Cold Medicine for High Blood Pressure: Drug Safety Tips – Verywell Health

Kelly Burch is a freelance journalist who has covered health topics for more than 10 years. Her writing has appeared in The Washington Post, The Chicago Tribune, and more.
Rochelle Collins, DO, is board-certified in family medicine. She is an assistant clinical professor of family medicine at Quinnipiac University and works in private practice in Hartford, Connecticut.
High blood pressure, known medically as hypertension, is extremely common, affecting about half of American adults. People with high blood pressure or heart disease should be aware that common over-the-counter (OTC) medications, including cold medicine and decongestants, can raise blood pressure.
If you have hypertension you should talk with your healthcare provider about alternatives to cold and cough medicine for people with high blood pressure.
This article will cover how OTC drugs, including cough medicine, sinus medicine, and decongestants, can cause side effects for people with high blood pressure. It will also discuss safer options for people with high blood pressure. 
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There are lots of different types of cold and flu medications. Many of them combine decongestants, cough suppressants, and pain relievers (which also reduce fever). Although these ingredients can help you feel better, they might make heart disease and high blood pressure worse.
If you have high blood pressure, you should always talk to your healthcare provider before using OTC medications. There are two common ingredients that you should be particularly mindful of. 
Decongestants work by causing blood vessels to shrink. This helps treat congestion, which happens when blood vessels in the nose become swollen. Unfortunately, decongestants can also raise blood pressure.
People with high blood pressure should talk to their healthcare provider before using decongestants, including those containing pseudoephedrine or phenylephrine. 
NSAIDs are common OTC pain relievers and fever reducers. Aleve (naproxen sodium) and Advil and Motrin (ibuprofen) are all NSAIDs. Although these are effective for treating pain, they can cause a rise in blood pressure when they’re taken by mouth.
They can increase the risk for heart attack (blockage of blood flow to the heart muscle) and stroke (blockage of blood flow to the brain or a bleed in the brain) as well, so people with high blood pressure are advised not to use NSAIDs.
It’s possible to find a safe cold medicine for high blood pressure. However, it may take some extra work.
It’s best to start by asking your healthcare provider for their recommendations so you can be prepared before you are sick with a cold or the flu. They can give you a list of medications that are safe to address various symptoms, such as nasal or sinus congestion, fever, aches, or cough.
Your healthcare provider can also tell you which medications to avoid and may suggest several ways you can deal with these symptoms without medications.
When you’re selecting an over-the-counter medication, learn to read drug labels. It’s most important to look at the active ingredients. Those are the ingredients that have the biggest impact on your body. If you have high blood pressure, avoid medications that have the following active ingredients:
Each of these comes in several other brands, and they may also be present in multisymptom cold and flu medications that combine different active ingredients.

There are safe alternatives to cold medicine for people with high blood pressure. Talk with your healthcare provider about what will work best for you. Here’s what you can consider:
These OTC medications are safe for people with high blood pressure, but can alleviate some of the symptoms of colds:
You can also control your symptoms with home remedies and natural remedies for colds, including:
People with high blood pressure need to be cautious about using over-the-counter cold medications. Common ingredients in cold medicines, including decongestants and NSAID pain relievers, can increase blood pressure.
If you have high blood pressure, ask your doctor about safer ways to treat a cold, including using Tylenol, antihistamines, and natural remedies. 
Dealing with a cold can be miserable. When you’re not feeling well, it may be hard to remember which cold medicines are safe if you have underlying health conditions. Plan ahead by talking to your healthcare provider when you’re well about how to treat a cold, with your hypertension and heart health in mind. 
Many OTC cold medicines contain decongestants and NSAID pain relievers. Both of these medications can raise blood pressure, so if you have hypertension you should ask your doctor before taking them. 
Topical decongestants work directly in the nasal passages and are not absorbed in the bloodstream to travel throughout the body the way that decongestants taken orally can.
They might be safer because they stay in the nasal area, but you should still talk to your healthcare provider before using them if you have high blood pressure. 
Looking to start a diet to better manage your high blood pressure? Our nutrition guide can help.
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Centers for Disease Control and Prevention. Facts about hypertension.
American Heart Association. Taking medicine for a cold? Be mindful of your heart.
Ruschitzka F, Borer JS, Krum H, et al. Differential blood pressure effects of ibuprofen, naproxen, and celecoxib in patients with arthritis: the PRECISION-ABPM (Prospective randomized evaluation of celecoxib integrated safety versus ibuprofen or naproxen ambulatory blood pressure measurement) TrialEuropean Heart Journal. 2017;38(44):3282-3292. doi:10.1093/eurheartj/ehx508
Harvard Health. Ask the doctor: Can allergies cause high blood pressure? June 10, 2019.

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