A pharmacist has cautioned people with high blood pressure against using Sudafed and similar decongestants, citing ingredients that can raise blood pressure.
Dr Ethan Melillo, whose TikTok account has more than 680,000 followers and 26 million likes, shared the advice in a video about Sudafed. He told viewers to avoid products containing pseudoephedrine or phenylephrine if they have high blood pressure.
"If you have high blood pressure, you should not be taking Sudafed, you should not be taking anything with pseudoephedrine or phenylephrine," he said.
Official Guidance on Decongestants
UK health guidance supports caution around decongestants, although the advice is more specific than a blanket warning against every product. The NHS says people with high blood pressure should speak to a GP or pharmacist before using decongestants, including medicines containing pseudoephedrine.
The MHRA says pseudoephedrine must not be used by people with very high blood pressure or hypertension that is not controlled by their medication. It also warns against its use in people with severe kidney disease or kidney failure, following a review of rare but serious side effects.
How These Medicines Affect Blood Pressure
Dr Melillo said these medicines have a lesser-known effect, adding: "These medications will actually increase your blood pressure, so you want to avoid them." The NHS explains that pseudoephedrine works by reducing swelling in the nose, helping mucus and air move through more easily.
Rather than relying on a medicated decongestant, Dr Melillo recommended saline nasal spray as an option for congestion. NHS advice also includes salt-water nasal sprays and solutions among treatments people can consider for conditions such as allergic rhinitis.
A salt-water rinse can help clean the inside of the nose, and the NHS provides instructions for making a homemade solution using boiled and cooled water, salt and bicarbonate of soda. Its sinusitis guidance suggests cleaning the nose with this solution as one way to ease symptoms.
Alternatives and Precautions
The TikTok pharmacist also questioned the usefulness of quercetin products marketed as alternatives for nasal congestion. People considering supplements should seek advice from a pharmacist, rather than assuming a product advertised as a natural option will provide the same relief as an established treatment.
Dr Melillo also mentioned chlorphenamine, an antihistamine, while discussing products that may be included in some congestion remedies. The NHS classifies chlorphenamine as a drowsy antihistamine and warns it can cause sleepiness, dizziness and difficulty concentrating.
Anyone with high blood pressure who is considering a cold or flu medicine should check its active ingredients and speak to a pharmacist before taking it. This is particularly important because some combination remedies contain several medicines, and the NHS advises against using decongestants without professional guidance if you have hypertension.
