Medications That Cause High Blood Pressure

High Blood Pressure and Drug Safety

To make sure your medication for high blood pressure is working effectively, avoid certain other drugs because:

Some medicines can make blood pressure rise. If you have high blood pressure to begin with, it can rise to dangerous levels.
Some medications may interact with your blood pressure medicine. This can prevent either drug from working properly.

Here are common types of drugs that can make your high blood pressure worse.

Non-steroidal Anti-inflammatory Drugs (NSAIDs)

NSAIDs include both prescription and over-the-counter medication. They are often used to relieve pain or reduce inflammation from conditions such as arthritis. However, NSAIDs can make your body retain fluid and decrease the function of your kidneys. This may cause your blood pressure to rise even higher, putting greater stress on your heart and kidneys. NSAIDs can also raise your risk for heart attack or stroke, especially in higher doses. Common NSAIDs that can raise blood pressure include:

Ibuprofen (Advil, Motrin)
Naproxen (Aleve, Naprosyn)

You may also find NSAIDs in over-the-counter medication for other health problems. Cold medicine, for example, often contains NSAIDs. It's a good idea whenever you purchase an over-the-counter drug to check the label for NSAIDs. Ask your doctor if any NSAID is okay for you to use. Your doctor may be able to recommend alternatives, such as using acetaminophen instead of ibuprofen.

Cough and Cold Medications

Many cough and cold medications contain NSAIDs to relieve pain. As mentioned above, NSAIDs may increase your blood pressure. Cough and cold medications also frequently contain decongestants. Decongestants can make blood pressure worse in two ways:

Decongestants may make your blood pressure and heart rate rise.
Decongestants may prevent your blood pressure medication from working properly.
Pseudoephedrine (Sudafed) is a specific decongestant that can increase blood pressure.

What can you do? Avoid using cough and cold medicine that contains NSAIDs or decongestants, especially pseudoephedrine. Ask your doctor for suggestions about other ways to ease congestion symptoms, such as antihistamines or nasal sprays.

Migraine Headache Medications

Some migraine medications work by tightening blood vessels in your head. This relieves migraine pain. However, they also constrict blood vessels throughout your body. This makes your blood pressure rise, perhaps to dangerous levels. If you have high blood pressure or any other type of heart disease, talk with your doctor before taking a drug for migraines or severe headaches

Weight Loss Drugs

Some weight loss drugs may make heart disease worse: Appetite suppressants tend to "rev" up your body. This can make blood pressure rise and put more stress on your heart. Before using any weight loss drug, whether prescription or over-the-counter, be sure to check with your doctor. These medications can be useful for weight loss, but may do you more harm than good.

More Tips for Avoiding Medication Problems

Be sure any medications you choose to use are safe for people who have high blood pressure. These suggestions can help:

Give a list of ALL the medications you use, both prescription and over-the-counter, to every doctor you visit.
Read medication labels before buying over-the-counter products. Make sure the medicine doesn't contain ingredients that could make your high blood pressure worse, such as NSAIDs or decongestants.
Talk to your doctor before using any over-the-counter medication, herbal preparation, vitamins, or other nutritional supplements. Ask for alternatives to potentially harmful medicines.

Frequently Asked Questions:

You should not use ibuprofen if you have high blood pressure, unless your doctor has explicitly told you that you can. Ibuprofen can also impair the effectiveness of common blood pressure medicines like ace inhibitors (such as Lotensin, Capoten, and Vasotec) and beta blockers (such as Coreg, Lopressor, and Corgard.)

Acetaminophen (Tylenol) is often the pain reliever of choice for people with high blood pressure (hypertension) because most other options are types of nonsteroidal anti-inflammatory drugs like ibuprofen (Motrin, Advil) or naproxen (Naprosyn, Aleve), which can raise blood pressure.

Aspirin does not elevate blood pressure. Among nonselective NSAIDs, ibuprofen increases the risk of hypertension and stroke. Diclofenac does not increase the risk of hypertension, but does increase the risk of stroke. Naproxen (Naprosyn) does not increase the risk of hypertension or stroke.

Naproxen. Another anti-inflammatory drug, which works much like ibuprofen. Some studies show this may be a better choice than ibuprofen for people at risk for heart disease.