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Beers Criteria - Auxiliary Tables

American Geriatrics Society 2023 updated AGS Beers Criteria^® - Auxiliary Tables Reference
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CNS Active Drug List [Table 5 supplement]

Avoid concurrent use of ≥3 CNS-active drugs; minimize the number of CNS-active drugs.
Drug	Drug Type(s)	Drug	Drug Type(s)
acetaminophen-codeine	Opioids	lamoTRIgine	Antiepileptics^a
acetaminophen-HYDROcodone	Opioids	levETIRAcetam	Antiepileptics^a
acetaminophen-oxyCODONE	Opioids	levomilnacipran	Antidepressants (SNRIs)
acetaminophen-traMADol	Opioids	LORazepam	Antiepileptics^a, Benzodiazepines
ALPRAZolam	Benzodiazepines	loxapine	Antipsychotics¹
amitriptyline	Antidepressants (TCAs)	lurasidone	Antipsychotics²
ARIPiprazole	Antipsychotics²	meperidine	Opioids
asenapine	Antipsychotics²	metaxalone	Skeletal muscle relaxants
baclofen	Skeletal muscle relaxants	methadone	Opioids
brexpiprazole	Antipsychotics²	methocarbamol	Skeletal muscle relaxants
brivaracetam	Antiepileptics^a	midazolam	Antiepileptics^a, Benzodiazepines
cannabidiol	Antiepileptics^a	milnacipran	Antidepressants (SNRIs)
carBAMazepine	Antiepileptics^a	morphine	Opioids
cariprazine	Antipsychotics²	nortriptyline	Antidepressants (TCAs)
carisoprodol	Skeletal muscle relaxants	OLANZapine	Antipsychotics²
cenobamate	Antiepileptics^a	orphenadrine	Skeletal muscle relaxants
chlordiazePOXIDE	Benzodiazepines	oxazepam	Benzodiazepines
chlorproMAZINE	Antipsychotics¹	OXcarbazepine	Antiepileptics^a
chlorzoxazone	Skeletal muscle relaxants	oxyCODONE	Opioids
citalopram	Antidepressants (SSRIs)	oxyMORphone	Opioids
cloBAZam	Antiepileptics^a, Benzodiazepines	paliperidone	Antipsychotics²
clomiPRAMINE	Antidepressants (TCAs)	PARoxetine	Antidepressants (SSRIs)
clonazePAM	Antiepileptics^a, Benzodiazepines	perampanel	Antiepileptics^a
clorazepate	Benzodiazepines	perphenazine	Antipsychotics¹
cloZAPine	Antipsychotics²	PHENobarbital	Antiepileptics^a
codeine	Opioids	phenytoin	Antiepileptics^a
cyclobenzaprine	Skeletal muscle relaxants	pimavanserin	Antipsychotics²
dantrolene	Skeletal muscle relaxants	pimozide	Antipsychotics¹
desipramine	Antidepressants (TCAs)	pregabalin	Antiepileptics^a
desvenlafaxine	Antidepressants (SNRIs)	primidone	Antiepileptics^a
diazePAM	Antiepileptics^a, Benzodiazepines, Skeletal muscle relaxants	prochlorperazine	Antipsychotics¹
divalproex sodium	Antiepileptics^a	QUEtiapine	Antipsychotics²
doxepin	Antidepressants (TCAs)	risperiDONE	Antipsychotics²
droperidol	Antipsychotics¹	rufinamide	Antiepileptics^a
DULoxetine	Antidepressants (SNRIs)	sertraline	Antidepressants (SSRIs)
escitalopram	Antidepressants (SSRIs)	stiripentol	Antiepileptics^a
eslicarbazepine	Antiepileptics^a	SUFentanil	Opioids
estazolam	Benzodiazepines	temazepam	Benzodiazepines
eszopiclone	"Z-drugs"^b	thioridazine	Antipsychotics¹
ethosuximide	Antiepileptics^a	thiothixine	Antipsychotics¹
everolimus	Antiepileptics^a	tiaGABine	Antiepileptics^a
felbamate	Antiepileptics^a	tiZANidine	Skeletal muscle relaxants
fenfluramine	Antiepileptics^a	topiramate	Antiepileptics^a
fentaNYL	Opioids	traMADol	Opioids
FLUoxetine	Antidepressants (SSRIs)	triazolam	Benzodiazepines
fluPHENAZine	Antipsychotics¹	trifluoperazine	Antipsychotics¹
fLuvoxaMINE	Antidepressants (SSRIs)	valproic acid	Antiepileptics^a
gabapentin	Antiepileptics^a	venlafaxine	Antidepressants (SNRIs)
ganaxolone	Antiepileptics^a	vigabatrin	Antiepileptics^a
haloperidol	Antipsychotics¹	zaleplon	"Z-drugs"^b
HYDROmorphone	Opioids	ziprasidone	Antipsychotics²
iloperidone	Antipsychotics²	zolpidem	"Z-drugs"^b
imipramine	Antidepressants (TCAs)	zonisamide	Antiepileptics^a
lacosamide	Antiepileptics^a
Footnotes: ^a including gabapentinoids ^b Nonbenzodiazepine benzodiazepine receptor agonist hypnotics ¹ 1^st Generation Antipsychotics ² 2^nd Generation Antipsychotics

Drugs with strong anticholinergic properties. [Table 7]

Note: This table is not a comprehensive list of all medications with anticholinergic properties.
Drug	Drug Type	Drug	Drug Type
amitriptyline	Antidepressants	homatropine	Antispasmodics
amoxapine	Antidepressants	hydrOXYzine	Antihistamines (1st-generation)
atropine	Antispasmodics	hyoscyamine	Antispasmodics
benztropine	Antiparkinsonian agents	imipramine	Antidepressants
brompheniramine	Antihistamines (1^st generation)	meclizine	Antihistamines (1^st generation)
chlorpheniramine	Antihistamines (1^st generation)	nortriptyline	Antidepressants
chlorproMAZINE	Antipsychotics	OLANZapine	Antipsychotics
clidinium-chlordiazePOXIDE	Antispasmodics	orphenadrine	Skeletal muscle relaxants
clomiPRAMINE	Antidepressants	oxybutynin	Antimuscarinics^a
cloZAPine	Antipsychotics	PARoxetine	Antidepressants
cyclobenzaprine	Skeletal muscle relaxants	perphenazine	Antipsychotics
cyproheptadine	Antihistamines (1^st generation)	prochlorperazine	Antiemetics
darifenacin	Antimuscarinics^a	promethazine	Antiemetics
desipramine	Antidepressants	promethazine	Antihistamines (1^st generation)
dicyclomine	Antispasmodics	scopolamine	Antispasmodics
dimenhyDRINATE	Antihistamines (1^st generation)	solifenacin	Antimuscarinics^a
diphenhydrAMINE	Antihistamines (1^st generation)	tolterodine	Antimuscarinics^a
doxepin (>6 mg/day)	Antidepressants	trihexyphenidyl	Antiparkinsonian agents
doxylamine	Antihistamines (1^st generation)	triprolidine	Antihistamines (1^st generation)
fesoterodine	Antimuscarinics^a	trospium	Antimuscarinics^a
flavoxATE	Antimuscarinics^a
Footnotes:
^a Antimuscarinics (for urinary incontinence): Data on whether certain bladder antimuscarinics confer greater adverse cognitive effects than others lack consistent quality. oxybutynin has the best evidence for adverse cognitive effects. However, caution is warranted for all bladder antimuscarinics given their potential anticholinergic effects.

Principles for how patients, clinicians, health systems, and payors should use the AGS Beers Criteria^®. [Table 11]

TABLE 11 Principles for how patients, clinicians, health systems, and payors should use the AGS Beers Criteria^®.

• Medications in the AGS Beers Criteria^® are potentially inappropriate, not definitely inappropriate.

• Read the rationale and recommendations statements for each criterion. The caveats and guidance listed there are important.

• Understand why medications are included in the AGS Beers Criteria^® and adjust your approach to those medications accordingly.

• Optimal application of the AGS Beers Criteria^® involves identifying PIMs and, when appropriate, offering safer nonpharmacologic and pharmacologic therapies.

• The AGS Beers Criteria^® should be a starting point for a comprehensive process of identifying and improving medication appropriateness and safety.

• Access to medications included in the AGS Beers Criteria^® should not be excessively restricted by prior authorization and/or health plan coverage policies.

• The AGS Beers Criteria^® are not equally applicable to all countries (because of cross-national differences in drug availability).

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