The American Geriatrics Society has published the 2019 Beers Criteria which includes updated information on medications that may be potentially inappropriate for use in older adults. The entire guideline has been published in the Journal of the American Geriatrics Society. Some examples of drugs that were removed from the 2015 Beers Criteria include ticlopidine, guanabenz, methyldopa, reserpine, meprobamate, ergoloid mesylates, and oral pentazocine. Reasons for removal include change in evidence, rarely used anymore, off the market, and disease/drug combinations that are not geriatric specific. Caveat: Deleting does not mean endorsement of use. There were a few changes in the Drug-Syndrome Interactions, Potentially Inappropriate Medications to Be Used with Caution in Older Adults, and Drug-Drug Interaction tables. New drugs added to the "Use with Caution" list include rivaroxaban (increased bleeding risk), tramadol (risk of SIADH and low sodium), dextromethorphan/quinidine (limited efficacy in dementia patients without pseudobulbar affect), and TMP-SMX interactions with ACEIs and ARBs causing increased potassium. There will likely be a staff development on this topic in the future.