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Cough and Cold Medications with High Blood Pressure
Q. I have high blood pressure. Is it safe to take cough and cold medications with high blood pressure or heart disease?
A.
When you're suffering the symptoms of a cold or flu, the last thing you want to hear is that you can't take medication to relieve those symptoms. Runny nose (rhinorrhea), stuffy nose (nasal congestion), cough, sore throat and aches and pains (myalgia) are all troubling symptoms of a cold.
A flu, in contrast, is often accompanied by fever, more prominent fatigue or tiredness and possibly some of the symptoms of a cold. Many times a flu results in more severe symptoms and can be very dangerous in the young or old. The flu can be prevented with an annual flu shot (talk to your doctor if you haven't received one) and proper handwashing. Because they are caused by viruses, neither a common cold, nor the flu can be treated by antibiotics. However, sometimes the flu is treatable in early stages with antiviral medications such as oseltamivir (Tamiflu).
Most people with cough and cold and minor flu symptoms are left to ride out the illness and manage these symptoms with over-the-counter products. Your local pharmacy probably has a cough and cold aisle with an overwhelming array of products from which to choose. Definitely not an easy task when you just want to get home and rest!
But don't overlook the importance of appropriate selection of cough and cold medication. These medications are safe in most people, but in certain people, cough and cold medications can contribute to dangerous, potentially fatal, side effects. Also, anyone taking these medications inappropriately (such as wrong dose) could experience severe consequences.
Patients with high blood pressure and/or a history of heart disease are often highlighted as having a high risk of problems with some of these medications. The trick to navigating these medications safely is reading the label to look at medicinal ingredients, following the recommended dosage, and asking the pharmacist to ensure that this medication is right for you.
You might be suprised to know that this seemingly endless selection of over-the-counter medications for cough and cold consists of only a few potential types of medications:
Decongestants: help to relieve stuffy nose. They can be taken orally as liquids or tablets, and topically as nasal sprays. Some examples of nasal decongestants include phenylephrine, pseudoephedrine (Sudafed), oxymetazoline
Antihistamines: are generally taken by mouth to help relieve runny nose. Some examples of antihistamines include diphenhydramine (Benadryl) and chlorpheniramine.
Analgesics: are also known as pain-releivers or antipyretics because they can reduce fever. Some examples of analgesics are acetaminophen (Tylenol), naproxen, ibuprofen (Motrin or Advil).
Cough suppressants: you guessed it, suppress coughs! Dextromethorphan, also known as DM, is the main cough suppressant available in both the US and Canada.
Expectorants: help to loosen phlegm so you can more easily cough it out. Paradoxically, they are often combined with cough suppressants. Guaifenesin is the main expectorant found in cough and cold products.
It's those 5 main ingredient categories that can be found in various combinations in cough and cold products. Makes the cough and cold aisle seem a lot shorter, doesn't it?
Now, for patients with a history of heart disease or high blood pressure (also called hypertension), you should avoid decongestants (example: pseudoephedrine (Sudafed), phenylephrine). These medications constrict blood vessels and can raise blood pressure and cause your heart to beat faster. Some patients with high blood pressure that is well-controlled can be safely given decongestants for short periods of time. But it is best to speak to your doctor or pharmacist before trying this. Additionally, If you are taking Aspirin, which is common in folks with high blood pressure or heart disease, acetaminophen may be your pain reliever of choice. This is because some of the other drugs, called anti-inflammatories, can interact with Aspirin and decrease its effectiveness.
Also, anyone with cough and cold symptoms should be sure to try non-drug measures of symtom relief as a supplement or replacement to medications. Getting plenty of rest and replacing fluids, just like your mother told you, are often very helpful. If you've still got a lot of nasal congestion, try a saline nasal spray to help clear out the mucus.
If you have any other medical conditions, such as diabetes, thyroid disease, bladder or urinary problems, some of the above medications may not be right for you. So, check with your pharmacist.
For more information about the safe management of cold and flu symptoms... Ask Your Pharmacist!