Understanding High Blood Pressure and the Medications That Can Raise It

High blood pressure, or hypertension, happens when the force of blood against your artery walls stays consistently too high. A reading above 130/80 mmHg is generally considered hypertensive. Left unchecked, high blood pressure puts extra strain on your heart and arteries, increasing your risk for serious conditions like heart disease, stroke and kidney failure.

Managing high blood pressure involves lifestyle adjustments, medication and regular monitoring. But did you know certain medications can actually raise your blood pressure? Understanding which ones to avoid is an important part of keeping your numbers in check. If you’re wondering, “What medications increase blood pressure?” here’s what you need to know.

How can medications affect blood pressure?

When your blood pressure rises, your heart has to work harder, which can lead to damage over time. Certain medications, including over-the-counter drugs, herbal supplements and prescriptions, can contribute to this increase. Knowing which medications might be problematic is key to protecting your heart health. If you’re unsure about a specific medication, your doctor or pharmacist can help you find a safer alternative.

Which medications can increase blood pressure?

1. Oral nasal decongestants

Medications like Sudafed (pseudoephedrine) and Sudafed PE (phenylephrine) are commonly used for colds and allergies, but they constrict blood vessels, raising both blood pressure and heart rate. If you need relief from congestion, Coricidin HBP products are a safer choice for people with high blood pressure.

2. Topical nasal decongestants

Nasal sprays like Afrin (oxymetazoline) and Neo-Synephrine (phenylephrine) work similarly to oral decongestants by causing vasoconstriction. Instead, try Breathe Right strips or saline sprays like Ocean Saline, which can clear nasal passages without affecting blood pressure. If you’re using a Neti pot, always use sterile or distilled water.

3. Hemorrhoid medications

Topical treatments such as Preparation H Hemorrhoidal Ointment contain phenylephrine, which can raise blood pressure. For relief without the added risk, consider using Preparation H Anti-Itch Cream with Hydrocortisone or Tucks Hemorrhoidal Ointment.

4. Asthma medications

Over-the-counter asthma treatments like Primatene and Bronkaid contain ephedrine, which can cause a significant rise in blood pressure. If you have asthma and hypertension, work with your doctor to find a prescription-based alternative rather than self-medicating with over-the-counter options.

5. Non-steroidal anti-inflammatory drugs (NSAIDs)

Pain relievers such as Advil (ibuprofen), Aleve (naproxen) and even aspirin can lead to fluid retention and reduced kidney function, both of which can elevate blood pressure. If you need pain relief, use the lowest effective dose for the shortest duration, and ask your doctor about safer alternatives.

6. Nicotine replacement therapies

Products like Nicorette gum, NicoDerm patches and Commit lozenges can temporarily raise blood pressure. However, quitting smoking has undeniable long-term heart health benefits. If you’re using nicotine replacement therapy, consult your doctor to monitor its effects on your blood pressure.

7. Herbal supplements

Some herbal remedies can interfere with blood pressure control. Avoid supplements containing ephedra, which can raise both blood pressure and heart rate. Other herbs, such as ginkgo (used for memory) and St. John's Wort (used for mood support), may also interact with blood pressure medications. Always consult your doctor before taking herbal supplements.

Which prescription medications can raise blood pressure?

Certain prescription drugs can also raise blood pressure. These include:

• Birth control pills
• Hormone replacement therapy
• Tricyclic antidepressants
• Migraine and ADHD medications containing stimulants

Review your medication list, including over the counter and herbal products, with your doctor to avoid interactions that could affect your blood pressure.

How can you manage blood pressure effectively?

Avoiding certain medications is only part of the equation. Here’s how you can keep your blood pressure in check:

• Monitor your blood pressure regularly: Use an at-home blood pressure monitor to track your numbers and make necessary adjustments.
• Eat a heart-healthy diet: Focus on fruits, vegetables, whole grains, lean proteins and low-fat dairy while limiting salt, sugar and saturated fats.
• Stay active: Regular exercise helps regulate blood pressure. Aim for at least 30 minutes of moderate activity, like walking, most days of the week.
• Take medications as prescribed: If your doctor prescribes blood pressure medication, follow their instructions carefully; don’t adjust dosages on your own.
• Manage stress: Chronic stress can contribute to high blood pressure. Incorporating mindfulness techniques, hobbies and good sleep habits can help keep it under control.

If you’ve been diagnosed with high blood pressure or are concerned about the effects of your medications, schedule an appointment with an Ochsner cardiologist. Our team is here to provide expert guidance tailored to your health needs.