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Cold And Flu Medicine Safe For High Blood Pressure

According to the American Heart Association, individuals with high blood pressure, heart disease, and strokes are at increased risk to have more severe forms of flu, when compared with those who have other chronic illnesses. While it is important to manage the symptoms, the medicine should be chosen carefully. Some cold and flu medicines can raise blood pressure, while others can interfere with blood pressure medication. Which drugs are safe to use, and which ones should be avoided? Let’s review more details in this article. 

  • First thing first: all adults should check their blood pressure. It can be checked at the local pharmacy, although it is best to  have a blood pressure monitor at home.  If the numbers go consistently and excessively over 140/90 mmHg they should seek medical advice. 
  • Hypertension is also known as “the silent killer” because it does not cause symptoms unless the numbers are very high. High blood pressure is often underdiagnosed, and found in some cases at the doctor’s office during a routine examination. 
  • Everyone with known  high blood pressure and heart diseases should monitor the blood pressure closely when they experience a cold, flu or other infections. As the body fights the illness, the blood pressure numbers can go higher. The cold and flu drugs can also increase the blood pressure, especially in those who have poor control of hypertension. 

What cold and flu medicines raise blood pressure?

  • Decongestants  such as pseudoephedrine, ephedrine, phenylephrine, naphazoline and oxymetazoline. These drugs cause the most concern among individuals with hypertension. Decongestants help reduce congestion and  stuffy nose by narrowing blood vessels. Other blood vessels in the body also narrow, leading to increased blood pressure and heart rate. Decongestants also interfere with high blood pressure drugs and not allow them  to work properly.
  • Avoid combination formulas that contain many ingredients which include pseudoephedrine, ephedrine, phenylephrine, naphazoline and oxymetazoline
  • Cold and flu medication that contains sodium. Mayo Clinic experts recommend checking the label of these drugs and avoid them if they have  high sodium content. High amounts of sodium are well known to raise blood pressure.
  • Avoid cold and flu medications that have warnings on the labels for individuals who have hypertension or take heart/blood pressure medication. 
  • Pain relievers. Non-steroid antiinflammatory drugs (NSAIDs) like ibuprofen and naproxen can contribute to high blood pressure and heart diseases. NSAIDs can increase fluid retention, decrease kidney function which can lead to an increased blood pressure. 

Which cold and flu medicines are safer for people with high blood pressure?

  • Pain relievers.  Acetaminophen and aspirin can be used to manage sore throat, headaches and other body aches and fever.  Note: those who already take baby aspirin should check with a doctor if they can have regular strength aspirin to manage colds and flu symptoms. 
  • Guaifenesin is an option to help  thin and clear mucus 
  • Dextromethorphan  can be used to suppress coughs
  • Antihistamine drugs like chlorpheniramine, doxylamine can be used for runny nose
  • Special cough and cold medicine labeled as “decongestant-free”, designed for those with hypertension. For example, the brand Coricidin HBP (Bayer) is marketed “To promote cough relief for people with high blood pressure”. Other formulas are for cold and flu, for daytime and nighttime symptoms. The key active ingredients include : Guaifenesin, dextromethorphan, acetaminophen, Chlorpheniramine, doxylamine. NyQuil Cold & Flu HBP (brand Vicks) is another  product created to manage symptoms of colds and flu in individuals with high blood pressure. The active ingredients are doxylamine, acetaminophen and dextromethorphan and should be used at bedtime. Dayquil HBP cold Flu from the same brand contains  acetaminophen and dextromethorphan and is recommended for daytime use. 

Still, health experts believe that the safest options are home remedies like nasal sprays with saline solution,  gargle with warm salt water hot teas with lemon and honey, menthol lozenges, or menthol ointments applied on the chest. Menthol-based products come in many forms: ointments, sticks, patches, drops, and even shower tablets. 

 Take over-the-counter medication only when needed, and seek medical advice from a doctor or pharmacist if symptoms do not improve or they get worse.

Getting plenty of rest and adjusting the temperature and humidity at home can also improve the symptoms. 

There are a few things that can help prevent or manage both respiratory infections like colds and flu and also high blood pressure. They are related to healthy lifestyle choices. Regular exercise,  a healthy diet, Mediterranean style, sleep optimization, and stress management are all important. Unhealthy habits such as smoking, drinking alcohol in excess, and consuming high salt, high sugar processed foods should be reduced from the diet. 

While there is no vaccine for the common cold, the flu shot is widely available and is updated each year. There are different options to choose from, based on age, health status, or allergies (ie egg allergies). For the 2021-2022 season, available flu shots in the US  include quadrivalent inactivated influenza vaccines, recombinant influenza vaccines, or live attenuated influenza vaccines (LAIV4). Live attenuated influenza vaccines are not suitable for pregnant, immunocompromised persons, and some other groups.

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