Cold medicine for high blood pressure: drug safety tips

High blood pressure, known medically as hypertension, is extremely common and affects approximately half of American adults. People with high blood pressure or heart disease should be aware that common over-the-counter medications, including cold medicines and decongestants, can raise blood pressure.

If you have high blood pressure, you should talk to your health care provider about alternatives to cold and cough medicines for people with high blood pressure.

This article discusses how over-the-counter medications, including cough medicine, sinus medicine, and decongestants, can cause side effects in people with high blood pressure. He will also discuss safer options for people with high blood pressure.

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Cold medicine to avoid with high blood pressure

There are many types of cold and flu medicines. Many of them combine decongestants, cough suppressants and pain relievers (which also reduce fever). While these ingredients can help you feel better, they can make heart disease and high blood pressure worse.

If you have high blood pressure, you should always consult your health care provider before using over-the-counter medications. There are two common ingredients you need to be especially mindful of.


Decongestants work by causing blood vessels to narrow. This helps treat congestion, which occurs when blood vessels in the nose become swollen. Unfortunately, decongestants can also raise blood pressure.

People with high blood pressure should consult their healthcare provider before using decongestants, including those containing pseudoephedrine or phenylephrine.

Nonsteroidal anti-inflammatory drugs (NSAIDs)

NSAIDs are common over-the-counter painkillers and antipyretics. Aleve (naproxen sodium) and Advil and Motrin (ibuprofen) are all NSAIDs. Although effective in treating pain, they can cause an increase in blood pressure when taken by mouth.

They can also increase the risk of heart attack (blockage of blood flow to the heart muscle) and stroke (blockage of blood flow to the brain or bleeding in the brain). People with high blood pressure are therefore advised not to use NSAIDs. .

Finding Safe and Effective Cold Medicine

It is possible to find a safe cold medicine for high blood pressure. However, this may require additional work.

Talk to your health care provider about options

It’s best to start by asking your health care provider for their recommendations so you can be prepared before you catch a cold or the flu. They can give you a list of medications that are safe to treat various symptoms, such as nasal or sinus congestion, fever, body aches, or cough.

Your healthcare provider can also tell you which medications to avoid and suggest several ways to manage these symptoms without medication.

Learn to read drug labels

When choosing an over-the-counter medication, learn to read drug labels. It is very important to look at the active ingredients. These are the ingredients that have the greatest impact on your body. If you have high blood pressure, avoid medications containing the following active ingredients:

  • Pseudoephedrine (a decongestant): Brand names include Sudafed and Drixoral.
  • Phenylephrine (a decongestant): Brand names include Neo-Synephrine and Sudafed PE.
  • Ibuprofen (an NSAID): brand names include Advil, Motrin and Nuprin
  • Naproxen (an NSAID): Brand names include Aleve and Naprosyn.

Each of these products is available in several other brands, and they may also be found in multi-symptom cold and flu medications that combine different active ingredients.

Treating a Cold with High Blood Pressure

There are safe alternatives to cold medicine for people with high blood pressure. Talk to your healthcare provider about what will work best for you. Here’s what you can consider:

Over-the-counter medications

These over-the-counter medications are safe for people with high blood pressure, but may ease some cold symptoms:

  • Antihistamines: Antihistamines can help clear congestion and are generally safer than decongestants for people with high blood pressure. They are more often used for allergies, but can also relieve cold symptoms.
  • Tylenol: The active ingredient in Tylenol is acetaminophen, which has not been linked to high blood pressure. If you have aches, pains, or a fever with your cold, Tylenol can help.
  • Guaifenesin: This ingredient, found in Mucinex and other over-the-counter cold medications, is an expectorant that helps you clear sinus and chest congestion.
  • Dextromethorphan: This is a cough suppressant found in many over-the-counter cough medicines.

Other remedies

You can also control your symptoms with home remedies and natural cold remedies, including:

  • Saline nasal sprays to clear congestion
  • A hot shower and a humidifier to soothe coughs
  • Honey to reduce cough


People with high blood pressure should exercise caution when using over-the-counter cold medicines. Common cold medicine ingredients, including decongestants and NSAID pain relievers, can raise blood pressure.

If you have high blood pressure, ask your doctor about safer ways to treat a cold, including using Tylenol, antihistamines, and natural remedies.

A word from Verywell

Dealing with a cold can be miserable. When you’re not feeling well, it can be hard to remember which cold medicines are safe if you have underlying health conditions. Plan ahead by talking with your health care provider when you feel well about how to treat a cold, taking into account your high blood pressure and heart health.

Frequently Asked Questions

  • What are the risks of taking over-the-counter cold medicines with high blood pressure?

    Many over-the-counter cold medicines contain decongestants and NSAID pain relievers. Both of these drugs can raise blood pressure, so if you have high blood pressure you should ask your doctor before taking them.

  • Are topical decongestants safe for high blood pressure?

    Topical decongestants work directly in the nasal passages and are not absorbed into the bloodstream and travel throughout the body like decongestants taken by mouth can.

    They might be safer because they stay in the nasal area, but you should always talk to your healthcare provider before using them if you have high blood pressure.