From pain medications to stimulants, know which drugs and supplements can affect your blood pressure.

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Some prescription and over-the-counter medications, as well as supplements and other substances, can raise your blood pressure. Certain ones can also interfere with medications intended to lower your blood pressure.

Here are some medications, supplements and other substances that can increase your blood pressure. If you're using any of these substances and are worried about the effect it could have on your blood pressure, talk to your healthcare provider.

Pain medications

Certain pain and anti-inflammatory medications can cause you to retain water, creating kidney problems and increasing your blood pressure. Examples include:

• Indomethacin (Indocin, others)
• Acetaminophen (Tylenol, others)
• Aspirin, naproxen sodium (Aleve, Anaprox) and ibuprofen (Advil, Motrin IB, others)
• Piroxicam (Feldene)

Have your blood pressure checked regularly. Talk to your healthcare provider about which pain medication is best for you. If you must continue taking a pain medication that raises your blood pressure, your provider may recommend lifestyle changes or additional medication to control your blood pressure.

Antidepressants

Antidepressants work by changing your body's response to brain chemicals, including serotonin, norepinephrine and dopamine, that affect your mood. These chemicals may also cause an increase in blood pressure. Examples of antidepressants that can raise your blood pressure are:

• Venlafaxine (Effexor XR)
• Monoamine oxidase inhibitors
• Tricyclic antidepressants
• Fluoxetine (Prozac, Sarafem, others)

If you take antidepressants, have your blood pressure checked regularly. If your blood pressure increases or isn't well-controlled, ask your healthcare provider about alternatives to these medications.

Hormonal birth control

Birth control pills and other hormonal birth control devices contain hormones that may increase your blood pressure by narrowing smaller blood vessels. Nearly all birth control pills, patches and vaginal rings come with warnings that high blood pressure may be a side effect. The risk of high blood pressure is greater if you're older than age 35, overweight or a smoker.

Not all women will have increased blood pressure from using hormonal birth control. But if you're worried, have your blood pressure checked at least every six to 12 months. If you already have high blood pressure, consider using a different form of birth control. While nearly all birth control pills can raise your blood pressure, your blood pressure may be less likely to increase if you use a birth control pill or device that contains a lower dose of estrogen.

Caffeine

About 200 to 300 milligrams of caffeine can cause a temporary spike in blood pressure.

Caffeine blocks a hormone that keeps your blood vessels open, allowing blood to easily pass through. This may temporarily increase blood pressure. It also may cause you to produce more cortisol and adrenaline, which speeds up blood flow, causing a spike in blood pressure. However, there isn't enough evidence to prove that caffeine raises your blood pressure long term.

Examples of caffeine-containing medications and products include:

• Caffeine pills (Vivarin, others)
• Coffee
• Energy drinks and other beverages

The caffeine content of coffee can vary widely, so it's difficult to say how many cups of coffee you can drink a day. In addition, some studies suggest that coffee may contain a substance that lowers blood pressure, thus counteracting any stimulating effects.

To see if caffeine raises your blood pressure, check your blood pressure about 30 minutes after drinking a cup of coffee or another caffeinated beverage. If your blood pressure goes up by five to 10 points, you may be sensitive to the blood pressure raising effects of caffeine.

Cold medicines (decongestants)

Decongestants narrow your blood vessels, which makes it harder for blood to flow through them, increasing blood pressure. Decongestants may also make some blood pressure medications less effective. Examples of decongestants are:

• Pseudoephedrine (Sudafed, Sudogest)
• Phenylephrine (Neo-Synephrine)

Check the label of your cold or allergy medication to see if it contains a decongestant. If you have high blood pressure, it's best to avoid decongestants. Ask your health care provider or pharmacist about over-the-counter cold products made for people who have high blood pressure.

Herbal supplements

Remember to tell your healthcare provider about any herbal supplements you take or are thinking about taking, to see if the supplement could raise your blood pressure or interact with blood pressure medications. Examples of herbal supplements that can affect your blood pressure or blood pressure medications include:

• Arnica (Arnica montana)
• Bitter orange (Citrus aurantium)
• Ephedra (ma-huang)
• Ginseng (Panax quinquefolius and Panax ginseng)
• Guarana (Paullinia cupana)
• Licorice (Glycyrrhiza glabra)
• St. John's wort (Hypericum perforatum)

Herbal supplements aren't necessarily safe just because they're natural. Check with your healthcare provider before taking any herbal supplements. You may need to avoid supplements that raise your blood pressure or interfere with your blood pressure medications.

Biological therapies

Powerful drugs used in biological therapies can have side effects, including high blood pressure. Some of these drugs target specific cells, and some use your body's own immune system to fight a variety of autoimmune diseases and cancers.

Angiogenesis inhibitors in particular and some monoclonal antibodies can cause an increase in blood pressure. Examples of these drugs include:

• Bevacizumab (Avastin, Mvasi)
• Gefitinib (Iressa)
• Imatinib (Gleevec)
• Pazopanib (Votrient)
• Ramucirumab (Cyramza)

Immunosuppressants

These drugs are given to nearly everyone who's had an organ transplant. Some immunosuppressants can raise your blood pressure, possibly because of the ways immunosuppressants can affect your kidneys. Examples of immunosuppressants that can increase your blood pressure include:

• Cyclosporine (Neoral, Sandimmune, Gengraf)
• Tacrolimus (Astagraf, Prograf, Envarsus XR)

Have your blood pressure checked regularly. If your blood pressure increases or isn't well-controlled, ask your healthcare provider about alternatives to these medications. Your provider may recommend lifestyle changes or additional medications to control your high blood pressure.

Stimulants

Stimulants, such as methylphenidate (Ritalin, Concerta, others), can cause your heart to beat faster or irregularly, raising your blood pressure.

Have your blood pressure checked regularly if you take a stimulant. If your blood pressure increases or isn't well-controlled, ask your health care provider about alternatives to these medications. He or she may recommend lifestyle changes or additional medications to control your high blood pressure.

A caution on illegal drugs

Illegal drugs can raise blood pressure by narrowing the arteries that supply blood to your heart. This increases your heart rate and damages your heart muscle.

Examples of illegal drugs that can affect your heart include:

• Amphetamines, including methamphetamine
• Anabolic steroids
• Cocaine

If you're using illegal drugs, it's important to stop. Ask your healthcare provider for information on counseling or drug treatment programs.

This article is written by Mayo Clinic Staff. Find more health and medical information on mayoclinic.org.

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