Key takeaways:
There are many options for cold medications. But if you’re living with a heart condition, you should avoid taking oral decongestants or nonsteroidal anti-inflammatory drugs (NSAIDs). They can increase your heart rate or blood pressure.
Cold medications that are unlikely to cause any heart problems include cough medications, decongestant nasal sprays, and antihistamines. But keep in mind that these medications still have other risks and side effects to know about.
Medication-free options — such as rinsing with a neti pot or using a humidifier — can help relieve cold symptoms without any heart-related risks.
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There’s no cure for the common cold, but there are a lot of options that help treat your symptoms. At your local pharmacy, you can find decongestants, pain relievers, and nasal sprays — to name a few. But if you’re living with a heart condition, some of these may be safer than others.
Below, we run through some basic guidelines for people with heart disease or high blood pressure. This way, you know how to choose the best cold medication for you.
Safe cold medications for people with heart disease
The following cold medications can help relieve your symptoms — without increasing your blood pressure or heart rate.
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Cough suppressants and expectorants
Typically, cough medications like guaifenesin (Mucinex, Robitussin) and dextromethorphan (Delsym) are considered safe to take if you have a heart condition. Just make sure you stick to the recommended dosage and take them for the shortest number of days possible. This will help you avoid other unwanted side effects, such as dizziness and upset stomach.
Antihistamines
Antihistamines don’t raise your heart rate and blood pressure. But if you have a heart condition, don’t reach for one just yet. There are a few things to understand first.
There are two types of antihistamines:
Newer antihistamines — such as cetirizine (Zyrtec) and loratadine (Claritin) — are often used to treat allergies. They’re less effective for relieving cold symptoms.
Older antihistamines — such as diphenhydramine (Benadryl) and doxylamine (Unisom) — can sometimes help with cold symptoms like a runny nose or trouble sleeping.
But older antihistamines come with a few notable risks:
They cause drowsiness. So you shouldn't combine these antihistamines with other sedating medications. And don’t drive while they’re active in your system.
They may not be safe for older adults. This is because they lead to more serious side effects in this group, like confusion and constipation. They can also increase the risk of falls in older adults.
They can interact with other medications, so it’s best to review your medication list with your healthcare team before taking one.
They’ve been linked to an increased risk of dementia. However, this is mainly a concern with long-term use.
At very high doses, Benadryl can lead to serious heart complications — such as a fast heart rate and an irregular heartbeat. So it’s important to only take antihistamines as directed and avoid taking more than recommended.
The risk of side effects decreases with short-term, occasional use of an antihistamine when you have a cold. But it’s still a good idea to check with your healthcare team or your local pharmacist before taking one. They can help you figure out if an antihistamine is safe for you.
Add GoodRx as a trusted source on GoogleAdd GoodRx as a trusted sourceDecongestant nasal sprays
You should avoid oral decongestants if you have a heart condition. (We explain this in more detail below.) But decongestant nasal sprays, such as oxymetazoline (Afrin), may be safe for some people.
One study found that decongestant nasal sprays didn’t significantly increase blood pressure. But this research was done in people without existing heart conditions. There are some case reports of nasal decongestants causing heart problems. But this was likely due to excessive use above the recommended dosage.
If you’re in need of a decongestant, nasal sprays are likely safer than oral pills. Still, it’s a good idea to check with your healthcare team before using one. And be sure to use the medication as recommended — for no more than 3 days in a row — to avoid rebound congestion.
What about Coricidin HBP?
Coricidin HBP is marketed to be a safer cold and flu option for those with heart problems or high blood pressure. It’s a combination medication that contains:
Acetaminophen (Tylenol)
Chlorpheniramine (an older antihistamine)
Dextromethorphan (a cough suppressant)
We covered older antihistamines and dextromethorphan above. Both are unlikely to raise your blood pressure. But there's mixed evidence on whether acetaminophen can raise your blood pressure. Some studies say occasional use at lower doses is unlikely to cause issues. And acetaminophen is still likely safer for your heart than similar medications, such as ibuprofen (Advil).
Keep in mind that you should only take Coricidin HBP if you need all 3 medications it contains. If you only have one or two symptoms, it’s better to take individual medications for them. This helps you avoid taking extra medication (and the possibility of side effects) you don’t need.
What cold medications should people with heart problems avoid?
People with heart conditions or high blood pressure should avoid:
Oral decongestants
Nonsteroidal anti-inflammatory drugs (NSAIDs)
Examples of oral decongestants include pseudoephedrine (Sudafed) and phenylephrine (Sudafed PE). These medications can raise your blood pressure and/or heart rate.
Examples of NSAIDs include ibuprofen (Advil, Motrin) and naproxen (Aleve, Naprosyn). People with heart problems should avoid NSAIDs because they can:
It’s important to know that decongestants and NSAIDs are included in many combination cold products. Be sure to check the over-the-counter (OTC) label of the cold medication you’re considering. Your pharmacist can also help you determine whether a certain product contains an oral decongestant or NSAID.
Good to know: Your prescriber may OK an oral decongestant or NSAID for cold symptoms if your blood pressure is well controlled or only slightly elevated. But it’s best to try medication-free treatments first. And you shouldn’t take oral decongestants or NSAIDs without your prescriber’s approval.
Tips when taking cold medications if you have a heart condition
When you’re taking cold medication, there are a few things you can do to help decrease the risk of any heart-related side effects:
Check your heart rate and blood pressure: You may already routinely check your blood pressure and heart rate at home. If you don’t, ask a healthcare professional how to do this while taking extra medication. Keep in mind that your cold can also increase your heart rate and blood pressure. But you should still let your prescriber know if your numbers are higher than usual.
Take the lowest dosage possible: Taking cold medications (even heart-friendly ones) for a longer time increases the risk of potentially harmful side effects. If your cold symptoms aren’t resolving after about 7 to 10 days, talk to your healthcare team.
Pay attention to your symptoms: Seek immediate medical help if you experience any new symptoms that could be a sign of heart trouble. These include chest pain, shortness of breath, nausea, or even extreme fatigue or weakness.
After reading this article, you may be worried about taking any cold medication at all if you have a heart condition. But the purpose here is just to make sure you know the potential problems. That way, you can take your medications safely and get help when you need it.
Many people with heart disease take cold medication without any complications or side effects. That being said, you can always start with medication-free options to relieve cold symptoms to reduce any potential issues, which is covered in the next section.
What are the best alternatives to cold medication for people with heart problems?
If you’re living with a heart condition, keep in mind there are medication-free tips for managing a cold. Sometimes, the best remedies for a cold are the most simple:
Get plenty of rest.
Drink tea with honey to help soothe your cough — and to keep you hydrated.
Gargle with salt water for a sore throat.
Rinse with a neti pot for nasal congestion.
Use a humidifier or take warm showers to help loosen congestion.
Frequently asked questions
If you’re living with heart disease, it’s best to avoid combination products like Tylenol Cold & Flu (acetaminophen / dextromethorphan / phenylephrine / guaifenesin). They often combine oral decongestants with antihistamines and/or cough medications.
Some ingredients might be safe — like the cough medications. However, the oral decongestants can raise your heart rate and blood pressure. Several types of Tylenol cold and flu products are available. A pharmacist can help you know which products are safe for you.
It’s best to avoid DayQuil if you have a heart problem. Most DayQuil products contain three main ingredients:
Acetaminophen (Tylenol)
Dextromethorphan (cough suppressant)
Phenylephrine (oral decongestant)
The oral decongestant can increase your heart rate and blood pressure. And acetaminophen may also raise your blood pressure.
If a cold medication increases your heart rate, it can cause heart palpitations. The most common cold medications that do this are oral decongestants: pseudoephedrine (Sudafed) and phenylephrine (Sudafed PE). And keep in mind that a cold itself can also increase your heart rate.
If you’re living with heart disease, it’s best to avoid combination products like Tylenol Cold & Flu (acetaminophen / dextromethorphan / phenylephrine / guaifenesin). They often combine oral decongestants with antihistamines and/or cough medications.
Some ingredients might be safe — like the cough medications. However, the oral decongestants can raise your heart rate and blood pressure. Several types of Tylenol cold and flu products are available. A pharmacist can help you know which products are safe for you.
It’s best to avoid DayQuil if you have a heart problem. Most DayQuil products contain three main ingredients:
Acetaminophen (Tylenol)
Dextromethorphan (cough suppressant)
Phenylephrine (oral decongestant)
The oral decongestant can increase your heart rate and blood pressure. And acetaminophen may also raise your blood pressure.
If a cold medication increases your heart rate, it can cause heart palpitations. The most common cold medications that do this are oral decongestants: pseudoephedrine (Sudafed) and phenylephrine (Sudafed PE). And keep in mind that a cold itself can also increase your heart rate.
The bottom line
If you’re living with a heart condition, it may feel like all cold medications are off limits. But some are safer than others — such as cough suppressants, expectorants, and decongestant nasal sprays.
The most important medications to avoid if you have a heart condition are oral decongestants and nonsteroidal anti-inflammatory drugs (NSAIDs). But don’t forget that there are many non-medication options that can help you get through a cold. Your prescriber or pharmacist can help you find a cold medication that’s safe for you.
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References
Bellew, S. D., et al. (2018). Effect of intranasal vasoconstrictors on blood pressure: A randomized, double-blind, placebo-controlled trial. The Journal of Emergency Medicine.
Pakkir, M., et al. (2026). Cardiovascular and cerebrovascular events linked to abuse and misuse of sympathomimetic nasal decongestants: A narrative review of clinical evidence. Cardiovascular & Hematological Agents in Medicinal Chemistry.
