How to Prevent Falls: Learn About Drug Side Effects - Page 2

How to prevent falls: Know prescription drug side effects

Prescription drugs are often necessary to treat health problems and can be life-saving. But if they cause unsteadiness or dizziness, a talk with your doctor about changing dosage or switching to another medication may help you avoid falls in the future.

Beta-blockers are a case in point. This class of drugs has been used for decades. They are highly effective at lowering high blood pressure; they are also prescribed for angina and other heart conditions, anxiety, and migraine headaches. They work by blocking the effects of the hormone epinephrine, also known as adrenaline. Although beta-blockers are usually well tolerated, they can cause fatigue and dizziness in some people. And, researchers have found they may increase the risk for falls.

A Yale School of Medicine study of almost 5,000 seniors over age 70 found taking high blood pressure drugs, especially beta-blockers, increased the risk of serious fall injuries by 30 to 40 percent. The research, published in JAMA Internal Medicine, concluded the fall-caused injuries sustained by the elders taking beta-blockers over the course of three years were about as damaging physically — and even as deadly — as the heart attacks and strokes the drugs were taken to prevent.

An analysis of two large studies involving more than 10,000 people, published in the British Journal of Clinical Pharmacology, revealed a specific type of beta-blocker may be riskier than others when it comes to falls.  Geriatrician Nathalie van der Velde, MD, of the University Medical Centre Rotterdam, found adults over the age of 55 who took non-selective beta-blockers were at 22 percent higher risk of falling compared to those taking a different kind of medication called selective beta-blockers.

The non-selective type of the drugs, which includes propranolol (Inderal), nadolol (Corgard), timolol maleate (Blocadren), and others, binds to adrenaline receptors in many different areas of the body. That means they can affect the liver, muscles, and kidneys as well as the heart. On the other hand, selective beta-blockers, such as metoprolol (Lopressor, Toprol XL), acebutolol hydrochloride (Sectral), and isoprolol fumarate (Zebeta), affect mostly the heart, with little impact on the rest of physiology.

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