7 Side Effects of Blood Pressure Medications You Should Know About

Nearly 120 million U.S. adults live with high blood pressure. Untreated high blood pressure puts you at a greater risk for heart disease, stroke, and chronic kidney disease. It can even affect your eyesight.

High blood pressure medications can help reduce these risks and protect your heart health. But they also come with side effects to be aware of. Here, we’ll review the most commonly prescribed blood pressure medications and the side effects you may experience while taking them.

Common blood pressure medications

The most common medication classes used to lower blood pressure include:

• Angiotensin-converting enzyme (ACE) inhibitors, such as lisinopril (Zestril, Qbrelis) 

• Angiotensin II receptor blockers (ARBs), such as losartan (Cozaar)

• Diuretics, such as hydrochlorothiazide and furosemide (Lasix)

• Beta blockers, such as metoprolol (Lopressor, Toprol XL)

• Calcium channel blockers (CCBs), such as amlodipine (Norvasc, Katerzia) and verapamil (Verelan)

Below, we’ll look at seven blood pressure medication side effects to be aware of. Keep in mind that each type of blood pressure medication has its own risks and side effects to consider. Your healthcare team can provide more specific information based on the exact medication you’re taking.

1. Dizziness or feeling lightheaded

Dizziness is a common side effect of blood pressure medications. You may also feel lightheaded, especially when sitting up or standing (orthostatic hypotension).

These side effects are likely related to the drop in blood pressure that happens when you start taking blood pressure medications or after a dose increase. In most cases, the dizziness will go away as your body adjusts to the medication.

In the meantime, take your time when changing positions to give your body time to adjust. And use caution when driving or during activities that require coordination until you know how your blood pressure medication affects you. Let your prescriber know if your dizziness worsens or doesn’t improve over time.

Good to know: Dizziness can also be a sign of dehydration. This is more common with diuretics, since they remove excess fluid from the body. Be sure to stay hydrated to help prevent this.

2. Fatigue

Blood pressure medications can make you feel tired or fatigued as a result of your lowered blood pressure. This side effect can be more severe with beta blockers and CCBs. That’s because these medications can also slow your heart rate, along with lowering your blood pressure, which can make fatigue more likely.

In most cases, your energy levels will return as your body adjusts to a lower blood pressure. But let your prescriber know if you’re unable to participate in normal daily tasks or are feeling extreme fatigue after a few weeks have passed.

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3. Nausea

Nausea can occur with any blood pressure medication. But it seems to be more likely with beta blockers and ARBs.

Nausea should go away on its own over time. In the meantime, try eating smaller meals and avoiding spicy or fried foods, which may worsen nausea. Taking your dose with a small snack (if your healthcare team OKs it) and staying hydrated can also help. But if your nausea doesn’t go away or becomes bothersome, let your prescriber know.

4. Diarrhea or constipation

Blood pressure medications can affect your bowel movements, causing either diarrhea or constipation. Constipation is more likely with CCBs, while diarrhea is more common with ARBs and ACE inhibitors. Beta blockers can cause both diarrhea and constipation.

Staying hydrated is important to help prevent and manage constipation. It can also prevent dehydration from diarrhea. In most cases, bowel changes will resolve on their own. But talk to your prescriber about an over-the-counter treatment option in the meantime, if needed.

5. Peeing more often

Diuretics lower blood pressure by removing extra fluid from the body. They do this by making you pee more often. But this side effect is specific to diuretics. It isn’t a common side effect of other types of blood pressure medication.

While this side effect can be annoying, it’s a sign the medication is working. If your prescriber OKs it, taking your diuretic in the morning can help you avoid nighttime trips to the bathroom. But let them know if frequent urination is disruptive to your daily life. They may make changes to your medication to help reduce this issue for you.

Good to know: Don’t avoid liquids in an effort to reduce how often you need to pee while taking a diuretic. This can lead to dehydration and unwanted changes in your electrolyte levels. Your prescriber can help you determine your daily fluid goals based on your personal history. 

6. Dry cough

Some people taking ACE inhibitors may develop a dry cough. This is another side effect that’s specific to one type of blood pressure medication — most others don’t typically cause it.

A dry cough can develop soon after starting an ACE inhibitor or even months later. This cough isn’t dangerous, but it can be annoying. Unfortunately, the only way to get rid of the cough is to stop taking your ACE inhibitor. But you shouldn’t stop taking it on your own. Instead, let your prescriber know if your cough is bothersome. They can help you safely switch to a different blood pressure treatment.

7. Swollen ankles

CCBs can cause your ankles to swell, another class-specific side effect. Swollen ankles are more common with CCBs such as amlodipine, nifedipine (Procardia XL), and felodipine. Diltiazem (Cardizem) and verapamil are less likely to cause this side effect.

If your ankles become puffy or feel tight while taking a CCB, let your prescriber know. They may recommend wearing compression socks or elevating your legs to help. In some cases, you may need a lower CCB dosage or an additional medication to manage this side effect.

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Written by:

Emilie White, PharmD

Emilie White, PharmD, is a clinical pharmacist with over a decade of hospital pharmacy experience. Her professional areas of interest include critical care as well as infectious and autoimmune diseases.

Edited by:

Stacia Woodcock, PharmD

Stacia Woodcock, PharmD, is a pharmacy editor for GoodRx. She earned her Doctor of Pharmacy degree from the University of Kentucky and is licensed in New York and Massachusetts.

Reviewed by:

Austin Ulrich, PharmD, BCACP

​​Austin Ulrich, PharmD, BCACP, is a board-certified ambulatory care clinical pharmacist. Ulrich’s experience includes direct patient care in hospital and community pharmacies.

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