Drugs That Can Raise Your Blood Pressure

If you have high blood pressure, you should be aware that some prescription medicines as well as some over-the-counter drugs and supplements can easily raise it. Here’s how you can stay safe:

1. Keep a list

Let all your doctors know about all the medicines you are prescribed. That way, each doctor can check for possible interactions that can affect your blood pressure. Also tell your doctors about any OTC medicines, herbal remedies and supplements you take.

When you’re prescribed a new medication, such as any of the following, ask about its possible effect on blood pressure:

• Antidepressants

• Drugs to suppress the immune system

• Medicines that contain hormones

• Pain medications

• Stimulants such as methylphenidate (Ritalin, Concerta)

Many of these drugs as well as other medicines can have a negative effect on blood pressure. If you’re concerned about a medicine that has the potential to raise blood pressure, ask if there’s an alternative that won’t have that effect—or if your dose can be lowered.

You can also talk to your pharmacist about the effects of the medicines you take and any possible interactions. Pharmacists are good sources for information about nonprescription remedies too.

2. Read labels

If you are being treated for high blood pressure, you are probably already looking at food labels. You should also be reading the labels on any over-the-counter medicines, supplements, or herbal products you buy. See if the product contains the same ingredients you seek to avoid in foods, especially sodium, also listed on nutrient labels as salt or soda. High sodium intake causes you to retain fluid, which can raise your blood pressure.

The most important things to look for on labels are warning statements. If the label has a warning for people who take blood pressure medicine or who have high blood pressure, do not take that medicine before talking with your doctor about it. Your doctor can tell you whether it’s safe for you and suggest possible alternatives.

3. Just say ‘no’

Here are some products you should avoid:

• Decongestants containing pseudoephedrine or phenylephrine. Many cold and flu remedies contain decongestants among their ingredients and should be avoided. Ask your pharmacist about topical decongestants as an alternative. Also consider using nasal strips that open breathing passages—without the use of medicine.

• Nonsteroidal anti-inflammatory drugs (NSAIDs). Pain medications such as ibuprofen (Advil) or naproxen (Aleve), especially when taken at prescription strength, can raise blood pressure. NSAIDs are also commonly found in other medicines. An occasional tablet may be OK, but be sure to ask your pharmacist or doctor about other pain remedies. An occasional dose of acetaminophen (Tylenol) may be safer. Also consider massage or applying ice or a warm compress to a painful area of the body.

• Products containing caffeine or other stimulants. For most people, the caffeine in coffee doesn’t seem to be a problem. But definitely avoid products such as energy drinks with high, concentrated doses.

• Smoking cessation products that contain nicotine, such as gum, patches, or lozenges. Talk with your doctor before using these.

• Herbal supplements such as bitter orange, ephedra, ginkgo, ginseng, licorice, and St. John’s wort. All of these can affect blood pressure.

4. Monitor yourself

Checking your own blood pressure, especially when you start taking a new medicine, can help you spot problems early. Inexpensive, easy-to-use blood pressure monitors are available for purchase. Your pharmacist can help you choose one that’s right for you.

Talk with your doctor about what your numbers should be. For most people, blood pressure that’s below 140/90 is a reasonable target for lowering the risk of a first stroke, according to a joint statement issued in 2015 by the American Heart Association, , the American College of Cardiology, and the American Society of Hypertension. If you’ve already had a stroke, the target is lower—130/80.

Blood pressure can go up or down many times in just one day; this doesn’t mean there’s a problem. But if your readings are persistently above the target numbers, call your doctor to see what you should do.