Is It Safe to Take Cold Medicine With High Blood Pressure?

Many cold medicines aren't safe, but there are alternatives

High blood pressure, known medically as hypertension, is extremely common, affecting about half of American adults. People with high blood pressure or heart disease should be aware that common over-the-counter (OTC) medications, including cold medicine and decongestants, can raise blood pressure.

If you have hypertension you should talk with your healthcare provider about alternatives to cold and cough medicine for people with high blood pressure.

This article will cover how OTC drugs, including cough medicine, sinus medicine, and decongestants, can cause side effects for people with high blood pressure. It will also discuss safer options for people with high blood pressure. 

Cold Medicine Alternatives for People With High Blood Pressure - Illustration by Danie Drankwalter

Verywell / Danie Drankwalter

Cold Medicine to Avoid With Hypertension

There are lots of different types of cold and flu medications. Many of them combine decongestants, cough suppressants, and pain relievers (which also reduce fever). Although these ingredients can help you feel better, they might make heart disease and high blood pressure worse.

If you have high blood pressure, you should always talk to your healthcare provider before using OTC medications. There are two common ingredients that you should be particularly mindful of. 


Decongestants work by causing blood vessels to shrink. This helps treat congestion, which happens when blood vessels in the nose become swollen. Unfortunately, decongestants can also raise blood pressure.

People with high blood pressure should talk to their healthcare provider before using decongestants, including those containing pseudoephedrine or phenylephrine. 

Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)

NSAIDs are common OTC pain relievers and fever reducers. Aleve (naproxen sodium) and Advil and Motrin (ibuprofen) are all NSAIDs. Although these are effective for treating pain, they can cause a rise in blood pressure when they’re taken by mouth.

They can increase the risk for heart attack (blockage of blood flow to the heart muscle) and stroke (blockage of blood flow to the brain or a bleed in the brain) as well, so people with high blood pressure are advised not to use NSAIDs.

Finding Safe and Effective Cold Medicine

It’s possible to find a safe cold medicine for high blood pressure. However, it may take some extra work.

Talk to Your Healthcare Provider About Options

It’s best to start by asking your healthcare provider for their recommendations so you can be prepared before you are sick with a cold or the flu. They can give you a list of medications that are safe to address various symptoms, such as nasal or sinus congestion, fever, aches, or cough.

Your healthcare provider can also tell you which medications to avoid and may suggest several ways you can deal with these symptoms without medications.

Learn to Read Drug Labels

When you’re selecting an over-the-counter medication, learn to read drug labels. It’s most important to look at the active ingredients. Those are the ingredients that have the biggest impact on your body. If you have high blood pressure, avoid medications that have the following active ingredients:

  • Pseudoephedrine (a decongestant): Brand names include Sudafed and Drixoral.
  • Phenylephrine (a decongestant): Brand names include Neo-Synephrine and Sudafed PE.
  • Ibuprofen (an NSAID): Brand names include Advil, Motrin, and Nuprin
  • Naproxen (an NSAID): Brand names include Aleve and Naprosyn.

Each of these comes in several other brands, and they may also be present in multisymptom cold and flu medications that combine different active ingredients.

Treating a Cold With High Blood Pressure

There are safe alternatives to cold medicine for people with high blood pressure. Talk with your healthcare provider about what will work best for you. Here’s what you can consider:

Over-the-Counter Medications

These OTC medications are safe for people with high blood pressure, but can alleviate some of the symptoms of colds:

  • Antihistamines: Antihistamines can help clear congestion and are generally safer than decongestants for people with high blood pressure. They’re more often used for allergies but can also help with cold symptoms
  • Tylenol: Tylenol’s active ingredient isacetaminophen, which has not been linked to high blood pressure. If you have aches, pain, or fever with your cold, Tylenol can help. 

Other Remedies

You can also control your symptoms with home remedies and natural remedies for colds, including:

  • Saline nasal sprays to clear congestion
  • A hot shower and humidifier to soothe coughing
  • Honey to reduce coughing


People with high blood pressure need to be cautious about using over-the-counter cold medications. Common ingredients in cold medicines, including decongestants and NSAID pain relievers, can increase blood pressure.

If you have high blood pressure, ask your doctor about safer ways to treat a cold, including using Tylenol, antihistamines, and natural remedies. 

A Word From Verywell 

Dealing with a cold can be miserable. When you’re not feeling well, it may be hard to remember which cold medicines are safe if you have underlying health conditions. Plan ahead by talking to your healthcare provider when you’re well about how to treat a cold, with your hypertension and heart health in mind. 

Frequently Asked Questions

  • What are the risks of taking over-the-counter cold medicine with hypertension?

    Many OTC cold medicines contain decongestants and NSAID pain relievers. Both of these medications can raise blood pressure, so if you have hypertension you should ask your doctor before taking them. 

  • Are topical decongestants safe with high blood pressure?

    Topical decongestants work directly in the nasal passages and are not absorbed in the bloodstream to travel throughout the body the way that decongestants taken orally can.

    They might be safer because they stay in the nasal area, but you should still talk to your healthcare provider before using them if you have high blood pressure. 

4 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Centers for Disease Control and Prevention. Facts about hypertension.

  2. American Heart Association. Taking medicine for a cold? Be mindful of your heart.

  3. Ruschitzka F, Borer JS, Krum H, et al. Differential blood pressure effects of ibuprofen, naproxen, and celecoxib in patients with arthritis: the PRECISION-ABPM (Prospective randomized evaluation of celecoxib integrated safety versus ibuprofen or naproxen ambulatory blood pressure measurement) TrialEuropean Heart Journal. 2017;38(44):3282-3292. doi:10.1093/eurheartj/ehx508

  4. Harvard Health. Ask the doctor: Can allergies cause high blood pressure? June 10, 2019.

By Kelly Burch
Kelly Burch is has written about health topics for more than a decade. Her writing has appeared in The Washington Post, The Chicago Tribune, and more.