8 Types of Medications That Can Increase Your Risk of Falling

Drugs that make you feel dizzy or drowsy can throw off your balance. Plus, how to lower your fall risk

Liz Szabo,

AARP

Reviewed by

Zachary Cox, PharmD

Comments

En español

Published January 14, 2025

illustrated gif of someone balancing on a pill capsule

Ben Hickey

More than 90 percent of adults aged 65 and older take at least one prescription medication, with 66 percent of people in that age group taking more than three prescriptions a month.

But many people who take daily medications are unaware that certain drugs in their pill box can also increase their risk of falling, which can lead to devastating, even fatal, complications.

Falls are the leading cause of injury in Americans 65-plus, and can be life-changing for many. About half of those who break a hip are no longer able to live independently. Broken hips also increase the risk of death.

How medications can lead to falls

Prescription drugs can lead to falls in several ways. For example, pills that lower blood pressure can make you feel dizzy or lightheaded, especially if you stand up suddenly. This can be especially risky in people who are frail or unsteady on their feet.

Beware of mixing medications and alcohol

People who take prescription medications need to be more careful about consuming alcohol at any age.

Combining alcohol with certain medications increases the risk of drowsiness and fainting, and reduces a person’s coordination.

That’s especially true for older people. “If you are taking an antidepressant in your 70s and you have a glass of wine, you get a double whammy,” Shubert says.

Drugs that make you drowsy — such as sleeping pills, anti-anxiety medications or certain pain relievers — also increase your risk of falling, says Tiffany Shubert, a physical therapist in Chapel Hill, North Carolina, and chair of the American Physical Therapy Association Geriatrics and National Council on Aging Task Force. She recommends that people talk to their doctor or pharmacist if any of their medications make them sleepy to ask about how to lower their likelihood of falling.

It's also important to know that medicines work differently in our body as we get older, says Sarah Nosal, M.D., president-elect of the American Academy of Family Physicians.

“Our kidneys and liver change how they process medications and our body loses muscle mass and has more fatty tissue as we age, all of which can change how our bodies break down medications and clear them from our systems,” Nosal says.

Substances such as medications and alcohol tend to stay in our bodies longer, potentially increasing the risk of side effects that can lead to falls, Nosal adds. Medications that were safe when we were younger may pose greater risks as we age. Older people may need a lower dose of some drugs than younger folks.

“If you were prescribed Valium for anxiety in your 40s and keep taking that dose in your 70s, it could be like [taking] a double dose,” Shubert says.

Medications that can increase your fall risk

Several classes of medications are known to increase the risk of falls, says Binal Patel, a geriatric pharmacist and director of clinical initiatives at PerformRx, part of AmeriHealth Caritas, a national managed care organization.

Common ones include:

Allergy and motion sickness pills, including those sold over the counter
Bladder control medications
Depression, mood, and anxiety medications
High blood pressure or heart drugs
Mood stabilizing or anti-psychosis drugs
Muscle-relaxants
Prescription pain relievers (such as opioids or narcotics)
Sleep aids

Some medications are safe on their own, but can increase the risk of serious side effects when combined with other drugs. Taking five or more medications significantly increases the risk of falls and other side effects, Patel says.

Combinations of medications can increase the risk of falls in unexpected ways, Shubert says. For example, a person might take one medication that makes them sleepy, and another pill that makes them wake up at night to urinate. That can lead them to trip and fall in the middle of the night while trying to get to the bathroom.

Should older people avoid certain medications?

The American Geriatrics Society publishes a list of “potentially inappropriate” medications for people 65 and over, known as the Beers Criteria or Beers list. Although doctors aren’t forbidden from prescribing these medications to older people, they should be aware of potentially serious side effects. In some cases, doctors may decide that using a medication from the Beers list is medically necessary. In other cases, they may try safer alternatives.

Sleeping pills, for example, are not only risky in older people, but often unnecessary, Nosal says.

Sleep cycles change as we age, so that we don’t need as much sleep as we did when we were younger, she says. Some of her older patients ask for sleeping pills because they worry about not getting eight hours of sleep. Although people should let their doctor know if they are experiencing ongoing sleep problems or significant changes in sleep, doctors may not feel these medications are safe for them, Nosal says.

How to lower your risk of falling

Nosal recommends bringing all medications, including any vitamins and supplements you’re taking, to medical visits. That allows doctors to see exactly what you are taking — and at what dose — rather than relying on a patient’s or caregiver’s memory. Ask your doctor if any of these medications raise the risk of falls. Doctors may be able to prescribe a lower dose or an alternative medication.

People shouldn’t stop taking a medication without first talking to their health care providers, Patel says.

Patients and caregivers can also ask doctors to explain what each of their medications does and why it’s necessary, Nosal says.

Sometimes, a health care provider may prescribe a drug for a temporary condition, but forget to remove it from the person’s medication list. Pharmacies may continue filling the prescription long after a person has stopped needing it. That can create unnecessary risks.

“We encourage ‘deprescribing,’ by asking, ‘Are there any medications that we can take off this list?’” Nosal says. “We want to be suretotake the stuff that’s really necessary and avoid medications that we know have the highest risk for complications and falls.”

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Liz Szabo is an award-winning health writer based in Washington and previously worked at USA TODAY and KFF Health News.

Zachary Cox is a pharmacist and professor at Lipscomb University College of Pharmacy and adjunct professor at Vanderbilt University School of Medicine in Nashville, Tennessee.