7 Medicines That Don’t Mix With Driving

2. Some antidepressants

“First-generation antidepressants (amitriptyline, nortriptyline and others) and antihistamines (diphenhydramine, hydroxyzine and others) used to treat anxiety can also be very sedating,” Zammit says. Anyone over the age of 65 taking any of the above “should have a discussion with their health care provider about potentially safer options.”

The newer antidepressants such as fluoxetine (Prozac), citalopram (Celexa), sertraline (Zoloft), venlafaxine (Effexor) and other SSRIs and SNRIs (short for selective serotonin reuptake inhibitors and serotonin–norepinephrine reuptake inhibitors) aren’t as sedating as their older counterparts, “but they could have alternate central nervous system effects apart from sedation that impair driving ability,” Zammit says.

3. Pain medications

Prescription opioids such as hydrocodone (Vicodin) and oxycodone (OxyContin, Percocet) contain chemicals that relax the body and relieve moderate to severe pain; side effects include sleepiness and lightheadedness. But even over-the-counter pain relievers carry these potential side effects.

In a study published in 2023, in JAMA Network Open, researchers looked at cognitively healthy adults 65 and older and found that those taking NSAIDs (short for nonsteroidal anti-inflammatory drugs such as aspirin, ibuprofen and naproxen) or acetaminophen (Tylenol) were at a higher risk of failing a road test over time. Complicating matters, the study suggests, long-term use of NSAIDs could result in drug interactions that exacerbate medical conditions known to contribute to driving impairment, such as hypertension and heart failure.

“Some drugs can affect how another drug gets metabolized,” Issa explains. “You may take a drug that is mildly sedating and then take another that affects the breakdown of the (first) drug and makes it much more sedating.” Don’t combine medications without first discussing with your doctor or pharmacist.

“Metabolism affects everything — including how your body breaks down medications — and it slows down as you grow older,” he says. “There’s roughly a 10 percent decrease in the breakdown of these medications per decade, on average.” 

4. Cold and flu remedies

Granted, the last thing you want to do if you’re battling a nasty cold or the flu is get out of bed, much less drive, but keep in mind that cold and flu medicines that contain dextromethorphan (for instance, Mucinex DM and Delsym) can cause dizziness or drowsiness.

5. Allergy meds

Allergy sufferers who reach for antihistamines to help get them through the spring allergy season should know: First-generation antihistamines such as diphenhydramine (Benadryl) can cause drowsiness, while second-generation products including loratadine (Claritin), cetirizine (Zyrtec) and fexofenadine (Allegra) are considered nonsedating, Zammit says. However, “the claim of nonsedating is not universal, as some people report sleepiness even with the newer agents,” she says. “This underscores the importance of evaluating your own response to any given drug. Navigating this question is a good discussion to have with your pharmacist or health care provider.”

6. Anti-seizure medications

Drugs prescribed to help prevent seizures are also prescribed for other conditions such as migraine headaches, anxiety, restless leg syndrome and pain from nerve damage. Whatever the reason, “all anti-seizure medications impact the central nervous system — and some may be more sedating than others,” Zammit says. “Any patient initiating or increasing an anti-seizure medication must be closely monitored for multiple adverse effects.” In addition to sleepiness, these include blurred vision, dizziness and nausea. 

7. Sleep aids

If you take something before bedtime to help you sleep through the night, that something may interfere with your ability to perform everyday activities including driving. “Z-drugs” such as eszopiclone (Lunesta), zaleplon (Sonata) and zolpidem (Ambien, Edluar and Zolpimist) work by slowing activity in the brain — all in the name of helping you get a good night’s sleep. Problem is, they may still be in your system when you get behind the wheel the next morning. That’s especially true for older adults.

“Z drugs should be avoided by older adults,” Zammit says. If you take one of the above or another sleep aid, talk with your health care provider about alternatives, if not ways to take the lowest effective dose.