The Best Allergy Medications for People With High Blood Pressure

When allergy season comes around, many people find themselves desperate for relief. A stuffy nose and itchy eyes can really get in the way of going outside and enjoying the fresh air. 

Luckily, there are a lot of options when it comes to allergy medication. 

But, if you have a health condition like high blood pressure, choosing the right one is important. That’s especially true if your blood pressure isn’t well managed with medication.

What do allergy medications do to the body?

Most allergy medications work by blocking a chemical produced in the body called histamine. Histamine causes inflammation that leads to allergy symptoms. That’s why these medications are also called antihistamines.

The earliest antihistamines are sometimes referred to as first-generation antihistamines. These first-generation antihistamines, like diphenhydramine (Benadryl), are more likely to make you sleepy. Newer, second-generation antihistamines, like loratadine (Claritin), have an improved side effect profile. This means they’re less likely to make you feel drowsy. 

There’s another type of allergy medication known as a decongestant. Decongestants narrow the blood vessels in your nose. If you have a stuffy nose, this helps to reduce congestion and allows you to breathe better.

Which allergy medications are best for people with high blood pressure?

Second-generation antihistamines that aren’t combined with decongestants are the best choice for people with high blood pressure. These include oral medications like:

• Cetirizine (Zyrtec)

• Fexofenadine (Allegra)

• Loratadine (Claritin)

• Levocetirizine (Xyzal)

• Desloratadine (Clarinex)

If you have a runny or itchy nose, nasal sprays for allergies are also safe. Some examples of these are:

• Fluticasone (Flonase)

• Budesonide (Rhinocort)

• Mometasone (Nasonex)

• Triamcinolone (Nasacort)

If you have itchy eyes, you can use antihistamine eye drops safely, too. These include:

• Ketotifen (Zaditor)

• Olopatadine (Pataday)

It’s important to be aware of combination medications that include an antihistamine and a decongestant in one. These should be avoided if you have high blood pressure. 

Often, if the medication contains a decongestant, the name will have a dash and the letter “D” at the end. But you can also ask your pharmacist for help if you’re not sure.

Which allergy medications can raise blood pressure?

Figuring out which allergy medications can raise your blood pressure comes down to the ingredients. Most antihistamines are safe for people with hypertension. But decongestants should be avoided, since they can raise your blood pressure further. 

Examples of allergy medications and decongestants that can raise blood pressure are: 

• Fexofenadine/pseudoephedrine (Allegra-D) 

• Loratadine/pseudoephedrine (Claritin-D)

• Cetirizine/pseudoephedrine (Zyrtec-D)

• Desloratadine/pseudoephedrine (Clarinex-D)

Can I still take decongestants if I have high blood pressure?

Decongestants work by constricting or squeezing blood vessels in your nose. But they also affect the other blood vessels in your body. That’s why they have the potential to raise your blood pressure. 

Generally, if you have high blood pressure, you’ll want to avoid taking decongestants if you can. 

But taking decongestants is more dangerous for people whose high blood pressure isn’t well controlled by medication. And raising the blood pressure even higher can increase the risk of complications like heart attack, stroke, and kidney injury.

If you have high blood pressure in the normal range with medication, you may not need to avoid taking decongestants. More information on that is included below.

Exceptions to the rule

Research has looked at whether decongestants are safe for people who use medication to keep their blood pressure in the normal range. And experts have concluded that short-term use (3 to 4 days) of an oral decongestant is safe in these cases. These studies have found no adverse effects with pseudoephedrine (Sudafed).

Always talk with your healthcare professional before starting any medication, including for allergies. They can check for any unsafe interactions to help you avoid complications. 

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Written by:

Cherilyn Davis, MD

Cherilyn Davis, MD, is a board-certified pediatrician in New York City. She has held local and national roles at the American Medical Women’s Association including board member of the physician division and physician chair of social media.

Edited by:

Karla Robinson, MD

Karla Robinson, MD, is a medical editor for GoodRx. She is a licensed, board-certified family physician with almost 20 years of experience in health through varied clinical, administrative, and educational roles.

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