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Why you need to avoid decongestants

If you have high blood pressure, chances are you are already getting plenty of exercise and eating healthy foods to try and manage your condition as best as possible. But did you know that decongestants and similar OTC medications have an adverse affect on your blood pressure?

 

The formulation of most decongestants are specifically aimed at the relief of nasal swelling associated with colds and flu, and these same ingredients affect other blood vessels in the body, causing blood pressure and heart rate to rise - a potentially dangerous situation for those with high blood pressure.

Unforunately, few people with high blood pressure are aware they should avoid decongestants when they have a cold or flu. Now that we are in the midst of flu season, it's important for people with high blood pressure to talk to their doctors or pharmacists about which OTC medicines to avoid, since cold and flu sufferers automatically reach for an over-the-counter decongestant to clear a stuffy nose but pay little head to the warning label: "Do not use this product if you have heart disease or high blood pressure.”

If you have high blood pressure, replace OTC medicines that contain decongestants with remedies that don't - and your pharmacist will be able to assist you with this.

Alternatives are available. In the drug realm, antihistamines such as Benadryl, Chlor-Trimeton, Zyrtec, and Claritin can help with a stuffy nose from a cold and are safe for the heart. If you want to avoid medications altogether, you can try a variety of things to clear your head.

  • Choose a cold medication designed for people who have high blood pressure. Some cold medications don't contain decongestants. However, these medications may contain other powerful drugs, such as dextromethorphan, that can be dangerous if you take too much. Follow the dosing instructions carefully.

  • Take a pain reliever. To relieve a fever, sore throat, headache or body aches, try aspirin or acetaminophen.

  • Use saline nasal spray. To relieve nasal congestion, try saline nasal spray. The spray can help flush your sinuses.

  • Soothe your throat. To relieve a sore or scratchy throat, gargle with warm salt water or drink warm water with lemon juice and honey.

  • Drink plenty of fluids. Water, juice, tea and soup can help clear your lungs of phlegm and mucus. Drinking plenty of hot fluids keeps mucus moist and flowing.

  • Increase the humidity in your home. Use a cool-mist humidifier or vaporizer to moisten the air and ease congestion and coughing.

  • Get plenty of rest. If you're not feeling well, take it easy.

Medications to avoid:

Oral nasal decongestants, such as Sudafed (pseudoephedrine) and Sudafed PE (phenylephedrine), can increase blood pressure by increasing your heart rate and by causing blood vessels to narrow, also known as vasoconstriction.   These effects are greater with immediate release products and higher doses.   Pseudoephedrine and phenylephedrine can also be found in many cold, cough, and flu combination products.  

Topical nasal decongestants, such as Afrin (oxymetazoline), Neo-synephrine (phenylephrine), Privine (naphazoline), and Vivks Vapor Inhaler (l-desoxyephedrine/levmetamfetamine), can also cause an increase in blood pressure. 

Aspirin and NSAIDS, such as Advil (ibuprofen) and Aleve (naproxen), are used for inflammation and pain.  These medications can cause your body to retain fluid and decrease your kidney function, causing your heart and kidneys to work harder, thereby increasing your blood pressure.  According to product labeling, topical NSAIDs can also increase blood pressure.  NSAIDs can reduce the efficacy of blood pressure medications (e.g., ACE inhibitors, ARBs, beta-blockers, and diuretics) to varying degrees.  The combination of NSAIDs, ACE inhibitors or ARBs, and diuretics should generally be avoided, except in patients with compelling indications for these blood pressure medications (e.g., diabetes or heart failure) and when the use of an NSAID is unavoidable.  Daily use of NSAIDs can affect blood pressure after just a week or so.  For those with hypertension who require NSAIDS, it is recommended to use the lowest effective dose for the shortest time possible. 

Sources:

Harvard Medical School Family Guide

Ochsner Pharmacy

Mayo Clinic

Wikipedia