Does Tylenol Raise Blood Pressure?

Key takeaways:

For people with high blood pressure, Tylenol (acetaminophen) has been considered the safest over-the-counter (OTC) pain medication. It’s still a safe choice, but emerging evidence shows it may affect blood pressure.
There are several versions of Tylenol. Some Tylenol products may be safer than others for people with high blood pressure.
If you have high blood pressure and need OTC medication for pain relief, discuss this with your primary care provider. They can help you choose the safest option.

Tylenol (acetaminophen) is a popular over-the-counter (OTC) medication for pain and fever. You can also find it combined with other OTC medications to treat cold and flu, sinus symptoms, and occasional sleeping problems.

For most people, it’s safe and effective at the recommended doses. But, if you have high blood pressure (hypertension), you may be wondering if it’s a safe choice. Here we’ll review what the research says about whether Tylenol will raise your blood pressure.

Can you take Tylenol if you have high blood pressure?

If you have high blood pressure, Tylenol has long been regarded as a safe choice for OTC pain relief. But there’s still some evidence that Tylenol may raise blood pressure.

One large study from 2013 looked at people with high blood pressure who were prescribed Tylenol. It didn’t find an increase in blood pressure compared with a similar group of people who didn’t take Tylenol.

A study from 2022 had different results. It showed that people with high blood pressure who took the maximum daily dose of Tylenol (4 g per day) every day for 2 weeks did have an increase in blood pressure. Their average daytime systolic blood pressure (the top number) increased by about 5 mmHg. Even though this study showed an increase in blood pressure in people taking Tylenol, this was at the highest dose. Most people don’t take this much on a regular basis. And an increase in systolic blood pressure of about 5 mmHg is relatively small. But, if the blood pressure stays high, this could still be enough to warrant an increased dose of blood pressure medication.

So, although there’s some evidence that Tylenol can raise blood pressure, researchers are still working to figure out the details. We need more research to know:

Exactly how Tylenol works in the body to raise blood pressure
If taking Tylenol when you have high blood pressure increases your risk of heart disease
If Tylenol interferes with how well your blood pressure medicines work
If lower doses are less likely to increase blood pressure

Given the present research, it makes sense to pay attention to how much Tylenol you’re taking if you have high blood pressure. But you should also pay attention to combination Tylenol products that contain additional medications.

Are other versions of Tylenol safe if you have high blood pressure?

There are several versions of OTC Tylenol. Some contain different doses of acetaminophen than others. And sometimes Tylenol is combined with other OTC medications to treat common problems like:

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When you’re looking at different Tylenol products at your pharmacy, it helps to know how the other added medications can affect your blood pressure. You’ll find a list of the ingredients on the label, found on the bottle or box.

Here are some common OTC Tylenol products.

Tylenol Extra Strength

Tylenol Extra Strength contains only Tylenol and no other medications. Compared with regular-strength Tylenol, it contains a higher dose of acetaminophen per pill. The extra-strength version contains 500 mg of acetaminophen per pill, compared with 325 mg in a regular-strength pill.

Follow the instructions on the back of the package to be sure you’re taking the right dose. This prevents problems, like liver damage, that can occur from taking too much Tylenol.

Tylenol for arthritis pain

Tylenol 8 HR Arthritis Pain Relief contains a higher dose of acetaminophen per pill (650 mg) than both regular- and extra-strength Tylenol. Since it’s a higher dose, Tylenol’s arthritis medication is taken less often — every 8 hours. (Regular-strength Tylenol is taken every 4 to 6 hours.)

Tylenol PM

Tylenol PM combines acetaminophen with diphenhydramine (Benadryl). Diphenhydramine is an antihistamine that causes drowsiness, so some people use it to fall asleep. Antihistamines, like diphenhydramine, aren’t known to raise blood pressure. But it’s worth noting that research doesn't show that it improves sleep quality, so experts don’t recommend using it for insomnia.

Tylenol for sinus pain and congestion relief

There are various Tylenol products available to help with sinus and congestion problems, as well as cold and flu symptoms. Here are medicines you’ll find in these versions of Tylenol:

Decongestants: Decongestants, like phenylephrine (Sudafed PE) and pseudoephedrine (Sudafed), relieve nasal and sinus congestion. But these can raise your blood pressure. If you have high blood pressure, it’s a good idea to talk with a healthcare professional first before taking a version of Tylenol with one of these decongestants.
Antihistamines: Antihistamines can help with congestion. One of the most common antihistamines is diphenhydramine. Other examples of antihistamines in cold medicines are chlorpheniramine and doxylamine (Unisom SleepTabs). These won’t raise your blood pressure.
Cough medicines: Cough medicines, like dextromethorphan (Delsym) and guaifenesin (Mucinex), help by suppressing your cough and clearing mucus. They’re OK to take if you have high blood pressure. Just be aware that versions of Tylenol that contain cough medications may also contain the decongestants listed above.

Motrin Dual Action with Tylenol

Motrin Dual Action with Tylenol is primarily an ibuprofen (Motrin) product, but it’s combined with acetaminophen (Tylenol). Since this product contains ibuprofen, it may be less safe if you have high blood pressure. Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAIDs), which carries these risks:

Increased blood pressure
Interactions with common blood-pressure medications
Increased risk of heart attack when taken at high doses or long term

Recap: What to look out for

In short, most medications you’ll find in different versions of Tylenol are safe to take if you have high blood pressure.

When comparing Tylenol products, look for:

The amount of Tylenol in each dose
Decongestants (which can raise your blood pressure)
Any combination that includes an NSAID, like ibuprofen (which can raise your blood pressure and interact with blood-pressure medication)

Which pain medications are safe if you have high blood pressure?

In addition to Tylenol, NSAIDs are the other main category of OTC medications used to treat pain, fever, and other common conditions. NSAIDs include medications like ibuprofen (Motrin, Advil) and naproxen (Aleve, Naprosyn).

As mentioned above in the discussion about Motrin Dual Action with Tylenol, NSAIDs aren’t usually the safest choice for people with high blood pressure. They can increase blood pressure, interact with blood-pressure medications, and increase your long-term risk of heart problems.

This doesn’t mean that you can’t take Tylenol or NSAIDs if you have high blood pressure. But talk with a healthcare professional first to check your options. They may suggest a safer OTC or prescription alternative. And it’s a good idea to monitor your blood pressure whenever you start taking a new medication.

Frequently asked questions

The safest pain reliever to take on a daily basis depends on your other health conditions and medications. For example, acetaminophen (Tylenol) may be safer than ibuprofen (Advil) for someone with kidney disease. But ibuprofen may be safer than acetaminophen for someone with liver disease. For most people, one of the safest pain relievers is often a topical treatment, like diclofenac gel (Voltaren Arthritis Pain) or a lidocaine patch. These pain relievers are applied directly to the area of pain. Since the medication gets absorbed locally rather than through the entire body, this lowers the risk of unwanted side effects or impact on your other health conditions.

Some versions of Tylenol’s sinus medications contain decongestants, like pseudoephedrine. This can raise your blood pressure and heart rate. If you have high blood pressure, it’s best not to take a Tylenol sinus medication until you discuss this with a healthcare professional.

The maximum daily dose of Tylenol for adults is 4,000 mg. But that dose may not be safe for everyone, especially on a daily basis. If you have certain health conditions — like liver disease or high blood pressure — you may need to stay at a lower dose.

The bottom line

If you have high blood pressure, it’s important to know which over-the-counter (OTC) medications are safe. For a while experts have known that nonsteroidal anti-inflammatory drugs (NSAIDs) and decongestants can raise blood pressure. But some evidence suggests that Tylenol (acetaminophen) may also have an effect. This doesn’t mean that you can never take Tylenol — especially if your blood pressure is well controlled. But, before you start taking Tylenol, talk with a healthcare professional about how to use this medication safely.

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Written by:

Sarah Pozniak, MD

Sarah Pozniak, MD, has 9 years of experience since graduating medical school (6 since completing residency). She is a board-certified general internal medicine physician and has practiced as a primary care physician in both Utah and Washington, D.C. Currently, she cares for patients with chronic illnesses such as diabetes and high blood pressure using telemedicine as part of a virtual care program.

Edited by:

Katie E. Golden, MD

Katie E. Golden, MD, is a board-certified emergency medicine physician and a medical editor at GoodRx.

Reviewed by:

Christina Aungst, PharmD

Christina Aungst, PharmD, is a pharmacy editor for GoodRx. She began writing for GoodRx Health in 2019, transitioning from freelance writer to editor in 2021.

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