For residents in long-term care (LTC) and senior living settings, a fall can change everything. What begins as a single misstep can lead to fractures, hospitalizations, and a lasting decline in mobility and independence. According to the Centers for Disease Control and Prevention, more than 14 million older adults report falling each year and one fall doubles the risk of falling again.

Falls can happen for many reasons, from poor lighting and tripping hazards to mobility challenges. But one risk factor is often overlooked: medications.

Fall Prevention Awareness Month is an important reminder of the role pharmacists play in helping care teams identify and address that risk, protecting the safety, dignity, and quality of life of the residents they serve.

Why Medications Matter

Understanding fall risk starts with understanding how medications can affect the body. Certain medications increase the risk of falls by causing side effects, such as confusion, fatigue, drowsiness, blurred vision, irregular heart rate, and orthostatic hypotension, a drop in blood pressure when standing after sitting or lying down.

And it’s not only prescription medications that matter. Over-the-counter (OTC) products, vitamins, and supplements can also contribute to drug interactions and raise fall risk in ways care teams and families may not anticipate.

The medication classes most commonly associated with falls include:

• Benzodiazepines (e.g., alprazolam, clonazepam, temazepam)

• Antipsychotics (e.g., aripiprazole, quetiapine, risperidone, haloperidol)

• Anticholinergics (e.g., hydroxyzine, oxybutynin, benztropine)

• Opioids (e.g., hydrocodone, oxycodone, tramadol)

• OTC antihistamines (e.g., diphenhydramine, meclizine, doxylamine)

• Supplements (e.g., valerian root, kava, melatonin)

• Antihypertensives, muscle relaxants, and sedatives

Because so many commonly used medications carry fall-related risks, having someone who can see the full picture of a resident’s regimen is essential. That’s where pharmacists make a real difference.

How Pharmacists Help Reduce Risk

Reducing fall risk in LTC requires a team-based approach. Pharmacists work alongside physicians, nurses, physical therapists, and caregivers with a shared goal: helping each resident maintain a medication regimen that carries the lowest possible fall risk.

At the center of that work is the comprehensive medication review. Because residents are often prescribed medications by multiple physicians, no single provider may have a complete picture of everything a resident takes. Pharmacists bring a 360-degree view of each resident’s entire medication regimen to make sure drug combinations are safe, medications are necessary, and help identify potential adverse effects early. Through this review, pharmacists can flag high-risk medications, recommend safer alternatives when appropriate, and identify opportunities to deprescribe medications that may no longer be necessary.

When a new medication is considered, a pharmacist consultation is a practical and proactive step toward ensuring it is safe, appropriate, and unlikely to introduce new risks to an already complex regimen.

Taking Action to Prevent Falls

Many falls are preventable and medications can be a contributing factor that hasn’t yet been identified. If a resident experiences side effects, those concerns should be communicated promptly to the care team and pharmacist, with regular follow-up as the regimen evolves.

If there are concerns about fall risk, requesting a medication review is a smart place to start. Thoughtful, ongoing medication management helps reduce falls, prevent injuries, and support a better quality of life.