Can Cough and Cold Medications, Like Mucinex, Increase Your Blood Pressure?

Over-the-counter (OTC) pain relievers, decongestants, and cough medications can help relieve symptoms of the common cold. Most people tolerate these medications well. But you may need to be more cautious if you have a medical condition like high blood pressure or diabetes.

High blood pressure can damage your body if it’s uncontrolled. For example, it can make heart attacks, stroke, and kidney problems more likely over time. Since most people have at least one cold every year, it’s important to know what medications you may need to avoid if you have a condition like high blood pressure.

What are cough and cold medications?

Many people turn to cough and cold medications when they have the common cold. Although these medications won’t cure a cold, they can relieve symptoms like cough, nasal congestion, and sore throat. 

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Cough and cold medications are grouped into different categories based on how they work and what symptoms they treat. 

Pain relievers

Pain relievers can help with headaches and/or muscle aches. They can also reduce fever. Two of the most common pain relievers are ibuprofen (Advil, Motrin) and acetaminophen (Tylenol). 

Decongestants

Oral and nasal decongestants help relieve a stuffy nose. Pseudoephedrine (Sudafed) and phenylephrine (Sudafed PE) are two of the most common oral decongestants. Afrin (oxymetazoline) and phenylephrine nasal spray (Neo-Synephrine) are intranasal options. These nasal sprays should only be used for 3 days; otherwise, they may actually worsen a stuffy nose.

Cough medications

Two of the most common cough medications are dextromethorphan (Delsym, Robitussin) and guaifenesin (Mucinex). Dextromethorphan is best for dry coughs that don’t produce mucus. Guaifenesin is an “expectorant,” which is a medication that helps loosen mucus in your airways so you can cough it up.

You can find dextromethorphan and Mucinex together in products like Mucinex DM. While there’s not much evidence that these medications work, some people find them helpful.

Antihistamines

For a runny nose and sneezing, look for an antihistamine. Diphenhydramine (Benadryl) and doxylamine are popular oral antihistamines found in many cough and cold medications. But they’re known for causing drowsiness. Other OTC antihistamines that aren’t known to cause drowsiness include cetirizine (Zyrtec) and loratadine (Claritin). For an intranasal option, you can consider taking azelastine (Astepro).

Combination cough and cold medications

It’s important to know that many of the above medications are available together in combination cough and cold products. For example, NyQuil Cold and Flu contains acetaminophen, dextromethorphan, and doxylamine. And Advil Cold and Sinus contains ibuprofen and pseudoephedrine. 

If you’re taking a cough and cold medication, make sure you read the “Drug Facts” label so that you know exactly what’s in it.

Which cough and cold medications increase blood pressure?

Some cough and cold medications can increase blood pressure. These include:

• Non-steroidal anti-inflammatory drugs (NSAIDs): Common NSAIDs like ibuprofen may increase blood pressure. But, if this happens, the increase is usually small. Still, if you have high blood pressure or a heart condition, talk to your healthcare provider before taking a product that has an NSAID in it.

• Acetaminophen: This common OTC pain reliever may increase blood pressure. But the research on this is mixed. If you have high blood pressure, talk to your provider about whether or not you should avoid acetaminophen. 

• Oral decongestants: Medications like pseudoephedrine work by constricting (tightening) blood vessels in your nose, which relieves congestion. But they also constrict blood vessels in other areas of your body, which can raise your blood pressure. So if you have high blood pressure, decongestants may not be recommended.

Which cough and cold medications don’t affect blood pressure?

Some cough and cold medications aren’t known to cause high blood pressure. These include:

• Antihistamines: Antihistamines don’t have a significant effect on blood pressure. But remember that certain types, like diphenhydramine and doxylamine, are known to cause drowsiness.

• Cough medications: In general, cough medications like dextromethorphan and Mucinex aren’t known to raise blood pressure. But keep in mind that some combination products that contain dextromethorphan and/or Mucinex may include other ingredients that do increase blood pressure.

• Intranasal decongestants: These medications, including Afrin, haven’t been found to increase blood pressure. But this may only be true in people who don’t have existing high blood pressure. People who have high blood pressure should be cautious about taking intranasal decongestants and check with their healthcare provider first.

If you’re worried about your blood pressure, you can also try natural cold remedies. You may be able to relieve nasal congestion with nasal saline irrigation (e.g., Neti pots) or a saline nasal spray. You can also try using a humidifier at home to moisten the air, which can ease congestion and a sore throat. Gargling warm salt water may also help soothe a sore throat. And certain types of honey, like buckwheat honey, may reduce cough.

How much will my blood pressure go up after taking cough and cold medications?

Everyone experiences medication side effects differently. So you can’t necessarily predict how much your blood pressure could increase after taking cough and cold medications. But some research has found:

• Ibuprofen can increase systolic blood pressure (SBP) up to 5 mmHg.

• Acetaminophen may increase SBP by up to 5 mmHg when taken at the maximum dosage of 4,000 mg per day. But the amount of acetaminophen in daily doses of cough and cold medications are usually much lower than this.

• Pseudoephedrine may increase SBP up to 2 mmHg. But phenylephrine, another common oral decongestant, may not have a major impact on blood pressure.

For those with uncontrolled high blood pressure, the risk of fluctuations is more serious. Those who don’t have high blood pressure — or who have it under control — generally don’t have as great of a risk. 

How can I prevent blood pressure changes from cough and cold medications?

If you have high blood pressure, talk to your healthcare provider or pharmacist before starting a new cough and cold medication. They can help you decide which medication options are least likely to raise your blood pressure. To avoid major fluctuations, continue taking blood pressure medications regularly if they’re prescribed to you. And regularly check your blood pressure at home to monitor any increases in blood pressure.

If you don’t have high blood pressure and you need cough and cold medications, take the lowest dose that works for you. Take it for the shortest amount of time possible (and not longer than the medication label recommends). 

If my blood pressure goes up while taking cough and cold medications, will it go back down?

If you experience elevated blood pressure while taking cough and cold medication, it’s likely that your blood pressure will return to its usual level after the medication leaves your system. Immediate-release cough and cold products tend to stay in your system for just a few hours. Extended-release (ER) formulations, like Mucinex ER tablets, may stick around for longer. 

If you notice an increase in your blood pressure, talk to your healthcare provider. They can help you decide if you need to make any changes to your medication regimen.

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Written by:

Alexa Mader, PharmD

Alexa Mader has been a practicing pharmacist since 2018. She earned her Doctor of Pharmacy degree from the University of Georgia College of Pharmacy.

Edited by:

Amy B. Gragnolati, PharmD, BCPS

Amy Gragnolati, PharmD, BCPS, is a pharmacy editor for GoodRx. Amy currently holds her pharmacist license in Georgia and California.

Reviewed by:

Joshua Murdock, PharmD, BCBBS

Joshua Murdock, PharmD, BCBBS, is a licensed pharmacist in Arizona, Colorado, and Rhode Island. He has worked in the pharmacy industry for more than 10 years and currently serves as a pharmacy editor for GoodRx.

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