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If you have high blood pressure or are at risk of developing it, it’s important to use caution when choosing over-the-counter medications and prescription medications. Many drugs that are generally safe for most people could increase your blood pressure levels. Additionally, some medications may interfere with your blood pressure medication. Here’s a look at some of the most common over-the-counter and prescription medications and how they affect your blood pressure.

Allergy, cold and flu medications and high blood pressure

Over-the-counter allergy medications can provide relief from seasonal allergy symptoms, including sneezing, itchy eyes and a runny nose. Cold medicines usually alleviate multiple symptoms associated with colds and contain more than one drug. Most cold, flu and allergy medications contain one of 

Antihistamines 

Antihistamines block or interfere with histamine, an immune system chemical that triggers allergy symptoms. These tend to be the best sinus meds for people with high blood pressure.

Zyrtec 

Zyrtec is the brand name version of cetirizine. It is also available with a decongestant as Zyrtec D (cetirizine and pseudoephedrine). Zyrtec doesn’t usually raise blood pressure, but Zyrtec D may.

Claritin 

Claritin is a brand name for the drug loratadine, which doesn’t usually raise blood pressure. Claritin-D, a combination of loratadine and pseudoephedrine, can elevate blood pressure.

Benadryl 

Benadryl is the best-known brand name for the drug diphenhydramine. Normally, Benadryl does not cause high blood pressure when taken in standalone form. However, the combination drug Benadryl D can increase blood pressure because it contains diphenhydramine and pseudoephedrine.

Nasal sprays

Steroid nasal sprays reduce swelling in the nasal passages to alleviate congestion. These include fluticasone (Flonase) and triamcinolone (Nasacort). Steroid nasal sprays aren’t known to increase blood pressure.

Saline nasal sprays thin mucus to alleviate congestion. These nasal sprays are a saline solution made of salt and water and include products like Ocean and Ayr. Saline nasal sprays aren’t known to increase blood pressure levels. 

Pseudoephedrine 

The sinus decongestant pseudoephedrine, the active drug in Sudafed, is known to raise blood pressure. Avoid these medications if you have high blood pressure.

Phenylephrine 

Phenylephrine is a decongestant from the same class of drugs as pseudoephedrine. Although it doesn’t generally increase blood pressure, it’s possible — so consult your doctor before taking it.

What cough medicine can I take with high blood pressure?

There are two main types of cough medicine:

  • Antitussives: suppress your cough reflex. Dextromethorphan is the most common over-the-counter antitussive and is found in numerous cough medicines.
  • Expectorants: thin mucus to make it easier for you to clear it from your airways. Guaifenesin is the only expectorant available over the counter. It is found in Mucinex and in Robitussin Chest Congestion.

Generally, standalone antitussives and expectorants don’t raise blood pressure. However, many popular combination cold and flu medications also contain pseudoephedrine and NSAIDs, which may increase blood pressure.

These drugs have the potential to increase blood pressure on their own and when taken in combination with cold medicines.

Nyquil and high blood pressure

Nyquil is a popular brand name over-the-counter cold medication. The brand offers multiple products, each of which has different key ingredients. You should avoid most Nyquil liquid and capsule cold medications if you have high blood pressure.

However, the brand does offer the product NyQuil HBP Cold & Flu medicine specifically for people with hypertension. It contains drugs that alleviate sneezing, sore throat, headache, fever, runny nose, cough and body aches but is free of medications that increase blood pressure.

Pain relievers and high blood pressure

There are three main categories of over-the-counter pain relievers:

Acetaminophen (Tylenol)

Acetaminophen acts on the part of the brain that receives pain messages and controls body temperature. Since acetaminophen doesn’t normally increase blood pressure, it’s a common pain reliever recommended for people with hypertension. Generally, doctors recommend that people with high blood pressure take acetaminophen for pain and fever relief. 

Non-steroidal anti-inflammatory drugs (NSAIDs) 

NSAIDs like aspirin, ibuprofen (Advil) and naproxen (Aleve) interfere with hormones that act on the nerves and cause pain sensations and swelling. These are known to increase blood pressure. Don’t start a low-dose aspirin regimen or use aspirin for pain relief without consulting your primary care physician. 

Combination drugs

Combination pain relievers typically contain acetaminophen plus an NSAID and are most commonly used to treat headaches. It’s best to avoid combination medications if you have high blood pressure.

What sleep aid can you take with high blood pressure?

Over-the-counter sleep aids can help alleviate insomnia and are generally considered safe for most people to use for short periods. If you have high blood pressure, read the labels carefully when choosing a sleep aid.

Antihistamine sleep aids like diphenhydramine, doxylamine succinate and cyclizine are unlikely to raise blood pressure. However, some antihistamine sleep aids, such as Advil-PM, contain NSAIDs, which can increase blood pressure. For pain relief plus a sleep aid, Tylenol PM that contains acetaminophen is generally a better option.

Prescription medications and high blood pressure

It’s important to tell your doctor about all medications you’re taking, including vitamins and supplements. Some very common prescription medications can cause increases in blood pressure — or, if you’re taking blood pressure medication, cause low blood pressure.

Adderall 

Adderall is a prescription medication used to treat attention-deficit hyperactivity disorder (ADHD). Since it can increase blood pressure levels, doctors typically don’t prescribe it for people who have uncontrolled hypertension or heart problems. People who take Adderall recreationally may experience high blood pressure, and in large doses, the risk increases. You should never take Adderall unless a doctor has prescribed it for you.

Lexapro and Zoloft

Lexapro is the brand name for the prescription medication escitalopram, and Zoloft is the brand name for sertraline. Both of these commonly prescribed medications are in a class of drugs known as selective serotonin reuptake inhibitors (SSRIs) and are used to treat depression and generalized anxiety disorder (GAD).

Lexapro and Zoloft aren’t generally known to increase blood pressure, but when they’re combined with monoamine oxidase (MAO) inhibitors like isocarboxazid (Marplan), linezolid (Zyvox) and phenelzine (Nardil), they can lead to dangerous blood pressure spikes as well as low sodium levels, which can lead to confusion, headaches and difficulty concentrating. This is most common in older adults who take both medications.

Muscle relaxants 

Muscle relaxants used to treat muscle spasms and cramping normally don’t increase blood pressure. In fact, they often lower it. As a result, muscle relaxers may not be safe to take with certain blood pressure medications.

Viagra

Viagra (sildenafil) is a prescription medication used to treat erectile dysfunction in men. It causes blood vessels to widen, increasing blood flow to the penis. This actually lowers blood pressure. Taking Viagra with blood pressure medication can cause dizziness and fainting. As a result, doctors use caution when prescribing Viagra and similar medications for men taking blood pressure medication.

Blood thinners 

Blood thinners prevent clots from forming in blood and help blood circulate more freely through the body. Taking a blood thinner is unlikely to increase your blood pressure. However, people with uncontrolled high blood pressure are more at risk for bleeding while taking blood thinners.

Steroids

Prescription steroids or corticosteroid medications like Prednisone reduce inflammation and treat a range of conditions. In some people, steroids can increase blood pressure. However, the benefits of steroids sometimes outweigh the risk of increased blood pressure and may be prescribed even if your blood pressure is already high. In this case, your doctor will keep a close eye on your blood pressure and may recommend that you follow a low-sodium diet.

Your primary care provider is the best source of advice

The information outlined above is general advice only. Your medical history may make an over-the-counter or prescription drug that’s generally safe for people with hypertension less than ideal for you. Only your primary care provider, armed with your medical history, can provide you with individual guidance on what drugs you should take and which you should avoid if you have high blood pressure. Always consult with your physician before you start any new over-the-counter medication or dietary supplement.

Forward makes managing multiple medical conditions simpler

When you have high blood pressure and another medical condition that requires treatment with over-the-counter or prescription medication, you need a specialized plan of care that addresses both. Acting as your primary care provider, we provide one-to-one, personalized care that takes into consideration your medical history and lifestyle. Our 12-week, doctor-led Healthy Heart Program can get you on the path to lowering your blood pressure, and we can help you determine which medications are the right fit for your unique needs.

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