Decongestants That Don’t Affect Blood Pressure

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Safer Alternatives for Nasal Congestion

Having high blood pressure doesn’t mean you’re without options. Whether you’re looking for an alternative over-the-counter (OTC) medication or a natural remedy you can execute at home, you don’t have to live with the discomfort of congestion.

Antihistamines for Allergy Symptom Prevention

If allergies are the source of the congestion, medicines containing antihistamines are commonly used as alternatives to decongestants. Histamine increases mucus and mucus production, especially in people with allergies. By blocking the action of histamine, antihistamines can reduce mucus, ultimately decreasing nasal congestion.

Antihistamines can also be helpful for prevention. OTC medications like loratadine (Claritin) or fexofenadine (Allegra) are safer, decongestant-free choices that you can reach for before those symptoms start to kick up. Unfortunately, Dr. Patel says if allergies aren’t the source of your sinus pressure, antihistamines won’t be an effective choice for your acute symptoms.

Nasal Sprays

For allergy-related congestion, Patel also suggests inhaled corticosteroids like fluticasone (Flonase). Similar to an antihistamine, Patel says this won’t work for an acute, cold-related stuffy nose, but can support and prevent congestion due to allergies.

Other nasal sprays options include:

  • Oxymetazoline Nasal Spray (such as Afrin): This is an OTC option that is often effective for quick relief. It is important to note this product should not be used for more than three days. Both Patel and Jones say it leads to rebound symptoms – this means that using it longer than the recommended time will likely cause your congestion to return.
  • Phenylephrine Nasal Spray (such as Neo-Synephrine): Another localized spray option that you can grab from the pharmacy without a prescription. Similar to the Oxymetazoline, this product should not be used for more than three days.

Patel also says although the risks for increased blood pressure with phenylephrine nasal spray are not as significant as an oral decongestant, they are still present.

Try a Specialty Line

If you’ve already tried the natural remedies and allergies aren’t at the root of your congestion, you might consider a decongestant brand tailored toward people with hypertension. An example is Coricidin HBP, which uses a combination of the antihistamine Chlorpheniramine alongside cough suppressants and pain-relievers like acetaminophen to treat cold and flu symptoms.

“Coricidin HBP is a safer option for patients with high blood pressure because it avoids decongestants that can raise blood pressure, but it’s not a true decongestant,” Patel says.

Because of this, Patel encourages her patients to choose simple products based on their specific symptoms and to read labels carefully, “because even ‘heart-safe’ doesn’t always mean risk-free.”

Tread Lightly with NSAIDs

You might be tempted to try an NSAID, like ibuprofen (Advil) for that sinus inflammation, but the experts warn against this as a first-line defense as well. Even though NSAIDs like Advil and Motrin are over-the-counter and generally safe, they also have the potential to affect your blood pressure, so you should check in with your primary care provider before using to treat congestion, especially if it’s an ongoing problem.

Jones says, “There are other cold and flu formulations that aren’t necessarily decongestants, but contain things like ibuprofen, which can also raise your blood pressure. I really urge people to look at the little asterisk on all of the boxes.”



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