Falls are a serious concern for older adults and are one of the leading causes of injury, hospitalization, and loss of independence. While many factors contribute to falls, medications are one of the most common — and modifiable — risk factors.
Certain medications can cause side effects like dizziness, drowsiness, confusion, or sudden drops in blood pressure, all of which can make falls more likely. Taking multiple medications from these categories can further increase the risk.
Understanding which medications may affect balance and alertness is an important part of fall prevention for older adults. Reviewing prescriptions regularly can significantly reduce the likelihood of preventable falls.
Below are 10 common categories of medications that may raise fall risk in older adults.
1. Sleep Aids and Sedatives
Medications used for insomnia often affect balance, alertness, and reaction time, especially during nighttime awakenings.
Examples include:
- Zolpidem (Ambien)
- Eszopiclone (Lunesta)
- Zaleplon (Sonata)
Long-term use can increase fall risk, and non-drug sleep therapies are often safer options for older adults.
2. Anti-Anxiety Medications
Benzodiazepines are frequently prescribed for anxiety or sleep but are well known for increasing fall risk due to sedation and slowed reflexes.
Examples include:
- Lorazepam (Ativan)
- Alprazolam (Xanax)
- Diazepam (Valium)
- Temazepam (Restoril)
These medications are particularly risky when used for more than a short period.
3. Antidepressants
Some antidepressants affect balance, blood pressure, and alertness. Older tricyclic antidepressants (TCAs) carry a higher risk, but some newer medications may also contribute.
Examples include:
- Amitriptyline
- Nortriptyline
- Sertraline (Zoloft)
- Escitalopram (Lexapro)
Medication choice and dosing can often be adjusted to reduce risk.
4. Opioid Pain Medications
Opioids can cause drowsiness, dizziness, slowed breathing, and confusion, all of which increase fall risk.
Examples include:
- Oxycodone
- Hydrocodone
- Hydromorphone
- Fentanyl
When possible, non-opioid pain management strategies may be safer for older adults.
5. Muscle Relaxants
Muscle relaxants often cause sedation and confusion in seniors and are generally recommended only for short-term use.
Examples include:
- Cyclobenzaprine (Flexeril)
- Methocarbamol (Robaxin)
- Metaxalone (Skelaxin)
Alternatives like physical therapy or gentle exercise may help reduce reliance on these medications.
6. Blood Pressure Medications
Medications that lower blood pressure can sometimes cause orthostatic hypotension — a sudden drop in blood pressure when standing up.
Examples include:
- Beta blockers (e.g., carvedilol)
- ACE inhibitors (e.g., lisinopril)
- Diuretics (e.g., hydrochlorothiazide)
Fall risk may increase when doses are changed or medications are newly started.
7. Diabetes Medications That Lower Blood Sugar
Low blood sugar (hypoglycemia) can cause weakness, dizziness, confusion, and fainting.
Examples include:
- Insulin
- Sulfonylureas (e.g., glipizide)
- Injectable medications like semaglutide
The risk is higher if meals are skipped or appetite decreases.
8. Antipsychotic Medications
Often used to manage behavioral symptoms in dementia, antipsychotics can cause sedation, blurred vision, and balance issues.
Examples include:
- Haloperidol (Haldol)
- Fluphenazine
- Perphenazine
Dose adjustments may help reduce fall risk when these medications are necessary.
9. Anti-Seizure Medications
Anticonvulsants can affect coordination, alertness, and balance.
Examples include:
- Gabapentin
- Carbamazepine
- Lamotrigine
- Valproic acid
These medications are sometimes used for conditions beyond seizures, so regular review is important.
10. Anticholinergic Medications
These medications can cause confusion, blurred vision, dry mouth, and dizziness — especially in older adults.
Examples include:
- Oxybutynin
- Benztropine
- Diphenhydramine (Benadryl)
Fall risk increases when multiple anticholinergic medications are taken together.
What Older Adults and Families Can Do
If you or a loved one takes medications from these categories, it doesn’t automatically mean a fall will happen. However, there are proactive steps that can help lower risk:
- Review medications regularly with a doctor or pharmacist
- Ask about dose adjustments or safer alternatives
- Stay physically active to maintain strength and balance
- Schedule routine vision exams
- Reduce tripping hazards at home
Concerned about fall risks for yourself or a loved one?
At A Place At Home – Kirkland, WA our caregivers help seniors stay safe at home by supporting daily routines, mobility, and medication reminders — all while watching for fall risks and changes in health.
If you or a loved one could benefit from extra support at home, we’re here to help.
How Do Caregivers Spot Fall Risks Before an Accident Happens?