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Allergy Medicines and Hypertension

By Rosanna Sutherby, PharmD

April 29, 2020

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Allergy season is in full swing in many parts of the country. For some, that means battling symptoms, such as sneezing, congestion, runny nose, itching, and watery eyes. If you are among the over 50 million Americans who suffer from allergies each year, you may be headed to a pharmacy near you for relief of your allergy symptoms. Choosing allergy medication that is right for you may be tricky if you have hypertension (high blood pressure). Read on to learn how some allergy medicines may affect your blood pressure and your blood pressure medication.

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What Are Different Types of Allergy Medicines?

Today, multiple products are available to treat several allergy symptoms. Antihistamines are used for relief of runny nose, sneezing, itching, and watery eyes. Second-generation antihistamines are used more often for seasonal allergies because they do not cause as much drowsiness as older antihistamines, and their effects last longer. Medications in this category include the following:

fexofenadine (Allegra)
desloratadine (Clarinex)
loratadine (Claritin)
levocetirizine (Xyzal)
cetirizine (Zyrtec)

Oral decongestants, such as the following, are available for relief of congestion or stuffy nose:

pseudoephedrine (Sudafed and others)
phenylephrine (Sudafed PE and others)

Steroid nasal sprays, such as the following, are also effective at relieving nasal congestion:

fluticasone (Flonase)
triamcinolone (Nasacort)
budesonide (Rhinocort)
beclomethasone (Beconase and Qnasl)

Antihistamine nasal sprays, such as the following, can target allergy symptoms directly in the nose and sinuses:

azelastine (Astelin and Astepro)
olopatadine (Patanase)

Saline nasal sprays and rinses are also effective at clearing nasal passages and relieving congestion. Common names for saline nasal sprays and rinses include the following:

Ocean
Ayr
Simply Saline
Neti Pot

Antihistamine eye drops can be beneficial for treating itchy and watery eyes. The following products are commonly used for long-lasting relief:

olopatadine (Pataday and Patanol)
ketotifen (Zaditor)

Which Allergy Medications Affect My Blood Pressure?

You should avoid decongestants if you have high blood pressure or heart problems. Decongestants constrict (narrow) blood vessels to open nasal passages and facilitate breathing. Because decongestants constrict blood vessels throughout your body, they can worsen hypertension. Additionally, decongestants stimulate the release of norepinephrine in your body, which raises your blood pressure and your heart rate.

When choosing an allergy medication, be aware of combination products that contain decongestants. Products that contain a decongestant typically have the words sinus, cold, congestion, or decongestant on the label. They may also be labeled with the letters D, PD, or PE after the name.

Examples of allergy medicines that contain decongestants include the following:

Allegra D (fexofenadine and pseudoephedrine)
Benadryl D (diphenhydramine and pseudoephedrine)
Clarinex D (desloratadine and pseudoephedrine)
Claritin D (loratadine and pseudoephedrine)
Sudafed Sinus and Allergy (chlorpheniramine and pseudoephedrine)
Zyrtec D (cetirizine and pseudoephedrine)

The list above is a small sample of allergy medications that contain decongestants. Always check with your pharmacist before choosing allergy medications.

Do Allergy Medicines Interact with My Blood Pressure Medication?

Most antihistamines are generally safe to take with your blood pressure medication. However, keep in mind the following drug interactions if you are taking medication for your blood pressure:

fexofenadine (Allegra): Carvedilol (Coreg) may increase the effects of fexofenadine. Use fexofenadine cautiously if you are taking carvedilol.
cetirizine (Zyrtec) and levocetirizine (Xyzal): You may experience increased drowsiness if you take cetirizine or levocetirizine in combination with methyldopa (Aldomet).
diphenhydramine (Benadryl): Any product containing diphenhydramine may counteract the effects of many of your blood pressure medications. Be sure to talk with your pharmacist before taking any diphenhydramine products.

What Allergy Medicines Can I Take if I Have High Blood Pressure?

Although some allergy medicines affect your blood pressure or interact with your blood pressure medication, safe options for treating your allergy symptoms exist if you have high blood pressure.

Second-generation antihistamines that are not combined with decongestants are generally safe to use if you are not taking the blood pressure medicines listed in the drug interaction section above. Second-generation antihistamines include the following:

Allegra (fexofenadine)
Clarinex (desloratadine)
Claritin (loratadine)
Xyzal (levocetirizine)
Zyrtec (cetirizine)

If your symptoms include nasal congestion, the following options are generally safe to use as decongestants:

steroid nasal sprays, such as Flonase (fluticasone), Nasacort (triamcinolone), and Rhinocort (budesonide)
antihistamine nasal sprays, such as Astelin (azelastine) and Patanase (olopatadine)
saline nasal sprays or rinses, such as Ayr, Ocean, Simply Saline, or Neti Pot

Antihistamine eye drops, such as Pataday (olopatadine) and Zaditor (ketotifen), are safe options for itchy watery eyes.

Can I Compare Prescription Prices before Filling My Allergy Medicine?

The majority of allergy medications are now available over the counter. This means that many insurance plans no longer cover your allergy medicine. If your insurance does not cover your medication, you can use a prescription savings card to get the lowest prescription price. You can save up to 80% or more off the retail price by using the ScriptSave® WellRx discount card at a pharmacy near you.

Check Allergy Rx Prices

Rosanna Sutherby is a freelance medical writer who has been a practicing pharmacist in her community for close to 20 years. She obtained her Doctor of Pharmacy from Nova Southeastern University in Ft. Lauderdale, FL. She utilizes her clinical training in the pharmacy, where she helps patients manage disease states such as asthma, diabetes, heart disease, hypertension, and many others. Dr. Sutherby reviews and recommends drug regimens based on patients’ concurrent conditions and potential drug interactions.

References:

https://www.aafa.org/allergy-facts/

https://www.wellrx.com/fexofenadine%20hcl/drug-information/

https://www.wellrx.com/desloratadine/drug-information/

https://www.wellrx.com/loratadine/drug-information/

https://www.wellrx.com/levocetirizine%20dihydrochloride/drug-information/

https://www.wellrx.com/cetirizine%20hcl/drug-information/

https://www.wellrx.com/pseudoephedrine%20hcl/drug-information/

https://medlineplus.gov/druginfo/meds/a606008.html

https://www.wellrx.com/flonase%20allergy%20relief/drug-information/

https://www.wellrx.com/nasacort/drug-information/

https://www.wellrx.com/rhinocort%20allergy/drug-information/