As cold and flu season rages on, health experts are warning people with high blood pressure to think twice before popping or pouring over-the-counter medications to relieve their symptoms.
Decongestants, a common ingredient in cold and flu drugs, constrict blood vessels to help relieve congestion. And constricted blood vessels can temporarily raise blood pressure levels and reduce blood flow in people with poor circulation. Decongestants may also interfere with the effectiveness of prescribed blood pressure medication, the American Heart Association says.
"It's kind of a general thing that blood vessel constrictors are not a good idea for people with high blood pressure,” Sandra J. Taler, a professor of medicine and physician in the Division of Nephrology and Hypertension at the Mayo Clinic, cautions. “And probably a lot of people don't know that.”
Oftentimes, however, it's not obvious what pills and syrups contain decongestants. If pseudoephedrine and phenylephrine are listed as ingredients, the medicine contains a decongestant, Taler says. The letters “CF” or “D” on the box or bottle is another signal that a decongestant is present, she adds.
People with high blood pressure should also be cautious of cold medicine combinations containing nonsteroidal anti-inflammatories (NSAIDs); Advil Cold & Sinus is one example. NSAIDs can counteract the effectiveness of high blood pressure medications, Taler explains.
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What to take if you have high blood pressure
So what can you turn to? Taler points to guaifenesin (Mucinex) as an option if you need to thin and clear mucus. And dextromethorphan (Robitussin) can be used to suppress coughs. Even with these, be sure to avoid the “CF” and “D” varieties. Some drug manufacturers also make cold medicines specifically for people with high blood pressure; these are usually marked with “HBP” on the package.
But Ian K. Smith, a physician and wellness author, suggests that with all the combination therapies and confusing trade and generic names, it's a good idea to make a quick call to your doctor's office, to make sure you're in the clear — both for blood pressure and other side effects. And be sure to pay attention to dosing instructions, as many cold and flu medicines reduce alertness.
"What people have to understand is that even good medications that are helpful and useful can have side effects,” Smith says. And all too often, “people don't think of over-the-counter meds as a concern,” Taler adds.
Smith stresses the importance of hand hygiene during cold and flu season, as well as exercise and a healthy diet. Rest and plenty of fluids also help kick a cold, Taler says.
Purchasing over-the-counter medications is a quick and easy way to relieve the daily coughing, sneezing, and aching that accompanies that pesky cold or flu.
All medications, however, carry risks of side effects and bad interactions, even over-the-counter meds. This warning is particularly specific to those suffering from high blood pressure.
You may want to steer clear of some of these over-the-counter meds as they can increase blood pressure and interfere with blood pressure medication. Common medications that can affect blood pressure levels are decongestants, pain relievers, and anti-inflammatory medications.
Decongestants can cause narrowing of blood vessels throughout the body. Certain pain relievers and anti-inflammatory meds may cause water retention, increasing the chance of raising your blood pressure.
Studies show that most people have a minimal increase in blood pressure after taking common cold meds and decongestants. If you have high blood pressure, try a cold or flu medication that is free of decongestants.
Learn what works for you
If you have high blood pressure, educate yourself before you decide to take over-the-counter medication:
Read labelsMany over-the-counter medicines are labeled safe for people with high blood pressure—keep a watchful eye out for these labels. Also be sure to look out for medications that having a warning label such as “Do not use this product if you have heart disease, high blood pressure, etc.”
One reason many over-the-counter meds increase blood pressure is due to large amounts of salt (also listed as sodium or soda). If you have high blood pressure, aim for 1,500 mg of sodium or less per day, including sodium found in many over-the-counter medicines.
Keep an eye on your blood pressureWhen you begin taking an over-the-counter medication, make sure to monitor your blood pressure if you have or are at risk for high blood pressure.
Play it safeTalk with your doctor about any over-the-counter medications you take or plan to take if you have high blood pressure.
A final note
Consider making lifestyle changes to improve your blood pressure. University of Iowa cardiologist Ramzi El Accaoui, M.D., recommends eating healthy, limiting alcohol consumption, daily exercise, weight loss, and smoking cessation to help prevent and treat high blood pressure.