Common medication reference — what the most prescribed drugs do

Reviewed by the How To Help Your Elders Team

The average adult over 65 takes four or more prescription medications daily, according to the CDC, and nearly 40 percent take five or more. Understanding what each drug does, what side effects to watch for, and why the doctor prescribed it gives you the ability to catch problems early and ask informed questions. This reference covers the medication classes most commonly prescribed for aging adults, organized by condition.

Blood Pressure Medications Keep the Numbers Down and Protect the Heart

High blood pressure affects nearly 75 percent of Americans over 65, per the CDC's National Health and Nutrition Examination Survey. It is the most common chronic condition in aging, and the medications used to treat it fall into several categories that work differently.

ACE inhibitors (names ending in "-pril" like lisinopril, enalapril, and ramipril) and ARBs (names ending in "-sartan" like losartan, valsartan, and olmesartan) relax blood vessels so blood flows more easily. Both classes also protect the kidneys, which matters especially for people with diabetes. ACE inhibitors commonly cause a dry, persistent cough. If your parent develops that cough, the doctor will often switch to an ARB, which works similarly without causing it.

Beta-blockers (metoprolol, atenolol, carvedilol, bisoprolol) slow the heart rate and reduce how hard the heart pumps with each beat. They're particularly useful when your parent also has a heart condition or history of heart attack. Side effects include fatigue, dizziness when standing up, and sometimes erectile dysfunction. Dizziness on standing is worth watching closely in older adults because it increases fall risk.

Calcium channel blockers (amlodipine, diltiazem, verapamil) relax blood vessels and can slow the heart rate. Amlodipine commonly causes ankle and foot swelling that looks alarming but is a known side effect, not a sign of heart failure. Diltiazem and verapamil slow the heart more significantly and require closer monitoring.

Diuretics (furosemide, hydrochlorothiazide, spironolactone) increase urination to remove excess fluid and sodium. They lower blood pressure effectively but can cause dehydration and electrolyte imbalances, particularly in older adults. Regular blood tests and adequate fluid intake are important when your parent takes a diuretic.

A blood pressure target of around 130/80 is standard for most older adults, though CMS clinical guidelines note that targets vary based on comorbidities and overall health. Your parent's doctor should explain their specific goal and how often monitoring is needed.

Diabetes Medications Work Through Different Mechanisms

About 29 percent of Americans aged 65 and older have diabetes, according to the CDC's National Diabetes Statistics Report. Treatment usually involves one or more medications from distinct classes.

Metformin is the usual first-line medication for type 2 diabetes. It reduces glucose production by the liver and helps the body use insulin more effectively. Gastrointestinal side effects like diarrhea and nausea are common early on but often improve with time or by taking it with food. Kidney function needs regular monitoring through blood tests.

Sulfonylureas (glipizide, glyburide, glimepiride) stimulate the pancreas to produce more insulin. They work well but carry a real risk of low blood sugar, which is especially dangerous in older adults. Regular blood glucose monitoring matters, and weight gain is a common side effect.

GLP-1 receptor agonists (semaglutide, liraglutide, dulaglutide, tirzepatide) are newer injectable medications that increase insulin production when blood sugar is high and slow digestion. They often help with weight loss and have demonstrated cardiovascular benefits beyond blood sugar control. Nausea is common when starting but usually fades. Most are given as weekly injections.

SGLT2 inhibitors (empagliflozin, canagliflozin, dapagliflozin) cause the kidneys to excrete glucose through urine. They provide protection for both the heart and kidneys, making them particularly useful when your parent has heart disease or kidney disease alongside diabetes. The trade-off is an increased risk of urinary tract and genital infections.

If your parent takes insulin, it means their body no longer produces enough on its own. Insulin management requires careful coordination with meals and monitoring for low blood sugar episodes. Signs of low blood sugar include shakiness, sweating, confusion, and rapid heartbeat. The A1C blood test, done a few times per year, shows average blood sugar control over three months. For most older adults, a target A1C between 7 and 8 percent is appropriate, though the goal varies with overall health.

Pain Relievers Carry Different Trade-Offs in Aging

Pain management in older adults requires balancing effectiveness against risks that increase with age.

Acetaminophen (Tylenol) is the safest over-the-counter option for most older adults. The ceiling is 3,000 mg per day; exceeding that damages the liver, and many combination medications already contain acetaminophen, so checking labels prevents accidental overdose.

Ibuprofen (Advil, Motrin) and other NSAIDs are effective for inflammation but raise the risk of gastrointestinal bleeding, kidney problems, and cardiovascular events in older adults. The American Geriatrics Society Beers Criteria lists NSAIDs as potentially inappropriate for long-term use in people over 65. If your parent takes an NSAID regularly, stomach protection and kidney monitoring are standard practice.

Prescription opioids (oxycodone, hydrocodone, morphine) are appropriate for severe pain from cancer or post-surgical recovery, but the CDC's prescribing guidelines emphasize non-opioid approaches first for chronic pain due to risks of dependence, constipation, drowsiness, and falls. Constipation from opioids is a serious quality-of-life issue for older adults and should be managed proactively.

Non-opioid prescription options include duloxetine, which treats nerve pain and depression simultaneously, and topical creams containing NSAIDs or other pain-relieving ingredients. Topical application delivers relief with less systemic absorption than pills, reducing side effect risk.

Physical therapy, heat, ice, and gentle movement are part of a solid pain management plan for most older adults. New, sudden, severe pain always warrants a doctor visit to rule out something serious.

Sleep Aids Require Caution in Older Adults

Over-the-counter antihistamines like diphenhydramine (Benadryl) and doxylamine (Unisom) are on the American Geriatrics Society Beers Criteria list of medications to avoid in older adults. They cause confusion, dizziness, dry mouth, and urinary retention. If your parent takes these nightly, bringing it up with their doctor is worth doing.

Prescription options include benzodiazepines (lorazepam, temazepam) and non-benzodiazepine "z-drugs" (zolpidem, zaleplon). Both classes increase fall risk and dependence in older adults. The CDC reports that fall-related injuries are the leading cause of injury death in adults over 65, and sedating sleep medications are a contributing factor. These drugs are generally recommended for short-term use only.

Melatonin, a hormone the body produces naturally, is a safer alternative for many older adults. Typical doses range from 0.5 to 2 mg taken an hour before bed. It works best as a short-term aid alongside good sleep habits.

Long-term sleep improvement relies on consistent bedtimes, limiting caffeine after midday, avoiding large meals before bed, and getting daytime exercise. If your parent snores heavily or wakes frequently gasping, sleep apnea testing and treatment address the root cause more effectively than any medication.

When your parent takes multiple medications, interactions become a real concern. Every medication visit should include a review of what's currently being taken, whether each drug is still necessary, and whether any interactions exist. Pharmacists are trained to conduct these reviews and often catch issues that slip past busy physicians. Your parent's pharmacy can flag interactions, side effects, or duplicate prescriptions, and taking advantage of that service is straightforward preventive care.

Frequently Asked Questions

How do I keep track of all my parent's medications?
Keep a single written list that includes every medication name, dose, frequency, prescribing doctor, and what it treats. Bring this list to every medical appointment and update it when anything changes. Many pharmacies will print a comprehensive medication list for you at no charge.

Should I be worried about drug interactions?
With four or more medications, interactions become a real possibility. Ask the pharmacist to run an interaction check any time a new medication is added. Signs of a drug interaction include new or worsening side effects, unusual drowsiness, confusion, or changes in how well existing medications seem to work.

What should I do if my parent misses a dose?
It depends on the medication. For most drugs, taking a missed dose as soon as you remember is fine unless it's close to the next scheduled dose. Never double up. For medications with narrow timing windows, like insulin or blood thinners, call the pharmacist or prescriber for specific guidance.

Can my parent stop taking a medication if the side effects are bad?
Never stop a medication without talking to the prescriber first. Some drugs require gradual tapering to avoid withdrawal or rebound effects. If side effects are intolerable, the doctor can often switch to an alternative medication or adjust the dose.

Why does my parent's doctor keep ordering blood tests?
Many medications require monitoring of kidney function, liver function, electrolytes, or blood sugar levels to catch problems before they become dangerous. Blood tests are how the doctor confirms that a medication is working safely in your parent's body. Regular testing is a sign of careful prescribing, not a sign of trouble.