hormone down to your ovaries to start them maturing about 200 eggs. As those eggs mature they release three main estrogens, Estadiol, Estrone and Estriol and progesterone. Let's say you have a 28 day cycl