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High Blood Pressure and Cold Medicine Don't Mix

Some over-the-counter flu remedies can elevate pressure, interfere with meds

bedside table with cold and flu remedies and tissues
Tero Vesalainen/Getty Images

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.

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"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.

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