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Can I take Sudafed with my blood pressure medicine?

Updated on April 21, 2014

This hub is part of the series "Ask a pharmacist." For more helpful tips about using your pharmacy, visit my central hub.

Have you asked your pharmacist about cold medicine interactions before?

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The question

A 43 year old women was came to the pharmacy looking for relief from her cold symptoms. She reported feeling stuffy, having a headache, and using lots of Kleenex. It all started yesterday, and she has no other symptoms. She also takes medicine for high cholesterol and high blood pressure.

She asks, "What is safe to take if I have high blood pressure?"

The short answer

When people are looking for medicine for their cold, they usually want a decongestant. Decongestants relieve pressure in the sinuses, which in turn resolve some of the other cold symptoms, including headache, sore throat, and coughing. Unfortunately, just by their nature, decongestants also raise blood pressure. In general, people with high blood pressure should not use decongestants. However, if you are careful, small doses for short periods may be ok.

The long answer

Decongestants, such as pseudoephederine (Sudafed), are wonderful drugs that can make a severe cold bearable. They work by closing down blood vessels that would otherwise deliver too much fluid to the sinuses. Unfortunately, this effect also results in a rise in blood pressure.

For people who don't have high blood pressure, the increase probably won't even be noticed. They may still feel it a bit, by way of an increased heart rate or mild anxiety, but it isn't dangerous. Enjoy your decongestant!

For people who do have high blood pressure and are not well controlled, the increase could be dangerous. Whether you are taking high blood pressure medication that isn't working strong enough, or you aren't taking medicine at all, if your blood pressure right now is too high, you should avoid decongestants. The extra rise could put too much strain on your heart, putting you at risk for heart attacks, stroke, or other complications. If your not sure if your blood pressure is OK, your pharmacist can take it for you.

For people who do have high blood pressure, but are well controlled, whether by diet and exercise or by medication, a short therapy of mild decongestants would be OK. You can still expect the blood pressure increase, but it won't be dangerous. Limit decongestant use to 3 to 5 days, and have your pharmacist help you find a mild decongestant.

I have high blood pressure and now I'm terrified, what else can I take?

What does it do?
Is it safe with high blood pressure?
Nasal decongestant
The same thing as Sudafed, but acts locally in the nose.
Safer, since it stays in the sinuses. It can only be used for 5 days, and can still raise blood pressure.
Air humidifier
Breaks up mucus with moist air.
Completely safe.
Nasal strips
Opens up airways to make breathing easier.
Completely safe.
Cough syrup
Stops a cough
Stops a headache
Of course.

As far as treating congestion goes, decongestants really have the market. There are some other medicines (see above) that can help, but they won't even be quite as powerful. But when you have high blood pressure, safety is the most important part.

You can treat other symptoms of a cold with targeted medications. Talk to your pharmacist and explain exactly what you want to treat and they can help you find the best medicine for you. Remember to tell them if you have high blood pressure and any other health conditions you have.

Of note, there is a brand of cold medication targeted to people with high blood pressure called Coricidin. They have a number of products that are all decongestant-free. They usually have a combination of ingredients, so it's important to have your pharmacist help you choose one that has everything you need and nothing you don't.

A bit more on the topic

There are literally hundreds of over-the-counter medicines available today. When you consider the hundreds of medications and dozens of common health conditions, it's no surprise that there is high potential for interactions (drug-drug, drug-condition, etc).

It's important to know when you have a health condition or take a medication that puts you at higher risk for these interactions. High blood pressure is one of those conditions. There are a lot of medications you should avoid. Your pharmacist is a valuable resource in using medication safely.

When selecting over-the-counter medication for self-treatment, always:

  • Read the entire labeling.
  • Ask questions.
  • Know your own health conditions and what to look for on the box.
  • Ask questions.
  • Stick with products that have worked safely in the past.
  • Ask questions.

The final word

Decongestants like Sudafed will raise your blood pressure. Whether this is dangerous for you personally depends on if you have high blood pressure and if it's controlled. There are other medications you can use that won't raise your blood pressure. Your pharmacist is a valuable resource for finding the right over-the-counter product for you.

Brandon Y is a community pharmacist working in Minnesota with over 10 years of experience in pharmacy. He welcomes comments and questions. Find more great pharmacy tips here.


The information provided on this page is intended for general educational and informational use only. It is not specific, personalized healthcare advice for you. For healthcare advice regarding your particular situation, talk to members of your healthcare team. Contact this hubs author for more information.

Copyright BYPharm.D. (author) 2013. All rights reserved


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      Brandon Young 20 months ago from Minnestoa

      If the active ingredient is phenylephrine, then you probably can. Phenylephrine is an older decongestant that is "weaker" than the typical pseudoephedrine found in regular Suadfed. It also does not have the same side effects. For someone who has well controlled high blood pressure, 3 to 5 days of phenylephrine is generally considered OK.

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      Bea Smith 20 months ago

      I have high blood pressure but I take two different kinds of blood pressure medicines to lower it; will I be able to use the new Sudafed with the heart on the box?