Can you take claritin with high blood pressure medicine

Allergy medications might seem harmless enough — they're sold over the counter (OTC), so that makes them safe, right?

Not necessarily.

Though allergy drugs can stop the misery of seasonal bouts with pollen, hay fever, and grasses, some can aggravate a heart condition, or be downright dangerous when mixed with blood pressure drugs and certain heart medicines.

"If a patient has allergies or a cold and is considering OTC medications, it is always recommended to talk with the pharmacist on site, or to ask your physician for recommendations in the context of the other medications that are prescribed," says L. Kristin Newby, MD, MHS, a cardiology professor at Duke Medicine in Durham, North Carolina.  

"Some OTC medications — for example, those containing pseudoephedrine or similar components — may cause increases in heart rate or blood pressure that could exacerbate some cardiac conditions," explains Dr. Newby.

Which Allergy Meds Are Safe for Your Heart?

There are three major classes of allergy medications:

• antihistamines
• decongestants
• 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 (FDA).

Antihistamines for allergies include common OTC allergy drugs such as loratadine (Claritin), fexofenadine (Allegra), and cetirizine (Zyrtec). 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 (Sudafed and other brands). "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."

The way decongestants ease allergy congestion is by constricting the blood vessels, which helps to shrink swollen mucus membranes in the nose. "Unfortunately, this vasoconstriction can also occur throughout the body and can lead to an increase in blood pressure and/or heart rate," says Kristen Bova Campbell, PharmD, a cardiology clinical pharmacist and program director of the cardiology pharmacy residency at Duke University Hospital.

"This can reduce the antihypertensive effects of blood pressure medications and lead to loss of blood pressure control," adds Dr. Campbell.

Anti-inflammatory allergy medications, such as intranasal steroids, are typically considered safe, as long as you take the exact prescribed dosage. Take too many, and you can wind up with salt and water retention. And they can raise blood pressure, counteracting the effects of your blood pressure medications, Krasuski says.

Heart-Healthy Tips for Allergy Drug Safety

Problems with over-the-counter allergy medications are not uncommon. That makes it all the more important to rely on the knowledge and guidance of your healthcare team, from your doctor to your pharmacist.

Your individual risk can depend on a number of factors, but there's a basic rule of thumb: More drugs means more risk. "The more medications that the patient is on, the greater the risk for interactions," Krasuski says. "Most medications are either removed from the body by the liver or the kidney. Patients with liver or kidney problems as well as older patients are also at great risk for medication problems."

To be safe, always check labels before taking an allergy medication to make sure you know what's in it. "It is important to recognize that antihistamines are often paired with the decongestants," says Krasuski. "In such cases, the medication name will have a “D” at the end, which stands for pseudoephedrine."

As noted above, anyone with high blood pressure, heart rhythm problems, or other heart problems should avoid allergy medications with a "D" added after the name.

But you can still find relief from allergy symptoms, and safely, even if you have heart problems. "There are prescription medications that are generally well tolerated when used in conjunction with heart medications," Newby says. Talk over your options at your next a visit with your cardiologist or other health care provider.

"It is always important to discuss your medications with both your doctor and your pharmacist," stresses Krasuski. "Bring your medicines to your appointment or to the pharmacy. Sharing your list of OTC medications is critical as this is often missed during routine office visits."

Also, try to have all of your prescriptions filled at the same pharmacy. This way, the staff has all of your medications on file. And don't be shy about asking your pharmacist some safety questions. Be your own health advocate.

Alternative Methods for Controlling Allergies

If you continue to suffer from allergy symptoms but can't take allergy medications because of high blood pressure or other heart problems, there are other ways you can help mitigate the sneezing, sniffling, coughing, and watery eyes that allergies can trigger.

Consider these allergy-control methods:

• Run a dehumidifier, because mold loves moisture.
• Use allergen-reducing bedding such as mattress and pillow protectors.
• Try a saline nasal spray or wash to reduce nasal congestion.

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