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Nieca Goldberg, MD, FACC
Medical Director & Cardiologist
Atria Institute
Clinical Associate Professor, NYU Grossman School of Medicine
A National Spokesperson for the American Heart Association
Founder and Former Medical Director, Joan H. Tisch Center for Women’s Health
Dr. Nieca Goldberg is Medical Director of Atria New York City and Clinical Associate Professor of medicine at NYU Grossman School of Medicine. She was the Co-Medical Director of the 92nd Street Y’s Cardio Rehab Program. Dr. Goldberg is a cardiologist, author, and podcast host of “Beyond the Heart – Improving Your Health One Conversation at a Time,” and a nationally recognized pioneer in women’s heart health.
Dr. Goldberg is a national spokesperson for the American Heart Association and started the “Go Red for Women” campaign. Before joining Atria New York City, she was medical director of NYU Women’s Heart Program, Senior Advisor of Women’s Health Strategy NYU Langone Health, the founder, and Medical Director of the Joan H. Tisch Center for Women’s Health at the NYU Langone Medical Center.
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Medically Reviewed
Q:
Many over-the-counter medications warn against taking them if you have high blood pressure. What medications should I avoid and why?
A:
It's funny, isn't it? We often assume that just because a medication is available without a prescription that it must somehow be safer than prescription medications. But the reality is that all drugs can have harmful side effects. Even aspirin can increase the risk of stomach bleeding, and acetaminophen (Tylenol) can contribute to liver damage.
Thus, the decision to use a specific medication should always depend on a complete understanding of its potential risks and benefits.
You are correct. Several over-the-counter (OTC) medications can contribute to high blood pressure. Others could interact with your high blood pressure medication, making it less effective. The OTC medications to watch out for include:
Pain relievers. Non-aspirin, nonsteroidal anti-inflammatories (NSAIDs) such as ibuprofen (Motrin) and naproxen (Alleve) can increase blood pressure even if you're already taking an anti-hypertensive medication. They appear to constrict blood vessels and increase the amount of sodium your body holds onto, both of which can cause high blood pressure. Chronic use of high-dose NSAIDs also causes kidney damage, which raises blood pressure.
Oral contraceptives. Birth control pills that contain estrogen can cause high blood pressure in about 5 percent of women who take them. That's why women with a history of high blood pressure or other risk factors for high blood pressure such as smoking are usually warned not to take estrogen-based contraceptives. Progestin-only pills are a contraceptive option for women with high blood pressure.
Antihistamines and decongestants. Products containing either of these ingredients (think Benadryl and Sudafed) can increase blood pressure and interact with your blood pressure medications. Check labels of allergy, flu and cold preparations, most of which contain one or both.
Weight-loss preparation. Many of these products contain antihistamines and other substances like caffeine that can increase blood pressure. Instead of taking pills to lose weight, talk to your health care professional about lifestyle changes you can make.
Caffeine. Caffeine, which can increase blood pressure, is found in a surprising number of OTC remedies, including some aspirin formulations.
Herbal remedies. Herbal remedies that contain ephedra, found in some weight-loss supplements, can be dangerous in those with high blood pressure. Also avoid taking gingko, an herbal remedy sometimes used for memory problems, if you are also taking a thiazide diuretic. St. John's Wort can interact with high blood pressure medications.
If you have high blood pressure, talk with your health care professional about which OTC medications and herbal remedies are safe for occasional use. Also make a point of reading the ingredient lists on OTC remedies and the inserts that come with all products.
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