Decongestants can pose a dangerous risk to people with hypertension. Try these other steps to safely treat a cold or allergies.
Cold medicines are not off-limits if you have heart disease, but patients with high blood pressure, or hypertension, should check the label carefully when choosing a cold or allergy medicine.
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That’s because decongestants such as pseudoephedrine, ephedrine, phenylephrine, naphazoline and oxymetazoline can increase your blood pressure and heart rate. Make sure the cold or allergy medication you plan to take is free of those ingredients.
Decongestants can also prevent your blood pressure medication from working properly. And always check the active and inactive ingredient lists, because many medications are high in sodium, which also raises blood pressure.
For allergy sufferers with heart disease, medicines such as Allegra, Zyrtec or Claritin should be safe. However, medicines containing decongestants — including Allegra-D, Zyrtec-D and Claritin-D — could increase your blood pressure and heart rate or interfere with your heart medication.
Managing a cold with hypertension
If you can’t take a decongestant because of high blood pressure, there are other ways to reduce your cold or allergy symptoms:
Take Coricidin HBP, which is free of decongestants
Drink plenty of fluids — including water, juice, tea and soup — to prevent dehydration and clear mucus from your lungs
Take a pain reliever such as Tylenol or Motrin for fever, sore throat, body aches and headache
Flush your sinuses with a saline spray to relieve nasal congestion
Soothe a sore or scratchy throat with lozenges
Use a vaporizer or humidifier if necessary to boost humidity
Get plenty of rest
Return to your doctor after five to seven days to make sure you’re on the road to recovery
Before taking any new medication
Always check with your pharmacist before you take a new medication, whether it’s for a cold, allergies or something else, to find out if it is compatible with certain medical conditions and your current drug therapy.
SEE ALSO: Millions More People Now Have High Blood Pressure. Why That’s a Good Thing
If you have a heart condition, be sure to discuss all medication choices with your cardiologist before taking anything.
It’s allergy season and you can’t breathe the fresh air because your nose is congested and stuffed. You visit the pharmacy and purchase a box of Sudafed. Your pharmacist asks if you have a history of high blood pressure, and you answer “yes.” The pharmacist replies that she does not recommend Sudafed for you, but why?
What you need to know about Pseudoephedrine:
Brands of common over-the counter decongestants that contain pseudoephedrine: Allegra-D, Alka Seltzer Plus Cold Medicine Liqui-Gels, Aleve Cold and Sinus Caplets, Benadryl Allergy and Sinus Tablets, Claritin-D Non-Drowsy 24 Hour Tablets, Robitussin Cold Severe Congestion Capsules, Sudafed 24 Hour Tablets, SudoGest, Wal-phed 12 hour, Suphedrine.2
Indications: nasal congestion, sinus congestion, and Eustachian tube congestion
Adverse side effects of pseudoephedrine:
- Common: insomnia, nervousness, excitability, dizziness, and anxiety
- Infrequent: tachycardia (rapid heart beat) or palpitations
- Rare: dilated pupils, hallucinations, arrythmias (irregular heartbeat), high blood pressure, seizures, inflammation of the large intestine, and severe skin reactions
Contraindications for pseudoephedrine:
- Diabetes mellitus
- Cardiovascular disease
- Severe or uncontrolled high blood pressure
- Severe coronary artery disease
- Prostatic hypertrophy
- Hyperthyroidism
- Closed angle glaucoma
- Pregnant women
Pseudoephedrine and High Blood Pressure Interaction
In 2005, a study showed that pseudoephedrine increased systolic blood pressure and heart rate, but had no effect on diastolic blood pressure.1 They also found that higher doses and immediate-release formulations of pseudoephedrine were associated with higher blood pressures.1 In addition, the study revealed that patients with well controlled hypertension had higher systolic and diastolic blood pressures after taking immediate release pseudoephedrine formulations.1
What are safe alternatives to pseudoephedrine in patients with high blood pressure?
There are a few safe and effective alternatives to pseudoephedrine in patients with high blood pressure that can relieve nasal or sinus congestion symptoms. Placing a humidifier in the bedroom keeps moisture in the air, which helps prevent your nasal passages from drying out. Humidifiers can also help break up mucus and soothe inflamed nasal passageways.3 In addition, propping your head up on 2 pillows may help the mucus flow out of your nose and relieve some congestion. Saline sprays are also another safe option that can loosen congestion and improve drainage.3 If a patient with high blood pressure insists on taking a medication that includes pseudoephedrine, their pharmacist or physician will recommend the patient to monitor their blood pressure and take a sustained-release formulation to reduce the risk of increasing blood pressure.3
Next time you have sinus or nasal congestion, ask your physician before using pseudoephedrine if you have high blood pressure. Your local pharmacist can also help manage nasal congestion symptoms, provide valuable information regarding safer alternatives, and ensure optimal drug selection in patients with high blood pressure.
Resources:
- Salerno SM, Jackson JL, Berbano EP. Effect of Oral Pseudoephedrine on Blood Pressure and Heart Rate: A Meta-analysis. Arch Intern Med. 2005;165(15):1686–1694. doi:10.1001/archinte.165.15.1686.
- Radack KDeck CC Are oral decongestants safe in hypertension? an evaluation of the evidence and a framework for assessing clinical trials. Ann Allergy 1986;56396- 401.
- High Blood Pressure and Cold Remedies: Which Are Safe? Mayo Clinic. //www.mayoclinic.org/diseases-conditions/high-blood-pressure/expert-answers/high-blood-pressure/faq-20058281. Published January 09, 2019. Accessed January 20, 2019.
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