Is Cold Medicine Safe for People with High Blood Pressure?

Many cold medicines contain decongestants and other ingredients that could raise blood pressure. If you have high blood pressure, speak with your doctor before taking any cold medicines. This article explains the effects of cold medicines on high blood pressure. It also highlights what to look for on a drug label and which ingredients to avoid.

Over-the-counter (OTC) cold medicines could have unwanted effects on blood pressure, according to the American Heart Association (AHA) Trusted Source American Heart Association Highly respected national organization Go to source . 

The AHA references 2017 guidelines Trusted Source AHA/ASA Journals Peer reviewed journal Go to source that list nonsteroidal anti-inflammatory drugs (NSAIDs) and decongestants as medications that people with high blood pressure should avoid. These ingredients are often found in cold medicines.

The specific effects of these medications, according to the AHA, include:

• raising your blood pressure
• constricting your blood vessels 
• raising your risk of heart attack, heart failure, and stroke

It is important for everyone — including healthy people — to monitor their blood pressure when taking new medications. If you have high blood pressure, check with your doctor before using cold medicines.

Here is a list of common ingredients in cold medicines that could increase blood pressure:

• decongestants, such as:
  • phenylephrine
  • ephedrine
  • pseudoephedrine
• NSAIDs, such as: 
  • ibuprofen (Advil)
  • naproxen (Aleve)
• acetaminophen (Tylenol) or paracetamol

A 2015 review of research Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source suggests that a combination of phenylephrine and paracetamol at a dose of 15 milligrams (mg) or more could increase blood pressure and decrease heart rate.

The researchers also shared that an oral dose of 45 mg of phenylephrine could increase blood pressure in people with normal blood pressure.

Ephedrine should not Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source be taken by someone with hypertension. It increases the heartbeat rate and the force with which the heart beats. An overdose of ephedrine could also cause a rapid rise in blood pressure.

Evidence from 2018 suggests that pseudoephedrine can cause a slight increase in systolic blood pressure (SBP), but has no effect on diastolic blood pressure (DBP). SBP and DBP are the two figures on a blood pressure reading.

Older research from 2000 Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source found that indomethacin and other NSAIDs can affect blood pressure by inhibiting prostaglandin production. Prostaglandin is a naturally-occurring fat that helps coordinate the widening and narrowing of blood vessels.

Learn 7 more things about NSAIDs.

Research in 2022 Trusted Source AHA/ASA Journals Peer reviewed journal Go to source suggests that a daily intake of 4 grams (g) of acetaminophen increases SBP in people with high blood pressure by 5 millimeters of mercury (mm Hg). Researchers studied 110 people with high blood pressure.

While short-term use of acetaminophen at the lowest effective dose may be safe for people with high blood pressure, long-term use of high doses should be avoided. According to the U.S. Food and Drug Administration Trusted Source Food and Drug Administration (FDA) Governmental authority Go to source , 4 g of acetaminophen is the maximum daily dose for adults. 4 g is equal to 8 extra strength pills of 500 mg each.

Cold medicines are generally not recommended for people with high blood pressure. However, some may be safer than others.

The study from 2000 Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source notes that aspirin does not appear to raise blood pressure (BP) significantly, even in people with high blood pressure. The researchers also suggest that sulindac (Clinoril) may not elevate BP significantly. Sulindac is a type of NSAID that’s available by prescription.

A study from 2015 Trusted Source AHA/ASA Journals Peer reviewed journal Go to source also concluded that aspirin does not appear to raise blood pressure significantly. In fact, the researchers note that low dose aspirin taken to help prevent cardiovascular disease could have a beneficial effect on blood pressure.

It helps to check drug labels for ingredients that may raise BP before buying any cold medicine.

These ingredients include:

• phenylephrine 
• ephedrine
• pseudoephedrine
• acetaminophen (Tylenol)
• ibuprofen (Advil)
• naproxen (Aleve)

Speak with your doctor before trying any new medications.

There are safe ways to relieve cold symptoms for people with high blood pressure. They include:

• drinking lots of water
• using lozenges
• consuming honey
• getting sufficient rest
• using saline nasal sprays
• taking a hot shower

If your symptoms persist, consult your doctor before taking any OTC medications.

Cold medicine could have effects on blood pressure if they contain certain ingredients. Effects include raising your BP, constricting your blood vessels, and raising your chances of having heart issues.

NSAIDs, acetaminophen, and decongestants in cold medicines are all examples that may affect BP.

Specific cold medicine ingredients to avoid if you have high blood pressure include pseudoephedrine, phenylpropanolamine, and ephedrine.

There are other ways to treat a cold if you have high blood pressure, including drinking lots of water and fluids, using lozenges, and getting sufficient rest.

Speak with your doctor before trying any new medications.