Decongestants That Don’t Affect Blood Pressure

Decongestants are used to reduce nasal stuffiness or congestion caused by allergies, the common cold or other infections. Nasal congestion occurs because of swelling of tissues lining the nose or the accumulation of secretions within the nose. Decongestants reduce congestion by acting directly on blood vessels in the nasal lining, causing the vessels to become narrower. This reduces swelling of the lining tissues. But decongestants may affect blood vessels outside the nose as well. When blood vessels are narrowed in other parts of the body, the blood pressure can increase. While the increase is usually small, it can be especially important in people who already have high blood pressure. All decongestants can potentially increase blood pressure, but it is less likely with nasal sprays or drops than with oral decongestants. Treating nasal congestion by natural methods or medicines that don’t contain decongestants are the best ways to avoid any effects of decongestants on blood pressure.

Oral Versus Nasal Decongestants

When decongestants are taken by mouth as pills or liquids, they are first absorbed from the gut into the bloodstream. As they travel through the blood, the decongestants enter blood vessels throughout the body, causing the vessels to narrow and the blood pressure to rise. Pseudoephedrine (Silfedrin, Sudafed) and phenylephrine (Sudafed PE) are examples of oral decongestants.

When decongestants are used as nasal sprays or drops, they act primarily in the nose. A small amount of decongestant will be absorbed from the nose into the bloodstream, but the quantity reaching other areas of the body is much less than with oral decongestants. Oxymetazoline (Afrin, Dristan), phenylephrine (Neo-Synephrine), naphazoline (Privine) and propylhexedrine (Benzedrex) are nasal decongestants. The risk of increased blood pressure may be less with propylhexedrine than with the first 3 drugs.

Non-Decongestant Medicines

Medicines containing antihistamines are commonly used as alternatives to decongestants. Histamine increases nasal secretions, especially in people with allergies. By blocking the action of histamine, antihistamines can reduce secretions and decrease nasal congestion. Common over-the-counter antihistamines include chlorpheniramine (Chlor-Trimeton), loratadine (Claritin) and cetirizine (Zyrtec). Coricidin HBP and Nyquil HBP are product lines of cold and flu combination medicines marketed specifically for people with hypertension. Both contain antihistamines but no decongestants.