High Risk Medications List - 2017 (Page 3 of 7) in pdf

High risk medications

pdated May 2017

Alternatives When Diagnosis is NOT KNOWN

Classification

Drug name

Risk

If diagnosis is known - refer to FER Alternatives document

Cardiovascular

disopyramide (NORPACE, NORPACE CR)

Disopyramide is a potent negative inotrope and may induce

For atrial fibrillation rate control:

(other)

heart failure in older adults.

diltiazem (generic for Cardizem)

diltiazem CD (generic for Cardizem CD)

diltiazem ER (generic for Cardizem LA, Tiazac)

verapamil (generic for Calan, Isoptin)

verapamil ER (generic for Calan SR, Isoptin SR)

verapamil SR (generic for Verelan)

digoxin

Digoxin is not a first-line drug for use in atrial fibrillation. The

For atrial fibrillation rhythm control:

(>0.125 mg/day) (LANOXIN)

*Digoxin is included in CMS's 5-star measure only when a

beneficiary has 2 or more fills with an average daily dose >

0.125 mg.

flecainide

(generic for Tambocor)

propafenone

(generic for Rythmol)

dofetilide (TIKOSYN)

Cardiovascular

nifedipine (immediate-release)

Risk of precipitating myocardial ischemia and possible hypotens

amlodipine

(generic for Norvasc)

(other)

felodipine ER

(generic for Plendil)

nifedipine ER

(generic for Procardia XL)

Tertiary tricyclic

amitriptyline (ELAVIL)

These drugs are highly anticholinergic (risk of confusion, dry

For depression:

antidepressants

mouth, constipation, blurred vision, drowsiness, hallucinations,

(single

amitriptyline/chlordiazepoxide (LIMBITROL)

bupropion

agent and combination

difficulty urinating) and cause orthostatic hypotension.

amitriptyline/perhenazine (TRIAVIL)

bupropion (generic for Wellbutrin)

products)

clomipramine (ANAFRANIL)

bupropion SR (generic for Wellbutrin SR)

doxepin (>6 mg/day)* (SINEQUAN)

bupropion XL (generic for Wellbutrin XL)

Does higher than 6 mg/day are included in CMS's 5-star

FORFIVO XL

measure for beneficiaries with two or more fills in a

SSRI's

calendar year. Doses of doxepin less than 6 mg/day are

citalopram (generic for Celexa)

not included because its side effect profile is similar to

escitalopram (generic for Lexapro)

placebo.

fluoxetine (generic for Prozac)

fluoxetine delayed-release (generic for Prozac Weekly)

imipramine (TOFRANIL, TOFRANIL-PM)

sertraline (generic for Zoloft)

trimipramine (SURMONTIL)

VIIBRYD

SNRI's

desvenlafaxine ER

duloxetine (generic for Cymbalta)

FETZIMA

PRISTIQ

venlafaxine (generic for Effexor)

venlafaxine ER (generic for Effexor XR)

* Alternatives are recommended by The American Geriatrics Society, unless otherwise noted. Alternatives are not diagnosis-specific.

¹ OTC (over-the-counter) drugs are not covered by Medicare Part D

High Risk Medications List - 2017 Page 3

Related Articles

Related forms

Related Categories