This table is the result of merging the lists in Anticholinergic Drugs to Avoid in the Elderly and List of Anticholinergic Drugs and Why Some of Them are Dangerous for Seniors. As the titles of the two source lists suggest, these drugs should be avoided by senior/elderly people, if at all possibe.
Many of the below drugs are found in over-the-counter (OTC) products or in combination with other medications (prescription or OTC).
If you have concerns about using anticholinergic drugs, check with your pharmacist, or possibly your doctor.
For example, multiple over-the-counter sleep medications contain diphenhydramine (Benadryl), a strong anticholinergic antihistamine.
If you have concerns about using anticholinergic drugs, check with your pharmacist, or possibly your doctor.
For example, multiple over-the-counter sleep medications contain diphenhydramine (Benadryl), a strong anticholinergic antihistamine.
The table below is not a complete list of anticholinergic drugs, but includes many of the most common ones to avoid, when possible.
| Antihistamines, First-Generation | |
|---|---|
| brompheniramine | |
| carbinoxamine | Arbinoxa, Karbinal ER, Palgic |
| chlorpheniramine | Actifed, Aller-Chlor, Allergy & Congestion Relief, Chlor-Trimeton, Codeprex, Efidac-24 Chlorpheniramine, etc. |
| clemastine | Tavist Allergy |
| cyproheptadine | Periactin |
| dexbrompheniramine | Ala-Hist IR |
| dexchlorpheniramine | Polaramine, Polaramine Repetabs |
| dimenhydrinate | Dramamine |
| diphenhydramine*1(oral) | Advil PM, Aleve PM, Allermax, Bayer PM, Benadryl, Excedrin PM, Nytol, Simply Sleep, Sominex, Tylenol PM, Unisom, etc.) |
| doxylamine | Aldex AN, Unisom, Nytol Maximum Strength |
| hydroxyzine | Atarax, Visteril |
| meclizine | Antivert, Bonine, D-Vert, Dramamine Less Drowsy |
| promethazine | Phenergan |
| pyrilamine | an ingredient of combination cold medicines |
| triprolidine | Histex, Zymine, Tripohist |
| *1Use of diphenhydramine in acute allergic reactions may be appropriate; many OTC sleep agents have diphenhydramine as an active ingredient, be sure to check labels. | |
| Antiparkinsonian Agents*2 | |
| benztropine | Cogentin |
| trihexyphen | |
| *2In general, these agents are not recommended for prevention of extrapyramidal symptoms with antipsychotics. In addition, more-effective agents are available for treatment of Parkinson disease, especially for older individuals. | |
| Skeletal Muscle Relaxants | |
| cyclobenzaprine | Amrix, Fexmid, Flexeril |
| methocarbamol | Robaxin |
| orphenadrine | Norflex |
| Antiarrhythmics | |
| disopyramide | Norpace, Norpace CR |
| Antidepressants | |
| amitriptyline | Elavil |
| amoxapine | |
| clomipramine | Anafranil |
| desipramine | Norpramin |
| doxepin | Adapin, Silenor, Sinequan |
| imipramine | Tofranil, Tofranil-PM |
| nortriptyline | Pamelor |
| paroxetine | Brisdelle, Paxil, Paxil CR, Pexeva |
| protriptyline | Vivactil |
| trimipramine | Surmontil |
| Antimuscarinics (Urinary Incontinence) | |
| darifenacin | Enablex |
| fesoterodine | Toviaz |
| flavoxate | Urispas |
| oxybutynin | Ditropan, Ditropan XL, Oxytrol |
| solifenacin | Vesicare |
| tolterodine | Detrol, Detrol LA |
| trospium | Sanctura, Sanctura XR |
| Antipsychotics*3 | |
| chlorpromazine | Thorazine |
| clozapine | Clozaril, FazaClo, Versacloz |
| loxapine | Loxitane |
| olanzapine | Zyprexa, Zyprexa Relprevv, Zyprexa Zydis |
| perphenazine | |
| thioridazine | |
| trifluoperazine | Stelazine |
| *3Boxed warnings exist about the use of antipsychotics in the elderly with dementia. Antipsychotics are not approved for use in psychotic conditions related to dementia. Antipsychotics may increase the risk of death in older adults with dementia-related conditions. | |
| Antispasmodics | |
| atropine | excludes ophthalmic [eye] agents |
| belladonna alkaloids | |
| clidinium-chlordiazepoxide | Librax |
| dicyclomine | Bentyl |
| homatropine (excludes ophthalmic [eye] agents | Tussigon) |
| hyoscyamine | Anaspaz, Levbid, Levsin, NuLev |
| methscopolamine | Pamine, Pamine Forte |
| propantheline | |
| scopolamine (excludes ophthalmic) | Transderm Scop |
| Antiemetics | |
| prochlorperazine | Compazine |
| promethazine | Phenergan |
