Can Common Medications Raise Blood Pressure? What You Need to Know

High blood pressure, or hypertension, occurs when the force of blood against the artery walls remains consistently elevated. Generally, a reading over 130/80 mmHg is classified as hypertensive. If untreated, high blood pressure can place additional stress on the heart and arteries, heightening the risk of severe conditions like heart disease, stroke, and kidney failure.

Addressing high blood pressure requires lifestyle changes, medication, and consistent monitoring. Surprisingly, some medications may actually elevate your blood pressure, and understanding which ones to avoid is crucial for maintaining healthy numbers. If you're curious about which medications might increase blood pressure, here's what you should know.

How can over-the-counter medications affect blood pressure?

When blood pressure rises, the heart must exert more effort, potentially leading to long-term damage. Various medications, including over-the-counter drugs, herbal supplements and prescriptions, may contribute to this increase. Identifying potentially problematic medications is essential for safeguarding heart health. If you're uncertain about a specific medication, consult your doctor or pharmacist for safer options.

Which over-the-counter medications can raise blood pressure?

1. Oral nasal decongestants

Drugs like Sudafed (pseudoephedrine) and Sudafed PE (phenylephrine) are widely used for colds and allergies but can constrict blood vessels, raising both blood pressure and heart rate. For congestion relief, Coricidin HBP products are a safer choice for those with high blood pressure.

2. Nasal decongestant sprays

Nasal sprays such as Afrin (oxymetazoline) and Neo-Synephrine (phenylephrine) work similarly to oral decongestants by narrowing the blood vessels in the nose. Instead, consider Breathe Right strips or saline sprays like Ocean Saline, which clear nasal passages without affecting blood pressure. Another drug-free option is nasal irrigation using a Neti pot, a small device designed to flush the nasal passages with a saline solution. Always use distilled water with a Neti pot.

3. Hemorrhoid medications

Topical treatments like Preparation H Hemorrhoidal Ointment contain phenylephrine, potentially raising blood pressure. For relief without added risk, try 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 significantly raise blood pressure. If you have asthma and hypertension, collaborate with your doctor to find a prescription-based alternative instead of 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 cause fluid retention and reduced kidney function, both of which can elevate blood pressure. For 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.
Why is it important to monitor your blood pressure at home?
Regularly monitoring your blood pressure at home is a crucial aspect of managing hypertension effectively. It allows you to keep track of your blood pressure levels in a comfortable setting and detect any significant changes early.
Home monitoring provides valuable information to your healthcare provider, helping them adjust your treatment plan as needed. When selecting a home blood pressure monitor, look for one that is validated and easy to use. Properly following the instructions and maintaining a consistent schedule for measurement can enhance the accuracy of your readings. If you have questions about how to correctly monitor your blood pressure at home, consult your healthcare provider for guidance.
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.