Beers List Criteria: Medication Alternatives Independent of Condition/Disease

Special Note

[medication alternatives to potentially inappropriate drugs in patients 65 yo and older, independent of a specific condition or disease]

Allergy/Cold Agents

[antihistamines, 1st generation alternatives ]

Alternative agents: normal saline (intranasal), steroids (intranasal), 2nd generation antihistamine

Analgesics/Musculoskeletal Agents

[muscle relaxant alternatives ]

Alternative agents for mild-moderate pain use in patients without heart failure or with CrCl >30: acetaminophen, ibuprofen, naproxen, salsalate

Info: give NSAIDS with PPI if tx >7 days

[NSAIDS: alternatives to indomethacin, ketorolac]

Alternative agents for mild-moderate chronic pain use in patients without heart failure or CrCl <30: acetaminophen, ibuprofen, naproxen, salsalate

Info: give NSAIDS with PPI if tx >7 days

[opioids: alternatives to meperidine, pentazocine]

Alternative agents for acute moderate-severe pain use: morphine, oxycodone IR/acetaminophen, tramadol

Alternative agents for chronic moderate-severe pain use: capsaicin topical, gabapentin, lidocaine patch, morphine, oxycodone IR/acetaminophen, pregabalin, SNRI, tramadol

Cardiovascular Agents

[alpha agonists: alternatives to guanfacine, methyldopa]

Alternative agents: ACEI, ARB, long-acting dihydropyridine CCB, thiazide-type diuretic

[antiarrhythmics: alternatives to disopyramide]

Alternative agents for rate control use: beta-blocker, non-dihydropyridine CCB

Alternative agents for rhythm control use: dofetilide, flecainide, propafenone

[antithrombotics: alternatives to dipyridamole (oral IR)]

Alternative agents for secondary prevention of non-cardioembolic stroke use: aspirin/dipyridamole, clopidogrel

[calcium channel blockers: alternatives to nifedipine (IR)]

Alternative agents: long-acting dihydropyridine CCB

CNS Agents

[antipsychotics: alternatives to thioridazine]

Alternative agents for schizophrenia use: non-anticholinergic antipsychotics (except chlorpromazine, loxapine, olanzapine, perphenazine, thioridazine, trifluoperazine)

[barbiturate alternatives]

Alternative agents for epilepsy use: lamotrigine, levetiracetam

[ergot mesylates: alternatives to dihydroergotamine, ergotamine]

Alternative agents: acetylcholinesterase inhibitors, memantine, Vitamin E

[TCAs: alternatives to amitriptyline, clomipramine, imipramine, trimipramine]

Alternative agents for depression use: bupropion, SNRI, SSRI (except paroxetine)

Alternative agents for neuropathic pain use: capsaicin topical, gabapentin, lidocaine patch, pregabalin, SNRI

Endocrine Agents

[estrogens (+/- progestogen): alternatives to estradiol, conjugated estrogens, esterified estrogen, estropipate]

Alternative agents for vasomotor symptoms use: gabapentin, SNRI, SSRI, vaginal estrogen

[sulfonylureas: alternatives to glimepiride, glipizide, glyburide]

Alternative agents: metformin

[thyroid hormones, desiccated: alternatives to thyroid (porcine)]

Alternative agents: levothyroxine

Neurologic Agents

[antiparkinson agents: alternatives to benztropine (oral), trihexyphenidyl]

Alternative agents: carbidopa/levodopa