Often yes, but not every cold medicine: the main ingredient to avoid or ask about first is a decongestant (pseudoephedrine or phenylephrine), because MedlinePlus lists nasal decongestants among medicines that can raise blood pressure. NSAIDs like ibuprofen (Advil, Motrin) are on that list too, and the Advil label tells you to ask a doctor first if you have high blood pressure. Products sold as HBP, such as Coricidin HBP and Vicks DayQuil or NyQuil High Blood Pressure, leave the decongestant out, but they still have their own warnings and they do not unblock a stuffy nose. For that, the CDC lists saline nasal spray or drops.
What should I check on the box first?
Turn the box over and read the Drug Facts panel, not the front. The front says what the product is for. The back lists the active ingredients, and that is what decides whether it fits with high blood pressure.
MedlinePlus lists nasal decongestants, NSAIDs and many over-the-counter cough and cold medicines among the medicines that can cause high blood pressure. So with high blood pressure, look for 3 things:
- A decongestant: pseudoephedrine or phenylephrine. Check the active ingredients even when the name doesn't say decongestant. With high blood pressure or heart disease, ask a doctor or pharmacist before you take one. MedlinePlus also says not to take phenylephrine with an MAOI or within 2 weeks of stopping one.
- An NSAID: ibuprofen (Advil, Motrin) or naproxen. Some multi-symptom products include one. The Advil label says to ask a doctor before use if you have high blood pressure, heart disease or kidney disease, or take a diuretic.
- A repeat ingredient: if the cold medicine already has acetaminophen (Tylenol), dextromethorphan or an antihistamine, do not add a second product that has the same one.
What is in the HBP versions?
These products are sold for people with high blood pressure. Here is what each one's own DailyMed label lists. None of them contains a decongestant.
- Coricidin HBP Cold & Flu tablets: acetaminophen 325 mg and chlorpheniramine 2 mg (an antihistamine) per tablet. The label lists aches, headache, fever, sneezing and runny nose.
- Vicks DayQuil High Blood Pressure Cold & Flu: acetaminophen 650 mg and dextromethorphan 20 mg (a cough suppressant) per 30 mL. Up to 4 doses in 24 hours. The carton says "decongestant free".
- Vicks NyQuil High Blood Pressure Cold & Flu: acetaminophen 650 mg, dextromethorphan 30 mg and doxylamine 12.5 mg (a sleepy antihistamine) per 30 mL. Up to 4 doses in 24 hours. The carton says "decongestant free".
- Other HBP items in the same lines have different ingredients. Check the panel on the exact box you pick up.
Does HBP mean it has no warnings?
No. Leaving out the decongestant removes one ingredient MedlinePlus lists as able to raise blood pressure, but the other ingredients still carry their usual warnings. From the labels:
- Acetaminophen limit: all 3 contain acetaminophen. Do not take them with Tylenol or any other acetaminophen product, and stay under the daily maximum on the box. The labels warn of severe liver damage above it, or with 3 or more alcoholic drinks a day.
- MAOI warning: the DayQuil and NyQuil HBP labels say do not use if you take a prescription MAOI (certain medicines for depression, psychiatric conditions or Parkinson's disease), or for 2 weeks after stopping one, because of the dextromethorphan.
- Antihistamine warnings: NyQuil HBP and Coricidin HBP tell you to ask a doctor first if you have glaucoma or trouble peeing from an enlarged prostate. They can cause drowsiness, so avoid alcohol and take care driving.
- Do not stack them: Coricidin HBP plus NyQuil HBP means 2 doses of acetaminophen and 2 antihistamines. DayQuil HBP and NyQuil HBP share acetaminophen and dextromethorphan, so do not take them at the same time. Our page on taking DayQuil and NyQuil together covers spacing.
What can I use for a stuffy nose instead?
The HBP products do not list nasal congestion in their uses. Their antihistamines target sneezing and a runny nose, not a blocked nose. The decongestant is the part that unblocks, and it is the part they left out on purpose.
To ease cold symptoms, the CDC suggests saline nasal spray or drops, breathing in steam from a hot shower or a bowl of hot water, and a clean humidifier or cool mist vaporizer. Honey can ease a cough in adults and children 1 year and older. Rest and plenty of fluids help too. If you still want a decongestant, ask a pharmacist or doctor first and tell them your blood pressure readings and medicines. Our Sudafed page covers pseudoephedrine with high blood pressure in more detail.
When should you get care?
In an emergency, call 911Stop ibuprofen and contact a doctor the same day if you get leg swelling after taking it. See a doctor soon if you know your blood pressure is poorly controlled, if you get dehydrated, if a fever lasts longer than 4 days, or if symptoms last more than 10 days without getting better or improve and then come back or get worse.
Call 911 if you have chest pain or pressure, trouble breathing, blurred vision, confusion, a headache with any of these, slurred speech, numbness or weakness in your face, arm or leg, or a seizure. MedlinePlus and the Advil label list these as signs of dangerously high blood pressure, a heart problem or a stroke.
How our AI doctor decides when to send you to care ›What about pain and fever?
Ibuprofen (Advil, Motrin) and naproxen are NSAIDs. The Advil label tells you to ask a doctor before use if you have high blood pressure or heart disease, or take a diuretic (water pill). It also carries a heart attack and stroke warning: NSAIDs other than aspirin increase the risk of heart failure and stroke, and these can be fatal.
Acetaminophen (Tylenol) is what the HBP cold products use, and their labels do not list high blood pressure as an ask-a-doctor condition. But MedlinePlus includes acetaminophen on its list of medicines that can cause high blood pressure, so it is not a free pass either. Stick to the label dose and count every acetaminophen source. Never take 2 NSAIDs together, for example ibuprofen and naproxen.
If you take medicine for your blood pressure, tell the pharmacist which one before you buy a cold medicine. The Advil label calls out diuretics (water pills) by name.
Common questions
Can I take cold medicine with high blood pressure?
Often yes, if you pick one without a decongestant. Pseudoephedrine and phenylephrine can raise blood pressure, so ask a doctor or pharmacist before you take them. Decongestant-free products like Coricidin HBP and DayQuil or NyQuil High Blood Pressure exist, but read the full label, because they still contain acetaminophen and other ingredients with their own limits.
Is Coricidin HBP safe for high blood pressure?
It has no decongestant. Its label lists acetaminophen 325 mg and chlorpheniramine 2 mg per tablet. Do not take it with any other acetaminophen product, and ask a doctor first if you have glaucoma, liver disease, a breathing problem or trouble peeing from an enlarged prostate.
Can I take DayQuil High Blood Pressure and Tylenol?
No, not together. DayQuil High Blood Pressure already contains 650 mg of acetaminophen per 30 mL dose, and Tylenol is acetaminophen. Its label says not to use it with any other drug containing acetaminophen.
Can I take Advil or Motrin for a cold if I have high blood pressure?
Ask a doctor first. The Advil label lists high blood pressure, heart disease and taking a diuretic as reasons to ask before use, and MedlinePlus lists NSAIDs among medicines that can raise blood pressure. If you have heart disease, have had a stroke, or take aspirin for your heart, do not decide this on your own.
Do antihistamines raise blood pressure?
MedlinePlus's list of medicines that can raise blood pressure names decongestants and NSAIDs, not antihistamines on their own. The HBP cold products use antihistamines (chlorpheniramine or doxylamine) and no decongestant, and their labels do not list high blood pressure as a warning. Some allergy and cold products pair an antihistamine with a decongestant, so check every active ingredient.
Is a nasal decongestant spray OK with high blood pressure?
Ask a doctor or pharmacist first. MedlinePlus lists nasal decongestants among medicines that can cause high blood pressure, without splitting sprays from pills. Saline spray or drops do not contain a decongestant, and the CDC lists them for easing cold symptoms.
Pymander is not a replacement for a physician and does not provide medical advice, diagnosis, or treatment. Always seek the advice of a qualified health provider with questions about a medical condition. If you think you may have a medical emergency, call 911.