From acetaminophen to stimulants, know which drugs and supplements can affect your blood pressure.
By Mayo Clinic Staff
Some prescription and over-the-counter medications, as well as supplements and other substances, can raise your blood pressure. These substances also can interfere with medications intended to lower your blood pressure.
Here are some medications, supplements and other substances that can increase your blood pressure. If you're using any of these substances and are worried about the effect it could have on your blood pressure, talk to your doctor.
People who take acetaminophen (Tylenol, others) daily are more likely to develop high blood pressure than are those who don't take acetaminophen. There's no evidence that occasional use of acetaminophen causes any long-term increase in blood pressure.
Tell your doctor if you take acetaminophen regularly. Your doctor might recommend alternating between acetaminophen and other pain relievers. Because pain relievers affect blood pressure in different ways, alternating between them may give your body a break. Also consider other ways to control pain, such as warm or cold compresses, exercise or massage.
Certain pain and anti-inflammatory medications can cause you to retain water, creating kidney problems and increasing your blood pressure. Examples include:
- Indomethacin (Indocin, others)
- Naproxen (Aleve, Naprosyn)
- Naproxen Sodium (Anaprox)
- Piroxicam (Feldene)
- Ibuprofen (Advil, Motrin IB)
- Meloxicam (Mobic)
Have your blood pressure checked regularly. Talk to your doctor about which pain medication is best for you. If you must continue taking a pain medication that increases your blood pressure, your doctor may recommend lifestyle changes or additional medication to control your blood pressure.
Antidepressants work by changing your body's response to brain chemicals, including serotonin, norepinephrine and dopamine, that affect your mood. These chemicals may also cause your blood pressure to increase. Examples of antidepressants that can raise your blood pressure include:
- Venlafaxine (Effexor)
- Bupropion (Wellbutrin)
- Desipramine (Norpramin)
If you take antidepressants, have your blood pressure checked regularly. If your blood pressure increases or isn't well controlled, ask your doctor about alternatives to these medications. Your doctor may recommend lifestyle changes or additional medications to control your high blood pressure.
Birth control pills and other hormonal birth control devices contain hormones that may increase your blood pressure by narrowing smaller blood vessels. Virtually all birth control pills, patches and vaginal rings come with warnings that high blood pressure may be a side effect. The risk of high blood pressure is greater if you're older than age 35, overweight or a smoker.
Not all women will have increased blood pressure from using hormonal birth control, but if you're worried, have your blood pressure checked at least every six to 12 months. If you already have high blood pressure, consider using a different form of birth control. While nearly all birth control pills can raise your blood pressure, your blood pressure may be less likely to increase if you use a birth control pill or device that contains a lower dose of estrogen.
The role caffeine plays in blood pressure is still debatable. Consuming 200 to 300 milligrams of caffeine can temporarily cause a spike in your blood pressure, but it's unclear whether the effect is temporary or long lasting.
Caffeine may temporarily increase your blood pressure by blocking a hormone that keeps your blood vessels widened, allowing blood to easily flow through them. In addition, caffeine may cause you to produce more cortisol and adrenaline, which makes your blood flow faster, thus increasing your blood pressure. There isn't enough evidence to prove that caffeine raises your blood pressure long term.
Examples of caffeine-containing medications and products include:
- Caffeine pills (Vivarin, others)
- Coffee, energy drinks and other beverages
Some studies suggest that coffee may contain a substance that lowers blood pressure, thus counteracting any effects from caffeine. In addition, the caffeine content of coffee can vary widely, so it's difficult to say how many cups of coffee you can drink a day.
To see if caffeine raises your blood pressure, check your pressure within 30 minutes of drinking a cup of coffee or another caffeinated beverage you regularly drink. If your blood pressure increases by five to 10 points, you may be sensitive to the blood pressure raising effects of caffeine.
Decongestants narrow your blood vessels, which makes it harder for your blood to flow through them, increasing blood pressure. Decongestants may also make some blood pressure medications less effective. Examples of decongestants include:
- Pseudoephedrine (Sudafed)
- Phenylephrine (Neo-Synephrine)
Check the label of your cold or allergy medication to see if it contains a decongestant. If you have high blood pressure, it's best to avoid decongestants. Ask your doctor or pharmacist about over-the-counter cold products made for people who have high blood pressure.
The way each herbal supplement increases your blood pressure varies. Remember to tell your doctor about any herbal supplements you take or are thinking about taking, to see if the supplement could raise your blood pressure or interact with blood pressure medications. Examples of herbal supplements that can affect your blood pressure or blood pressure medications include:
- Arnica (Arnica montana)
- Bitter orange (Citrus aurantium)
- Ephedra (Ma-Huang)
- Ginkgo (Ginkgo bilboa)
- Ginseng (Panax quinquefolias and Panax ginseng)
- Guarana (Paullinia cupana)
- Licorice (Glycyrrhiza glabra)
- Senna (Cassia senna)
- St. John's wort (Hypericum perforatum)
Herbal supplements aren't necessarily safe just because they're natural. Check with your doctor before taking any herbal supplements. You may need to avoid supplements that raise your blood pressure or interfere with your blood pressure medications.
Some immunosuppressants can raise your blood pressure, possibly because of the ways immunosuppressants can affect your kidneys. Examples of immunosuppressants that can increase your blood pressure include:
- Cyclosporine (Neoral, Sandimmune)
- Tacrolimus (Prograf)
Have your blood pressure checked regularly. If your blood pressure increases or isn't well controlled, ask your doctor about alternatives to these medications. Your doctor may recommend lifestyle changes or additional medications to control your high blood pressure.
NSAIDs can cause you to retain water, creating kidney problems and increasing your blood pressure. Examples of NSAIDs include:
- Ibuprofen (Advil, Motrin, others)
- Meloxicam (Mobic)
- Naproxen (Naprosyn)
- Naproxen sodium (Aleve)
Have your blood pressure checked regularly. Talk to your doctor about which pain medication is best for you. If you must continue taking an NSAID that increases your blood pressure, your doctor may recommend lifestyle changes or additional medication to control your blood pressure.
Stimulants, such as methylphenidate (Ritalin), can cause your heart to beat faster or irregularly, raising your blood pressure.
Have your blood pressure checked regularly if you take a stimulant. If your blood pressure increases or isn't well controlled, ask your doctor about alternatives to these medications. He or she may recommend lifestyle changes or additional medications to control your high blood pressure.
Illegal drugs can raise blood pressure by narrowing the arteries that supply blood to your heart. This increases your heart rate and damages your heart muscle.
Examples of illegal drugs that can affect your heart include:
- Amphetamines, including methamphetamine
- Anabolic steroids
- Phencyclidine (PCP)
If you're using illegal drugs, it's important to stop. Ask your doctor for information on counseling or drug treatment programs.
March 13, 2013
- Grossman E, et al. Drug-induced hypertension: An unappreciated cause of secondary hypertension. The American Journal of Medicine. 2012;125:14.
- Basile JN, et al. Identifying and managing factors that interfere with or worsen blood pressure control. Postgraduate Medicine. 2010;122:35.
- Sudano I, et al. Acetaminophen increases blood pressure in patients with coronary artery disease. Circulation. 2010;122:1789.
- AskMayoExpert. Hypertension: Care process model. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2012.
- Medication guide for nonsteroidal anti-inflammatory drugs (NSAIDS). U.S. Food and Drug Administration. http://www.fda.gov/downloads/Drugs/DrugSafety/ucm088646.pdf. Accessed Jan. 6, 2013.
- Goldman L, et al. Cecil Medicine. 24th ed. Philadelphia, Pa.: Saunders Elsevier; 2012. http://www.mdconsult.com/das/book/body/191371208-2/0/1492/0.html#. Accessed Jan. 6, 2013.
- Bonnema RA, et al. Contraception choices in women with underlying medical conditions. American Family Physician. 2010;82:621.
- Mesas AE, et al. The effect of coffee on blood pressure and cardiovascular disease in hypertensive individuals: A systematic review and meta-analysis. The American Journal of Clinical Nutrition. 2011;94:1113.
- Steffen M, et al. The effect of coffee consumption on blood pressure and the development of hypertension: A systematic review and meta-analysis. Journal of Hypertension. 2012;30:2245.
- Over-the-counter medications and high blood pressure. American Heart Association. http://www.heart.org/HEARTORG/Conditions/HighBloodPressure/PreventionTreatmentofHighBloodPressure/Over-the-Counter-Medications_UCM_303245_Article.jsp. Accessed Jan. 6, 2013.
- Jalili J, et al. Herbal products that may contribute to hypertension. Plastic and Reconstructive Surgery. 2013;131:168.
- Rakel D. Integrative Medicine. 3rd ed. Philadelphia, Pa.: Saunders Elsevier; 2012. http://www.mdconsult.com/das/book/body/208746819-2/0/1494/0.html. Accessed Jan. 6, 2013.
- Stimulants. National Institute on Drug Abuse. http://teens.drugabuse.gov/facts/facts_stim2.php#shortterm. Accessed Jan. 6, 2013.
- LSD (Acid). National Institute on Drug Abuse. http://www.drugabuse.gov/drugs-abuse/lsd-acid. Accessed Jan. 6, 2013.
- Cocaine. National Institute on Drug Abuse. http://www.drugabuse.gov/drugs-abuse/cocaine. Accessed Jan. 6, 2013.