These medications may unintentionally raise your blood pressure

More than 100 million U.S. adults have high blood pressure (hypertension), and nearly half of those diagnosed don’t have their blood pressure under control.¹ There are a number of factors that can increase your risk for developing high blood pressure, including age, living a sedentary lifestyle, and family history.

Many individuals don’t realize that certain medications may also cause adverse changes in blood pressure. In fact, one study found that nearly 1 in 5 people with hypertension unknowingly takes medication that can make their blood pressure worse.²

Medications that can increase blood pressure

While medications play a crucial role in managing various health conditions, certain medications can cause changes to your blood pressure either by directly raising blood pressure or by making blood pressure medications less effective. Here are some of the most common ones:

• Non-steroidal anti-inflammatory medications (NSAIDs): Medications like ibuprofen and aspirin can cause blood vessels to narrow. They can also make the body retain fluid and decrease kidney function, which can elevate blood pressure. Keep in mind that cold medications often contain NSAIDs. You can find that information on the “Drug Facts” label. If you have concerns about blood pressure, talk with your doctor or pharmacist about whether your NSAID is safe to use. They may recommend checking your blood pressure regularly or provide an alternative medication that has less of an effect on blood pressure.
• Decongestants: Decongestants can cause blood vessels to narrow, increasing blood pressure. Some decongestants may also make certain blood pressure medications less effective. Sudafed^® specifically can increase blood pressure. Individuals with hypertension should consult with their doctor or pharmacist before using decongestants.
• Oral contraceptives: Some hormonal birth control pills may contribute to elevated blood pressure, particularly in women over the age of 35, women who are overweight, women who smoke, or women who are predisposed to hypertension. Hormones from birth control pills can constrict blood vessels, which makes it harder for blood to flow. Most birth control pills contain a warning about high blood pressure as a side effect. If you’re concerned about blood pressure, your doctor may recommend getting it checked every 6 months. If you already have high blood pressure, your doctor or pharmacist may recommend a different form of birth control or one with a lower dose of estrogen that is less likely to raise blood pressure.
• Antidepressants: Certain classes of antidepressants, such as serotonin and norepinephrine reuptake inhibitors (SNRIs), can increase blood pressure, likely due to their ability to influence the constriction of blood vessels. If you take antidepressants, it’s important to monitor your blood pressure regularly. Your healthcare provider may adjust your medication if necessary or prescribe another medication that won’t affect your blood pressure as much.
• Steroids: These types of medications can cause patients to retain fluid, which can lead to an increase in blood pressure. Long-term use and higher doses of steroids may raise blood pressure even more and require closer monitoring.
• Herbal supplements: Supplements like arnica, ephedra, ginseng, and guarana, and licorice all have the potential to affect blood pressure or may interact with blood pressure medications to make them less effective. Always check with your healthcare provider before taking herbal supplements, as some may interact with your current medications.

Tips for keeping your blood pressure in check

High blood pressure is often called the “silent killer” because you may not show any obvious symptoms. Therefore, the best way to avoid unnecessary risks to increased blood pressure is to stay informed about all of your medications and to work with your healthcare team to answer any questions you may have.

When you fill a new prescription, remember to tell your pharmacist about any other medications you’re taking (including over-the-counter medications, vitamins, and supplements) so they can make sure it won’t have any unintended consequences on your blood pressure. Also, always remember to read the medication label and any printed information that comes with it. The medication side effects will usually be listed there.

At Express Scripts^® Pharmacy, we have pharmacists specially trained in cardiovascular conditions, including high blood pressure, and they’re available 24/7 to answer any questions you may have. If you have concerns about high blood pressure, your pharmacist may recommend regular monitoring or suggest alternative medications that are less likely to affect your blood pressure.

1 FDA: High Blood Pressure‒Understanding the Silent Killer (accessed February 6, 2024): fda.gov/drugs/special-features/high-blood-pressure-understanding-silent-killer.
2 JAMA Internal Medicine: Prevalence of Medications That May Raise Blood Pressure Among Adults With Hypertension in the United States (November 22, 2021): jamanetwork.com.