Can You Take NyQuil If You Have High Blood Pressure?

Answer

There are a number of different NyQuil products on the market and some are safe if you have high blood pressure, while others should be avoided unless otherwise directed by your doctor.

You want to be on the lookout for any NyQuil product that contains a nasal decongestant, such as phenylephrine or pseudoephedrine, as nasal decongestants have been linked to increases in blood pressure.

To give some examples, the original NyQuil, NyQuil Cold & Flu contains the following drugs:

• Acetaminophen
• Dextromethorphan
• Doxylamine

All of these are safe if you have high blood pressure and will not raise it.

However, NyQuil Cold & Flu Severe does have a nasal decongestant in it:

• Acetaminophen
• Dextromethorphan
• Doxylamine
• Phenylephrine

Since NyQuil Cold & Flu Severe contains phenylephrine, it should not be taken if you have high blood pressure unless your doctor directs you that it is safe to use.

If you want to avoid looking at the labels of all the different NyQuil products, there are NyQuil Cold & Flu HBP (High Blood Pressure) products that don't contain a decongestant either.

Why Decongestants Should Be Avoided If You Have High Blood Pressure

Several studies have reported that nasal decongestants, such as phenylephrine and pseudoephedrine, can raise blood pressure, and increase cardiovascular risk in those with pre-existing conditions.

It must be said, the results from studies are mixed, and many report that nasal decongestants only slightly increase blood pressure for a short amount of time. One of these studies concluded the following:

Pseudoephedrine caused a small but significant increase in SBP [systolic blood pressure] with no effect on DBP [diastolic blood pressure]. The effect in patients with controlled hypertension demonstrated an SBP increase of similar magnitude. Higher doses and immediate-release preparations were associated with greater BP increases

The above study notes blood pressure increases averaging only around 1-2mmhg, but also noted that there were associated increases in heart rate as well.

Another study reported similar results and made note that more studies are needed to determine the potential health effects of blood pressure increases:

Pseudoephedrine causes an average increase of 1.2 mm Hg in systolic blood pressure (BP) in patients with controlled hypertension. However, the studies are not adequately powered to provide evidence about whether this rise in systolic BP is linked to patient-oriented outcomes

Although there is limited data on this subject, we at least know nasal decongestants have some effect on blood pressure, and due to this, the FDA requires (CFR - Code of Federal Regulations Title 21) the following warning on any topical or nasal decongestant product:

Do not take this product if you have heart disease, high blood pressure, thyroid disease, diabetes, or difficulty in urination due to enlargement of the prostate gland unless directed by a doctor.

Alternative Options

As mentioned, if you have high blood pressure, even if you take medication for it, you don't want to take a decongestant without talking to your doctor first.

There are several NyQuil products that do not contain a nasal decongestant (such as the original NyQuil Cold & Flu), so look for those if you are looking to treat cough/cold symptoms and help you sleep at night

Other options to help treat your nasal congestion include nasal steroids (e.g., Flonase) and nasal saline sprays (especially hypertonic saline sprays, as these decrease swelling of nasal tissues).

Final Words

I hope you found this answer helpful! Thanks for reaching out.