Dozens of common medications can raise blood pressure, including over-the-counter painkillers, cold medicines, hormonal contraceptives, and certain antidepressants. Some do it by causing your body to hold onto extra sodium and water; others stimulate your heart or tighten your blood vessels directly. If your blood pressure has crept up unexpectedly, something in your medicine cabinet may be part of the reason.
Pain Relievers: NSAIDs and COX-2 Inhibitors
Nonsteroidal anti-inflammatory drugs are among the most widely used medications on the planet, and they’re one of the most common culprits behind unexplained blood pressure increases. This category includes ibuprofen, naproxen, and indomethacin, along with prescription COX-2 inhibitors like celecoxib. They work by blocking an enzyme involved in inflammation, but that same enzyme plays a role in how your kidneys handle sodium and water. When it’s suppressed, your kidneys retain more sodium, which pulls extra fluid into your bloodstream and raises pressure against your artery walls.
The effect is most pronounced in people who already have high blood pressure or are taking medication to control it. NSAIDs can directly interfere with certain blood pressure drugs, reducing the effectiveness of diuretics, beta-blockers, and ACE inhibitors. Calcium channel blockers appear to be less affected. Prescription-strength COX-2 inhibitors tend to have a stronger blood pressure effect than standard NSAIDs because they more completely block the enzyme, which means greater sodium retention alongside their stronger pain relief.
Low-dose aspirin used for heart protection does not appear to raise blood pressure in the same way. The key factor is dose: higher doses of any NSAID, taken regularly, pose the greatest risk.
Decongestants
Pseudoephedrine, the active ingredient in many cold and sinus products, works by narrowing blood vessels in your nasal passages to relieve congestion. That vessel-narrowing effect isn’t limited to your nose. A meta-analysis found pseudoephedrine raises systolic blood pressure (the top number) by about 1 mmHg on average. That sounds small, but in people whose blood pressure is already borderline or elevated, even a modest push can tip readings into a higher category. Phenylephrine, the decongestant found in many “PE” formulations sold without a pharmacy counter requirement, works through a similar mechanism.
These effects are temporary and resolve when you stop taking the medication, but people who use decongestants frequently during allergy season or chronic sinus problems may see a sustained impact.
Hormonal Contraceptives
Birth control pills that contain estrogen and progestin are linked to a meaningful increase in hypertension risk. A large meta-analysis found that long-term oral contraceptive use raised the risk of developing high blood pressure by 47% compared to minimal or no use. The relationship is dose-dependent over time: for every five years of use, hypertension risk increased by about 13%.
Earlier generations of birth control pills contained higher doses of estrogen, which likely carried a greater blood pressure effect. Modern formulations use lower estrogen doses and newer types of progestin, which may reduce the risk, though researchers haven’t been able to quantify the difference precisely because older studies didn’t consistently record which formulations women were taking. If you’re on hormonal contraceptives and notice your blood pressure climbing, that connection is worth exploring with your prescriber.
Antidepressants That Affect Norepinephrine
Not all antidepressants raise blood pressure, but one class stands out: SNRIs, which increase levels of both serotonin and norepinephrine in the brain. Norepinephrine is the same chemical your body releases during a stress response, and higher levels stimulate your cardiovascular system.
Venlafaxine is the most studied offender. At lower doses it primarily affects serotonin, but above 225 mg per day it increasingly boosts norepinephrine, and that’s where blood pressure problems emerge. The immediate-release form causes sustained high diastolic pressure (the bottom number) in 10 to 15% of patients, with increases as large as 15 mmHg. The extended-release version carries a lower risk, affecting roughly 6% of patients. Related drugs in the same class, desvenlafaxine, milnacipran, and levomilnacipran, also raise both systolic and diastolic pressure by about 2 to 3 mmHg on average.
An older class of antidepressants called MAOIs, including tranylcypromine and phenelzine, pose a different and more dramatic risk. These drugs can trigger a hypertensive crisis, a sudden dangerous spike in blood pressure, if you eat foods rich in tyramine while taking them. Tyramine is found in aged cheeses, cured meats, fermented foods, and certain wines. The interaction can be severe enough to cause organ damage, which is why MAOIs come with strict dietary restrictions.
Corticosteroids
Prescription corticosteroids like prednisone and dexamethasone cause your body to retain sodium and water through a mechanism similar to the hormone aldosterone. When taken for more than a few days, they can raise blood pressure noticeably. The effect is dose-related: higher doses and longer courses produce larger increases. People on long-term steroid therapy for conditions like autoimmune disease or organ transplant rejection often need blood pressure monitoring as part of their ongoing care.
Licorice Root and Herbal Supplements
Real licorice (not the artificially flavored candy) contains a compound called glycyrrhizin that raises blood pressure through a surprisingly potent mechanism. Glycyrrhizin blocks an enzyme in your kidneys that normally deactivates cortisol. When cortisol stays active in the kidneys, it mimics the effects of aldosterone, a hormone that tells your kidneys to reabsorb sodium and excrete potassium. The result is water retention, low potassium, and elevated blood pressure, a pattern so distinctive it has its own clinical name: pseudohyperaldosteronism.
This matters because licorice root appears in teas, herbal supplements, chewing tobacco, and some imported candies. People who consume it regularly without realizing its effects can develop significant hypertension that resolves only after they stop.
Medicines That Intentionally Raise Blood Pressure
Some people have blood pressure that’s too low, particularly when standing up, a condition called orthostatic hypotension that causes dizziness and fainting. Several FDA-approved medications exist specifically to raise blood pressure in these cases.
Midodrine works by directly stimulating receptors on blood vessels, causing them to tighten and increasing resistance to blood flow. It’s the most established drug for this purpose. Fludrocortisone takes a different approach: it’s a synthetic steroid that causes your kidneys to retain sodium and water, expanding your blood volume. Over time, it also increases the sensitivity of blood vessels to tightening signals. Droxidopa, a newer option, gets converted into norepinephrine in the body, raising levels of this blood-pressure-boosting chemical directly.
These medications are prescribed specifically because they raise blood pressure, so their effect is the intended goal rather than a side effect.
How These Medications Interact With Blood Pressure Treatment
If you’re already taking medication to lower your blood pressure, adding a drug that raises it can partially or fully cancel out your treatment. NSAIDs are the most common example. They reduce the effectiveness of diuretics, beta-blockers, and ACE inhibitors, which are three of the most widely prescribed blood pressure drug classes. This can create a frustrating cycle where blood pressure seems uncontrollable despite taking medication as prescribed. Calcium channel blockers and centrally-acting blood pressure drugs appear to be less affected by NSAID interference.
The 2025 blood pressure guidelines classify hypertension starting at 130/80 mmHg for people with diabetes, kidney disease, or elevated cardiovascular risk, and 140/90 mmHg for the general population. Even a 5 to 10 mmHg increase from a blood-pressure-raising medication can shift someone from a well-controlled range into one that requires additional treatment. When blood pressure proves difficult to manage, reviewing every medication, supplement, and over-the-counter product for blood-pressure-raising potential is one of the most productive steps in finding the cause.