Medications to Avoid if You Have High Blood Pressure

LPSO issues firework guidelines for New Year’s celebrations
December 26, 2022
LA State Fire Marshal offers firework safety tips ahead of the New Year holiday
December 27, 2022

By Megan McKenzie, Pharm. D.

Blood pressure is best understood as the force of blood pressing against the walls of your arteries. A person can be diagnosed with high blood pressure, also called hypertension, when their blood pressure is consistently greater than 140/90 mm Hg.

When a person’s blood pressure is too high, their hearts need to work harder which can cause serious damage to the arteries. Over time, uncontrolled high blood pressure increases the risk of heart disease, stroke and kidney disease.


Some medications can increase your blood pressure, so it’s important to be aware of which medications to avoid if your blood pressure is already elevated. If you are unsure of whether a medication might impact your current blood pressure state, your physician or pharmacist are the first resources you should consult. Often, they will be able to recommend an alternative product that will not affect your blood pressure.

Oral Nasal Decongestants

Oral nasal decongestants like Sudafed (pseudoephedrine) and Sudafed PE (phenylephedrine) can increase blood pressure by elevating your heart rate and causing blood vessels to narrow, also known as vasoconstriction. Pseudoephedrine and phenylephedrine can also be found in many cold, cough and flu combination products. If you suffer from cold, cough or flu symptoms, try Coricidin HBP products.


Topical Nasal Decongestants

Topical nasal decongestants such as Afrin (oxymetazoline), Neo-Synephrine (phenylephrine), Privine (naphazoline), and Vicks VapoRub Inhaler (l-desoxyephedrine/levmetamfetamine) can also cause an increase in blood pressure. Safer options for people with high blood pressure are Breathe Right strips and saline products such as Ocean Saline Nasal Spray and Neti pots. Neti pots are a great way to irrigate nasal passages, however, if you choose to use one DO NOT USE tap water. It is essential to always use sterile or distilled water.

Topical Hemorrhoid Products


Topical hemorrhoid products such as PREPARATION H Hemorrhoidal Ointment contain phenylephrine, the same active ingredient in Sudafed PE. Phenylephrine causes vasoconstriction, or the constriction of blood vessels, to help decrease swelling. Patients can try Preparation H Anti-Itch Cream with Hydrocortisone or Tucks Hemorrhoidal Ointment.

Asthma Products

Asthma products such as Primatene and Bronkaid tablets contain ephedrine, which can cause an increase in blood pressure. There are no over the counter medications that are appropriate for asthma, and patients with asthma should be seen on a regular basis by their primary care physician.

Aspirin and Non-steroidal Anti-Inflammatory Drugs (NSAIDs)


Aspirin, Advil (ibuprofen) and Aleve (naproxen) are used for inflammation and pain. These medications can cause your body to retain fluid and decrease your kidney function, causing your heart and kidneys to work harder and increasing your blood pressure. For those with hypertension who require non-steroidal anti-inflammatory drugs, it is recommended to use the lowest effective dose for the shortest time possible.

Nicotine Cessation Products,

Products that reduce the urge to smoke including Nicorette gum, NicoDerm patches, and Commit lozenges all warn patients to speak to their physician before use if they have high blood pressure. Kicking a smoking habit may not be easy, but it is worthwhile! The benefits of quitting include improved tolerance for exercise, and a reduction in the risk of developing lung cancer, bladder cancer and heart disease.


Herbal Remedies

This one may come as a surprise to some patients. Herbal remedies that contain ephedra, which can be found in some weight-loss supplements, are dangerous to those with high blood pressure. Weight loss medications or appetite suppressants increase your heart rate and blood pressure. Additionally, patients with high blood pressure should avoid taking gingko, which is an herbal remedy sometimes used for memory problems, and St. John’s Wort, which is commonly used for mood and depression.

Other Medications:


Other medications that can cause an increase in blood pressure are: eye medications, migraine medications, steroids, birth control and hormone replacement pills, tricyclic antidepressants, asthma medications, and stimulants.

If you have been diagnosed with high blood pressure, consult your physician before taking any new medications. Always bring a complete and updated list of your prescription medications, over-the-counter medications, and herbal supplements to every doctor’s appointments.