About the AGS Beers Criteria®and Alternatives
For more than 20 years, the American Geriatrics Society (AGS) Beers Criteria® for Potentially Inappropriate Medication have been a valuable resource for healthcare providers about the safety of prescribing drugs for older people.
The AGS recently released a list of possible alternative treatments for some of these drugs that appear in the AGS Beers Criteria®. Some of these alternatives are listed below.
Key Points
- Never stop taking a medication without first talking to your healthcare provider, even if the medication you’re taking is listed on the AGS Beers Criteria®.
- Know about the medications you are taking. Ask your clinician or pharmacist about the medications you are taking and their potential side effects. If you’re experiencing any symptoms, ask if they could be related to a medication you are taking or if it may be a sign of another problem. Use only trusted, reliable sources (such as MedlinePlus) to look up information.
- Review your medications regularly. You should regularly review all of the medications you are taking with your clinicians and pharmacists. You should report any problems with your medications, including any side effects, questions you may have about them, or any problems with taking them as prescribed (such as cost). These reviews should occur at least once a year as well as any time a new medication is prescribed.
REMEMBER: Potentially inappropriate medications are just that — potentially inappropriate. The AGS Beers Criteria® and the list of alternatives are resources, not a replacement, for the expertise and knowledge of your healthcare provider. The AGS Health in Aging Foundation has developed this resource to help you talk to your healthcare provider about these possible alternatives to the AGS Beers Criteria® medications you’re taking.
To access the complete AGS Beers Criteria® and its related resources, please visit GeriatricsCareOnline.org.
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Alternative Treatments to Selected Medications in the 2023 American Geriatrics Society Beers Criteria® * |
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| Instead Of . . . | Possible Alternatives to Discuss with your Healthcare Provider | Patient Resources that May be Helpful |
| Allergy Symptoms | ||
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First Generation Antihistamines
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Instructions on how to self-administer nasal sprays Instructions on safe use of Neti pots and nasal irrigation devices (FDA)
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| Insomnia | ||
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“Z-drugs”
Benzodiazepines Over-the-counter sleep aids or cough-and-cold remedies that include diphenhydramine (Benadryl) or other first-generation antihistamines – for example, Tylenol PM, Advil PM |
Cognitive behavioral therapy (CBT) for insomnia, a series of methods for calming your mind and helping you fall asleep, can be very helpful. It can be taught by a trained therapist or through self-guided phone apps and websites. Ask your healthcare provider about these and other strategies to improve your sleep (without medications). |
Digital CBT-I tools. Examples include:
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| Pain | ||
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NSAID pain medications for long-term, daily use
Muscle relaxants
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Depending on the kind of pain, some common alternatives include:
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Physical activity and self-management education programs for arthritis (CDC) Resources for geriatric pain assessment and management (GeriatricPain.org, University of Iowa) Managing osteoarthritis symptoms (National Council on Aging) Information and resources on physical therapy (American Physical Therapy Association) |
| Symptoms of Menopause | ||
| Estrogen pills and patches |
Hot flashes and night sweats: Ask your healthcare provider about behavioral therapies. If these are not effective, other drugs that can be helpful include:
Vaginal dryness:
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Pelvic floor disorder information and resources (American Urogynecologic Society)
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| Heartburn | ||
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Proton pump inhibitors for long-term daily use
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Ask your healthcare provider if you need to take this medication daily over the long term to protect your stomach. If not, alternative options include:
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Information and resources about acid reflux (American College of Gastroenterology) About acid reflux and GERD one-page infographic (American College of Gastroenterology) Information on causes and management of heartburn symptoms (My GI Health) Information on causes and management of acid reflux (My GI Health)
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| Constipation | ||
| Mineral oil, taken orally |
Incorporate the following lifestyle decisions:
Consider over-the-counter laxatives containing senna/sennosides, polyethylene glycol, or magnesium |
Information and resources on constipation (American College of Gastroenterology) Information and resources on constipation (MyGIHealth) Information and resources on constipation and defecation (MyGIHealth) Handout on chronic idiopathic constipation (American College of Gastroenterology)
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| *This is only a partial list of medications. Medications listed in parentheses are examples of brand names of the generic medications listed. | ||
This summary is from the full report titled Alternative Treatments to Selected Medications in the 2023 American Geriatrics Society Beers Criteria® published in the Journal of The American Geriatrics Society.
Last Updated July 2025