Written by Christina Aungst, PharmD | Reviewed by Joshua Murdock, PharmD, BCBBS Updated on June 13, 2022print_outlinedemail_outlined

Key takeaways:

• Hypertension (high blood pressure) is a common medical condition. Over time, having high blood pressure can lead to serious health problems, including heart attacks, other heart problems, and more.
• There are several risk factors for high blood pressure. There are also medications, supplements, and substances that can further elevate your blood pressure.
• There are a number of blood pressure supplements that may help people with hypertension. 

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Chronic high blood pressure is one of the most common medical ailments out there, affecting almost half of U.S. adults. Having chronic high blood pressure can also lead to a number of other health problems down the line, including stroke, heart attacks and other serious heart conditions. 

Unfortunately, many medications, supplements, and other substances can cause your blood pressure to go up. If you take these for a long time, they may have a more significant impact. 

Read on to learn about what medications, supplements, and other substances can raise your blood pressure, as well as what supplements may help lower it.

Common medications that can cause high blood pressure

Below are 10 common medications that can cause or worsen high blood pressure. If you use these medications for just a short time, your blood pressure should go back to what it was before, once you stop taking them. However, if you take them for a long time, the effects can be more long-lasting.

Some of these — like certain immunosuppressants and biologics — are important maintenance medications that happen to have blood pressure changes as a side effect. It can be dangerous to stop taking these medications without talking to your healthcare provider. If you take one of these maintenance medications, your healthcare provider can help you manage high blood pressure changes as needed. They will help you weigh the pros and cons and decide if the medication is right for you. 

1. Decongestants

Even when taken for just a few days, decongestants like pseudoephedrine (Sudafed) can make your heart beat faster and may elevate your blood pressure. Avoid or be cautious with medications that contain pseudoephedrine, phenylephrine PE (Sudafed PE), and ephedrine (Bronkaid, Primatene) if you have been diagnosed with high blood pressure. These medications can worsen your condition.

2. Certain stimulant medications, like amphetamines

Many prescription medications used to treat attention-deficit hyperactivity disorder (ADHD) are stimulants, including amphetamine salt combo (Adderall), methylphenidate (Ritalin), and methylphenidate ER (Concerta). These stimulant medications can put stress on the heart, causing some people who take them to experience high blood pressure.

3. Birth control pills that contain estrogen

Estrogen is a common ingredient in birth control pills, and taking estrogen has been shown to raise your blood pressure. So, if you have uncontrolled high blood pressure, this type of birth control may not be the best option for you. 

If this is the case, you and your healthcare provider may consider other contraception options, like progestin-only products (e.g., the “mini pill”, many IUDs, the Nexplanon implant) or non-hormonal alternatives (e.g., the copper IUD, condoms, diaphragms).

4. Non-steroidal anti-inflammatory drugs (NSAIDs)

Many over-the-counter (OTC) pain relievers, like ibuprofen (Advil, Motrin) and naproxen (Aleve), belong to the family of medications called non-steroidal anti-inflammatory drugs (NSAIDs). Taking these medications regularly can lead to high blood pressure and can worsen an existing condition. If you have high blood pressure, you should double check with your healthcare provider before taking NSAIDs.

5. Oral and injectable steroids

Corticosteroids (steroids) like prednisone, dexamethasone, and methylprednisolone are used to treat several conditions, including inflammation, allergic reactions, and certain infections. They also come with a lot of side effects, including high blood pressure. This is especially true if they’re taken for a long time. 

When possible, it is best to avoid long-term use of steroids, especially at high doses, if you have high blood pressure. Your healthcare provider will be able to help you decide if taking steroids is appropriate for you.Promotion disclosureinfo_outlined

6. Certain antidepressants

Many antidepressants can cause high blood pressure as a side effect. These include:

• Serotonin and norepinephrine reuptake inhibitors (SNRIs), like venlafaxine (Effexor)
• Atypical antidepressants, like bupropion (Wellbutrin XL)
• Tricyclic antidepressants

If you take an antidepressant medication, make sure your healthcare provider knows your full medical history. This can help them choose an antidepressant that doesn’t cause problems with your blood pressure, if that’s a concern.

7. Antipsychotics

Antipsychotics are often used to help manage health conditions like schizophrenia and bipolar disorder, but they can also be used to help treat depression. Many of the antipsychotics that are used to help boost the effects of antidepressants — like aripiprazole (Abilify), lurasidone (Latuda), and clozapine (Clozaril) — are known to cause high blood pressure.

Like with most medications, you are generally more likely to experience side effects with antipsychotics — like blood pressure spikes — when taking higher doses. If you are taking these medications, your healthcare provider will likely monitor your blood pressure, looking for any changes during checkups.

8. Certain immunosuppressants

If you’ve received an organ transplant or if you have an autoimmune condition, there’s a good chance you may be taking one or more immunosuppressants. Cyclosporine (Sandimmune) and tacrolimus (Prograf) are common immunosuppressants that can cause high blood pressure. 

If you experience blood pressure changes while taking immunosuppressant medications, make sure to let your healthcare team know. Changing immunosuppressant medications and doses can be tricky, so your providers will help you decide if your medication regimen needs to be altered. 

9. Certain biologics

Biologic medications — like adalimumab (Humira), infliximab (Remicade), and abatacept (Orencia) — are used to treat a variety of conditions, from autoimmune problems to high cholesterol and osteoporosis. While they can be effective options for a lot of people, they also can come with many side effects. While high blood pressure is a possible side effect of some biologics, the risk is pretty low (affecting between 5% to 7% of people, depending on the medication).

10. Testosterone

Low testosterone (or “low T”) is a health condition that is often treated with testosterone replacement therapy. Sometimes, people undergoing this treatment experience high blood pressure. If you’re taking testosterone, your healthcare provider will routinely monitor your blood pressure in order to make any necessary adjustments to your dose and/or treat your high blood pressure.

Herbal supplements that can raise blood pressure

It’s always important to tell your healthcare provider and pharmacist if you are taking dietary supplements or herbal remedies. 

Because the research on these products is limited, your provider may not be able to tell you much about the safety and effectiveness of the supplements you’re taking. But it is known that certain herbs may cause high blood pressure, raise your risk of heart-related effects, or interact dangerously with heart-related medications.

Herbs that are known to have a risk of these side effects are:

• Ma huang (also called ephedra)
• Guarana (an ingredient in many energy drinks)
• Ginseng
• Licorice
• St. John’s wort

Keep in mind, this isn’t a complete list of ingredients. There may be other supplements and vitamins to avoid with high blood pressure. If you notice your blood pressure going up after starting a new supplement, stop taking it and talk with your healthcare provider.

Other substances that can raise blood pressure

Medications and supplements aren’t the only things that can raise your blood pressure. You may already know this, but caffeine, alcohol, and nicotine are also common causes of high blood pressure.

Caffeine

Most people don’t consider caffeine a “drug,” especially since it’s so commonly consumed. But your morning cup of joe is a stimulant, and it can raise your blood pressure for a few hours, even if you don’t feel it. This is one reason why you’re asked to avoid it before certain medical tests and procedures.

Alcohol

You have likely heard that a small amount of alcohol every day might be good for your health, but this isn’t necessarily true. And too much alcohol can actually contribute to chronic high blood pressure, heart disease, liver problems, and more. 

The recommended maximum daily intake of alcohol is one drink, or serving, for women and two for men. Remember, one serving of alcohol is either 12 ounces (355 mL) of regular beer, 5 ounces (148 mL) of wine, or 1.5 ounces (44 mL) of liquor like gin, rum, or vodka.

Nicotine

Smoking and tobacco use is linked to many health problems, and high blood pressure is one of them. Because the nicotine in cigarettes, cigars, and chewing tobacco has stimulating effects, consuming these products may lead to issues with blood pressure.

While nicotine, along with caffeine and alcohol, is one of the most common substances associated with high blood pressure, it’s not the only one. If you notice that your blood pressure has been going up or is suddenly higher than normal, talk to your healthcare provider and make sure to tell them everything you are putting in your body — whether it’s prescribed, OTC, herbal, or another substance.

Are you at high risk for high blood pressure?

Certain genetic and lifestyle factors can put you at greater risk for developing high blood pressure (also known as hypertension), which can lead to heart disease, stroke, and kidney disease. Understand your risk so you can take steps now to help prevent future health problems.

Blood pressure supplements

While there are certain vitamins to avoid with high blood pressure, there are supplements that may actually help lower your blood pressure. The evidence is limited, but some possible blood pressure supplements include:

• Cocoa
• Fish oil
• Flaxseed
• Garlic
• Green or black tea
• Probiotics

Before starting any of these supplements, make sure to ask a pharmacist or healthcare provider if they’re OK for you to take. A provider can also advise you on whether you need medication to help control your blood pressure and which one may be right for you.

The bottom line

A number of medications, supplements, and other substances can cause high blood pressure as a side effect. But there are also many medications, and some supplements, that may help lower your blood pressure.