Medications and supplements that can raise your blood pressure

[David Baxter PhD]

Medications and supplements that can raise your blood pressure
By Mayo Clinic Staff
Oct. 4, 2008

Prescription and over-the-counter (OTC) medications, supplements and other substances can raise your blood pressure. In addition, these substances can sometimes interfere with medications intended to lower your blood pressure.

Here are some medications and supplements that can increase your blood pressure. If you're taking any of these medications or supplements and are worried about the effect it could have on your blood pressure, talk to your doctor.

Acetaminophen
Researchers are unsure why, but women who take 500 or more milligrams (mg) of acetaminophen daily are more likely to develop high blood pressure than are women who don't take acetaminophen. However, there's no evidence that temporarily taking acetaminophen causes any long-term increase in blood pressure. Examples of acetaminophen include:

• Tylenol
• Other brands

Tell your doctor if you take acetaminophen regularly. He or she might recommend alternating between acetaminophen and other pain relievers. Because they affect blood pressure in different ways, alternating may give your body a break. Also consider other ways to control pain, such as warm or cold compresses, exercise, massage, or complementary treatments such as acupuncture.

Antidepressants
Antidepressants work by changing your body's response to chemicals, including serotonin, norepinephrine and dopamine, that affect your mood. Although researchers are unsure why, these chemicals may also cause your blood pressure to increase. Examples of antidepressants include:

• Venlafaxine (Effexor, Effexor XR)
• Bupropion (Wellbutrin, Wellbutrin SR, Wellbutrin XL)
• Desipramine (Norpramin)
• Phenelzine (Nardil)

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. He or she may recommend lifestyle changes or additional medications to control your high blood pressure.

Birth control pills
Birth control pills and other hormonal birth control devices contain hormones that increase your blood pressure by narrowing smaller blood vessels. Virtually all birth control pills, patches and vaginal rings warn high blood pressure may be a side effect.

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.

Caffeine
Caffeine may increase your blood pressure by blocking a hormone that keeps your blood vessels widened, allowing blood to easily flow through. In addition, caffeine may cause you to produce more cortisol and adrenaline, which makes your blood flow faster, thus increasing your blood pressure. Examples of caffeine-containing medications and products include:

• Caffeine pills (Vivarin, others)
• Caffeine in energy drinks and other beverages

There isn't enough scientific evidence to prove that caffeine raises your blood pressure, although some doctors suggest limiting your daily amount of caffeine to no more than 200 milligrams ? about the amount in two 12-ounce (355 milliliters) cups of coffee.

Decongestants
Decongestants narrow your blood vessels, which makes it harder for your blood to flow through your veins, increasing blood pressure. Decongestants may also make some blood pressure medications less effective. Examples of decongestants include:

• Pseudoephedrine (Sudafed)
• Phenylephrine (Sudafed PE)
• Oxymetazoline (Afrin, others)

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 OTC cold products specially made for people who have high blood pressure.

Herbal supplements
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:

• Bitter orange
• Ephedra (ma-huang)
• Ginseng
• Guarana
• Licorice
• St. John's wort

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.

Immunosuppressants
Researchers aren't sure why some immunosuppressants raise some people's blood pressure, but they think it may relate to the way immunosuppressants can affect your kidneys. Examples of immunosuppressants that can increase your blood pressure include:

• Cyclosporine (Neoral)
• Cyclosporine (Sandimmune)
• Methylprednisolone (Medrol)
• 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. He or she may recommend lifestyle changes or additional medications to control your high blood pressure.

Nonsteroidal anti-inflammatory drugs (NSAIDs)
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
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.

A caution on illicit drugs
Illicit 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 illicit drugs that can affect your heart include:

• Amphetamines, including methamphetamine
• Anabolic steroids
• Cocaine
• Ecstasy
• Phencyclidine (PCP)

If you're using illicit drugs, it's important to stop. Ask your doctor if you need information on counseling or drug treatment programs.