8 Over-the-Counter Drugs the FDA Just Flagged as Dangerous for Anyone Over 60

That bottle of allergy medicine or nighttime pain reliever sitting in your medicine cabinet might not be as harmless as you think. Many older Americans regularly use over-the-counter medications without realizing that aging, chronic health conditions, and prescription drug interactions can change how their bodies respond.

According to the Food and Drug Administration (FDA), changes in kidney function, liver function, and other age-related factors can affect how medications work. Some familiar products may cause dizziness, confusion, digestive bleeding, or other complications, particularly when combined with prescriptions.

The American Geriatrics Society’s Beers Criteria identifies medications that adults 65 and older may need to avoid or use cautiously, depending on their health circumstances. These recommendations aren’t a blanket prohibition, and they aren’t the same as an FDA recall or newly issued safety warning.

For retirees watching both their health and their healthcare expenses, reviewing these eight common medications could help prevent unnecessary purchases and potentially costly complications.

1. Diphenhydramine (Benadryl and Certain PM Sleep Aids)

Diphenhydramine is a first-generation antihistamine found in some allergy medications, nighttime pain relievers, and over-the-counter sleep aids. The American Geriatrics Society recommends that most older adults avoid routine use because its anticholinergic effects can contribute to confusion, constipation, dry mouth, and an increased risk of falls. Someone taking a nighttime medication containing diphenhydramine may experience lingering drowsiness the following morning, making activities such as driving or navigating stairs more difficult. The Health in Aging Foundation identifies newer antihistamines and non-drug sleep strategies as alternatives worth discussing with a healthcare professional. Before purchasing another sleep aid, check whether you already take a medication containing diphenhydramine and ask your pharmacist whether a different approach would be safer.

2. Ibuprofen and Naproxen (Advil, Motrin, and Aleve)

Over-the-counter pain relievers such as ibuprofen and naproxen belong to a medication class called nonsteroidal anti-inflammatory drugs, or NSAIDs. Although these medications can relieve pain and inflammation, prolonged use can increase the risk of gastrointestinal bleeding, kidney injury, and worsening blood pressure, particularly in older adults. The American Geriatrics Society recommends avoiding chronic oral NSAID use in many older patients unless alternatives are ineffective and appropriate protective measures are considered. Someone taking blood thinners, corticosteroids, or certain other medications may face additional complications, making a pharmacist’s review especially important. Ask whether a topical treatment, physical therapy, or another pain-management approach would be appropriate rather than repeatedly purchasing oral pain relievers without addressing the underlying problem.

3. Omeprazole and Other Proton Pump Inhibitors (Prilosec, Nexium, and Prevacid)

Proton pump inhibitors, commonly called PPIs, reduce stomach acid and can be effective treatments for frequent heartburn and certain gastrointestinal conditions. However, the American Geriatrics Society advises against routine scheduled use beyond eight weeks for many older adults unless a clear medical reason supports continued treatment. The concern involves associations with complications such as Clostridioides difficile infection and bone-related problems, although individual risks depend on the patient’s circumstances. Over-the-counter PPI products are generally intended for a 14-day treatment course, and repeated or long-term use should be discussed with a healthcare professional. If you’ve been buying heartburn medication every month, ask whether you still need it, whether a different treatment would work, and whether continued use is justified before making any changes.

4. Pseudoephedrine and Oral Phenylephrine (Certain Cold and Sinus Medicines)

Decongestants deserve special attention among older adults managing high blood pressure, heart disease, or other cardiovascular conditions. Pseudoephedrine can increase blood pressure and heart rate, making it important to consult a pharmacist before using products containing this ingredient. Oral phenylephrine presents a different concern because the FDA proposed removing it as an over-the-counter nasal decongestant after determining that available evidence did not support its effectiveness at recommended doses. That proposal was based on effectiveness rather than a new finding that oral phenylephrine is unsafe at labeled doses. Before spending money on a multi-symptom cold medicine, read the Drug Facts label and ask whether a saline spray or another treatment would better address your symptoms without unnecessary ingredients.

5. Doxylamine (Unisom and Certain Nighttime Cold Medicines)

Doxylamine is another first-generation antihistamine commonly used in over-the-counter sleep aids and some nighttime cold remedies. Like diphenhydramine, it has anticholinergic effects that can cause confusion, dry mouth, constipation, and lingering drowsiness in older adults. The Beers Criteria includes doxylamine among medications generally recommended for avoidance in adults 65 and older because of these concerns. A retiree who takes a sleep aid along with a nighttime cold medicine could accidentally combine products containing sedating ingredients, increasing the risk of unwanted effects. If sleeplessness has become a recurring problem, ask your healthcare provider about evaluating the underlying cause and whether cognitive behavioral therapy for insomnia or another non-drug approach might help.

6. Bismuth Subsalicylate (Pepto-Bismol)

Bismuth subsalicylate is commonly used for occasional diarrhea, nausea, and upset stomach, but its salicylate component deserves attention. People taking blood thinners, aspirin, or certain other medications should ask a pharmacist about potential interactions before using it. Those with a history of gastrointestinal bleeding, ulcers, or kidney problems may also need additional precautions depending on their medical circumstances. Excessive or prolonged use can contribute to salicylate-related side effects, including ringing in the ears, and persistent digestive symptoms may indicate a condition requiring medical evaluation. Instead of repeatedly purchasing stomach remedies, track how frequently symptoms occur and discuss ongoing problems with a healthcare professional who can recommend an appropriate treatment.

7. Magnesium Citrate (Saline Laxatives)

Magnesium citrate is an over-the-counter saline laxative sometimes used for occasional constipation. Although it can be effective when used as directed, people with impaired kidney function may have difficulty eliminating excess magnesium from their bodies. Excessive use can contribute to dehydration, electrolyte disturbances, and potentially dangerous elevations in magnesium levels, particularly among people with kidney disease. Older adults who regularly struggle with constipation should discuss their symptoms and medication lists with a healthcare professional rather than relying on repeated laxative use. Depending on the cause, adjustments to fiber intake, fluid consumption, physical activity, or a different bowel regimen may offer a more appropriate long-term solution.

8. Chlorpheniramine (Certain Allergy and Multi-Symptom Cold Medicines)

Chlorpheniramine is another older antihistamine that can appear in allergy tablets and combination cold medications. The American Geriatrics Society includes it among first-generation antihistamines that most adults 65 and older should avoid because of anticholinergic side effects. These effects can include sedation, confusion, constipation, and urinary difficulties, which may be especially troublesome for people already managing several health conditions. The Health in Aging Foundation suggests discussing newer antihistamines such as loratadine or fexofenadine, or other allergy treatments, with a healthcare professional. Because brand-name cold medicines frequently contain several active ingredients, checking the label can help prevent accidentally combining medications that produce similar side effects.

How a Medication Review Could Protect Your Retirement Savings

Over-the-counter medications may seem inexpensive individually, but repeated purchases can become a meaningful expense for retirees living on fixed incomes. Someone spending $15 monthly on a sleep aid and another $20 on recurring heartburn treatments would spend $420 annually, even before considering prescription medications or medical appointments. More importantly, medication-related dizziness, falls, gastrointestinal bleeding, or other complications can result in additional doctor visits, emergency treatment, and out-of-pocket healthcare costs. A pharmacist can help identify duplicate ingredients, potentially unnecessary products, and interactions that might make a less expensive or more appropriate treatment worth discussing with your doctor. Bring a complete list of prescriptions, over-the-counter medications, vitamins, and supplements to your next medication review, and never discontinue a prescribed treatment without medical guidance.

The goal isn’t to stop using every familiar medication simply because you’ve reached a certain age. It’s to make sure each product still serves a useful purpose, fits your current health needs, and doesn’t expose you to avoidable risks. Taking a few minutes to review your medicine cabinet could be one of the simplest ways to protect both your health and your retirement budget.

Have you ever discovered that an over-the-counter medication was interacting with a prescription or causing unexpected side effects? Share your experience in the comments.