Watch Your Step: How Medications Can Make You Lose Your Footing
Medications and Falls
A fall can happen to anyone! Did you know that each year, around a third of people aged 65 and over experience a fall? These accidents can have serious consequences. In fact, falls are the leading cause of injury, hospitalization, and even death among older adults in Canada. Even when they don't cause injury, falls can lead people to limit their activities and become isolated, which reduces their quality of life.
There are many risk factors that can contribute to falls. Among them, did you know that medications can increase the risk of falling? In fact, the more medications you take, the greater your risk of falling. This is a direct result of what is called “medication overload.” Researchers have estimated that our risk of falling increases by 75% when we take as few as four medications! However, it’s important to recognize that not all medications increase the risk of falling to the same degree.
Certain types of medications increase the risk of falls
Different types of medications can increase our risk of falls by affecting the way our body works. Here are a few examples:
Some medications can cause dizziness or drowsiness, making us less alert, affecting our coordination and potentially causing us to lose our balance.
Some medications cause our blood pressure or heart rate to drop, which increases the risk of dizziness and low blood pressure. This is particularly true when changing positions: for example, when moving from lying down to standing up.
Some medications lower blood sugar levels. When blood sugar levels become too low (called hypoglycemia), it can make us feel weak or cause us to faint, leading to falls.
Examples of medications that can increase the risk of falls (not a full list)
Below are some examples of specific medications from each category that increases the risk of falls:
| Type of medication | Examples |
|---|---|
| Sleeping pills |
Zopiclone (Imovane®) Zolpidem (Sublinox®) Lorazepam (Ativan®) Oxazepam (Serax®) |
| Antipsychotic medications |
Quetiapine (Seroquel®) Risperidone (Risperdal®) |
| Antidepressants |
Sertraline (Zoloft®) Citalopram (Celexa®) Amitriptyline (Elavil®) |
| Anti-epileptic medications |
Gabapentin (Neurontin®) Pregabalin (Lyrica®) |
| Opioid medications |
Morphine (Statex®, M-Eslon®) Oxycodone (OxyNeo®) |
| Muscle relaxants |
Cyclobenzaprine (Flexeril®) Methocarbamol (Robaxacet®, Robax platinum®) |
| Diabetes medications |
Glyburide (Diabeta®) Gliclazide (Diamicron®) Insulin |
| Medications for enlarged prostates |
Tamsulosin (Flomax®) Alfuzosin (Xatral®) |
| Diuretics (pills that produce more urine) |
Furosemide (Lasix®) Indapamide (Lozide®) |
| Medications that dilate blood vessels |
Hydralazine (Apresoline®) Nitrates (e.g., Nitro-Dur® patches) |
De Vries M et al., Fall-Risk-Increasing Drugs: A Systematic Review and Meta-Analysis: I. Cardiovascular Drugs. 2018
Seppala LJ et al., Fall-Risk-Increasing Drugs: A Systematic Review and Meta-Analysis: II. Psychotropics. 2018
Seppala LJ et al., Fall-Risk-Increasing Drugs: A Systematic Review and Meta-analysis: III. Others. 2018
The good news: it’s possible to reduce your risk of falls caused by medications!
Are you currently taking medication that increases the risk of falls? There are ways to reduce your or a loved one’s risk of falling caused by medication. Whether you've recently suffered a fall or you're taking preventive action, a proactive approach is always a good idea.
How can I reduce my risk of falls? Speak with a healthcare professional such as your family doctor, pharmacist or nurse and request a full review of your medications. Together, you'll be able to determine whether your current medications put you at an increased risk of falling, as well as understand their overall benefits and risks. You can then assess whether your medications are still safe for you to take, and whether they’re helping you achieve your desired health goals. When appropriate, you and your healthcare professional may decide to stop or reduce the dose of certain medications. This process is called deprescribing.
Who should review their medications?
Anyone currently taking medications, especially those taking 4 or more medications.
If you’ve recently suffered a fall or near-fall.
If you take one or more medications that can increase your risk of falls (see list above for examples).
Click here for tips on how you can start a conversation about your medications with a healthcare professional.
Several brochures on types of medications that can increase your risk of falls are available on our website: click here to check them out!
Here are a few more ways to reduce your risk of falls
Strengthen your muscles: exercise can help strengthen your muscles, especially your legs, and improve your balance. There are many programs or activities that will help you achieve this. Exercising for at least 30 minutes each day is recommended to prevent falls.
Check your eyesight: have your vision assessed regularly by an optometrist. Correct problems as needed. When necessary, cataract surgery can help reduce the risk of falls.
Create a safe environment: limit carpets that slide easily over floors and that can cause you to slip and fall. Remove furniture that obstructs passageways. Use adequate lighting. A safe environment can reduce the risk of falls.
ALWAYS CONSULT YOUR DOCTOR, PHARMACIST OR NURSE BEFORE STOPPING OR CHANGING ANY MEDICATION.
Deprescribing means stopping or reducing the dose of medications that are no longer needed or may cause harm.