Various medications, supplements and other substances can trigger or worsen high blood pressure (hypertension). Sometimes these substances interfere with medications intended to lower blood pressure.

If you have high blood pressure and it's not responding well to treatment, talk to your doctor about any substances you're taking — including illicit drugs. Being open and honest with your doctor can help you effectively manage your blood pressure.

For more information about medications, supplements and other substances that can cause high blood pressure, click the tabs to the left.

The issue

Various prescription medications — from pain relievers to antidepressants and drugs used after organ transplants — can cause or aggravate high blood pressure.

Examples

Antidepressants

• Bupropion (Wellbutrin, Wellbutrin SR, Zyban)
• Desipramine (Norpramin)
• Phenelzine (Nardil)
• Venlafaxine (Effexor, Effexor XR)

COX-2 inhibitors

• Celecoxib (Celebrex)

Immunosuppressants

• Cyclosporine (Neoral, Sandimmune)
• Methylprednisolone (Medrol)
• Tacrolimus (Prograf, Protopic)

Others

• Epoetin alfa (Epogen, Procrit)
• Methylphenidate (Ritalin)
• Sibutramine (Meridia)
• Yohimbine (Yocon)

What to do

Have your blood pressure checked regularly. If your blood pressure increases or isn't well controlled, ask your doctor about alternatives to these medications. He or she may recommend lifestyle changes or additional medications to control your high blood pressure.

The issue

Most birth control pills can increase blood pressure — especially for women who are over 35, women who are overweight and women who smoke. The effect may be less pronounced for pills containing lower levels of estrogen.

Examples

• Alesse
• Ortho-Novum
• Ortho Tri-Cyclen
• Triphasil

What to do

Have your blood pressure checked regularly. If you already have high blood pressure, consider using a different form of birth control.

If your blood pressure increases significantly, you may need to try a different type of birth control pill or another form of birth control. If you choose to continue taking a birth control pill that increases your blood pressure, your doctor may recommend lifestyle changes or additional medications to control your blood pressure.

The issue

Over-the-counter and prescription nonsteroidal anti-inflammatory drugs (NSAIDs) can relieve many types of pain. But some NSAIDs can also cause fluid retention and kidney problems, which may increase blood pressure — especially for people who already have high blood pressure.

Examples

• Ibuprofen (Advil, Motrin)
• Meloxicam (Mobic)
• Naproxen (Naprosyn)
• Naproxen sodium (Aleve)

What to do

Have your blood pressure checked regularly. Talk to your doctor about which pain medication is best for you. If you must continue taking an NSAID that increases your blood pressure, your doctor may recommend lifestyle changes or additional medication to control your blood pressure.

The issue

Heavy use of the pain reliever acetaminophen may increase the risk of high blood pressure. In a 2005 study, women who took an average of 500 milligrams or more of acetaminophen daily over several years were more likely to develop high blood pressure than were women who didn't take any acetaminophen. It's not known if the same holds true for men.

Examples

• Tylenol

What to do

Tell your doctor if you take acetaminophen on a regular basis. He or she might recommend alternating between acetaminophen and NSAIDs. Because they affect blood pressure in different ways, alternating may give your body a break. Also consider other ways to control pain. Try warm or cold compresses, exercise, massage or complementary treatments, such as acupuncture.

The issue

Decongestants can reduce the effectiveness of blood pressure medications and narrow your blood vessels, which raises blood pressure. Cold and allergy medications — which often contain a combination of antihistamines and decongestants — can have the same effect. Taking these medications along with tricyclic antidepressants can compound the effect on your blood pressure.

Examples of ingredients in decongestants that can affect blood pressure

• Oxymetazoline
• Phenylephrine
• Pseudoephedrine

What to do

If you have high blood pressure, it's best to avoid decongestants. Ask your doctor or pharmacist about over-the-counter cold products specially formulated for people who have high blood pressure.

Because of life-threatening health concerns, the Food and Drug Administration has asked all drug companies to stop marketing products containing phenylpropanolamine (PPA). However, some products on the market may still contain PPA — including decongestants and over-the-counter weight-loss products — so be sure to read product labels carefully.

The issue

Herbal supplements aren't necessarily safe just because they're natural. Various herbal supplements can increase blood pressure or interfere with the effectiveness of blood pressure medications.

Examples

• Bitter orange
• Ephedra (ma-huang)
• Ginseng
• Licorice
• St. John's wort

What to do

Check with your doctor before taking any herbal supplements. You may need to avoid supplements that raise your blood pressure or interfere with your blood pressure medications.

The issue

Illicit drugs can raise blood pressure by narrowing the arteries that supply blood to your heart. This increases your heart rate and damages your heart muscle.

Examples

• Amphetamines, including methamphetamine
• Anabolic steroids
• Cocaine
• Ecstasy
• Phencyclidine (PCP)

What to do

If you're using illicit drugs, it's important to stop. Ask your doctor for help.