Is Histex DM Safe To Take If You Have High Blood Pressure?
In our latest question and answer, our pharmacist discusses whether or not Histex DM is safe if you have high blood pressure.
If high blood pressure is under control, is it okay to take Histex DM cough medicine in 5ml doses every 4 hours?
Jan 04, 2023- Histex DM contains phenylephrine, a nasal decongestant that has a precaution for people with high blood pressure because it may cause small increases in blood pressure. Research shows conflicting results on how much phenylephrine actually raises blood pressure, with some studies showing no effect at usual doses and others noting mild increases. Talk to your doctor before using Histex DM if you have high blood pressure, as the safety depends on your individual medical situation.
Answer
Thanks so much for reaching out. I'm happy to answer this for you.
First and foremost, let's list the ingredients contained in Histex-DM:
- Dextromethorphan
- Triprolidine
- Phenylephrine
Dextromethorphan is a cough suppressant, triprolidine is an antihistamine and phenylephrine is a nasal decongestant.
Safe With High Blood Pressure?
In general, any medication that contains a nasal decongestant, like phenylephrine, is going to have a precaution for those who have high blood pressure or take high blood pressure medication.
This is because nasal decongestants are associated with causing small increases in blood pressure, which could put some individuals more at risk for negative outcomes.
Now, it must be said that research is quite conflicting on just how much nasal decongestants can increase blood pressure.
Some studies report that phenylephrine, at usual doses, does not increase blood pressure:
Phenylephrine showed no consistent effect on heart rate or blood pressure for doses of 25 mg or less
However, other studies have noted that phenylephrine may be a culprit in some case reports documenting individuals experiencing high blood pressure after taking the medication.
The consensus on the matter is that oral decongestants, like phenylephrine, could potentially increase blood pressure, but not for everyone, and generally only to a mild degree (one study noted an average increase of 1.2mmHg with a similar decongestant, pseudoephedrine).
However, and this is an important point, there aren't any long-term studies that have evaluated the safety of nasal decongestants in someone who has blood pressure, so we don't have long-term outcomes data.
Recommendations
I recommend talking to your doctor regarding whether or not a medication that contains a nasal decongestant is right for you, as everyone's medical situation is different.
In my experience, if someone has been diagnosed with high blood pressure, and it is controlled, and they don't have other risk factors (such as a prior heart attack), the short-term use of a nasal decongestant is generally safe.
However, as mentioned, I recommend talking to your doctor so they can provide specific guidance for you.
Final Words
Thanks for reaching out. Please do so again anytime.
References & sources
- Histex-DM Monograph — PubMed
- Efficacy and safety of oral phenylephrine: systematic review and meta-analysis — PubMed
- Potential cardiovascular adverse events when phenylephrine is combined with paracetamol: simulation and narrative review — PubMed
- Cold medication containing oral phenylephrine as a cause of hypertension in children — PubMed
- Are oral decongestants safe in hypertension? An evaluation of the evidence and a framework for assessing clinical trials — PubMed
- Clinical Inquiry: Do oral decongestants have a clinically significant effect on BP in patients with hypertension? — PubMed
Glossary — Terms in This Answer
- Cough suppressant
- A medication that reduces or stops the urge to cough.
- Antihistamine
- A medication that blocks histamine, a chemical in the body that causes allergy symptoms like itching and sneezing.
- Nasal decongestant
- A medication that reduces swelling and congestion in the nasal passages to help with breathing.
- Precaution
- A warning or cautionary measure about a medication's use in certain situations or health conditions.
- Oral decongestants
- Decongestant medications taken by mouth as tablets or liquids rather than sprayed into the nose.
- MmHg
- A unit of measurement for blood pressure that stands for millimeters of mercury.
- Risk factors
- Characteristics or conditions that increase the likelihood of developing a disease or having a negative health outcome.
Dr. Brian Staiger, PharmD
Doctor of Pharmacy, board certified clinical pharmacist (BCPS), American Herbalist Guild, Medication Therapy Management certified
Brian Staiger, PharmD, BCPS, is a licensed pharmacist with more than 13 years of experience across retail pharmacy, clinical pharmacy, medication safety, pharmacy program development, and healthcare administration. He is the founder of HelloPharmacist.com, where he helps patients...
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