Diphenhydramine appears in some allergy remedies and nighttime sleep products. The American Geriatrics Society advises older adults to avoid it in many circumstances because its effects can include confusion, dry mouth, constipation and difficulty urinating.
It is one example in the society’s Beers Criteria, a guide to medicines that may be inappropriate for adults 65 and older. The list is intended to support clinical judgment. It does not mean that everyone taking a listed medicine should stop it, or that a necessary prescription has automatically become a mistake.
The most useful review includes more than the prescriptions in a patient portal. Over-the-counter sleep products, cold remedies, vitamins and supplements can matter too. A pharmacist or clinician can check active ingredients, doses, timing and combinations against the person’s conditions and other treatment.
Take a hypothetical reader, Elaine, 68. She remembers to mention her blood-pressure prescription at appointments but regards her occasional nighttime tablet as a household product. Writing down its active ingredient puts it into the same conversation. It also allows her to explain how often she uses it and what she is trying to treat.
Elaine does not need to arrive with a replacement drug in mind. She needs to describe the problem: trouble falling asleep, waking repeatedly, or symptoms that have changed since starting a medicine. Those details give the clinician something more useful than a request for a stronger tablet.
The society’s patient guidance discusses alternatives, including cognitive behavioral therapy for insomnia. Whether any alternative fits depends on the condition being treated. Changing or stopping prescribed medicines without advice can create new problems. A medication review is a chance to ask whether each product still has a purpose, whether it is helping, and whether its risks have changed.
