Can You Take Benadryl With High Blood Pressure?

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Whether you suffer from seasonal or year-round allergies, or are having a mild acute allergic reaction (like after eating a food you’re allergic to), symptoms like a runny nose, sneezing, watery eyes, and hives can have you reaching for the antihistamine Benadryl (diphenhydramine). If you also have high blood pressure, you might wonder if these medications are safe to take. The short answer is yes, says Arun Manmadhan, M.D., an assistant professor of Medicine at Columbia University in New York City.

“Most allergy medications, especially ones like Benadryl that contain diphenhydramine, are pretty neutral as far as blood pressure effects are concerned,” Dr. Manmadhan says. One exception is allergy medications with decongestants, such as epinephrine or pseudoephedrine, which could cause trouble for those with high blood pressure, he adds.

How Allergy Medications Like Benadryl Work

Benadryl is an antihistamine. Histamine is the chemical your body releases when you’re exposed to an allergic trigger like pollen, ragweed, mold, or your dog’s dander (dead skin cells).

In an effort to protect your body, histamine stimulates mucous glands in your nose, which makes it stuff up and run. It also tightens muscles in your lungs, which is why you might wheeze and cough after being exposed to your allergy triggers. Basically, you can thank histamine for your allergy symptoms. Antihistamines like diphenhydramine keep histamine from causing these symptoms in your body.

How Do Allergy Medications Affect Blood Pressure?

With Benadryl, the answer is it doesn’t, really. Blocking histamine from activating histamine receptors shouldn’t have much, if any, effect on your blood pressure—especially newer antihistamines like Claritin. An older antihistamine like Benadryl is also unlikely to raise blood pressure, although very rarely it can speed up your heart rate, says Ahmed Ansari, M.D., an interventional cardiologist with Memorial Hermann Health System in Houston. (Another very rare side effect is a slight drop in blood pressure in some people, particularly the elderly, says Dr. Manmadhan.)

Inhaled steroids like Flonase (fluticasone) and Nasacort (triamcinolone), which bring down inflammation in your lungs to help you breathe easier during an allergy attack, also are fine for people with blood pressure issues. “The risk of getting high blood pressure with those are very minimal,” Dr. Ansari adds.

Allergy Medications That Don’t Raise Blood Pressure

These are some of the allergy medications that you can feel comfortable taking with high blood pressure:

• Allegra (fexofenadine)

• Astepro (nasal spray, azalastine)

• Benadryl (diphenhydramine)

• Claritin (loratadine)

• Flonase (nasal spray, fluticasone)

• Nasacort (nasal spray, triamcinolone)

• Zyrtec (cetirizine)

Allergy Medications That Do Raise Blood Pressure

Where you want to be careful is allergy medications that also have certain decongestants, including pseudoephedrine and phenylephrine. These are not so blood pressure-friendly. “What they do is constrict or narrow the blood vessels in the nose to help with congestion, but that also can have effects on arteries in the rest of your body,” explains Dr. Manmadhan. “That can cause the blood pressure to go up.”

Nasal decongestants like Afrin can have a similar effect. They’re a different kind of nasal spray than Flonase and Nasacort. “Unlike steroids, [nasal decongestants] can cause blood pressure to go up. They should not be taken by people who have elevated blood pressure,” Dr. Ansari says.

You’ll have to read packaging carefully to know exactly what ingredients are in each product. These are some of the decongestant-containing medicines to watch out for:

• Advil Allergy Sinus

• Advil Cold and Sinus

• Afrin (nasal spray)

• Aleve-D Sinus and Cold

• Allegra-D

• Claritin-D

• Sudafed

• Zyrtec-D

These may be okay to take for a couple of days if your blood pressure is under good control, says Dr. Manmadhan. (Not sure? Check with your doctor.) But if you need to take them for longer than two or three days, check in with your healthcare provider to make sure your blood pressure is being monitored during that time, he suggests.

It’s also worth noting that some allergy medications combine multiple active ingredients. Before buying a product you’ve never tried before, check with your pharmacist and/or doctor, suggests Jeanne Lomas, D.O., a board-certified allergist and director of Allergy & Immunology at WellNow Allergy in Rochester, NY.

That advice holds true for any concern you have about over-the-counter or prescription drugs for allergies (or anything else) and their effect on your blood pressure. And while its generally okay to take allergy medications simultaneously with blood pressure drugs, a bit of caution is warranted. “You should always check with the pharmacist for any specific medication interactions,” Dr. Lomas advises.

Notes: This article was originally published December 28, 2010 and most recently updated January 25, 2023.

Allergy Symptoms: MedlinePlus. (2022.) “Diphenhydramine.” https://medlineplus.gov/druginfo/meds/a682539.html

How Antihistamines Work (1.): Advances in Dermatology and Allergology. (2014.) “Cardiovascular Safety of Antihistamines.” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4112269/

How Antihistamines Work (2.): StatPearls. (2022.) “Diphenhydramine.” https://www.ncbi.nlm.nih.gov/books/NBK526010/

Medications That Contain Decongestants: MedlinePlus. (2018.) “Pseudoephedrine.” https://medlineplus.gov/druginfo/meds/a682619.html

Our Review Process

Does diphenhydramine raise blood pressure?

Medically reviewed by Sally Chao, MD. Last updated on Oct 7, 2021.

Increased blood pressure is not a typical side effect of diphenhydramine, a first-generation antihistamine that lowers the effects of histamines in your body. However, in rare cases, the drug may cause hypotension, or decreased blood pressure. This side effect is most likely to occur in people who are over the age of 60.

First-generation antihistamines like diphenhydramine are generally considered safe in healthy adults and unlikely to raise blood pressure when taken alone. But because diphenhydramine has an atropine-like action, it may lower your blood pressure, and caution should be taken if you have hypertension (high blood pressure) and take medication. If you are taking a prescription medication to lower your blood pressure, diphenhydramine may compound its effects, so be sure to consult with your doctor or pharmacist before taking diphenhydramine.

Also, when combined with a decongestant such as pseudoephedrine or phenylephrine, increased blood pressure is likely to occur, and caution should be taken by people with hypertension when using such products.

Diphenhydramine is typically used to treat:

• Allergies
• Itching/hives
• Vertigo
• Motion sickness
• Nausea
• Insomnia
• Involuntary muscle contractions

There are more than 20 brand name options, including, among others:

• Banophen
• Benadryl
• Benadryl Allergy
• Dytan

The medication can be administered by mouth (tablet, capsule or oral suspension) or by intramuscular or intravenous injection.

References

1. Drugs.com. Diphenhydramine. February 2021. Available at: https://www.drugs.com/pro/diphenhydramine.html – CONTRAINDICATIONS. [Accessed September 20, 2021].
2. Sicari V, Zabbo P. Diphenhydramine. StatPearls. 2021 Jan. Available at: https://www.ncbi.nlm.nih.gov/books/NBK526010/. [Accessed September 20, 2021].
3. U.S. National Library of Medicine MedlinePlus. Diphenhydramine. August 15, 2018. Available at: https://medlineplus.gov/druginfo/meds/a682539.html. [Accessed September 22, 2021].
4. U.S. National Library of Medicine MedlinePlus. Antihistamines for allergies. May 30, 2020. Available at: https://medlineplus.gov/ency/patientinstructions/000549.htm. [Accessed September 22, 2021].

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Medical Disclaimer

Paracetamol and hypertension: regular use increases blood pressure

• Nikolay Voronin
• Science correspondent

February 8, 2022

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Image copyright, Getty Images

Image caption,

Paracetamol has long been suspected by medical practitioners to increase blood pressure in hypertensive patients, but no real clinical trials have been conducted on this issue yet

People with hypertension should be careful about taking paracetamol, as regular use of this popular anti-inflammatory and pain reliever slightly raises blood pressure.

This is the conclusion of a study by scientists from Edinburgh, who studied whether the regular use of acetaminophen (as paracetamol is known to American doctors) affects the blood pressure of hypertensive patients.

“Acetaminophen is widely used as a first line treatment for chronic pain because it is believed to be safe and, unlike non-steroidal anti-inflammatory drugs, has little or no effect on blood pressure,” write the authors of an article published in the Journal of the American Association of Cardiology Circulation, which is one of the three most authoritative scientific publications on the problem of cardiovascular diseases.

“While observational studies [of patients] suggest that acetaminophen may actually raise blood pressure, there have been no clinical trials [of this suggestion],” they say.

Safety questionable

Clinical trials involving 110 people suffering from chronically high blood pressure were conducted in an Edinburgh clinic over a period of more than five years.

The volunteers were divided into two groups. Participants in one of them took 4 g of paracetamol daily for two weeks (four times a day, 1 g – the maximum daily dose recommended by the British Ministry of Health). In another, under the guise of paracetamol, volunteers received a placebo. ” with the opposite sign”: volunteers from the experimental and control groups were swapped.

At the beginning and at the end of both periods of taking the tablets, the doctors monitored the pressure of each individual volunteer during the day, continuously recording the readings of the tonometer. In addition, one-time measurements were periodically carried out during the experiment, and the pressure of the participants was measured in several different ways.

Summing up the results, the researchers concluded that regular two-week intake of paracetamol by hypertensive patients still slightly increases their systolic blood pressure – by about 5 mmHg. And this, the authors of the article argue, in turn “increases the risk of developing cardiovascular disease, and in such a situation [when the user suffers from hypertension] calls into question the safety of regular use of paracetamol.”

“Highest scientific standard”

Experts who did not participate in the study note that the Scottish experiment – albeit rather modest in scale – was carried out in accordance with the highest scientific standards developed for such research.

First, the authors used a randomized, double-blind, placebo-controlled method – that is, participants were divided into groups at random, and neither the volunteers themselves nor their attending physicians knew whether they were taking a real paracetamol tablet or a dummy.

Image copyright, Getty Images

Image caption,

Paracetamol is the most commonly used antipyretic, not least because of its maximum patient safety

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Second, the study was cross-over: after a predetermined two-week break (the purpose of which was to wait until the body of the participants was as clean as possible from taking the pills), the paracetamol drinkers and those who were given a placebo were switched.

Thus, the developers of the experiment had the opportunity to compare the pressure of the subjects not only with the results of the volunteers from the control group, but also with their own indicators obtained while taking the placebo. Indeed, in addition to taking paracetamol, there are an infinite number of other factors in the life of each volunteer that could greatly affect the results.

If we additionally compare the indicators of the same patient, obtained first when taking paracetamol, and then when taking placebo (or vice versa), the results are much more reliable and trustworthy.

However, noting the very convincing findings of the study, independent commentators still emphasize that they should not be attributed to people who take paracetamol not regularly or only for a few days – to get rid of headaches, fever and other symptoms of general inflammation .

Even those who really drink this popular painkiller often and in large quantities, do not forget that the participants in the experiment were initially selected from among patients who had already suffered from chronically high blood pressure for some time.

“The findings of any randomized trial directly relate only to people who are similar to the participants in the experiment in a number of characteristics. That is why clinical trials always clearly define the selection criteria: who can take part in them and who can not,” reminds the honorary Professor of Applied Statistics at the Open University Kevin McConway.

“While this particular study does not directly indicate that paracetamol increases blood pressure in patients who do not have hypertension, it is possible that long-term use of this drug in comparable doses has exactly the same effect on them,” he notes.

Pros, cons, pitfalls

Dipender Gill, who teaches a course in clinical pharmacology at St. George’s University in London, calls for interpreting the results of the experiment with caution, listing several unknowns at once, which in theory can somewhat reduce the reliability of the conclusions made by the authors of the work.

First, it is not known how long high blood pressure will last in hypertensive patients if they continue to take paracetamol regularly.

Secondly, the mere fact that with regular use of paracetamol, the pressure in hypertensive patients increases somewhat, does not necessarily mean that the risk of developing cardiovascular diseases also increases with it.

Thirdly, high blood pressure is often a symptom of experienced pain and muscle tension. So, it cannot be ruled out that, while relieving pain, paracetamol also helps to reduce the symptoms of hypertension.

Finally, fourthly, all those who took part in the Scottish hypertensive experiment were white people from Europe. A study involving immigrants from Asia and Africa may well give a slightly different result.

And yet, in general, the scientific work was highly appreciated by both medical theorists and practicing physicians.

“High blood pressure is a major factor in a patient’s risk of having a stroke,” recalls Richard Francis, head of research at the British Stroke Association. ) have done before. Regular use of paracetamol quickly leads to high blood pressure in people already at risk for stroke and heart attacks. Therefore, it is very important that doctors regularly review and weigh all the risks and benefits associated with prescribing paracetamol “, the expert concludes.

What not to do with high blood pressure

Arterial hypertension is dangerous for its complications. To prevent them, you need to follow the doctor’s recommendations.
and know what to do and what not to do with high blood pressure.

Contents

1. What is high blood pressure
2. What not to do with high blood pressure
1. Take hot baths and hot showers
2. Visit a bath, sauna
3. Rest in resorts with sudden changes in temperature
4. Subject the body to severe stress
5. Smoking, drinking alcohol
6. Eat too much salt
7. Skip medications
3. What can be done with high blood pressure
   1. Eat right
   2. Make time for moderate physical activity
   3. Take a contrast shower

What is high blood pressure

The optimal blood pressure for an adult is 120/90 mm. rt. Art. (exact ones depend on
age). The upper value is the systolic pressure and the second one is the diastolic
pressure.

In a healthy person, the pressure rises during physical activity, strong excitement, but its indicators should
be close to those observed in a calm state. If, with repeated measurements, systolic pressure
is from 140 mm. rt. Art. and (or) diastolic pressure – from 90 mm. rt. Art., then diagnose
arterial hypertension.

A steady increase in pressure is due to various reasons, among which are overweight, sedentary
lifestyle, malnutrition, constant and severe stress, alcohol abuse, smoking.

Even if the pressure has increased once, you need to monitor its performance and heart rate by periodically measuring
and entering the results in a diary. Self-control should be carried out at the same time, in the morning after sleep and in the evening.

If the doctor diagnosed hypertension, then you need to take medications. Treatment should not be stopped without
specialist approval.

What not to do with high blood pressure

If you have hypertension, do not follow the steps below.

Take a hot bath and hot shower

A hot shower or hot bath provokes an increase in blood pressure, as under the influence of high
temperatures dilate blood vessels, accelerates blood circulation. In addition, hot water increases heart rate. Taking a bath with
water temperature over 45 degrees can lead the patient to a hypertensive crisis.

Visit a bathhouse, sauna

There are some caveats here. At the first stage of hypertension, a bath and a sauna are allowed (with a sense of proportion).
At the second stage, you can go to the sauna, but not to the bathhouse. In the third stage of the disease,
both the bath and the sauna are prohibited. It is important to remember that you can visit the steam room only when the indicators are normalized.
pressure.

Eat certain foods

With hypertension, you can not use:

• strong tea;
• fatty meats;
• coffee;
• rich meat, fish broths;
• pickles;
• pepper;
• radish;
• mustard;
• spicy, fatty, salty;
• alcoholic beverages;
• chocolate;
• cocoa;
• fat, internal organs of animals.

Exercise hard

Bodybuilding is banned, as power loads increase blood pressure even in
young people. Static exercises are not recommended, especially if they are performed for a long time. Better
combine them with aerobic training, which have a beneficial effect on the condition of the heart and blood vessels.

Vacation in resorts with sudden temperature changes

A sharp change in weather conditions adversely affects the well-being of hypertensive patients. Places with
stable air temperature, for example, Anapa.

Subject the body to severe stress

If possible, hypertensive patients should protect themselves from stress, as it can significantly increase blood
pressure. This is fraught with the development of complications.

Smoking, drinking alcohol

Drinking alcohol with hypertension can provoke cerebral hypoxia, as well as a heart attack. WITH
The permission of the doctor is allowed no more than 40 g of red wine per day.

Smoking is also not worth it, because under the influence of nicotine, the walls of blood vessels narrow, and the indicators also increase.
cholesterol in the blood. People who smoke have a higher risk of developing complications from cardiovascular pathologies than those who
I do not smoke.

Eat too much salt

For hypertension, it is recommended to consume no more than one gram of salt per day (unless the doctor has prescribed otherwise). Availability
in the diet of salty foods can provoke fluid retention in the body and increase blood pressure.
It is necessary to abandon the use of salted nuts, cheeses, sausages, canned fruits and vegetables.

Skip medications

Even if the condition has returned to normal, you should not skip the treatment prescribed by your doctor. Regular therapy will help
prevent serious complications.

With hypertension, you need to follow the recommendations of a specialist. It is necessary to maintain a normal weight, because obesity
increases the risk of complications. To do this, you need to eat right, devote time to moderate physical
activity (with normal blood pressure).

What can be done with high blood pressure

With arterial hypertension, you can and should follow the actions listed below.

Eat right

It is useful to eat foods rich in potassium and magnesium, such as raisins, parsley, dried apricots, citrus fruits.