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Decongestants and High Blood Pressure?


Well, it’s allergy season. You know that feeling of nasal stuffiness? It is a result of increased blood flow to the sinuses by opening the tiny blood vessels in your nasal passages to help fight off colds or can happen with allergies. There is only so much room in there, so once things start to swell, it can get pretty uncomfortable. We do have some medications that help reverse the congestion, by causing the tiny blood vessels to constrict back to normal and this makes the swelling go down. Anti-inflammatory medication can also help do this but by blocking the inflammation to begin with so there is less swelling.

There are two main types of oral medications- phenylephrine and pseudoephedrine. In Ohio, you can only buy pseudoephedrine if you leave your information at the pharmacy desk. This is due to it being a main ingredient in making the illegal methamphetamine drug. The phenylephrine is available off the shelf (usually listed on the box as “PE”). It appears that you have to have a certain gene in order to convert this medication to a more active form, and only 10 percent of the population has that, so it really doesn’t work well as a decongestant for most people. The pseudoephedrine on the other hand, works great.


However, the packages come with a warning not to take them if you have high blood pressure. This is based on theory, studies show it only increases blood pressure by about 1.5 mmHG (so you might go from 130/80 to 132/80). Some people may still be sensitive to the medicine, but it really does not affect your blood pressure enough to be concerned about it.

The other common decongestant is the nasal spray oxymetazoline (Afrin). This works similarly to cause the blood vessels to constrict but does it on contact. You may have heard that you can get “addicted” to using it and must keep doing it in order to keep your sinuses clear if you use it too long. For most people, this takes 7-10 days for your body to form that type of dependency, and most colds only have a few days of bad congestion, so you can use it for a cold. I would not recommend it for allergies though, unless you have something like a temporary cat allergy when visiting a friend or something.


If you have issues with allergies or chronic sinusitis, ask me about acupuncture for these. I have several good protocols for them, and have helped numerous patients, especially those with combination allergies and chronic sinusitis.