Medications for high blood pressure can help prevent a range of complications, including heart disease and stroke. Lotensin, Inderal, and Teveten are just some of the names a doctor may mention.
According to the
- diuretics
- beta-blockers
- ACE inhibitors
- angiotensin II receptor blockers
- calcium channel blockers
- alpha-blockers
- alpha-2 receptor agonists
- combined alpha- and beta-blockers
- central agonists
- peripheral adrenergic inhibitors
- vasodilators
This article outlines the various blood pressure medications and their associated side effects and risks.
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Excess salt can cause a buildup of fluid within the blood vessels, which raises blood pressure. Diuretics help the body eliminate excess salt and water by increasing urine output.
There are different types of diuretics. Here are some
- chlorthalidone (Hygroton)
- amiloride hydrochloride (Midamar)
- furosemide (Lasix)
Possible side effects of diuretics
- weakness
- dizziness or lightheadedness
- heightened sensitivity to sunlight
- skin rash
- muscle cramps
- vomiting
- diarrhea
- constipation
- low blood pressure
- electrolyte imbalances
People taking diuretics may also experience decreased libido, though this is less common.
Some medications can interact with diuretics, so a person should ensure the doctor knows which other drugs they are taking. Drugs that may interact with diuretics include:
- digitalis
- digoxin
- other medications for high blood pressure
- some antidepressants
- nonsteroidal anti-inflammatory drugs (NSAIDs)
- lithium
- cyclosporine, an immunosuppressant
Diuretics may not be suitable for people who tend to become dehydrated quickly. They can also make the
- diabetes
- pancreatitis
- kidney problems
- gout
- irregular menstruation
- anuria, where a person produces little or no urine
Beta-blockers reduce blood pressure by blocking the action of hormones in the nervous system, such as epinephrine, also known as adrenaline.
Blocking these hormones slows down the nerve impulses traveling through the heart. As a result, the heart rate slows down and pumps blood less forcefully around the body.
Here are some
- acebutolol (Sectral)
- atenolol (Tenormin)
- propranolol hydrochloride (Inderal)
Some side effects of beta-blockers may
Less common side effects include:
- slow heart rate
- wheezing or difficulty breathing
- swelling of the hands or feet
- rash or itchy skin
- insomnia
- depression
- low blood pressure
Some drugs and medications can change the effectiveness of beta-blockers. These include:
- alcohol
- caffeine
- other blood pressure medications
- cough and cold medications, including antihistamines and decongestants
- insulin and some oral medications for diabetes
- allergy shots
- medicines to treat asthma, chronic bronchitis, emphysema, or chronic obstructive pulmonary disease (COPD)
- some antidepressants
Beta-blockers may not be suitable for people with the following conditions or problems:
- poor circulation
- diabetes
- hypoglycemia
- chronic bronchitis, emphysema, or COPD
- asthma
- overactive thyroid (hyperthyroidism)
- kidney disease
- liver disease
- food allergies
- slow heart rate
- low blood pressure
- Raynaud’s disease
Angiotensin-converting enzyme (ACE) is an enzyme that causes the body’s blood vessels to narrow, which leads to an increase in a person’s blood pressure.
ACE inhibitors lower blood pressure by blocking ACE, relaxing the blood vessels, and allowing blood to flow more freely.
Examples of ACE inhibitors include:
- benazepril hydrochloride (Lotensin)
- fosinopril sodium (Monopril)
- quinapril hydrochloride (Accupril).
On April 22, 2022, Pfizer issued a
A dry cough is the
Less common side effects include:
- loss of taste
- a metallic taste in the mouth
- loss of appetite
- an upset stomach
- constipation
- headaches
- tiredness and fatigue
- feeling dizzy or lightheaded
- sensitivity to sunlight
- low blood pressure
Medications that may interact with ACE inhibitors include:
- diuretics
- other blood pressure medications
- medications and supplements containing potassium
People who have any of the following medical conditions should speak with a doctor before taking ACE inhibitors:
- diabetes
- heart disease
- lupus
- kidney disease
- allergies to other medications
- hypovolemia
- aortic valve stenosis
ACE inhibitors may also be unsuitable for people who have had a heart attack and those who have received a kidney transplant. People should
Angiotensin II is an enzyme that narrows the blood vessels. Angiotensin II receptor blockers (ARBs) block the enzyme’s path to specific receptors, which allows the blood vessels to remain open.
Examples of these drugs are:
- eprosartan mesylate (Teveten)
- irbesartan (Avapro)
- valsartan (Diovan)
Headaches and dizziness are the
- upset stomach
- joint pain
- sore throat
- cough
- fever
- fatigue
- nervousness
- back pain
The following medications can increase or decrease the effect of ARBs:
- diuretics
- medications and supplements containing potassium
- other blood pressure medications
- some heart medications
- over-the-counter medicines for allergies, colds, and flu
ARBs may not be suitable for people who have previously had a bad reaction to ACE inhibitors. They may also not be suitable for people with the following conditions:
- diabetes
- severe congestive heart failure
- kidney or liver disease
- dehydration
People should
Calcium causes the smooth muscles of the heart and arteries to contract more strongly.
Calcium channel blockers slow the entry of calcium into these muscles. This reduces the strength of the contractions and lowers the blood pressure.
There are several calcium channel blockers available, such as:
- diltiazem hydrochloride (Cardizem)
- nifedipine (Procardia XL)
- verapamil hydrochloride (Calan SR)
Common side effects of calcium channel blockers
- tiredness
- flushing
- swollen feet or ankles
Less common side effects include:
- palpitations
- nausea
- dizziness
- shortness of breath
- upset stomach
- constipation
- rash or itchy skin
Drinking grapefruit juice while taking some calcium channel blockers can increase the risk of side effects.
Calcium channel blockers may interact with the following medications and supplements:
- diuretics
- other blood pressure medications
- some heart medications, such as antiarrhythmics and digitalis
- some eye medications
People taking more than
Also, calcium channel blockers may not be suitable for people with the following conditions:
- very low blood pressure
- heart failure or other conditions affecting the heart or blood vessels
- kidney or liver disease
- depression
Certain hormones in the body, such as norepinephrine, can bind to chemical receptors called alpha-receptors. When this happens, the blood vessels narrow, and the heart pumps blood faster, causing a rise in blood pressure.
Alpha-blockers
Examples of alpha-blockers are:
- doxazosin mesylate (Cardura)
- prazosin hydrochloride (Minipress)
- terazosin hydrochloride (Hytrin)
Possible side effects of alpha-blockers include:
- rapid heart rate
- a drop in blood pressure when standing up
- dizziness
- headaches
- nausea
- feeling tired, weak, or lethargic
- disturbed sleep
- skin rash or itchiness
- loss of bladder control in women
- erectile dysfunction in men
Other substances that lower blood pressure may cause a dangerous drop in blood pressure when taken alongside alpha-blockers. These substances include:
- alcohol
- medications classed as benzodiazepines or barbiturates
- other blood pressure medications
Alpha-blockers may make the following medical conditions worse:
- narcolepsy (a sleep disorder)
- angina
- heart failure
A fall in blood pressure when taking these drugs
Similar to alpha-blockers, these drugs
Methyldopa is an alpha-2 receptor agonist.
Alpha-2 receptor agonists
- tiredness
- drowsiness
- dizziness
People should speak with their doctor before using these drugs if they:
- have orthostatic hypotension, which makes a person dizzy when they stand up
- are using phosphodiesterase inhibitors, for example, for COPD
- are at risk of having problems with their autonomic nervous system
A doctor
Doctors
They may also prescribe them for people with a high risk of heart failure.
One example of this type of drug is carvedilol (Coreg).
People may experience the side effects of both alpha- and beta-blockers.
Some types of combined alpha- and beta-blockers may interact with the following medications:
- insulin
- digoxin
- some general anesthetics
They may also not be suitable for people with:
- asthma
- COPD
- slow heart rate
- liver disease
- diabetes
Central agonists
As a result, the heart pumps blood less forcefully, and blood vessels remain open.
Examples of this type of drug are:
- alpha methyldopa (Aldomet)
- clonidine (Catapres)
- guanabenz acetate (Wytensin)
- guanfacine hydrochloride (Tenex)
Depending on the drug, central agonists can cause the following side effects:
- feeling faint or weak, especially when standing up
- drowsiness or lethargy
- dry mouth
- fever
- anemia
- erectile dysfunction
- constipation
- nasal congestion
- pancreatitis
- liver disease
The following substances can cause a person’s blood pressure to drop too low when combined with central agonists:
- alcohol
- sleeping pills
- anti-anxiety medications
- medications classed as benzodiazepines and barbiturates
Central agonists may
- Parkinson’s disease
- high prolactin levels in the blood
- gynecomastia, or enlarged breast tissue in males
Peripheral adrenergic inhibitors (PAIs) block the neurotransmitters in the brain that cause blood vessels to constrict.
Blocking these receptors allows the blood vessels to stay relaxed and open, lowering a person’s blood pressure.
Doctors usually prescribe PAIs only if other blood pressure medications have been ineffective.
- guanadrel (Hylorel)
- guanethidine monosulfate (Ismelin)
- reserpine (Serpasil)
There are several types of PAI, and the side effects differ between types. Possible side effects
- nasal congestion
- heartburn
- diarrhea
- lightheadedness, dizziness, or weakness when standing up
- fainting
- low blood pressure
- erectile dysfunction
- depression
- bad dreams
Some PAIs may interact with the following substances:
- alcohol
- asthma medications
- diuretics
- other blood pressure medications
Anyone who wishes to stop taking tricyclic antidepressants while using a PAI should speak with a doctor. Stopping these medications too quickly while taking certain PAIs can cause a dangerous drop in blood pressure.
Some types of PAIs may not be suitable for people with certain medical conditions. These conditions include:
- congestive heart failure
- diseases of the vascular system
- asthma
- peptic ulcers
- fluid retention
- pheochromocytoma
- depression
- ulcerative colitis
Vasodilators, or blood vessel dilators, relax and widen the walls of the blood vessels, allowing blood to flow through them more easily. Direct-acting vasodilators specifically target the arteries.
Two
Minoxidil is the more potent of the two drugs. Doctors usually prescribe it to people with persistent and severe high blood pressure.
Hydralazine hydrochloride may cause the following side effects, which usually subside
- heart palpitations
- headaches
- swelling around the eyes
- joint pain
Possible side effects of minoxidil include:
- weight gain due to fluid retention
- excessive hair growth, in rare cases
The following drugs may enhance the effects of vasodilators:
- diuretics and other blood pressure medications
- medications for erectile dysfunction, such as sildenafil (Viagra), tadalafil (Cialis), or vardenafil (Levitra)
Taking erectile dysfunction medications in combination with a vasodilator can cause a life threatening drop in blood pressure.
Depending on the type, vasodilators may not be suitable during pregnancy or for people with the
- some types of heart disease
- angioedema
- angina
- slow heart rate
- low blood pressure
- cardiogenic shock
- severe COPD
Some blood pressure medications are
People who are pregnant or planning on getting pregnant should talk with their doctor about treatment options for high blood pressure.
There are many types of blood pressure medications. A doctor will consider the underlying cause of high blood pressure, as well as other health conditions and medications.
Anyone experiencing long-term or intolerable side effects from a blood pressure medication should speak with a doctor, who may prescribe an alternative.