Cold Medications and High Blood Pressure

Not all cold medicines raise blood pressure. In fact, people with high blood pressure (hypertension) that is well controlled can take most cold medicines (at label-recommended doses) without any problem.

Since we have no good medications to help cure colds, you can only treat the symptoms. So, symptom by symptom, here are your options if you have high blood pressure:

For headaches, body-aches, and fever, acetaminophen is your best bet, and is entirely safe for those with hypertension. (But everyone should be careful not to exceed the suggested dose, because acetaminophen is surprisingly dangerous if too much is taken, and not much more than the suggested dose can be too much.)

For runny nose and nasal congestion: decongestant nasal sprays are quite effective and safe, since little of the medicine is absorbed into the body. You should not use this type of spray for longer than 3 days, however, since longer treatment with these sprays causes “rebound” congestion: After stopping the medicine following prolonged use, you will end up stuffier than you began! Sedating, nonprescription antihistamines are effective for sneezing, runny nose, and post-nasal drip, but they do little for congestion. They are safe for those with hypertension.

Although generally safe in recommended dosages, medicines taken by mouth which contain decongestants like pseudoephedrine, phenylephrine, and phenylpropanolamine (PPA) are best avoided by those with high blood pressure, since they can raise the blood pressure or speed the heart rate in some cases. These medications are in a wide variety of combination remedies, so read labels carefully and try to avoid these types of decongestants if you have high blood pressure.

Cough is sometimes caused by postnasal drip, and it will be helped by the medications listed above. Medications containing dextromethorphan may also help with cough, and are safe. Prescription inhalers can help with a cough that lingers after the cold is gone. Finally, chicken soup is safe, and according to one study, more effective than placebo (a sugar pill) at relieving cold symptoms.

Again, rest and plenty of fluids are the tried and true ways to deal with a cold. As the great physician Osler put it over a century ago, “There is just one way to treat a cold, and that’s with contempt.”