• Topical pain relievers (creams, gels)

  • Non-drug approaches (heat, ice, physical therapy)

  • Important: If you must take NSAIDs, use the lowest effective dose for the shortest possible time—and tell your doctor.
  • 2. Decongestants
  • Common names: Pseudoephedrine (Sudafed), Phenylephrine (Sudafed PE), Oxymetazoline (Afrin nasal spray)
  • Found in: Many cold, flu, and allergy medications
  • The risk: Decongestants constrict blood vessels to relieve stuffiness—but they also constrict arteries throughout your body, raising blood pressure. They can also:

  • Increase heart rate

  • Interfere with blood pressure medications

  • Cause palpitations

  • Safer alternatives:

  • Saline nasal spray

  • Steam inhalation

  • Nasal strips

  • Antihistamines (for allergy-related congestion)

  • 3. Certain Antacids
  • Common names: Alka-Seltzer, Bromo-Seltzer, some effervescent pain relievers
  • The risk: These products often contain high levels of sodium—as much as 1,000 mg per dose. For someone with high blood pressure, that’s a significant amount of salt that can cause fluid retention and pressure spikes.
  • Safer alternatives:

  • Standard calcium carbonate antacids (Tums)

  • H2 blockers (Pepcid, Zantac)

  • Proton pump inhibitors (Prilosec, Prevacid)

  • Always check the sodium content on any effervescent or soluble medication.
  • Prescription Medications That Can Raise Blood Pressure
  • 4. Corticosteroids
  • Common names: Prednisone, Methylprednisolone, Hydrocortisone
  • Used for: Asthma, allergies, autoimmune conditions, inflammation
  • The risk: Corticosteroids cause sodium and fluid retention, leading to increased blood pressure, especially with long-term use.
  • What to do: If you need steroids, your doctor will monitor your blood pressure closely. Never stop steroid medication abruptly—it must be tapered.
  • 5. Hormonal Medications
  • Common names: Birth control pills (especially those containing estrogen), hormone replacement therapy
  • The risk: Estrogen can increase blood pressure in some women, particularly those who smoke, are overweight, or have a history of high blood pressure.
  • What to do: Discuss alternatives with your doctor—progestin-only options may have less impact on blood pressure.
  • 6. Certain Antidepressants
  • Common names: Venlafaxine (Effexor), Desvenlafaxine (Pristiq), Monoamine oxidase inhibitors (MAOIs)
  • The risk: Some antidepressants can raise blood pressure by affecting norepinephrine levels.
  • What to do: Don’t stop antidepressants abruptly. Work with your doctor to find an option that balances mental health needs with blood pressure control.
  • 7. Immunosuppressants
  • Common names: Cyclosporine, Tacrolimus
  • Used for: Organ transplant recipients, autoimmune conditions
  • The risk: These medications can significantly raise blood pressure by constricting blood vessels and affecting kidney function.
  • What to do: Regular monitoring is essential. Your doctor will adjust medications as needed.
  • 8. Erythropoiesis-Stimulating Agents
  • Common names: Epoetin alfa (Epogen, Procrit), Darbepoetin alfa (Aranesp)
  • Used for: Anemia related to kidney disease or cancer treatment
  • The risk: These medications increase red blood cell production, which can thicken blood and raise blood pressure.
  • Supplements That Can Affect Blood Pressure
  • Even “natural” supplements can impact blood pressure:

  • Ephedra (ma huang) – Banned in the US, but still found in some products

  • Bitter orange (Citrus aurantium) – Often used in weight loss products; can raise BP

  • Ginseng – Can interfere with blood pressure medications

  • Licorice root – Can cause sodium retention and potassium loss

  • St. John’s wort – Can interact with blood pressure medications

  • Yohimbine – Can raise blood pressure significantly

  • Always tell your doctor about any supplements you take.
  • What to Do: A Practical Guide
  • Step 1: Make a List
  • Write down every medication, supplement, and over-the-counter product you take regularly or occasionally. Include:

  • Prescription drugs

  • Over-the-counter pain relievers

  • Cold and allergy medications

  • Antacids

  • Vitamins and supplements

  • Herbal products

  • Step 2: Review With Your Pharmacist
  • Pharmacists are medication experts. Take your list to your local pharmacy and ask:

  • “Could any of these affect my blood pressure?”

  • “Are there safer alternatives?”

  • “What should I avoid in the future?”

  • Step 3: Talk to Your Doctor
  • Share your list with your doctor. They may:

  • Adjust your blood pressure medication

  • Recommend alternatives

  • Monitor you more closely

  • Step 4: Read Labels
  • Before taking any new over-the-counter medication, read the label carefully:

  • Look for warnings for people with high blood pressure

  • Check sodium content

  • Note active ingredients you recognize from this list

  • Step 5: Ask Before You Take
  • Before taking anything new—even something “harmless”—ask your pharmacist or doctor: “Is this safe for someone with high blood pressure?”
  • Red Flags: When to Seek Help
  • If you experience any of these after starting a new medication, contact your doctor immediately:

  • Severe headache

  • Chest pain

  • Shortness of breath

  • Vision changes

  • Irregular heartbeat

  • Sudden swelling in feet or ankles

  • Blood pressure readings significantly higher than usual

  • The Bottom Line
  • Managing high blood pressure is a daily commitment—and it involves more than just taking your prescribed medication. Over-the-counter drugs, supplements, and even seemingly harmless cold remedies can silently undermine your efforts.
  • You are your own best advocate. Know what you’re putting into your body. Ask questions. Read labels. And always keep your healthcare team informed.
  • Your heart is worth it.