Is Tylenol Safe If You Have High Blood Pressure? A Look at the Research

Tylenol (acetaminophen) is an over-the-counter (OTC) medication used to treat 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 OK for you to take. 

Here we’ll review what research says about Tylenol and high blood pressure as well as what to look for in different versions, so you can decide what’s right for you.

Is it OK to 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 did not find an increase in blood pressure compared with a similar group that 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, while there’s some evidence 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 other medications.

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

There are different versions of OTC Tylenol. Some of these versions contain different doses of acetaminophen in each pill. Other versions have Tylenol combined with other OTC medications to treat common problems like difficulty sleeping, cold and flu symptoms, and sinus headaches. 

When you’re looking at different versions of Tylenol at your pharmacy, it helps to know how these other medications can affect your blood pressure. You’ll find a list of the medications in each version of Tylenol by looking at the label on the bottle or box. Here are some common OTC versions you can find:

Extra Strength Tylenol

Extra Strength Tylenol contains only Tylenol and no other medications. Compared with Regular Strength Tylenol, it contains a higher dose of acetaminophen per pill — 500 mg 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 Arthritis

Tylenol Arthritis contains a higher dose of acetaminophen per pill (650 mg) than both Regular and Extra Strength Tylenol. Since it’s a higher dose, Tylenol Arthritis is taken less often — every 8 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 it be used for insomnia.

Tylenol Sinus 

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

• 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 your healthcare provider first before taking a version of Tylenol with one of these decongestants.

• Antihistamines can help with congestion. The most common antihistamine is Benadryl. Other examples of antihistamines in cold medicines are chlorpheniramine and doxylamine (Unisom). Like Benadryl in Tylenol PM, they won’t raise your blood pressure.

• 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.

Most medications you’ll find in different versions of Tylenol are safe to take if you have high blood pressure. The two key points when comparing Tylenol products is to look for:

• The amount of Tylenol in each dose

• Decongestants, which can raise your blood pressure

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

In addition to Tylenol, nonsteroidal anti-inflammatory drugs (NSAIDs) are the other main category of OTC medications used to treat pain, fever, and other common conditions. NSAIDs are medications like ibuprofen (Motrin, Advil) and naproxen (Aleve, Naprosyn). They are known to raise blood pressure and can interfere with the effectiveness of some high blood pressure medications.

This doesn’t mean that you can’t take Tylenol or NSAIDs if you have high blood pressure. But first talk about this with your healthcare provider to check your options. Depending on your symptoms, your provider may suggest a safer alternative — either OTC or prescription.

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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.

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