Examples of medications that may contribute to unintentional weight loss*

Category	Examples	Adverse effect
Analgesic and sedative	Benzodiazepines	Impaired cognition, anorexia
	NSAIDs (including aspirin and COX-2 selective)	Nausea, gastrointestinal distress, dysphagia
	Opioids	Nausea, vomiting
Anti-infectives	Erythromycin, lamivudine, metronidazole, trimethoprim-sulfamethoxazole	Anorexia, altered taste, nausea, vomiting
Anticholinergics (antimuscarinics)^¶	Benztropine, oxybutynin, tolterodine	Dry mouth, nausea
Cardiovascular	ACE inhibitors	Altered taste or smell
	Aspirin	Nausea, gastrointestinal distress, dysphagia
	Calcium channel blockers	Altered taste or smell
	Clonidine	Dry mouth
	Digoxin	Nausea, vomiting (particularly as serum levels increase)
	Loop diuretics	Dry mouth
	Propranolol	Altered taste or smell
	Spironolactone	Altered taste or smell
	Statins	Nausea, vomiting
	Thiazide diuretics	Dry mouth
Chemotherapy^Δ	Cisplatin, cyclophosphamide, carboplatin, cytarabine, doxorubicin	Nausea, vomiting, anorexia (varies by agent and combination)^Δ
Endocrine	Antidiabetic (eg, metformin)	Anorexia
	Hormones (eg, estrogens)	Nausea
	Osteoporosis (eg, bisphosphonates)	Dysphagia, nausea
H1 antihistamines	Diphenhydramine	Dry mouth
Neurologic	Alzheimer medications (eg, donepezil)	Nausea
	Antiparkinson medications (eg, amantadine, carbidopa-levodopa, selegiline)	Altered taste or smell, nausea, anorexia
	Antiseizure (eg, topiramate)	Anorexia
Psychiatric	Antipsychotics	Anorexia, nausea (varies by agent; several associated with weight gain)
	Bupropion	Anorexia
	Lithium	Nausea, vomiting (particularly as serum levels increase)
	SSRI antidepressants (eg, fluoxetine, paroxetine, sertraline)	Anorexia, nausea (generally short-lived)
	Tricyclic antidepressants	Dry mouth, nausea
Rheumatologic	Antigout (eg, allopurinol, colchicine)	Altered taste or smell (allopurinol) Anorexia, nausea, vomiting (colchicine)
Rheumatologic	Rheumatoid arthritis (eg, hydroxychloroquine)	Anorexia, nausea, vomiting
Supplements	Iron	Nausea, dysphagia, vomiting
Supplements	Potassium	Nausea, dysphagia, vomiting
Sympathomimetics	Decongestants	Anorexia
Other	Alcohol	Anorexia, gastrointestinal distress, impaired cognition, liver disease
Other	Nicotine	Anorexia

Commonly used drugs associated with loss of appetite and unintentional weight loss. Most drugs can cause nausea or vomiting. This list is not exhaustive. Increasing dose and additive effect from simultaneous use of several medicines (polypharmacy) can increase appetite suppression.

NSAIDs: nonsteroidal antiinflammatory drugs; COX-2: cyclooxygenase-2; ACE: angiotensin-converting enzyme; SSRI: selective serotonin reuptake inhibitor.
* Some of the medications listed in this table are considered inappropriate for use in older adults. For additional information and potential alternatives, refer to the UpToDate topic review on drug prescribing in older adults.
¶ Anticholinergic activity of medications is reviewed separately. Refer to the UpToDate topic review on drug prescribing in older adults, section on anticholinergic activity and accompanying table.
Δ Chemotherapy drug emetogenicity, including delayed effects, is reviewed separately. Refer to the UpToDate topic review of prevention and treatment of chemotherapy-induced nausea and vomiting.

Data from:

Stajkovic S, Aitken Em, Holroyd-Leduc J. Unintentional weight loss in older adults. CMAJ 2011; 183:443.
Gaddey H, Holder K. Unintentional weight loss in older adults. Am Fam Physician 2014; 89:718.
McMinn J, Steel C, Bowman A. Investigation and management of unintentional weight loss in older adults. BMJ 2011 Mar 29; 342:d1732.

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Examples of medications that may contribute to unintentional weight loss*