Can Blood Pressure Medicine Make You Tired? How to Manage Fatigue

Blood pressure medications can treat high blood pressure (hypertension), control heart rate in atrial fibrillation, and improve survival  after a heart attack. But can the same medications that help your heart stay strong also make you tired?

It’s a possibility. Beta blockers are the blood pressure medications most likely to cause fatigue. In one study, a quarter of people with cardiovascular disease taking a beta blocker stopped it within one year — mainly due to side effects.

So, what should you do if you think your blood pressure medications are sapping your energy? We’ll take a look here. 

Why do blood pressure medications cause fatigue?

There are several reasons why blood pressure medications can cause fatigue. Medications used for hypertension can cause one or more of the following:

• Low blood pressure, which is exactly what blood pressure medications are supposed to do. But if your blood pressure gets too low, it can cause fatigue. However, “too low” depends on the person and how high your blood pressure was in the first place.

• Low heart rate, which happens more often with beta blockers. Again, “too low” is different for different people.

• Depressed sympathetic nervous system, which is the “fight or flight” part of the nervous system. It’s also the part of the nervous system that makes us feel more awake.

• Electrolyte imbalances like low sodium, potassium, or magnesium, which can lead to fatigue, dizziness, and even falls.

Which blood pressure medications cause fatigue?

Most blood pressure medications can cause fatigue, for the reasons we just talked about. But some of the more common culprits include:

Beta blockers

• Carvedilol (Coreg)

• Metoprolol (Toprol)

• Atenolol (Tenormin) 

Calcium channel blockers

• Amlodipine (Norvasc)

• Nifedipine (Procardia)

• Diltiazem (Cardizem)

• Verapamil (Calan)

ACE inhibitor/ angiotensin II receptor blockers 

• Lisinopril (Prinivil, Zestril)

• Losartan (Cozaar)

• Valsartan (Diovan)

Diuretics

• Hydrochlorothiazide (HCTZ)

• Chlorthalidone (Hygroton)

• Spironolactone (Aldactone) 

Could your fatigue be from something else?

According to the National Sleep Foundation, half of Americans feel tired anywhere from 3 to 7 days per week.  If you felt more energetic before starting your blood pressure medication, your new prescription may be to blame. 

That said, there are many other causes of fatigue that are unrelated to medications. Some of these include:

• Lack of quality sleep: This may seem obvious, but not getting enough sleep at night can lead to fatigue during the day. Stress, alcohol, and medical conditions like sleep apnea  — a breathing disorder that interrupts deep sleep — are common reasons for poor quality sleep.

• Poor nutrition: Your body is like a car,  and it needs high-quality fuel to run well. Eating foods with too much added fat, sugar, and preservatives — and low nutritional value —  can lead to low energy levels.

• Not moving enough: Physical activity strengthens your heart and lungs, and allows your body to use energy more efficiently. If you aren’t getting enough exercise, you’re at risk for health issues and fatigue.

• Carrying excess weight: Overweight and obesity can cause various medical issues and drain your energy.   

• Feeling blue: People with depression commonly feel tired. Low mood can lead to sleep problems, and lower energy and motivation levels.

• Medical problems: Many medical issues can lead to fatigue including hypothyroidism, anemia, and cancer. That’s why it is important to check in with your healthcare providers frequently so they can monitor you for these issues.

How do you deal with fatigue from blood pressure medication?

What should you do if you are feeling tired after starting a new blood pressure medication? 

First, be patient. It can take a few weeks to get used to a new medication — and sometimes side effects can go away on their own. Other suggestions to help combat fatigue related to blood pressure medication include:

• Exercise regularly. Keeping active can reduce fatigue, and this is true even if you are on a medication that lowers your heart rate, like a beta blocker. Check with your provider about what your target heart rate should be when you exercise on your new medication.

• Make healthy food choices. Opt for a diet high in vitamins and minerals, and low in processed foods and sodium. This is true for everyone, but especially if you are trying to control your blood pressure and boost your energy.

• Up your electrolytes. Diuretic medications can lower electrolyte levels such as sodium, potassium, and magnesium,  which can lead to fatigue. Eating and drinking good sources of electrolytes can help.

When it comes to blood pressure treatment, it often takes a few tries to figure out which medication — and what dose — is right for you. Many people who have side effects from one medication do just fine on another.

And remember, even if you think your blood pressure medication is making you tired, never stop taking it suddenly. Stopping a blood pressure medication abruptly without guidance can cause dangerous surges in heart rate and blood pressure. That’s why it’s important to stay in touch with your healthcare team about medication side effects and instructions for how to start and stop medications safely. 

When should you see a doctor?

If you’ve recently started a new blood pressure medication, mild fatigue is likely nothing to worry about. It will probably improve in a few weeks. But sometimes, low energy levels may be a sign that something more serious might be going on. Contact your provider’s office if:

• You are having other symptoms in addition to fatigue like dizziness when standing, feeling like you are going to pass out, chest pain, and/or shortness of breath.

• You notice your blood pressure is too low (less than 90 systolic or 60 diastolic).

• You notice your heart rate is too low (less than 60 beats per minute when awake).

• Fatigue is interfering with your life or interfering with your ability to drive safely, do your job, or perform daily activities.

When it comes to heart rate and blood pressure, the “normal” range can vary from person to person. Check in with your healthcare team if you have any concerns, so they can instruct you on the next best steps.

Why trust our experts?

Written by:

Alice Perlowski, MD, MA, FACC

Dr. Alice Perlowski is a board-certified cardiologist and fellow of the American College of Cardiology. She has seen patients and supervised trainees in the academic and private sector, with focuses in interventional cardiology, vascular medicine, preventative cardiology, and women’s heart health.

Reviewed by:

Sophie Vergnaud, MD

Sophie Vergnaud, MD, is the Senior Medical Director for GoodRx Health. An experienced and dedicated pulmonologist and hospitalist, she spent a decade practicing and teaching clinical medicine at academic hospitals throughout London before transitioning to a career in health education and health technology.

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