Beers Criteria: Considering Diagnoses or Conditions 

Updated: Jun 30, 2022
Author: Abimbola Farinde, PharmD, PhD;

Potentially Inappropriate Medication Use in Older Adults

Cardiovascular disease (high severity rating [H])

  • Antiarrhythmic drugs (class Ia, Ic, III): Avoid as first-line agents for atrial fibrillation[1, 2, 3, 4]

  • Disopyramide

  • Dronedarone

  • Digoxin >0.125 mg/day[1]

  • High-sodium-content drugs

Hypertension (H)

  • Phenylpropanolamine hydrochloride

  • Pseudoephedrine

  • Diet pills

  • Amphetamines

Gastric/duodenal ulcer disease (H)

  • Nonsteroidal anti-inflammatory drugs (NSAIDs) (eg, aspirin >325 mg, diclofenac, etodolac, ibuprofen)

  • Non–cox-2–selective NSAIDs

  • Indomethacin

  • Ketorolac, including parenteral

Seizures or epilepsy (H)

  • Bupropion

  • Clozapine

  • Chlorpromazine

  • Olanzapine

  • Thioridazine

  • Thiothixene

  • Tramadol

Blood clotting disorders or anticoagulation therapy (H)

  • Aspirin

  • NSAIDS

  • Dabigatran

  • Dipyridamole

  • Ticlopidine

  • Clopidogrel

  • Prasugrel

Bladder outflow obstruction (H)

  • Anticholinergics/antispasmodic

  • Oral antimuscarinics (eg, oxybutynin, darifenacin, solifenacin)

  • First-generation antihistamines (eg, diphenhydramine, chlorpheniramine, cyproheptadine)

  • Gastrointestinal antispasmodics

  • Muscle relaxants

  • Oxybutynin

  • Flavoxate

  • Antidepressants

  • Decongestants

  • Tolterodine

Stress incontinence (H)

  • Alpha blockers

  • Anticholinergics

  • Tricyclic antidepressants

  • Long-acting benzodiazepines

Arrhythmias (H)

  • Tricyclic antidepressants

Insomnia (H)

  • Oral decongestants

  • Theophylline

  • Methylphenidate

  • Monoamine oxidase inhibitors (MAOIs)

  • Amphetamines

Parkinson disease (H)

  • Antiemetics (eg, metoclopramide, promethazine)

  • Conventional antipsychotics

  • Tacrine

Cognitive impairment (H)

  • Barbiturates

  • Anticholinergics

  • Antispasmodics

  • Muscle relaxants

  • CNS stimulants

  • H2 receptor antagonist

  • Antipsychotics (as needed and long-term use)

Depression (H)

  • Long-term benzodiazepines

  • Sympatholytic agents

Anorexia and malnutrition (H)

  • CNS stimulants

Syncope or falls (H)

  • Short- to intermediate-acting benzodiazepines

  • Tricyclic antidepressants

Syndrome of inappropriate antidiuretic hormone secretion/hyponatremia (low severity rating [L])

  • Selective serotonin reuptake inhibitors (SSRIs)

  • Carbamazepine

  • Antipsychotics

Obesity (L)

  • Olanzapine

Chronic obstructive pulmonary disease (H)

  • Long-acting benzodiazepines

  • Beta-blockers

Chronic constipation (L)

  • Nondihydropyridine calcium channel blockers (eg, diltiazem and verapamil)

  • Anticholinergics/antispasmodics

  • Tricyclic antidepressants