Table.
List of Mmedications That May Increase BP
| Ingredient | Clinical Use | Notes |
|---|---|---|
| Steroids | ||
| Glucocorticoid | Replacement therapy, rheumatic disease, collagen disease, dermatologic disease, allergic state, opthalmic disease, inflammatory bowel disease, respiratory disease, hematologic and neoplastic disease, nephropathies | Dose‐dependent sustained increase mainly in systolic BP |
| Mineralocorticoid | Dose‐dependent, sustained increase in BP characterized by hypokalemia, metabolic alkalosis, and suppressed plasma renin activity and aldosterone levels | |
| Licorice | Flavoring and sweetening agent | |
| Carbenoxolone | Ulcer medication | |
| 9‐α‐Fluoroprednisolone | Skin ointments, antihemorrhoid cream | |
| 9‐α‐Fluorocortisol | Ophthalmic drops, nasal sprays | |
| Ketoconazole | Antimycotic | |
| Sex hormones | Contraception, replacement therapy in premenopausal women. Severe hypertension has been reported. | |
| Estrogen + progesterone | Contraception, replacement therapy | Mild, sustained BP elevation, more common in premenopausal women. Severe hypertension has been reported. |
| Androgens | Prostate cancer | Mild dose‐dependent sustained increase in systolic BP |
| Danazol (semisynthetic androgen) | Anabolic effect, endometriosis, hereditary angioedema | |
| Anesthetics, narcotics | ||
| Ketamine hydrochloride | Anesthetic agent | Transient severe increase in BP has been reported |
| Fentanyl citrate | Narcotic analgesic and anesthetic agent | |
| Scopolamine | Preanesthetic medication, motion sickness | |
| Naloxone hydrochloride | Opioid overdose | Transient BP elevation |
| Drugs affecting the sympathetic nervous system | ||
| Phenylephrine hydrochloride | Upper respiratory decongestant, ophthalmic drops | Dose‐dependent, sustained increase in BP |
| Dipivalyl adrenaline hydrochloride | Opthalmic drops | Severe hypertension has been reported |
| Epinephrine (with β‐blocker) | Local anesthetic, anaphylactic reaction bronchodilatation, decongestant, antihemorrhoidal treatment | |
| Phenylpropanolamine | Anorectic, upper respiratory decongestant | |
| Pseudoephedrine hydrochloride | Upper respiratory decongestant | |
| Tetrahydrozoline hydrochloride | Opthalmic vasoconstrictor drops | |
| Naphazoline hydrochloride | Opthalmic vasoconstrictor and nasal decongestant drops | |
| Oxymetazoline hydrochloride | Upper respiratory decongestant drops | |
| Caffeine | Analgesia, vascular headache, beverages | Acute transient increase in BP |
| Herbal products | Complementary and alternative medicine | Mainly relate to dietary supplements that contain ephedra alkaloids |
| Cocaine | Local anesthetics | Transient severe increase in BP especially when used with β‐blockers |
| Antiemetic agents | ||
| Metoclopramide | Antiemetic | Transient increase in BP in association with cancer |
| Alizapride | Antiemetic | |
| Prochlorperazine | Antiemetic | |
| Other agents | ||
| Smokeless tobacco | Alternative to smoking | |
| Methylphenidate, demethylphenidate, amphetamine | Attention deficit/hyperactivity disorder | |
| Yohimbine hydrochloride | Impotence | Acute, dose‐dependent increase in BP |
| Sibutramine | Weight loss | |
| Clozapine | Antipsychotic agent | |
| Glucagon | Prevent bowel spasm | Only in patients with pheochromocytoma |
| Physostigmine | Reverse anticholinergic syndrome | |
| Ritodrine hydrochloride | Inhibition of preterm labor | Hypertensive crisis has been reported |
| Antidepressant agents | ||
| MAOIs | Antidepressive agents | Mainly with sympathomimetic amines and with certain food containing tyramine |
| Selegiline | Used mainly for Parkinson's disease | |
| Tricyclic antidepressants | Antidepressive agent | More common in patients with panic disorders |
| Buspirone | Anxiolytic agent | Mild, dose‐dependent increase in BP |
| Fluoxetine | Antidepressive agent | In combination with selegiline |
| Thioridazine hydrochloride | Psychotic and depressive disorders | Massive overdose may cause severe hypertension |
| Carbamazepine | Bipolar disorder and seizures | |
| Lithium | Manic depressive illness | Acute intoxication can cause severe hypertension |
| Immunosuppressive agents | ||
| Cyclosporine A | Immunosuppressive agent, prophylaxis of organ rejection, autoimmune disease, dermatologic disorders | Dose‐dependent, mild to moderate increase in BP; severe hypertension has been reported |
| Tacrolimus | Prophylaxis of organ rejection | Produces less hypertension than cyclosporine A |
| Rapamycin | Prophylaxis of organ rejection | Produces little BP increase |
| Antineoplastic agents | ||
| Alkylating agents | Antineoplastic agent | |
| Paclitaxel | Antineoplastic agent | |
| Cis‐diamminedichloroplatinum | Antineoplastic agent | Only during intra‐arterial administration |
| Bevacizumab | A recombinant monoclonal antibody against vascular endothelial growth factor that is used to treat metastatic cancers of the colon, rectum, kidney, and breast | |
| Sorafenib | Approved for advanced renal cell carcinoma | |
| Sunitinib | Advanced gastrointestinal stromal tumor and renal cell carcinoma | |
| Recombinant human erythropoietin | Anemia of renal failure | Dose‐related, mild increase, in BP; hypertensive crisis with encephalopathy has been reported |
| Alcohol | Beverage | Dose‐dependent, sustained increase in BP |
| Disulfiram | Management of alcoholism | Slight increase in BP. Severe hypertension may occur in alcoholic‐induced liver disease |
| NSAIDs | Rheumatic disease | Mild, dose‐dependent increase in BP |
| Heavy metals | ||
| Lead | Industry | |
| Cadmium | Industry | The association between cadmium exposure and hypertension is equivocal |
| Arsenic | Industry | |
| Bromocriptine mesylate | Suppression of lactation and prolactin inhibition in prolactinoma | Severe hypertension with stroke has been reported following the use for suppression of lactation |
| Amphotericin B | Fungal infections | |
| Torcetrapib | Cholesteryl ester transfer protein inhibitor that increases high‐density lipoprotein cholesterol levels | |
| Protease inhibitor | Anti‐human immunodeficiency virus treatment | |
| Abbreviations: BP, blood pressure; MAOI, monoamine oxidase inhibitors; NSAIDs, nonsteroidal anti‐inflammatory drugs. | ||