Medications and supplements that can raise your blood pressure

Some medicines, supplements and substances such as caffeine can raise blood pressure. Or they may affect how high blood pressure medicines work.

Here are some of the medicines and supplements that can raise blood pressure. If you use any of them and you're worried about high blood pressure, talk with your healthcare team.

Nonsteroidal anti-inflammatory drugs (NSAIDs)

NSAIDs are medicines used to treat pain or swelling. They can make the body hold onto water. Too much water in the body may affect the kidneys and raise blood pressure. Examples of NSAIDs are:

• Indomethacin (Indocin).
• Naproxen sodium (Aleve; Naprelan) and ibuprofen (Motrin IB, Advil).
• Piroxicam (Feldene).

Ask your healthcare team which is the safest pain medicine for you. If you take a pain medicine and your blood pressure goes up, you may need lifestyle changes and medicines.

Medicines for a stuffy nose, called decongestants

Decongestants narrow blood vessels. This can reduce swelling in the nose area and other parts of the body. But it's harder for blood to go through a narrowed blood vessel. So blood pressure can go up. Decongestants are found in many cold and allergy medicines. Watch for any of these ingredients:

• Pseudoephedrine.
• Phenylephrine.

If you have high blood pressure, it's best to stay away from decongestants. If you have a stuffy nose, choose a cold or allergy medicine that says it's made for people with high blood pressure.

Antidepressants

Antidepressants change the body's response to brain chemicals that affect mood. But in doing so, they may raise blood pressure. Types of antidepressants that can raise blood pressure include:

• Monoamine oxidase inhibitors.
• Tricyclic antidepressants.
• Selective serotonin reuptake inhibitors.

If you take antidepressants, get your blood pressure checked regularly. If your blood pressure goes up or isn't well controlled, talk with your healthcare professional about your options.

Birth control with hormones

Birth control pills and some birth control devices have hormones. The hormones may raise blood pressure in some people. Most birth control pills and patches have warnings that high blood pressure may be a side effect. The risk of high blood pressure goes up if you're older than age 35 or overweight or if you smoke.

If you have high blood pressure, talk with your healthcare professional. Together you can choose the best type of birth control for you. A birth control pill or device that has a lower dose of estrogen is less likely to raise blood pressure.

Caffeine

Caffeine can cause a short-term spike in blood pressure in people who don't use it all the time.

Caffeine helps keep blood vessels open, which improves blood flow. But this may make blood pressure go up for a short while. More research is needed to see if caffeine raises blood pressure for longer times.

Caffeine can be found in:

• Caffeine pills (Vivarin, NoDoz, others).
• Coffee.
• Soda, energy drinks and other beverages.

How much caffeine is in coffee varies widely. So it's hard to say how many cups of coffee you can drink a day.

You can see if caffeine raises your blood pressure. Check your blood pressure about 30 minutes after drinking a cup of coffee or another beverage that has caffeine. If your blood pressure goes up, you may be sensitive to caffeine.

Herbal supplements

Some herbal supplements contain ingredients that can raise blood pressure. Or they may interfere with how blood pressure medicines work. Tell your healthcare team about any herbal supplements you take. Those that may affect blood pressure or blood pressure medicines include:

• Arnica (Arnica montana).
• Ephedra (ma-huang).
• Ginseng (Panax quinquefolius, Panax ginseng).
• Guarana (Paullinia cupana).
• Licorice (Glycyrrhiza glabra).

Herbal supplements may not be safe just because they're natural. Check with your healthcare team before taking any herbal supplements.

Biological therapies

Biologics are powerful medicines that use the body's immune system to fight disease, including cancer. Biologics called angiogenesis inhibitors, and some monoclonal antibodies may raise blood pressure. Examples are:

• Bevacizumab (Avastin, Vegzelma, others).
• Gefitinib (Iressa).
• Imatinib (Gleevec).
• Pazopanib (Votrient).
• Ramucirumab (Cyramza).

Immunosuppressants

Most people who've had an organ transplant take immunosuppressants. These medicines help keep the body from rejecting the new organ. Some immunosuppressants can raise blood pressure. This may be due to the ways the medicines affect the kidneys. Examples of immunosuppressants that can raise blood pressure are:

• Cyclosporine (Gengraf, Neoral, Sandimmune).
• Tacrolimus (Astagraf XL, Prograf, Envarsus XR).

If you take these medicines, get regular blood pressure checks. If your blood pressure goes up or isn't well controlled, talk with your healthcare professional. You may need lifestyle changes or other medicines to control blood pressure.

Stimulants

Stimulants, such as methylphenidate (Concerta, Ritalin, others), are often used to treat attention deficit hyperactivity disorder (ADHD). They can make the heart beat faster or unevenly. As a result, blood pressure might go up.

Get your blood pressure checked regularly if you take a stimulant. If your blood pressure goes up or isn't well controlled, you may need medicines and lifestyle changes to control blood pressure.

Illicit drugs

Illicit drugs may raise blood pressure. Some can narrow the arteries that supply blood to the heart. This makes the heart beat faster. It also can damage the heart muscle.

Examples of illicit drugs that may affect the heart are:

• Amphetamines, including methamphetamine.
• Cocaine.
• Ecstasy (MDMA).

If you're using illicit drugs, it's important to stop. Talk with your healthcare professional about methods that can help you quit, such as counseling or drug treatment programs.