That prescription you’ve taken for years might deserve another look, especially if you’re over 65. Medications that once worked well can sometimes cause new problems as kidney function, overall health, and the other drugs you take change with age. And the consequences aren’t limited to uncomfortable side effects.
A medication that causes dizziness could contribute to a fall, while an unnecessary prescription might quietly add hundreds of dollars to your annual healthcare expenses. For retirees living on fixed incomes, both concerns deserve attention.
The American Geriatrics Society’s Beers Criteria identifies medications that may pose increased risks for older adults, including certain treatments for anxiety, insomnia, diabetes, and chronic pain. These guidelines don’t mean every listed medication is unsafe or should automatically be discontinued. Instead, they help healthcare professionals determine when the potential risks of a medication may outweigh its benefits.
Here are seven prescription drugs older adults should review with their pharmacists, along with questions that could protect their health and potentially reduce unnecessary medical expenses.
1. Alprazolam (Xanax) for Anxiety
Alprazolam, commonly sold under the brand name Xanax, treats anxiety and panic disorders but can become more problematic as people age. The American Geriatrics Society warns that benzodiazepines can increase the risk of confusion, falls, fractures, and dependence in older adults, particularly when combined with opioid pain medications or other sedating drugs.
Someone who has taken Xanax for years without obvious problems may develop greater sensitivity as their health or medication regimen changes. A fall related to dizziness or impaired coordination could also result in emergency care, rehabilitation, and other expenses that quickly exceed the medication’s monthly cost. Ask your pharmacist whether your dosage remains appropriate and whether alternative treatments are worth discussing with your prescriber, but never stop taking alprazolam abruptly because withdrawal can be dangerous.
2. Zolpidem (Ambien) for Sleep Problems
Zolpidem, commonly known as Ambien, is prescribed for insomnia, but its potential risks deserve careful consideration in older adults. The Beers Criteria identifies zolpidem and similar sleep medications as potentially inappropriate for many older patients because they can increase the risk of confusion, falls, fractures, and emergency department visits while providing relatively modest sleep improvements.
Consider someone who takes a sleeping pill and then gets up several times during the night to use the bathroom, when reduced alertness could make navigating a dark hallway more dangerous. Beyond the potential medical consequences, treating a medication-related injury may involve deductibles, copayments, transportation, and follow-up appointments. Ask your pharmacist whether your sleep medication remains necessary and whether treatments such as cognitive behavioral therapy for insomnia might be appropriate to discuss with your healthcare provider.
3. Glyburide for Type 2 Diabetes
Glyburide is an older diabetes medication that lowers blood sugar by encouraging the pancreas to release insulin. Glyburide carries a greater risk of prolonged hypoglycemia, or dangerously low blood sugar, than certain shorter-acting medications in the same drug class. Severe hypoglycemia can cause sweating, shakiness, confusion, weakness, and loss of consciousness, potentially requiring emergency treatment.
Although glyburide may be inexpensive at the pharmacy, its low purchase price doesn’t automatically make it the most economical choice when medication safety and potential complications are considered. Ask whether your kidney function, blood sugar readings, and treatment goals support continuing glyburide or whether another medication might provide a better balance of safety, effectiveness, and cost.
4. Omeprazole (Prilosec) for Acid Reflux
Omeprazole is commonly prescribed for acid reflux, gastroesophageal reflux disease, and other conditions involving excess stomach acid. It is recommended that patients try to avoid scheduled use of proton pump inhibitors beyond eight weeks in many older adults unless a clear medical indication supports continued treatment. Long-term use has been associated with concerns including certain intestinal infections and fractures, although these associations don’t establish that the medication will cause those problems in every patient.
Someone who continues refilling omeprazole long after an initial episode of heartburn has resolved may be paying for treatment that deserves reassessment, while people with Barrett’s esophagus, severe erosive esophagitis, or other conditions may genuinely need ongoing therapy. Ask your pharmacist whether your original reason for taking omeprazole still applies and whether your prescriber should consider a lower dose, alternative treatment, or supervised discontinuation.
5. Cyclobenzaprine (Flexeril) for Muscle Pain
Cyclobenzaprine is a muscle relaxant sometimes prescribed for back injuries, muscle spasms, and other painful conditions. It is a medication that older adults often tolerate poorly because of sedation, anticholinergic side effects, and an increased risk of fractures. An older adult taking cyclobenzaprine for recurring back discomfort might experience dizziness or unsteadiness that makes ordinary activities, including climbing stairs or getting out of bed, more hazardous.
Continuing to refill a medication that provides limited relief can also create unnecessary prescription expenses, particularly when the treatment was originally intended for a short-term injury. Ask your pharmacist whether continued use is appropriate and whether your healthcare provider should evaluate other approaches, such as physical therapy or a different pain-management strategy.
6. Amitriptyline for Depression or Nerve Pain
Amitriptyline is an older antidepressant also prescribed for certain types of nerve pain and headache prevention. It potentially has strong anticholinergic effects that can cause constipation, dry mouth, confusion, sedation, and blood pressure drops when standing. These problems may become more pronounced when amitriptyline is combined with other medications that produce similar effects, including certain allergy and bladder-control treatments.
Someone experiencing persistent dizziness or confusion might undergo additional medical evaluations before realizing that their medication combination deserves closer examination, potentially adding to their healthcare expenses. Ask your pharmacist to check your complete medication list for overlapping anticholinergic effects and discuss whether your current treatment remains the safest practical option.
7. Oral Diclofenac for Arthritis and Chronic Pain
Diclofenac is a nonsteroidal anti-inflammatory drug, or NSAID, used to treat arthritis and other inflammatory pain conditions. Chronic use of oral NSAIDs can increase the risk of gastrointestinal bleeding, ulcers, kidney injury, and elevated blood pressure, especially in older adults with certain medical conditions or medication combinations. These complications can require laboratory testing, specialist visits, hospitalization, or additional treatment, making the total financial consequences potentially much greater than the prescription price.
It’s important to distinguish oral diclofenac from topical diclofenac gel, which generally results in less medication circulating through the body and has a different risk profile. If you regularly take oral diclofenac, ask whether your kidney function, blood pressure, and other medications warrant closer monitoring or whether a different pain treatment would be appropriate.
A Medication Review Could Also Lower Your Pharmacy Bills
Reviewing prescription drugs older adults should review isn’t only about avoiding side effects; it can also uncover opportunities to reduce unnecessary healthcare spending. Someone taking eight medications prescribed by several specialists may be paying for duplicate treatments, outdated prescriptions, or brand-name drugs when suitable lower-cost alternatives are available.
For example, eliminating one unnecessary $25 monthly prescription under a clinician’s guidance would save $300 annually, although medication changes should always be based on clinical needs rather than price alone. Pharmacists can also help identify potentially less expensive formulations, appropriate generic alternatives, and opportunities to simplify complicated medication schedules. The goal is to make sure every prescription has a clear purpose and that you’re not spending retirement income on treatments that no longer provide enough benefit.
Medicare May Cover a Medication Review at No Additional Cost
Some Medicare beneficiaries can receive a comprehensive medication review through their prescription drug coverage without paying an additional fee. According to Medicare.gov, qualifying beneficiaries enrolled in plans with Part D coverage may receive Medication Therapy Management services, which include a review with a pharmacist or other healthcare professional.
The program can provide a written medication list and recommendations to help patients understand their prescriptions, identify potential problems, and coordinate care with their doctors. Eligibility depends on Medicare program requirements and individual circumstances, so not every beneficiary automatically qualifies for these services. Contact your Medicare drug plan to ask whether you’re eligible, and use the appointment to discuss medication safety, unnecessary prescriptions, and possible cost-saving alternatives.
What to Bring to Your Next Pharmacy Visit
A productive medication review begins with an accurate list of everything you take, including prescriptions, over-the-counter medications, vitamins, and dietary supplements. The National Institute on Aging recommends keeping medication information organized and sharing it with healthcare professionals to help identify potential problems
Write down each medication’s name, dosage, frequency, purpose, and any side effects you’ve noticed, along with the amount you typically pay for it. Ask your pharmacist which medications require monitoring, whether any combinations increase your risk of falls or confusion, and whether less expensive alternatives are available. If the review identifies a concern, work with your prescribing clinician to make changes safely rather than adjusting or stopping medications independently.
Your Prescription List Deserves a Financial and Health Checkup
Knowing which prescription drugs older adults should review can help protect both your well-being and your retirement budget. Medications such as Xanax, Ambien, glyburide, omeprazole, cyclobenzaprine, amitriptyline, and oral diclofenac may still be appropriate for certain patients, but their continued use deserves periodic evaluation. A pharmacist can help identify interactions, questionable combinations, unnecessary expenses, and situations where a prescriber should reassess treatment. Reviewing medications regularly doesn’t guarantee lower healthcare bills, but it can help ensure you’re paying for treatments that remain appropriate and necessary. Sometimes the most valuable question at the pharmacy counter isn’t how much a prescription costs, but whether it’s still the right medication for you.
When was the last time you asked your pharmacist to review your prescriptions, and have you ever discovered a medication you no longer needed? Share your experience in the comments.
What to Read Next
One Medicare Formulary Change Could Raise Your Prescription Costs Next Year
Your Prescription Is Covered This Year — Don’t Assume the Same Pharmacy Will Be Cheapest in 2027
Still Taking That Old Prescription? Check These 5 Things Before Your Next Dose
Read the full article here
