Did the AI miss a medicine warning?
List your medicines and paste what an AI said about them. The page checks them against FDA label warnings and the Beers list for people 65 and older, and shows what the answer missed.
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The 24 rules, each with its source
Read from the primary source on 2026-10-27: the FDA label on DailyMed (the National Library of Medicine's label site) or the American Geriatrics Society 2023 Beers Criteria (J Am Geriatr Soc 2023;71:2052-2081). A short list on purpose: it checks these rules and nothing else, and it never says a combination is safe. Agents can read the same rules at /api/medcheck.
| Rule | Level | Source |
|---|---|---|
| An erection pill (sildenafil, tadalafil and similar) with a nitrate for chest pain (nitroglycerin, isosorbide) can drop blood pressure dangerously. The labels say not to use them together. | The label says do not combine | Viagra (sildenafil) FDA label, section 4 Contraindications; the Cialis and nitroglycerin labels say the same |
| An opioid pain medicine with a benzodiazepine (Xanax, Ativan, Valium, Klonopin and similar) can slow or stop breathing. This is an FDA boxed warning, the label's strongest. | FDA boxed warning | OxyContin (oxycodone) FDA label, boxed warning; AGS Beers 2023 Table 5 also says avoid |
| Simvastatin with clarithromycin, erythromycin, itraconazole, ketoconazole, ritonavir and some others raises simvastatin to levels that can break down muscle. The label says not to combine them. | The label says do not combine | Zocor (simvastatin) FDA label, section 4 Contraindications |
| Simvastatin with gemfibrozil, cyclosporine or danazol is on the simvastatin label's do-not-use list (muscle injury). | The label says do not combine | Zocor (simvastatin) FDA label, section 4 Contraindications |
| An SSRI antidepressant (sertraline, escitalopram, fluoxetine, citalopram, paroxetine) with an MAOI (including the antibiotic linezolid) can cause serotonin syndrome. The labels say not to combine them, or to start one within 14 days of stopping the other. | The label says do not combine | Zoloft (sertraline) FDA label, section 4 Contraindications; the other SSRI labels say the same |
| Tizanidine (Zanaflex) with ciprofloxacin or fluvoxamine can drop blood pressure and cause heavy drowsiness. The label says not to combine them. | The label says do not combine | Zanaflex (tizanidine) FDA label, section 4 Contraindications |
| Warfarin with aspirin, clopidogrel, an NSAID pain reliever (ibuprofen, naproxen and others) or an SSRI or SNRI antidepressant raises the risk of bleeding. The warfarin label lists them and asks for close monitoring. | Label warning | Jantoven (warfarin) FDA label, section 7 Drug Interactions |
| Two of these products contain acetaminophen (Tylenol). Taking both can pass the daily limit without noticing; too much can cause severe liver damage. | Label warning | Tylenol Extra Strength FDA label, Liver warning |
| For people 65 and older, an opioid with gabapentin or pregabalin raises the risk of severe sedation and slowed breathing. Avoid, except while switching from one to the other or to lower the opioid dose. | Avoid at 65 and older (Beers 2023) | AGS Beers Criteria 2023, Table 5 |
| For people 65 and older, warfarin with amiodarone, ciprofloxacin, clarithromycin or erythromycin, sulfamethoxazole-trimethoprim (Bactrim) or an SSRI raises bleeding risk. Avoid when possible; if used together, the INR is checked closely. | Avoid at 65 and older (Beers 2023) | AGS Beers Criteria 2023, Table 5 |
| For people 65 and older, more than one strongly anticholinergic medicine (first-generation antihistamines like diphenhydramine, older antidepressants like amitriptyline, paroxetine) adds up: more confusion, falls and memory problems. | Avoid at 65 and older (Beers 2023) | AGS Beers Criteria 2023, Table 5 and Table 7 |
| First-generation antihistamines (diphenhydramine, as in Benadryl and most "PM" sleep aids, doxylamine, hydroxyzine, meclizine and others): avoid at 65 and older. They are strongly anticholinergic: confusion, constipation, falls. Short use for a severe allergic reaction can be appropriate. | Avoid at 65 and older (Beers 2023) | AGS Beers Criteria 2023, Table 2 |
| Benzodiazepines (alprazolam, lorazepam, diazepam, clonazepam and others): avoid at 65 and older. Older adults are more sensitive to them: memory problems, delirium, falls, fractures, car crashes. | Avoid at 65 and older (Beers 2023) | AGS Beers Criteria 2023, Table 2 |
| Zolpidem, eszopiclone, zaleplon ("Z-drug" sleep pills): avoid at 65 and older. Side effects like the benzodiazepines (falls, fractures, delirium) for little gain in sleep. | Avoid at 65 and older (Beers 2023) | AGS Beers Criteria 2023, Table 2 |
| Muscle relaxants (cyclobenzaprine, methocarbamol, carisoprodol and others): avoid at 65 and older. Poorly tolerated: sedation, anticholinergic effects, fractures. | Avoid at 65 and older (Beers 2023) | AGS Beers Criteria 2023, Table 2 |
| NSAID pain relievers (ibuprofen, naproxen, meloxicam and others): at 65 and older, avoid using them long term unless nothing else works and a stomach-protecting medicine is taken too. They raise the risk of stomach bleeding, blood pressure and kidney injury. | Avoid at 65 and older (Beers 2023) | AGS Beers Criteria 2023, Table 2 |
| At 65 and older, even short regular use of an NSAID is to be avoided alongside a steroid (prednisone and similar), a blood thinner or an antiplatelet, unless nothing else works and a stomach-protecting medicine is taken too. | Avoid at 65 and older (Beers 2023) | AGS Beers Criteria 2023, Table 2 |
| Indomethacin and ketorolac: avoid at 65 and older. Of the NSAIDs they carry the most bleeding, kidney and (indomethacin) confusion risk. | Avoid at 65 and older (Beers 2023) | AGS Beers Criteria 2023, Table 2 |
| Sulfonylureas (glipizide, glimepiride, glyburide): at 65 and older, avoid as a first or second diabetes medicine. Higher risk of low blood sugar and of heart events than the alternatives; glyburide and glimepiride cause longer lows. | Avoid at 65 and older (Beers 2023) | AGS Beers Criteria 2023, Table 2 |
| Stomach-acid pills (omeprazole, esomeprazole, pantoprazole and others): at 65 and older, avoid daily use past 8 weeks unless there is a specific reason (for example, also taking a steroid or an NSAID every day, or Barrett's esophagus). | Avoid at 65 and older (Beers 2023) | AGS Beers Criteria 2023, Table 2 |
| Meperidine (Demerol): avoid at 65 and older. Not effective by mouth at usual doses and more likely than other opioids to cause delirium. | Avoid at 65 and older (Beers 2023) | AGS Beers Criteria 2023, Table 2 |
| Metoclopramide (Reglan): avoid at 65 and older unless for gastroparesis, and then no longer than 12 weeks. It can cause movement disorders, including tardive dyskinesia. | Avoid at 65 and older (Beers 2023) | AGS Beers Criteria 2023, Table 2 |
| Megestrol (Megace): avoid at 65 and older. Little effect on weight, and a higher risk of blood clots and possibly death. | Avoid at 65 and older (Beers 2023) | AGS Beers Criteria 2023, Table 2 |
| Strongly anticholinergic antidepressants (amitriptyline, nortriptyline, imipramine, paroxetine and others): avoid at 65 and older. Sedation, confusion and dizziness on standing. | Avoid at 65 and older (Beers 2023) | AGS Beers Criteria 2023, Table 2 |
Also here: check an AI summary against the original and see what preventive care is due.