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 possible. Beta blockers are most commonly linked to fatigue. But other blood pressure medications can also contribute, depending on the specific medication or combination of medications, the dose, and your underlying health. 

So, what should you do if you think your blood pressure medications are sapping your energy? 

Why do blood pressure medications cause fatigue?

There are several reasons why blood pressure medications can cause fatigue. Medications used for high blood pressure 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.

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

Which blood pressure medications cause fatigue?

Fatigue is possible with several blood pressure medications, but it’s not inevitable. Here are some examples of blood pressure medications that may contribute to tiredness or related symptoms, plus a brief overview of how this happens. 

Could your fatigue be from something else?

It’s possible that your blood pressure medication may be making you tired. But fatigue has many possible causes, some of which may overlap with high blood pressure:

• Sleep problems: not getting enough sleep (like from insomnia) or sleep apnea

• Other medications or substances: sleep medicines, some antihistamines, sedatives, alcohol, and other prescription medicines

• Common health conditions: anemia, iron deficiency, underactive thyroid, infections, diabetes, and kidney or heart problems

• Mood and daily life: Depression, stress, and not getting enough good nutrition

If your fatigue continues, gets worse, or interferes with daily activities, talk with your medical team. They can review the medications and supplements you take and decide whether you need an exam or blood tests to look for another cause.

How do you deal with fatigue from blood pressure medication?

Fatigue after starting a blood pressure medicine may improve as your body adjusts. But it can also mean that your dose or combination needs review, or that another medicine or health problem is contributing. Here’s what to do if you feel tired after starting a new blood pressure medication: 

• Give it some time (up to a point). Some mild side effects improve over the first several weeks as your body adjusts to a new medication. But don’t ignore fatigue that’s severe, worsening, or interfering with work, driving, exercise, or daily activities. 

• Look for patterns. Note when you take your medicine and when fatigue starts. Record whether fatigue happens every day, after a dose, after standing, during exercise, or at a particular time of day. It can also be helpful to record your sleep, and how many times you woke or got up to pee during the night. If you have a blood pressure monitor at home, make a note of your blood pressure and resting pulse at different times of the day. Finally, keep a note of any other medicines or supplements you take, plus when you take them. This information can help your healthcare team decide what to check or change.

• Ask for a medication review. If fatigue began after you started or increased a blood pressure medication, tell your prescriber or pharmacist. It often takes a few tries to figure out which medication and what dose is right for you. They may decide to adjust the dose, switch medications, or use a combination at lower doses. 

• Ask whether you need electrolyte testing. Some diuretics can lower levels of sodium, potassium, or magnesium. Other blood pressure medications can raise potassium levels. Electrolyte imbalance can cause fatigue, weakness, cramps, dizziness, or palpitations. Your healthcare team can check your levels of electrolytes with a simple lab test to see if this could be contributing to your symptoms. 

• Exercise regularly. If you feel well enough, start with gentle activity such as a short walk and increase gradually. If you take a beta blocker, your heart rate may not be a reliable guide to exercise intensity. Ask your medical team how to judge your effort. The “talk test” is one way. Stop and seek medical care if you feel faint, unusually short of breath, weak, or have chest pain. 

• Make nutritious food choices. Eat regular, balanced meals. A healthy eating pattern, such as the DASH diet, can help support healthy blood pressure. Drink fluids according to your healthcare team’s advice, especially if you have heart or kidney problems. And don’t add salt, potassium, magnesium, or electrolyte drinks to treat fatigue without medical guidance.

And remember, even if you think your blood pressure medication is making you tired, don’t stop or change your blood pressure medicine on your own. Stopping a blood pressure medication abruptly without guidance can cause dangerous surges in heart rate and blood pressure. Your prescriber or pharmacist can help you lower, switch, or stop your blood pressure medication safely. 

When should you see a doctor?

Mild fatigue after starting a new medication can sometimes improve with time. 

But you should see a medical professional if you have fatigue that’s:

• Getting worse

• Not getting better

• Interfering with daily activities

• Accompanied by dizziness or lightheadedness

Another sign not to ignore is if your blood pressure or resting pulse is repeatedly lower than usual. The “normal” range for blood pressure and heart rate varies from person to person. So what matters is if the readings are persistently lower than normal for you, especially if you also have symptoms. 

Seek urgent help if you experience:

• Fainting

• Chest pain

• Severe shortness of breath

• New confusion

• Severe weakness

• An inability to stay awake

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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.

Edited by:

Sophie Vergnaud, MD

Sophie Vergnaud, MD, is the Senior Medical Director for GoodRx Health. A pulmonologist and hospitalist, she practiced and taught clinical medicine at hospitals in London for a decade before entering a career in health education and technology.

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