Antihistamines And Your Heart Risk
Every week I see allergic patients who are avoiding antihistamine medications because of a concern about their heart or blood pressure. But Most of this worry is outdated and unneeded.
Firstly, lets discuss the antihistamines themselves: older generation antihistamines like diphenhydramine , hydroxyzine or chlorpheneramine are messier chemicals with more side effects such as sedation and dry mouth. Versus newer generation antihistamines like ceterizine , loratadine or fexofenadine have fewer side effects and a bit more targeted action in the body.
High Blood Pressure Risk. The antihistamines alone are not associated with high blood pressure or making blood pressure worse. However many times the antihistamines are bundled with a We typically only recommend taking the combination antihistamine-decongestants on an occasional basis when really feeling sick and they should be avoided with poorly controlled blood pressure. To be safe, just stick with the plain antihistamine meds for allergies if you have high blood pressure.
Cardiac Arrythmia Risk. The risks of cardiac rhythm problems are small but do exist some with the first generation antihistamines. If you are at risk of QT prolongation or certain other rare rhythm disorders, avoiding first generation antihistamines is a good idea. Newer antihistamines like fexofenadine, ceterizine and loratadine are all fairly safe for the heart, with fexofenadine seeming to be the absolute safest if you are at risk of arrythmia.
Which Allergy Meds Are Safe For Your Heart
There are three major classes of allergy medications:
- anti-inflammatories
“In general, antihistamines are safe in patients with high blood pressure and other forms of heart disease,” explains Richard Krasuski, MD, director of adult congenital heart disease services at the Cleveland Clinic in Ohio, but an antihistamine may elevate blood pressure or increase heart rate, according to the U.S. Food and Drug Administration .
Antihistamines for allergies include common OTC allergy drugs such as loratadine , fexofenadine , and cetirizine . However, if the drug also has a D after the name, be aware that it contains an added decongestant that can cause problems.
The combination of decongestants and blood pressure problems can be big trouble, according to the American Heart Association. Dr. Krasuski says it’s important that people with high blood pressure and other heart problems avoid decongestants, especially pseudoephedrine . “They can raise the blood pressure and increase the pulse, neither of which is ideal in either problem,” he says. “They can also increase the risk for heart rhythm disturbances such as atrial fibrillation.”
“This can reduce the antihypertensive effects of blood pressure medications and lead to loss of blood pressure control,” adds Dr. Campbell.
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Other Allergy Medicine Options
There are other medication options for those on an extremely tight budget, including loratadine , fexofenadine and cetirizine . These should all be cost effective and range between $3-10 for a month supply depending on the pharmacy. These medicines are extremely effective and are a great second-line option.
I always recommend patients use the GoodRx app to compare costs between medications because it can help save money.
For those of you with hypertension and allergies who wish to try an over the counter nasal inhaler option, cromolyn sodium is available. Cromolyn stabilizes inflammatory cells which are involved in the allergy process. This medicine works. It is cost effective , but the big downside here is that a person has to use it 4 times daily. I have found that many people are non-adherent to more than twice a day medication regimens. And if you dont take the medication it wont work. Therefore, Cromolyn is my third line therapy.
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Do Allergy Medicines Interact With My Blood Pressure Medication
Most antihistamines are generally safe to take with your blood pressure medication. However, keep in mind the following drug interactions if you are taking medication for your blood pressure:
- fexofenadine : Carvedilol may increase the effects of fexofenadine. Use fexofenadine cautiously if you are taking carvedilol.
- cetirizine and levocetirizine : You may experience increased drowsiness if you take cetirizine or levocetirizine in combination with methyldopa .
- diphenhydramine : Any product containing diphenhydramine may counteract the effects of many of your blood pressure medications. Be sure to talk with your pharmacist before taking any diphenhydramine products.
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Other Ways To Reduce And Relieve Allergy Symptoms
While allergies can produce a variety of symptoms, one of the most common is itching, burning, stinging, or watery eyes. When you have an allergic reaction to pollen, dust, pet dander, or any allergen, the histamines released by your body can leave your eyes irritated until the allergen is gone. One effective method of relieving these symptoms is the use of eyedrops.
Allergy eye drops, such as Ophthalmic ketotifen and prescription ophthalmic olopatadine, and nonprescription ophthalmic olopatadine are safe options for itchy and watery eyes. Both ketotifen and olopatadine are antihistamines. These medications work by blocking the actions of histamines and provide safe, effective relief for itchy, watery eyes that are the result of many allergens.
Rinsing your nasal passageways with saline solution or nasal irrigation¹ is a simple, inexpensive, and effective way to relieve a variety of sinus and nasal conditions associated with allergies. Flushing the nasal cavity with saline solution can remove dust and pollen and help to loosen thick mucus. While plain water can irritate the mucous membranes, the saline solution can pass through delicate nasal membranes with little or no discomfort or irritation. In addition, nasal irrigation is safe for all ages, with no documented serious adverse effects reported.
While irrigation devices may differ slightly, they all work in the same fundamental way:
Three types of water are safe for use in nasal irrigation:
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Can Allergy Medications Increase Blood Pressure
Although allergies don’t usually directly increase blood pressure, they can indirectly contribute to high blood pressure. When you choose to use decongestants, such as pseudoephedrine and phenylephrine , you can worsen the existing high blood pressure.
Although these medicines can ease nasal congestion and improve breathing, they can constrict blood vessels throughout the body, making the heart work harder to pump blood. This is what increases blood pressure.
When choosing an over-the-counter allergy medication, beware of combination products that contain decongestants. These products typically have the words sinus, cold, congestion, or decongestant on the label. They also might be labeled with the letters D, PD, or PE after the name.
If you choose to take an over-the-counter allergy product, look for one that doesn’t contain pseudoephedrine or phenylephrine. Some Antihistamines can help with the congestion that accompanies allergies and is safer for the heart, such as cetirizine , fexofenadine diphenhydramine , and loratadine .
Can I Take Allergy Medicine With High Blood Pressure
Suppose you are one of the over 50 million Americans who suffer from allergies each year¹. In that case, allergy season often seems to be never-ending. If you are one of these allergy sufferers, the runny nose, congestion, sneezing, itchy nose and eyes, and red and watery eyes can have you hastily searching for relief.
For many allergy sufferers, these symptoms lead to a trip to the local pharmacy. There is a wide variety of over-the-counter medications available, formulated to provide relief of allergy symptoms. However, a common concern that people with hypertension have is whether they can safely take allergy medicine without causing their blood pressure to increase.
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Zyrtec And Other Antihistamines
Antihistamines work by blocking the effects of histamine, an inflammation-causing substance thats released during an allergic reaction.
Antihistamines come in many forms, including tablets, capsules, liquids, eye drops, intranasal sprays, and injections.
Antihistamines are generally considered a safer choice for those with blood pressure problems, although the U.S. Food and Drug Administration does warn that taking certain antihistamines with medications for high blood pressure may lead to increased blood pressure and heart rate.
Although they are safer for the heart and blood pressure, antihistamines have some undesirable side effects, including drowsiness, overheating, and blurred vision. They also shouldnt be used during pregnancy, and they can interact with other substances and drugs.
Zyrtec is a popular over-the-counter antihistamine medicine and generally considered a safe choice for those with high blood pressure. Zyrtec is less likely to cause extreme drowsiness and other side effects than first-generation antihistamines. Even though Zyrtec is an over-the-counter medication, anyone with hypertension should consult with a health care provider before using it.
Its important to note that many antihistamines come as combination drugs, often combined with a decongestant. Zyrtec-D, for example, is a combination antihistamine-decongestant drug.
Antihistamine-decongestant drugs should not be used by those with high blood pressure.
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