Medications for Hypertension

The information provided here is meant to give you a general idea about each of the medications listed below. Only the most general side effects are included, so ask your doctor if you need to take any special precautions. Use each of these medications as recommended by your doctor, or according to the instructions provided. If you have further questions about usage or side effects, contact your doctor.

Many different medications are available to lower your blood pressure. Your doctor will discuss the options with you and help you select a medication plan to meet your needs. Many times more than one drug is needed to control blood pressure.

Blood pressure medications must be taken daily. Do not stop taking your medication on your own. If you develop side effects, notify your doctor. You may be able to get the dose adjusted or have another drug prescribed to help minimize side effects while controlling your blood pressure.

Hypertension can be controlled, not cured. Taking your medications as ordered is vital to controlling this condition and reducing the risk of complications. It may be necessary to take the medications indefinitely. Be sure to discuss any questions or problems with your doctor.

Prescription Medications

Diuretics

  • Hydrochlorothiazide
  • Indapamide
  • Spironolactone

Beta blockers

  • Atenolol
  • Propranolol hydrochloride
  • Metoprolol
  • Nadolol
  • Betaxolol
  • Acebutolol
  • Pindolol
  • Bisoprolol

Angiotensin-converting enzyme (ACE) inhibitors

  • Benazepril hydrochloride
  • Captopril
  • Enalapril maleate
  • Quinapril
  • Perindopril
  • Ramipril
  • Trandolapril
  • Fosinopril
  • Moexipril
  • Lisinopril

Angiotensin II antagonists

  • Irbesartan
  • Losartan potassium
  • Valsartan
  • Candesartan
  • Olmesartan
  • Telmisartan
  • Eprosartan

Calcium channel blockers

  • Verapamil hydrochloride
  • Diltiazem hydrochloride
  • Amlodipine
  • Sustained release nifedipine
  • Felodipine
  • Nisoldipine

Alpha-blockers

  • Prazosin
  • Terazosin
  • Doxazosin

Alpha beta blockers

  • Labetalol
  • Carvediol

Centrally-acting nervous system drugs

  • Clonidine
  • Methyldopa

Vasodilators

  • Hydralazine hydrochloride

Prescription Medications

Diuretics

Common names include:

  • Hydrochlorothiazide
  • Indapamide
  • Spironolactone

Diuretics help the kidneys get rid of excess water and sodium by increasing urine production. Lower fluid levels in your blood can reduce pressure on your blood vessels. These medications are sometimes referred to as “water pills.”

Possible side effects include:

  • Lightheadedness
  • Frequent urination
Beta blockers

Common names include:

  • Atenolol
  • Propranolol hydrochloride
  • Metoprolol
  • Nadolol
  • Betaxolol
  • Acebutolol
  • Pindolol
  • Bisoprolol

Beta blockers reduce demands on the heart by reducing the rate and force of contraction. Less force from the heart will lead to lower blood pressure.

Possible side effects include:

  • Lightheadedness and/or fainting as a result of low blood pressure
  • Slow heart rate
  • Fatigue

Beta blockers may not be the first-line treatment for hypertension.

Angiotensin-converting Enzyme (ACE) Inhibitors

Common names include:

  • Benazepril hydrochloride
  • Captopril
  • Enalapril maleate
  • Quinapril
  • Perindopril
  • Ramipril
  • Trandolapril
  • Fosinopril
  • Moexipril
  • Lisinopril

ACE inhibitors relax the blood vessels and lower blood pressure by blocking the production of a hormone that causes the blood vessels to constrict.

Possible side effects include:

  • Dry, unproductive cough
  • Headache
  • Lightheadedness and/or fainting as a result of low blood pressure
Angiotensin II Receptor Antagonists

Common names include:

  • Irbesartan
  • Losartan potassium
  • Valsartan
  • Candesartan
  • Olmesartan
  • Telmisartan
  • Eprosartan

Angiotensin antagonists relax the blood vessels and lower blood pressure by shielding the blood vessels from a hormone that causes the blood vessels to constrict.

Possible side effects include:

Calcium Channel Blockers

Common names include:

  • Verapamil hydrochloride
  • Diltiazem hydrochloride
  • Amlodipine
  • Sustained release nifedipine
  • Felodipine
  • Nisoldipine

Calcium channel blockers relax the blood vessels and lower blood pressure by blocking some activities of heart and blood vessel muscle cells.

Possible side effects include:

Alpha blockers

Common names include:

  • Prazosin
  • Terazosin
  • Doxazosin

Alpha blockers lower blood pressure by decreasing nerve impulses to the blood vessels. This relaxes the blood vessels and helps lower blood pressure.

Possible side effects include:

  • Lightheadedness and/or fainting as a result of low blood pressure
  • Headache
Alpha-beta Blockers

Common names include:

  • Labetalol
  • Carvediol

Alpha-beta blockers lower blood pressure by decreasing nerve impulses to the blood vessels. They also slow the heart rate and decrease the force of contraction. This decreases the workload of the heart and helps lower the blood pressure.

Possible side effects include:

  • Lightheadedness and/or fainting as a result of low blood pressure especially when standing up
  • Fatigue
  • Nausea
Centrally Acting Nervous System Drugs

Common names include:

  • Clonidine
  • Methyldopa

Nervous system drugs lower blood pressure by controlling nerve impulses and relaxing blood vessels. These drugs can be taken orally. Clonidine is available through a skin patch.

Possible side effects include:

  • Dry mouth
  • Drowsiness
  • Lightheadedness
  • Redness, itching, and skin irritation (with skin patch)
Vasodilators

Common name—hydralazine hydrochloride

Vasodilators lower blood pressure by directly relaxing blood vessel walls.

Possible side effects include:

  • Fluid retention
  • Rapid heart rate

Special Considerations

If you are taking medications, follow these general guidelines:

  • Take your medication as directed. Do not change the amount or the schedule.
  • Do not stop taking them without talking to your doctor.
  • Do not share them.
  • Ask what the results and side effects are. Report them to your doctor.
  • Some drugs can be dangerous when mixed. Talk to a doctor or pharmacist if you are taking more than one drug. This includes over-the-counter medication and herb or dietary supplements.
  • Plan ahead for refills so you do not run out.

Note: Non-steroidal anti-inflammatory drugs such as ibuprofen and naproxen can elevate blood pressure and make your medications less effective. Talk to your doctor about other medications you may be able to take.

When to Contact Your Doctor

Contact your doctor if you:

  • Develop side effects to any of the medications
  • Check your own blood pressure and it regularly runs higher or lower than the target blood pressure range set by your doctor

Revision Information

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  • Antihypertensive medication selection. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated February 26, 2014. Accessed February 28, 2014.

  • How is high blood pressure treated? National Heart, Lung, and Blood Institute website. Available at: http://www.nhlbi.nih.gov/health/health-topics/topics/hbp/treatment.html. Updated August 2, 2012. Accessed February 28, 2014.

  • Hypertension. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated February 12, 2014. Accessed February 28, 2014.

  • Medications and blood pressure. American Heart Associatin website. Available at: http://www.heart.org/HEARTORG/Conditions/HighBloodPressure/PreventionTreatmentofHighBloodPressure/Medications-and-Blood-Pressure%5FUCM%5F301888%5FArticle.jsp. Updated February 26, 2014. Accessed February 28, 2014.

  • The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: The JNC 7 Report. JAMA. 2003;289:2560-2572.

  • 2/28/2014 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: CS Wiysonge, H Bradley, et al. Beta-blockers for hypertension. Cochrane Database Syst Rev. 2012;11:CD002003.

  • 4/2/2014 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Choosing wisely. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated March 26, 2014. Accessed April 2, 2014.