Can I Take Allergy Medicine With High Blood Pressure?

Suppose you are one of the over 50 million Americans who suffer from allergies each year¹. In that case, allergy season often seems to be never-ending. If you are one of these allergy sufferers, the runny nose, congestion, sneezing, itchy nose and eyes, and red and watery eyes can have you hastily searching for relief.

For many allergy sufferers, these symptoms lead to a trip to the local pharmacy. There is a wide variety of over-the-counter medications available, formulated to provide relief of allergy symptoms. However, a common concern that people with hypertension have is whether they can safely take allergy medicine without causing their blood pressure to increase.

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What types of medications are used to treat allergies?

Allergy medications are available in several forms, including pills, liquids, inhalers, nasal sprays, and eye drops. While there is no cure for allergies, allergy medications can help provide relief from your symptoms.

One of the most common medications used to treat allergy symptoms is an antihistamine. This type of drug blocks chemicals known as histamines, which are produced by your body when you experience an allergic reaction.

Histamines send signals between cells and work with the immune system to help protect our bodies from foreign invaders. However, when your immune system overreacts to harmless substances, such as pet dander or pollen, histamines cause tearing in the eyes, swelling, and congestion in the nose. They can also affect your nerves, causing itchiness.

One of the most common symptoms in patients who suffer from allergies is nasal congestion. A nasal corticosteroid spray² can often reduce nasal swelling and prevent or provide relief for stuffiness, sneezing, or a runny nose.

Finally, some allergy medications contain decongestants³, which you should avoid if you have high blood pressure. Generally, over-the-counter medications that treat multiple symptoms may contain a combination of these medications.

Is it safe to take allergy medicine if you have high blood pressure?

There’s a wide range of types and combinations of allergy medications on the market, so you may need a little help figuring out which one to take.

For example, if you're taking medication for high blood pressure, you should talk to your pharmacist or healthcare provider about your options before taking any over-the-counter medications. While some allergy medications are considered safe for people with high blood pressure, others can increase your blood pressure or interact with your blood pressure medications.

While allergies don't directly cause high blood pressure, nasal congestion and impaired breathing can affect blood pressure² and potentially cause serious problems for people with high blood pressure. Nasal corticosteroid sprays are a primary treatment option for nasal congestion and are also generally safe for people with high blood pressure, though they can impact water retention in the body. For that reason, you should consult with your doctor before using them.

Nasal corticosteroid sprays effectively reduce swelling and mucus production in the nasal passageway so that you can breathe easier. Research also shows that along with clearing your nasal passages during an attack of allergic rhinitis, intranasal steroids may also help lessen blood pressure².

Should certain ingredients be avoided, and why?

Antihistamine medications can come with a range of adverse effects, depending on the specific drug. For example, while most allergy medications are considered to be safe for people with high blood pressure, some, such as terfenadine and astemizole, can cause arrhythmias⁴ in some patients.

Typically, first-generation antihistamines⁵ produce more side effects than second or third-generation antihistamines. Drugs such as diphenhydramine, clemastine, triprolidine, and ketotifen can cross the blood-brain barrier⁶ easier than newer antihistamines, sometimes impacting cognitive function. The blood-brain barrier refers to a critical part of the immune system, which keeps pathogens from moving from the bloodstream, into the brain.

Antihistamines that can help with the congestion associated with allergies and are safer for the heart include cetirizine, fexofenadine, and loratadine.

If you have high blood pressure, you should not use decongestants. Although these medicines can relieve nasal congestion and improve breathing, decongestants can worsen your existing high blood pressure⁷.

Decongestants reduce nasal congestion by causing the blood vessels in the nose to constrict, which reduces swelling in the nose and allows you to breathe easier. However, it can also cause blood vessels in other parts of the body to constrict, which can increase your blood pressure. Some studies have found that decongestants such as pseudoephedrine⁸ or phenylephrine⁹ have the potential to cause a statistically significant rise in blood pressure.

It's also worth noting that many miscellaneous over-the-counter allergy medications that treat multiple symptoms contain several drugs, including an antihistamine and a decongestant. They may be labeled as treatments for cold and allergy relief, but if you decide to take an over-the-counter allergy product, choose one that doesn't contain a decongestant and be cautious with the type of antihistamines you choose.

With the many over-the-counter allergy medications available, it's always best to check with your doctor before taking any medicine if you are unsure about its compatibility with your high blood pressure.

Other ways to reduce and relieve allergy symptoms

While allergies can produce a variety of symptoms, one of the most common is itching, burning, stinging, or watery eyes. When you have an allergic reaction to pollen, dust, pet dander, or any allergen, the histamines released by your body can leave your eyes irritated until the allergen is gone. One effective method of relieving these symptoms is the use of eyedrops.

Allergy eye drops, such as Ophthalmic ketotifen and prescription ophthalmic olopatadine, and nonprescription ophthalmic olopatadine are safe options for itchy and watery eyes. Both ketotifen and olopatadine are antihistamines. These medications work by blocking the actions of histamines and provide safe, effective relief for itchy, watery eyes that are the result of many allergens.

Rinsing your nasal passageways with saline solution or nasal irrigation¹⁰ is a simple, inexpensive, and effective way to relieve a variety of sinus and nasal conditions associated with allergies. Flushing the nasal cavity with saline solution can remove dust and pollen and help to loosen thick mucus. While plain water can irritate the mucous membranes, the saline solution can pass through delicate nasal membranes with little or no discomfort or irritation. In addition, nasal irrigation is safe for all ages, with no documented serious adverse effects reported.

There are various ways to deliver saline into the nasal cavity. Nasal spray bottles can deliver a fine mist of saline solution and may be helpful to moisturize dry nasal passages; however, nasal irrigation devices are more effective at clearing out mucus, allergens, and bacteria and relieving congestion.

While irrigation devices may differ slightly, they all work in the same fundamental way:

  • Start by leaning your head sideways over a sink, with your forehead and chin roughly level to keep the saline solution from running into your mouth.

  • While breathing through your open mouth, insert the spout of your irrigation device into your upper nostril and allow the solution to drain through the lower nostril.

  • Clear your nostrils, tilt your head in the other direction and repeat the process on the other side.

While nasal irrigation is a safe and effective treatment, it's important to avoid using tap water because it's not adequately filtered or treated for use as a nasal rinse. Tap water sometimes contains low-level organisms such as bacteria and protozoa that may be harmless if swallowed because they die in the digestive system. However, these organisms can stay alive in the nasal passages and lead to potentially serious infections. According to the Centers for Disease Control and Prevention (CDC)¹¹, in some rare cases, these infections may even be fatal.

Three types of water are safe for use in nasal irrigation:

  • Distilled or sterile water can be purchased at the store and will be labeled as "distilled" or "sterile."

  • Tap water that has been boiled for three to five minutes and then is allowed to cool to a lukewarm temperature. Boiled tap water may be stored in a clean, closed container for use within 24 hours.

  • Water that has passed through a filtration system that is designed to trap and remove potentially infectious organisms.

Why is it important to speak to your healthcare professional before taking allergy medication if you have high blood pressure?

While some allergy medications are safe to take with high blood pressure, many are not. For example, allergy medications that contain a decongestant should always be avoided, as well as some antihistamines. Additionally, there is also a risk of drug interactions that can lead to dangerously high blood pressure.

In some cases, interactions may increase the side effects of allergy medicine, while in others, it may counteract the effects of your blood pressure medication. Therefore, if you have high blood pressure, you should always consult your pharmacist or doctor before deciding to take over-the-counter allergy medication.

The lowdown

The symptoms caused by allergies can be annoying and interfere with daily activities. Often, people seek relief through the use of over-the-counter medications. While many of these products may temporarily relieve your allergy symptoms, they can be dangerous if you have high blood pressure. If you have high blood pressure, you should consult with a healthcare professional before taking any medication in addition to that prescribed by your doctor.

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