By Rachel Nania, June 2022, AARP
Plus, the over-the-counter drugs to avoid as you age.
With aging come more ailments, aches and pains. But a strategically stocked medicine cabinet can help ease everyday exercise injuries, indigestion and allergies at 50 and beyond. But a strategically stocked medicine cabinet can help ease everyday exercise injuries, indigestion and allergies at 50 and beyond.
Before you start putting together your first-aid stash, talk to your doctor or pharmacist about the medications you take — including vitamins or supplements — and any potential drug interactions. Just because something is available without a prescription does not mean it’s harmless, says Stefanie Ferreri, a pharmacist and chair of the Division of Practice Advancement and Clinical Education at the UNC Eshelman School of Pharmacy. Over-the-counter drugs “are safe when they're used appropriately,” she says, but can be dangerous when misused or when mixed with other medications.
Older adults, especially, “have to be very cautious with the doses” of drugs, due to age-related changes that affect the way the body reacts to medications, says Katherine Bennett, M.D., assistant professor of medicine in the Division of Gerontology and Geriatric Medicine at the University of Washington. Again, this is where a doctor or pharmacist can help you choose the safest options available.
Here’s what you should and shouldn’t include, plus some additional advice from the experts:
1. Pain relievers
When it comes to pain relief, Bennett recommends that older patients in particular start with acetaminophen (Tylenol is the brand name). That’s because nonsteroidal anti-inflammatory drugs (NSAIDs) — which include ibuprofen (Advil) and naproxen (Aleve) — can raise bleeding risks in the gastrointestinal tract, and this risk increases with age, Bennett says. NSAIDs can also damage the kidneys and raise blood pressure, especially if used over a long period.
“For someone who is generally healthy, using an anti-inflammatory once in a while is OK. It can be safe, but only if you have talked to your doctor or pharmacist about whether there are reasons that one might not be safe for you,” Bennett adds. If you take an NSAID for longer than 10 days, you should see your doctor, the U.S. Food and Drug Administration (FDA) advises.
That said, acetaminophen isn’t risk-free. Taking too much can lead to severe liver damage. And just as with other medications, “there are a lot of drug interactions that could potentially exist with acetaminophen, too,” Ferreri says. So talk to a professional before you take it.
Often overlooked are topical pain relievers, such as methyl salicylate/menthol (Bengay, Icy Hot) for sore muscles, and diclofenac (Voltaren) for arthritis pain. “And many times in my older adult patients, I will go with those first,” Ferreri says — especially since they’re less likely to come with side effects. There are also over-the-counter lidocaine patches that can be applied to aches.
One more thing: Since heart attack risk increases in midlife, it doesn’t hurt to keep a full-dose aspirin (also an NSAID) on hand, just in case you or anyone around you experiences one. Taking aspirin during a heart attack, while waiting for emergency help to arrive, could reduce heart damage since it helps to keep the blood from clotting.
A daily aspirin regimen, however, is only recommended for some. In fact, the latest guidelines from the U.S. Preventive Services Task Force warn adults 60 and older not to start taking aspirin to lower their risk of a first heart attack or stroke, due to bleeding risks. People ages 40 to 59 who are at higher risk for cardiovascular disease but don’t have a history of it should talk to a health care provider before starting an aspirin regimen.
Medicine Safety Tips
Avoid combination medications: Treat the individual symptoms you have, and steer clear of combination formulas, such as a pain reliever coupled with a decongestant. Hidden ingredients can bring on unwanted side effects.
Check in with your pharmacist: The next time you head to the drugstore, make it a point to talk with the pharmacist. Many can do what’s called a medication check-in to answer safety questions about the drugs and supplements you’re taking.
Try to fill your prescriptions at the same pharmacy: This will better enable your pharmacist to do a comprehensive review of your medications each time you fill a prescription.
Clear out old drugs: Get rid of expired or unused medicines by taking advantage of a drug-takeback program to ensure your safety and the safety of others in your household.
2. Heartburn helpers
If you find yourself experiencing indigestion more now than in your younger years, you’re not alone. There are some age-related changes that make older adults more prone to heartburn (acid reflux), Bennett says. The muscle at the bottom of the esophagus that prevents acid from coming back up can get weaker with age, she explains. “And it can just make you more prone to having the acid end up in your esophagus instead of staying where it’s supposed to, in your stomach,” she says.
It's good to know your heartburn triggers — such as tomato sauce or spicy wings — so you can avoid a flare-up or plan accordingly. And keep an eye on how often it’s occurring. “The magic number is if they’re having it more than two days per week, they really should follow up with a physician,” Ferreri says.
For occasional heartburn, however, chewable calcium carbonate tablets (Tums, Rolaids) are “perfectly safe and can give you some quick relief,” Bennett says. There are also some over-the-counter pills that can ease discomfort, including famotidine (Pepcid). “But it’s not something you would want to take regularly without talking to your doctor, because again, there might be something else going on,” she adds.
3. Allergy alleviators
If you can't escape a change in seasons without red, itchy eyes and a runny nose, allergy relievers should be a medicine-cabinet staple. But “this is a category where there has to be a lot of caution,” Bennett says.
Both Bennett and Ferreri advise older adults — especially those in their 70s, 80s and 90s — to steer clear of diphenhydramine (Benadryl) because of its side effects. It can increase the risk for falls, cause dry mouth and lead to urinary incontinence, they point out. Long-term use has also been linked to an increased risk of dementia.
Safer options include cetirizine (Zyrtec) and loratadine (Claritin), Bennett says. Ferreri also points to fexofenadine (Allegra) — just be sure to avoid grapefruit juice, which can render it ineffective. And for a runny, stuffy or itchy nose, try a nasal steroid spray or nasal saline solution.
4. Cold and cough
Sometimes the best cure for a cough is in your kitchen, not the medicine cabinet. Bennett recommends hot tea with honey or even ice water to relieve symptoms. “There’s a little bit of evidence that dark chocolate can help a cough, too,” she says.
If you feel like you need something stronger, look for a single-ingredient medicine “so that you are not accidentally taking something that might have higher risk,” Bennett adds.
The same goes for other cold-related symptoms: The advice from the experts is to treat the individual symptoms you have and to avoid combination medicines — say, a pain reliever plus decongestant — which are more likely to come with unwanted side effects. Another tip: If you have high blood pressure, stay away from decongestants altogether. These work by narrowing blood vessels, which in turn can increase the pressure.
Is your cough due to COVID-19? A box or two of rapid tests — you can request several for free from the federal government — can come in handy. Confirming an infection and starting isolation can help you prevent spreading the virus to others. Learning your COVID status quickly also means you may be able to get a jump-start on any coronavirus treatments that help fight off severe disease.
5. First-aid fixes
Adhesive bandages, gauze, antibiotic ointment, calamine lotion, hydrocortisone cream — these are all good things to have on hand for cuts, scrapes and run-ins with bugs and poison ivy.
If you have thin or sensitive skin — and skin does change with age — you may want to consider sensitive-skin bandages. This type of bandage is typically made of silicone or a less-sticky material “so that when you take it off, it doesn’t cause irritation,” Bennett says.
A note about vitamins and supplements
There isn’t a specific vitamin or supplement that older adults need to take, experts say, especially for people with a healthy diet. However, it’s not a bad idea to make sure you’re not vitamin D deficient (your doctor can diagnose this with a blood test), since vitamin D plays such an important role in bone health. Deficiency, which can be corrected with a supplement or extra sunshine, has also been linked to immune system disorders, heart disease, diabetes and some cancers.
Calcium is another supplement to consider, especially for women. But again, it’s important to make this decision with your health care provider, since “the more things you add to your list [of medications you take], the more likely something’s going to interact with something else,” Bennett says. “In general, a healthy balanced diet is the best way for your body to really do a good job of absorbing what it needs.”