Tip Sheet: High Blood Pressure and Pain Relievers

Some over-the-counter pain relief medications can worsen high blood pressure symptoms. Keep these tips in mind.

Medically Reviewed by Carol DerSarkissian, MD on November 14, 2022
2 min read

When you have high blood pressure, you need to be very careful with over-the-counter pain medicines. Remember: No drug is risk-free. Here are some tips from the experts about using these medicines.

  • Take the safest medicine. Unless your doctor has told you it's OK, do not use over-the-counter ibuprofen, naproxen sodium, or ketoprofen for pain relief. Instead, use a painkiller less likely to increase your blood pressure, like aspirin or acetaminophen

  • Use as directed. Follow the directions for the recommended dosage. Most painkillers shouldn't be used for more than 10 days. If you're still in pain by that point, see your doctor. 

  • Get your blood pressure checked regularly. This is good advice for anyone with high blood pressure. But it's crucial if you use any of the pain relievers that can make your high blood pressure get worse. 

  • Avoid alcohol. Most over-the-counter pain relievers do not mix with alcohol. If you take nonsteroidal anti-inflammatory drugs (NSAIDs), including aspirin, just one drink a week can increase your risk of gastrointestinal bleeding. People who have three or more drinks a day should not use these medicines. Combining acetaminophen and alcohol may increase the risks of liver damage. 

  • Read the package insert. Admit it: When you buy a bottle of over-the-counter pain reliever, you throw out the printed insert along with the empty box. But you really should get in the habit of reading it. Find out what side effects you should look for. Look at the list of possible drug interactions. 

  • Read the ingredients of all medicines. Painkillers like aspirin, acetaminophen, and ibuprofen can show up in the most unlikely places. For instance, many over-the-counter medicines for colds or even heartburn also contain doses of pain reliever. Make sure you know what you're getting. 

  • Watch out for interactions. Many drugs for common health conditions can interact with over-the counter painkillers. For instance, NSAIDs can interact with many common medicines for high blood pressure and block their effects. 

    Mixing aspirin with a prescription "blood thinner" like Eliquis, Coumadin , Plavix, or Xarelta can also be risky, says Nieca Goldberg, MD, a cardiologist and spokesperson for the American Heart Association. If you take prescription drugs for high blood pressure -- or any other condition -- ask your doctor what over-the-counter medicines you need to avoid. 

  • Tell your doctor about all medicines, herbs, and supplements that you use. Interactions are a real danger. So your health care provider needs to know about all the medicines you take before you're prescribed a new medicine. Don't forget to mention over-the-counter medicines, herbal remedies, and vitamins

    "Bring a list of all the medicines and supplements you take to your doctor," says Goldberg. "It could actually save your life."