The Beers criteria for potentially inappropriate medication use in adults 65 and older in the United States is a compilation of drugs and drug classes found to increase the risk of adverse events in older adults. Frequently, older adults are more sensitive to the medications or their side effects. These adverse events have significant economic and quality of life costs for society and individuals and can result in more frequent hospitalizations, permanent injury, or death. Often, the potential for adverse events can be minimized by prescribing safer alternatives or prescribing at the lowest effective dose. The list below appears in Archives of Internal Medicine, volume 163, published in December2003. It represents an update to the original list, published in 1991 by Mark H. Beers, MD.

alprazolam (Niravam, Xanax)

ethacrynic acid (Edecrin)

amiodarone (Cordarone, Pacerone)

ferrous sulfate (iron, Feosol)

amitriptyline

fluoxetine (Prozac)

amphetamines

flurazepam (Dalmane)

anorexic agents

hydroxyzine (Vistaril)

barbiturates

hyoscyamine (Anaspaz, Levsin)

belladonna alkaloids (Donnatal)

meperidine (Demerol)

bisacodyl (Dulcolax)

meprobamate

carisoprodol (Soma)

metaxalone (Skelaxin)

castor oil

methocarbamol (Robaxin)

chlordiazepoxide (Librium)

methyldopa

chlordiazepoxide-amitriptyline (Limbitrol)

methyldopa-hydrochlorothiazide

chlorpheniramine (Chlor-Trimeton)

methyltestosterone (Android, Testred, Virilon)

chlorpropamide (Diabinese)

mineral oil

chlorzoxazone (Parafon Forte DSC)

naproxen (Aleve, Anaprox, Naprosyn)

cimetidine (Tagamet)

nifedipine (Adalat, Afeditab CR, Procardia)

clidinium-chlordiazepoxide (Librax)

nitrofurantoin (Furadantin, Macrobid, Microdantin)

clonidine (Catapres, Duraclon)

orphenadrine (Norflex)

clorazepate (Tranxene)

oxaprozin (Daypro)

cyclobenzaprine (Amrix, Fexmid, Flexeril)

oxazepam (Serax)

cyproheptadine

oxybutynin (Ditropan, Gelnique, Oxytrol)

dessicated thyroid (Armour Thyroid)

pentazocine (Talwin)

dexchlorpheniramine

piroxicam (Feldene)

diazepam (Valium)

promethazine (Promethegan)

dicyclomine (Bentyl)

propantheline

digoxin (Lanoxin)

propoxyphene (Darvon) and combination products

diphenhydramine (Benadryl)

quazepam (Doral)

dipyridamole (Persantine)

reserpine

disopyramide (Norpace)

temazepam (Restoril)

doxazosin (Cardura)

thioridazine

doxepin (Zonalon)

ticlopidine

ergoloid mesylates (Hydergine)

triazolam (Halcion)

estrogens

trimethobenzamide (Tigan)