Medications that increase the risk of falls: How to stay safe

If you have a condition, are in pain, or are just plain feeling under the weather, you know that medications can often make you healthier. There may be several drugs designed to address what you’re going through, and the goal of these meds is to help you manage your condition and feel better. And, in most cases, they’re very good at doing just that.

However, sometimes that help comes with an unintentional, additional result: a side effect.

Side effects are common. Almost every single medication has at least one side effect. But rest assured, their benefits tend to outweigh any drawbacks. Plus, most side effects aren’t harmful. Sometimes they’re just a little annoying, like a runny nose. What’s more, not everyone experiences all of the side effects of their meds.

“Side effects tend to be more common the older you are,” says Rosanne M. Leipzig, M.D., Ph.D., the Gerald and May Ellen Ritter Professor and the Vice Chair for Education of the Brookdale Department of Geriatrics and Palliative Medicine at the Icahn School of Medicine at Mount Sinai in New York. “That’s because how you process your meds changes with age. One common side effect is an increased risk of falling. They’re often called ‘fall risk increasing drugs’ (or FRIDs).”

Below, we highlight 12 types of medication that might increase the risk of falls, and what you can do to stay safe. If you’re taking any of these, be sure to talk to your doctor. It’s important to continue taking your medication(s). If you find yourself losing your balance often, your doctor can help you lessen those effects, often with other medications or a change in diet or exercise.

Medications That Might Increase the Risk of Falls

1. Anticonvulsants

Also known as antiepileptic drugs or antiseizure drugs, these can often cause drowsiness. Carbamazepine is the most common antiseizure medication, but mood-altering and anti-anxiety drugs like clonazepam, diazepam, and lorazepam are sometimes used to treat seizures as well.

2. Anticholinergics

These are most commonly used to treat COPD, overactive bladder, GI disorders, asthma, and involuntary muscle movements. Examples include trihexyphenidyl and amitriptyline. Long-term use of anticholinergics can cause drowsiness.

3. Antidepressants

These include selective-serotonin reuptake inhibitors (SSRIs), monoamine oxidase inhibitors (MAOIs), benzodiazepines (called “benzos”), and other kinds of antidepressants and anxiety medications.

4. Antihistamines

You’ll find these in cold and allergy medications, as well as in “PM” or “nighttime” versions of common over-the-counter meds.

5. Antihypertensives

These include nitrates (especially when mixed with drugs for erectile dysfunction) and alpha blockers. Any drug that lowers your blood pressure might also lower it too much, causing dizziness and falls.

6. Hypoglycemia agents

These can lower blood sugar levels that come with insulin resistance and diabetes. Like with blood pressure, excessively low levels of blood sugar can result in dizziness and fainting. That’s one more reason to ensure the correct dosage of insulin and other diabetes-related medications.

7. Diuretics

Also called water pills, these increase the amount of water and salt that your body releases, potentially increasing medication concentrations in your blood or causing dehydration. Other side effects can include dizziness, headaches, muscle cramps, joint disorders (like gout), and impotence.

8. Sedative-hypnotics

These drugs depress (or slow down) the body’s functions. Tranquilizers, sedatives, and sleeping pills can decrease coordination and reaction time, and cause dizziness.

9. Muscle relaxants

While all muscle relaxers can potentially cause muscle weakness, many forms work not just on the muscles but also the brain, increasing the risk of dizziness, drowsiness, and lowered blood pressure.

10. Neuroleptics and antipsychotics  

This includes medications for delusions, hallucinations, paranoia, or disordered thought, principally used to treat schizophrenia and bipolar disorder. These types of medications are also sometimes associated with certain side effects, including dizziness, dry mouth, constipation, agitation and sedation, and weight gain. These side effects can range from mild to severe.

11. Narcotics and opioids

Opioid medications are often used for pain management and include oxycodone, codeine, and morphine. Sedation and dizziness are common side effects.

12. Nonsteroidal anti-inflammatory drugs

When taken in large doses or for an extended period of time, nonsteroidal anti-inflammatory drugs (NSAIDs) such as naproxen and ibuprofen can often contribute to reduced kidney function. This makes it more likely that you may experience side effects (like dizziness) from other medications you take.

How to Stay Safe on Fall Risk Increasing Drugs

If you’re unsure if the medication you’re taking might be increasing your risk for falls, talk to your doctor as soon as possible. Do not make the decision to stop taking your medication without talking to your doctor. Your doctor prescribed it for a reason. Tell your doctor about any additional over-the-counter medications or supplements you may be taking. Discuss what medications are necessary and if you can lower the dosage of any of them in a healthy way.

“Some medications you absolutely need to take,” Dr. Leipzig says. “If you’ve taken a medication for a long time at the same dose, it may be time to lower [the] dosage.”

You may also reduce the risk of falling (while staying on the medication) in other ways. For example, drinking more water can improve hydration levels, while maintaining a healthy weight can reduce the levels of medications stored in fat tissue.

Top ways to help maintain your balance include being active (regularly performing muscle-strengthening and balancing exercises can reduce your risk of falls), staying well-hydrated, maintaining stable blood sugar levels through balanced meals, and addressing health concerns such as leg and foot abnormalities due to diabetic neuropathy.