As we get older, our bodies handle medications differently, making it all the more important to be extra cautious in deciding which ones to take. For instance, as your liver and kidneys age, you may begin to metabolize drugs more slowly, causing the medicine to linger in the body longer and build up to unsafe levels. Ultimately, this can cause unexpected side effects or dangerous interactions with other medications or supplements—both of which can take a serious toll on your health over time, or even trigger an acute medical emergency.
Even seemingly safe over-the-counter (OTC) medications can come with risks. So, while it might seem simple to grab a cold remedy or a pain reliever off the shelf, it’s always a good idea to check with a pharmacist or doctor first, especially if you’re over the age of 60. Read on to learn the six OTC medications that could be especially dangerous for seniors, according to doctors.
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1. NSAIDs
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Non-steroidal anti-inflammatory drugs like aspirin, ibuprofen (Motrin and Advil), and naproxen (Aleve) can all pose problems for seniors over the age of 60, says Meredith Bourne, MD, a family medicine physician working with PlushCare.
"These medications can cause ulcers, GERD, bleeding in the gastrointestinal tract, kidney problems, and can increase blood pressure," Bourne explains. "Most of these effects occur with prolonged, daily use for weeks or months, but effects can sometimes occur after just a few doses, especially if they are taken in higher amounts, or taken without adequate food or hydration."
In fact, a 2024 study found that repeated acetaminophen doses in people 65 and older led to an increased risk of peptic ulcers, heart failure, hypertension, and chronic kidney disease.
Bourne adds that aspirin can be especially harmful due to its effects as a blood thinner, which can cause uncontrolled bleeding—especially in seniors taking other blood thinners such as warfarin or Xarelto.
"Never take over-the-counter aspirin without consulting your doctor first," Bourne advises.
2. Calcium-containing antacids
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If you’re over 60, you should plan to use calcium-containing antacids such as Tums and Rolaids only sparingly, says Raj Dasgupta, MD, a quadruple board-certified physician and Chief Medical Advisor for Garage Gym Reviews.
“Occasional use is fine, but overuse can potentially lead to high calcium levels, which can cause constipation, confusion, and kidney problems,” he tells Best Life. “Seniors, particularly those with reduced kidney function, should be mindful of their total calcium intake from all sources,” he adds.
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3. Proton pump inhibitors
ShutterstockOver-the-counter proton pump inhibitors (PPIs) like omeprazole (Prilosec OTC), lansoprazole (Prevacid), and esomeprazole (Nexium) are sometimes recommended for the short-term treatment of stomach ulcers and acid reflux. However, they should be used with caution if you’re over 60.
"Using them long-term for acid reflux symptoms can increase the risk of life-threatening infections like Clostridium difficile (C. diff) and pneumonia," warns Bourne. "They have also been linked to risk of bone loss and fractures, cancers of the gastrointestinal tract, and possibly dementia," all of which disproportionately affect seniors.
4. Antihistamines
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Allergies acting up? Think twice before grabbing over-the-counter antihistamines if you’re over 60.
"Antihistamines like diphenhydramine (Benadryl) or doxylamine (Unisom) can cause drowsiness, dizziness, and confusion due to their effects on the central nervous system," Bourne explains, noting that this can increase the risk of falls and accidents. "In addition, many older adults may notice non-life-threatening, but bothersome, symptoms such as dry mouth, constipation, or trouble urinating."
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5. Decongestants
ShutterstockWhen you’re contending with cold symptoms, decongestants like pseudoephedrine (Sudafed) can offer fast relief. However, seniors should always talk to their doctors before reaching for these over-the-counter cold solutions.
"Decongestants can increase blood pressure and heart rate, as well as cause dizziness or confusion," Bourne says. She notes that the active ingredients found in decongestants are often "especially dangerous" when they are found in combination cold and flu medications like NyQuil, DayQuil, Theraflu, and Advil Cold & Sinus, as well as antihistamines.
"It may also lead to insomnia, nervousness, and difficulty urinating, especially in men with prostate issues," Dasgupta adds.
6. Imodium
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Loperamide (Imodium), often used to manage diarrhea by slowing movement in the intestines, is another OTC drug that Dasgupta cautions against for long-term use among seniors.
"Loperamide is generally safe in small doses for short periods," the physician says. "However, in older adults, it can cause constipation and, in rare cases, lead to serious heart rhythm disturbances if overused. It’s best used under clear guidance, especially if symptoms persist."
