Many common over-the-counter (OTC) pain relievers have been shown to increase blood pressure. This effect can occur in both people with normal blood pressure and in those with already diagnosed high blood pressure (hypertension). Many common medications, not just pain relievers, can affect blood pressure because of the way that they affect signaling systems within the body. It is not commonly appreciated that pain relief drugs can have side effects that involve changes in blood pressure.
Non-steroidal anti-inflammatory drugs (NSAIDs)
NSAIDs like aspirin, ibuprofen, naproxen, and others all have the capacity to increase blood pressure. The average increase is small, but the actual amount of increase can vary widely from individual to individual. This effect occurs at doses that are typically used for pain relief and reduction of inflammation. Moreover, these drugs can reduce the effect of many types of drugs used to treat elevated blood pressure. The effect on blood pressure seems to be due to a reduction in excretion of sodium and increased retention of water. Studies of NSAIDs showed that only low-dose aspirin (81 mg a day) did not have measurable effects on blood pressure.
Acetaminophen
Acetaminophen, the active ingredient in Tylenol and other drugs, has been shown in some studies to cause a mild increase in blood pressure, but it hasn't been associated with stroke or heart attack. Still, this medication has its own side effects and poses a risk of liver damage when taken in overly large doses. Prolonged use at high doses can also cause kidney failure.
Options for people with high blood pressure
If you have high blood pressure or heart conditions and would like to take pain control medications, discuss your options with your doctor beforehand. Most experts agree that acetaminophen and aspirin are the safest pain relief choices for people with high blood pressure. However, not everyone should use aspirin. Ask your doctor if aspirin is safe for you if you take medications for high blood pressure. Aspirin may also cause ulcers, heartburn, and upset stomach, and it can be dangerous to take if you have gout, liver disease, rheumatic fever, or if used in children. Pregnant women also should not take aspirin as it can be unsafe for both mother and baby.
Alternatives for pain relief
If you do not want to take pain medications for relief of headache or other mild aches and pains, there are other alternatives. Many people find that ice packs (for acute injuries) and heating pads (for chronic overuse injuries) can bring relief. Relaxation techniques like meditation, imagery, or yoga can be used to help manage pain. Physical activity may help with some kinds of pain, like that of arthritis. Finally, acupuncture and other nontraditional techniques can help some people with mild to moderate pain.
SLIDESHOW
How to Lower Blood Pressure: Exercise and Tips See SlideshowReferences
Medically reviewed by Robert J. Bryg, MD; Board Certified Internal Medicine with subspecialty in Cardiovascular Disease
REFERENCES:
Dawson, J. et al. "Acetaminophen use and change in blood pressure in a hypertensive population." Journal of Hypertension 2013.
Dedier, J. et al. "Nonnarcotic analgesic use and the risk of hypertension in U.S. women." Hypertension 40.5 (2002): 604-608.
Radack, K. L. et al. "Ibuprofen interferes with the efficacy of antihypertensive drugs. A randomized, double-blind, placebo-controlled trial of ibuprofen compared with acetaminophen." Annals of Internal Medicine 107.5 (1987): 628-635.
Sudano, I. et al. "Acetaminophen increases blood pressure in patients with coronary artery disease." Circulation 122.18 (2010) 1789-1796.
Updated on September 16, 2022 Ibuprofen can cause your
blood pressure drugs to be less effective, as can other medications. There's a good chance you may be taking one or more of them. Several popular over-the-counter (OTC) remedies do that, including some antacids, as well as a number of prescription drugs. Proper
blood pressure control is important for your cardiovascular health. So it's wise to key an eye on your blood pressure readings if you're taking anything that could cause a problem. That includes vitamins and other supplements that can affect your blood pressure.
This article looks at common drug types that can make your hypertension (high blood pressure) worse. It also discusses what they're typically used to treat and what you can try instead, keeping in mind that you should always discuss medication used with your healthcare provider.
1
Nonsteroidal Anti-Inflammatory Drugs
frankieleon / Flickr / CC BY 2.0
Nonsteroidal anti-inflammatory drugs (NSAIDs) are among the most popular over-the-counter (OTC) medicines in the world. They're used to:
- Treat headaches
- Reduce fever
- At higher doses, alleviate pain and inflammation
While NSAIDs are typically safe, prolonged use can raise your blood pressure.
Long-term use has also been linked to changes in kidney function. The kidneys play a key role in blood pressure regulation. There's research evidence that finds NSAIDs may increase cardiovascular risks, like heart attack and stroke, in some people.
OTC NSAIDs include:
- Advil/Motrin (ibuprofen)
- Aleve, Naprosyn (naproxen)
Ask your healthcare provider about pain-relief options that may be safer for you.
What Is the Safest Anti-Inflammatory?
All NSAIDs, except for aspirin, are linked to a higher risk of heart problems. They also present gastrointestinal and renal (kidney) concerns that grow with higher doses and length of time you take them. Aspirin is an option but it increases the risk of bleeding, so it's not for everyone. More research is needed, but some findings suggest Aleve (naproxen) may be safer for the heart.
2
Nasal Decongestants
Tom Merton / Getty Images
Decongestants slow the production of mucus, which can clog breathing passages.
They do this by constricting blood vessels in your nose and sinuses. That opens airways and makes you feel less stuffed up from colds or allergies.
Most decongestants contain either:
- Pseudoephedrine
- Phenylephrine
Those are both stimulants known to increase blood pressure.
When used short-term, decongestants are largely safe and effective. But overuse may raise blood pressure and undermine your treatment.
Look for non-stimulant decongestants, which may be just as effective for certain nasal conditions.
3
Multi-Symptom Cold and Flu Remedies
Jupiterimages / Getty Images
Dozens of combination pills, syrups, and tablets are marketed for cold and flu symptoms. Each has a different blend of similar ingredients. These include:
- Decongestants
- NSAIDs or Tylenol (acetaminophen)
- Cough suppressants
Constricted blood vessels and fluid retention are effects of these drugs when taken together. They can cause short-term blood pressure increases and make your treatment less effective.
4
Hormonal Birth Control
PhotoAlto / Getty Images
Virtually all hormonal birth control pills, patches, and devices can raise blood pressure.
Blood-vessel constriction is a common side effect of these products. They often have a larger effect on women who smoke, are overweight, or are over age 35.
Oral contraceptives with lower-dose estrogen may have lesser effects on blood pressure. If you still have a problem while taking these, you may need to consider other forms of birth control.
Increased Monitoring
Not all women are affected by hormonal birth control. But if you have hypertension, your healthcare provider will likely want to monitor you closely. Ideally, you should get checked every six to 12 months.
5
Antidepressant Drugs
Jonathan Nourok / Getty Images
Antidepressants change the activity of neurotransmitters (brain chemicals) tied to mood. They include:
- Serotonin
- Norepinephrine
- Dopamine
These drugs increase your levels of adrenaline and other stimulating hormones. That can increase blood pressure.
Dopamine is even used in emergencies to raise critically low blood pressure.
Several antidepressant classes are linked to increased blood pressure, such as:
- Tricyclics: Amitriptyline, doxepin, Norpramin (desipramine)
- SSRIs (selective serotonin reuptake inhibitors): Lexapro (escitalopram), Prozac (fluoxetine), Zoloft (sertraline)
- SNRIs (serotonin norepinephrine reuptake inhibitors): Cymbalta (duloxetine), Effexor (venlafaxine), Savella (milnacipran)
- MAOIs (monoamine oxidase inhibitors)*: Emsam (selegiline), Marplan (isocarboxazid), Nardil (phenelzine)
Ups and Downs of MAOIs
*MAOIs alone can lower your blood pressure. But they can lead to dangerously high blood pressure when combined with:
- Aged and fermented foods (e.g., sauerkraut, cured meats, soy sauce, and tofu)
- Acetaminophen or aspirin
- The heart medicine dobutamine
- The antibiotic isoniazid
- Many stimulants
Summary
Drugs that increase blood pressure either constrict blood vessels, increase fluid retention, or raise hormone levels. Use care with NSAIDs, decongestants, combination cold and flu medicines, hormonal birth control, and antidepressants.
A Word From Verywell
If you take any of these OTC drugs, talk to your healthcare provider about your risk of
hypertension. You may want to check your blood pressure at home until you know how the medication affects you. You may need to switch drugs, lower your dosage, or up the dosage of an anti-hypertensive drug.
Frequently Asked Questions
How much can OTC medication raise your blood pressure?
If your blood pressure is in the normal range, OTC medication should not increase it enough to be a concern. If you normally have high blood pressure, though, OTC medication may take it to a dangerous level. Talk to your healthcare provider if you have high blood pressure and need to take OTC medication that may raise it.
What are normal blood pressure numbers?
Blood pressure is measured as systolic pressure (first number) over diastolic pressure (second number). Normal blood pressure range does not exceed 120/ 80 millimeters of mercury (mmHg).
- Prehypertensive range = between 120-139/80-89
- Hypertensive range = 140 or higher/90 or higher
- Hypertensive crisis = above 180/above 120
Does ibuprofen raise blood sugar in diabetics?
Advil (ibuprofen) isn't as much of a blood sugar concern as Tylenol (acetaminophen), aspirin, and other drugs that can lower (or raise) blood sugar.But ibuprofen does present a concern for diabetics who take certain drugs, called ACE inhibitors, or have kidney disease or dysfunction.
What time of day is blood pressure highest?
Your blood pressure is likely to be at its highest at midday, and its lowest when you first wake up, but it also depends on the individual. When you check it at home, try to do so at the same times every day so the readings are consistent.
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.
Kotliar C, Obregón S, Koretzky M, Botto F, Di Leva A, Boscaro M, et al. Improved identification of secondary hypertension: use of a systematic protocol. Ann Transl Med. 2018 Aug;6(15):293. doi:10.21037/atm.2018.06.25.
Barcella CA, Lamberts M, McGettigan P, Fosbøl EL, Lindhardsen J, Torp-Pedersen C, et al. Differences in cardiovascular safety with non-steroidal anti-inflammatory drug therapy-A nationwide study in patients with osteoarthritis. Basic Clin Pharmacol Toxicol. 2019 May;124(5):629-641. doi:10.1111/bcpt.13182.
National Kidney Foundation. Watch out for your kidneys when you use medicines for pain.
Harvard Health. Heart-safer NSAID alternatives.
American Academy of Family Physicians. Decongestants: OTC relief for congestion.
American Heart Association. High blood pressure and women.
Calvi A, Fischetti I, Verzicco I, et al. Antidepressant drugs effects on blood pressure. Front Cardiovasc Med. 2021;8:704281. doi:10.3389/fcvm.2021.704281
American Heart Association. Understanding over-the-counter (OTC) medications and high blood pressure.
Centers for Disease Control and Prevention. High blood pressure symptoms and causes.
TriHealth. Medications that affect blood sugar.
Bigotte Vieira M, Neves JS, Baptista RB, Leitão L, Viegas Dias C, Vicente R. Prescrição de Anti-Inflamatórios Não Esteroides a Doentes com Diabetes Mellitus em Portugal [Prescribing of Non-Steroidal Anti-Inflammatory Drugs to Patients with Diabetes Mellitus in Portugal]. Acta Med Port. 2019 Feb 28;32(2):119-125. Portuguese. doi:10.20344/amp.10815.
George J, Macdonald T. Home blood pressure monitoring. Eur Cardiol. 2015;10(2):95-101. doi:10.15420/ecr.2015.10.2.95
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Craig O. Weber, MD
Craig O. Weber, MD, is a board-certified occupational specialist who has practiced for over 36 years.
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