Are cold medicines bought without a prescription safe for people who have high blood pressure?

Answer From Francisco Lopez-Jimenez, M.D.

Cold medicines aren't off-limits if you have high blood pressure, but it's important to make careful choices. Some ingredients in cold medicines can raise blood pressure. Talk to your health care provider before taking any medicines bought without a prescription, including supplements.

Medicines called decongestants cause the most concern for people who have high blood pressure. Decongestants help open a stuffy nose. The medicines narrow blood vessels, which can reduce swelling in the nose area and other parts of the body. But it's harder for blood to flow through a narrowed blood vessel. This can increase blood pressure.

If you have high blood pressure, check cough, cold, flu and sinus medicine labels carefully. Some of these medicines have warning labels for people who have high blood pressure or who take blood pressure medicine.

Check the ingredients to see if the product contains a decongestant. Do not take a decongestant if you have severe or uncontrolled high blood pressure.

Names of decongestants include:

  • Pseudoephedrine.
  • Ephedrine.
  • Phenylephrine.
  • Naphazoline.
  • Oxymetazoline.

Also, check medicine labels for sodium content. Too much salt can raise blood pressure.

If you have high blood pressure and need to treat cold symptoms, try these tips:

  • Choose a cold medicine that's made for people with high blood pressure. Some cold medicines don't contain decongestants. Always check the medicine label.
  • Consider pain medicine carefully. Use aspirin or acetaminophen to treat a fever, sore throat, headache or body aches. Do not take nonsteroidal anti-inflammatory drugs (NSAIDs). They may lead to high blood pressure. Examples of NSAIDs are ibuprofen (Motrin IB, Advil) and naproxen sodium (Aleve).
  • Use saline nasal spray. To treat a stuffy nose, try a saline nasal spray. The spray can help clear your nose.
  • Soothe your throat. To treat a sore or scratchy throat, gargle with warm salt water. You also could try drinking warm water with lemon juice and honey. Or try menthol cough drops.
  • Drink plenty of fluids. Try water, juice, tea or soup.
  • Increase the humidity in your home. Use a cool-mist humidifier or vaporizer to moisten the air. This may ease congestion and coughing.
  • Get plenty of rest. If you're not feeling well, take it easy.

Call your health care provider if your symptoms get worse instead of better or last more than 10 days.


Francisco Lopez-Jimenez, M.D.

April 12, 2023