Alternatives for Medications Listed in
the AGS Beers Criteria for Potentially
Inappropriate Medication Use in Older Adults
Never stop taking a medication without first
talking to your healthcare provider. Even if a
medication you’re taking is listed on the AGS Beers Criteria, don’t
stop taking it without discussing it with your healthcare provider.
Know about the medications you are taking.
Ask your clinician or pharmacist about the medications you are taking
and their potential side effects. If you’re experiencing any symptoms,
ask if they could be related to a medication you are taking or if it may
be a sign of another problem. Use only trusted, reliable sources (such
as MedlinePlus) to look up information about your medications.
Review your medications regularly. You should regularly
review all of the medications you are taking with your clinicians and
pharmacists. In these reviews, you should report any problems with
your medications, including any side effects, questions you may have
about them, or any problems with taking them as prescribed (such as
cost). These reviews should occur at least once a year as well as any
time a new medication is prescribed.
Expert information
from Healthcare
Professionals Who
Specialize in the
Care of Older Adults
Key Points
For more information on potentially inappropriate medication use, please read the
Ten Medications Older Adults Should Avoid or Use with Caution tip sheet.
Remember
potentially inappropriate
medications are just that—
potentially inappropriate. The
2015 Updated AGS Beers
Criteria and the list of alternatives
are resources, not a
replacement, for the expertise
and knowledge of your
healthcare provider.
The AGS Health in Aging
Foundation has developed
this resource to help you
talk to your healthcare
provider about these
possible alternatives to
Beers Criteria medications
you’re taking.
Recently, the American Geriatrics Society (AGS) released the 2015 Updated Beers Criteria for
Potentially Inappropriate Medication Use in Older Adults. For more than 20 years, the Beers Criteria
have been a valuable resource for healthcare providers about the safety of prescribing drugs for
older people.
To accompany the updated AGS Beers Criteria, the AGS also developed a list of safer medications
that are alternatives to some of the medications listed in the criteria. This first list of alternatives
focuses on those medications that are used in various quality measures, which are used by
America’s health plans to measure performance on important aspects of care. Your healthcare
provider may choose to substitute these alternatives in place of potentially inappropriate medications
included in the criteria.
For vaginal dryness:
• topical estrogen creams
For hot flashes and night sweats:
• gabapentin (Neurontin)
DISCLAIMER:This information is not intended to diagnose health problems or to take the place of medical
advice or care you receive from your physician or other healthcare provider.Always consult your healthcare
provider about your medications, symptoms, and health problems. Oct 2015
©2015 Health in Aging Foundation.All rights reserved.This material may not be reproduced, displayed,
modified, or distributed without the express prior written permission of the copyright holder.
For permission, contact info@healthinaging.org.
• saline nasal rinse
• steroid nasal sprays
such as fluticasone
(Flonase)
• Allergy products such as:
- cetirizine (Zyrtec)
- fexofenadine (Allegra)
- loratadine (Claritin)
• selective serotonin reuptake inhibitors (SSRIs) such as:
- citalopram (Celexa)
- sertraline (Zoloft)
• buproprion (Wellbutrin)
For epilepsy, anticonvulsants such as:
• lamotrigine (Lamictal)
• levetiracetam (Keppra)
Ask your healthcare provider about non-medication sleep
hygiene techniques.
These alternatives listed are
for moderate pain:
• acetaminophen (Tylenol)
• topical capsaicin products
• lidocaine patches
• serotonin–norepinephrine
reuptake inhibitors (SNRIs)
such as:
- duloxetine (Cymbalta)
- venlafaxine (Effexor)
For anxiety:
• buspirone (Buspar)
• selective serotonin reuptake
inhibitors (SSRIs) such as:
- citalopram (Celexa)
- sertraline (Zoloft)
For sleep:
• Ask your healthcare
provider about nonmedication
sleep hygiene
techniques.
For acute moderate to severe pain:
• tramadol (Ultram)
• morphine
• oxycodone immediate release with acetaminophen
(hot flashes continued)
• serotonin–norepinephrine
reuptake inhibitors (SNRIs)
• selective serotonin
reuptake inhibitors (SSRIs)
First Generation Antihistamines
(used for allergies)
• chlorpheniramine (AllerChlor)
• diphenhydramine (Benadryl)
Triclyclic Antidepressants for depression
• amitriptyline (Elavil)
• imipramine (Tofranil)
Barbituates
• phenobarbital
• other drugs ending in “barbital”
Sleeping Aids
• zolpidem (Ambien)
• zaleplon (Sonata)
• ezopiclone (Lunesta)
Pain Medication
People with chronic kidney disease or chronic
renal failure should avoid all non-aspirin, nonsteroidal
anti-inflammatory medications (NSAIDs).
Benzodiazepines (often used to treat anxiety
and sleep disorders as well as other conditions)
People with a history of falls should avoid
benzodiazepines, such as:
• alprazolam (Xanax)
• lorazepam (Ativan)
• diazepam (Valium)
HormoneTherapy
• Estrogen pills and patches
Pain Medication Opioids (Narcotics)
• meperidine (Demerol)
• pentazocine (Talwin or Talacen)
Medication Class/Examples
NOTE: This is only a partial list of medications. Medications listed in parentheses are examples of brand names of the 	
	 generic medications listed.
THE OFFICIAL FOUNDATION OF
THE AMERICAN GERIATRICS SOCIETY
Possible Alternatives
to Discuss with your Healthcare Provider