Primary Care in Rochester and Kasson

Do you have high blood pressure?

7/19/2021 by Laurel Lake, Pharm.D., R.Ph.


Consumers purchase many over-the-counter and herbal products each year. While they tend to think about these products as being safe, side effects can occur. When combined with a prescription, these products can worsen or cause new side effects, or lessen the response of that prescription.

Prescriptions for hypertension, or high blood pressure, are one example of medications that can be affected by over-the-counter and herbal products. Considering that nearly half of adults in the U.S. have hypertension or are taking a prescription for hypertension, it's important to be mindful of these potential interactions.

Several over-the-counter products have been shown to increase blood pressure, even when used as labeled. For example, nonsteroidal anti-inflammatory drugs used to treat pain, such as ibuprofen (Advil or Motrin) or naproxen sodium (Aleve) can increase blood pressure, as can decongestants to treat colds, such as pseudoephedrine (Sudafed) and phenylephrine (Sudafed-PE and Neo-Synephrine). Look for these ingredients in many other combination products for colds.

Herbal products also can increase blood pressure, including ginkgo, ephedra, licorice, caffeine, saw palmetto and St. John's wort. Other herbal products that can contribute to increased blood pressure include arnica, bitter orange, blue cohosh, dong quai, guarana and yohimbine.

If you've been told you have high blood pressure or are using a prescription to treat high blood pressure, talk to a member of your health care team before starting herbal or over-the-counter products to ensure they're safe for you. It's important to check the ingredient list on herbal and other over-the-counter products you take.

Since many herbal products have not been well-studied, it may be difficult to predict the exact effects on blood pressure. Further, some products can lower blood pressure, increasing the risks of side effects. If you decide to start an over-the-counter or herbal product, you're encouraged to closely monitor your blood pressure to watch for changes.

Laurel Lake, Pharm.D., R.Ph., is a pharmacist completing her residency training in ambulatory care at Mayo Clinic in Rochester.