Home Blood Pressure Medications Drug Reference Guide: Blood Pressure Medications
Blood Pressure Medications

Drug Reference Guide: Blood Pressure Medications

by BidRx Team
written by BidRx Team
hypertension-definition

Highlights 

  • Hypertension, also known as high blood pressure, can lead to serious health problems.
  • Blood pressure medications and lifestyle modifications are commonly prescribed to help bring a person’s blood pressure back to a normal range. 
  • Several classes of drugs are used to treat high blood pressure. 
  • BidRx can help you to get the lowest price for high blood pressure medications.

If your hypertension isn’t resolved with lifestyle changes, your provider will likely recommend starting a blood pressure medication. The right medication for you will depend on your existing health status, other medications you may be taking, and risk for certain side effects. 

Whichever hypertension medication you’re taking, you can find the lowest price with BidRx. 

Blood Pressure Medications — Overview

Numerous blood pressure drugs are used to treat hypertension. These drugs, called antihypertensives, help to lower blood pressure either on their own or in combination with another treatment.

There are many classes of hypertension medications. The mechanism of action, potential side effects, and drug interactions vary from class to class and from drug to drug. 

The main classes of high blood pressure drugs include:

  • Diuretics
  • Beta blockers
  • ACE inhibitors
  • Angiotensin receptor blockers (ARBs)
  • Calcium channel blockers
  • Alpha blockers

Other classes of high blood pressure drugs include:

  • Central agonists, also called central-acting agents
  • Peripheral adrenergic inhibitors (PAIs)
  • Renin inhibitors 
  • Vasodilators

Diuretics 

Diuretics lower blood pressure by helping the body rid itself of excess sodium and water. They are used to treat a variety of health conditions, including high blood pressure. Doctors often prescribe diuretics along with other medications.

Examples of diuretics include:

Diuretics Used To Treat Hypertension

There are three classes of diuretics used to treat high blood pressure.

  • Thiazide diuretics.Thiazide diuretics are considered a first-line treatment for hypertension. These diuretics act directly on the kidneys to promote urine flow. They do this by inhibiting the sodium/chloride cotransporter located in the distal convoluted tubule of a kidney cell.
  • Loop diuretics. Loop diuretics are approved to treat high blood pressure but are not as commonly prescribed as thiazide diuretics. Drugs in this class work by inhibiting the sodium-potassium-chloride cotransporter in the thick ascending loop of Henle (section of the kidney). They are considered a strong diuretic.
  • Potassium-sparing diuretics. These diuretics increase urination without the loss of potassium. They do this by interfering with the sodium-potassium exchange in the distal convoluted tubule of a kidney cell. Some also work as an antagonist at the aldosterone receptor. They are considered a weaker diuretic.

Contraindications (Who Should Not Take Diuretics)

Diuretics are generally considered safe when taken as directed. Some people may need to take extra precautions when taking diuretics.

Diuretics may be inappropriate for people who are:

  • Allergic to sulfa drugs  
  • Currently breastfeeding
  • Older and are more prone to dizziness and fainting from dehydration

Diuretic Warnings

Diuretics can cause some people with diabetes to have higher blood sugar levels. If you have diabetes, you may need to modify your diet and prescription medications while taking diuretics. 

Side Effects of Diuretics

The most common side effect of diuretics is increased urination. 

Other potential side effects include:

  • Reduced potassium levels
  • Gout
  • Impotence

Drug Interactions

Diuretics are commonly combined with other medications. Always tell your provider about any other medications or supplements you’re taking before starting diuretics. Drinking alcohol may also increase your risk of side effects.

Some medications may interact with diuretics. These include:

  • Antidepressants 
  • Cyclosporine
  • Digoxin
  • Lithium
  • Other high blood pressure drugs 

Special Considerations — Diuretics

Diuretics cause increased urination and can affect your potassium levels. Your provider may wish to conduct routine blood and urine tests to monitor your kidney function and mineral levels while you’re taking diuretics. 

Beta Blockers

Beta blockers, also known as beta-adrenergic blocking agents, lower blood pressure by helping to reduce the heart’s workload. They work by interfering with the effects of epinephrine (adrenaline). This lowers your heart rate and reduces blood flow throughout the body. 

Examples of beta blockers include:

Contraindications (Who Should Not Take Beta Blockers)

People with certain health conditions may experience additional risks or side effects when taking beta blockers. Beta blockers may not be safe for women who are pregnant or planning to become pregnant. 

Beta blockers may be inappropriate for people who have:

  • Asthma
  • Diabetes
  • High cholesterol

Beta Blocker Warnings

Beta blockers can affect cholesterol and triglyceride levels. This change is typically temporary but may warrant additional precautions or dietary changes. You should avoid drinking alcohol while taking beta blockers, as this can cause a severe drop in blood pressure.

Do not stop taking beta blockers without consulting your provider. Abruptly stopping this medication can increase your risk of heart attack and other serious health problems.

Side Effects of Beta Blockers

Potential side effects of beta blockers include:

  • Cold hands and feet
  • Depression
  • Fatigue 
  • Impotence
  • Insomnia
  • Shortness of breath
  • Slow heartbeat

Drug Interactions — Beta Blockers

Beta blockers can interfere with the effectiveness of other medications and vice versa. Combining beta blockers with other medications can also put you at a greater risk for side effects.

Beta blockers may interact with:

  • Allergy medications
  • Anesthetics
  • Antidepressants
  • Certain antibiotics
  • Cholesterol drugs
  • Decongestants and cold medications
  • Insulin and other diabetes medications
  • Medications for asthma and COPD
  • Medication for Parkinson’s disease 
  • Muscle relaxants
  • Nonsteroidal anti-inflammatory drugs (NSAIDs)
  • Other hypertension medications
  • Ulcer medications

Special Considerations – Beta Blockers

People with diabetes need to take extra precautions while taking beta blockers. This may include more frequent blood glucose monitoring. 

Angiotensin-converting enzyme (ACE) inhibitors lower blood pressure by helping the blood vessels to relax. They work by preventing the body from producing too much angiotensin, a chemical that causes the arteries to tighten. This allows your blood vessels to open up and have ample blood flow. 

ACE Inhibitors

Examples of ACE inhibitors include:

Contraindications (Who Should Not Take ACE Inhibitors)

People with certain health conditions may experience additional risks or side effects when taking ACE inhibitors. ACE inhibitors are not safe for pregnant women or those who are planning to become pregnant. 

ACE inhibitors may be inappropriate for people who:

  • Are breastfeeding
  • Have a history of angioedema
  • Have severe kidney disease or another disease affecting arteries that supply the kidneys

ACE Inhibitor Warnings

Do not stop taking ACE inhibitors without consulting with your provider. Abruptly stopping these medications can increase your risk of heart attack and other serious health problems.

Side Effects of ACE Inhibitors

Potential side effects of ACE inhibitors include:

  • Chronic, dry cough
  • Blurred vision
  • Fatigue
  • Dizziness 
  • Dry mouth
  • Headaches
  • Increased potassium and creatinine blood levels
  • Loss of taste
  • Skin rash
  • Sweating

Drug Interactions — ACE Inhibitors

ACE inhibitors can interfere with the effectiveness of other medications and vice versa. Combining ACE inhibitors with other medications can also put you at a greater risk for side effects.

Beta blockers may interact with:

  • Aliskiren (Tekturna)
  • Angiotensin receptor blockers (ARBs) 
  • Kidney medications
  • Medications affecting potassium or sodium levels
  • NSAIDS

Special Considerations — ACE Inhibitors

ACE inhibitors may not be as effective at lowering blood pressure in people of African American descent.

Angiotensin Receptor Blockers (ARBs)

Angiotensin receptor blockers lower blood pressure by helping the blood vessels stay open. They work by blocking the effects of angiotensin, a chemical that causes the arteries to tighten. While your body still produces this hormone, ARBs prevent the chemical from binding with angiotensin receptors. 

ARBs essentially work like jamming a lock. The hormone cannot attach to the receptor, so it’s unable to constrict the blood vessels. This allows the blood vessels to stay relaxed and open enough for ample blood flow. 

Examples of ARBs include:

Contraindications (Who Should Not Take ARBs)

People with certain health conditions may experience additional risks or side effects when taking ARBs. ARBs are not safe for women who are pregnant or planning to become pregnant. 

ARBs may be inappropriate for people who:

  • Are allergic to ARBs or any of their active ingredients
  • Have congestive heart failure
  • Have low levels of sodium in the blood
  • Have poor kidney function

ARB Warnings

Do not take an ARB if you’re pregnant or plan to become pregnant. These drugs can harm a developing fetus. If you suspect you are pregnant while taking an ARB, you should stop taking the medication right away and contact your doctor.

Side Effects of ARBs

Potential side effects of ARBs include:

  • Angioedema
  • Dizziness 
  • Increased levels of potassium in the blood
  • Intestinal problems, such as diarrhea 

Drug Interactions — ARBs

ARBs can interfere with the effectiveness of other medications and vice versa. Combining ARBs with other medications can also put you at a greater risk for side effects.

Do not take an ARB if you are already taking a drug containing aliskiren, which includes these brand names:

  • Tekturna
  • Takaml
  • Amturnide

You should also avoid taking an ARB with:

Special Considerations — ARBs

Ask your provider about any special treatment considerations while you’re taking an ARB. 

Alpha Blockers

Alpha blockers lower blood pressure by helping the blood vessels stay open and relaxed. They work by preventing norepinephrine from tightening the muscles in the walls of smaller arteries and veins. This allows for ample blood flow throughout the body.

Providers often prescribe alpha blockers combined with other blood pressure drugs, such as diuretics, to lower blood pressure. Drugs in this class can be short-acting or long-acting.

Examples of alpha blockers include:

Contraindications (Who Should Not Take Alpha Blockers)

People with certain health conditions may experience additional risks or side effects when taking alpha blockers. 

Alpha blockers may be inappropriate for people who:

  • Are undergoing cataract surgery 
  • Are breastfeeding
  • Have a history of orthostatic hypotension
  • Have kidney disease, circulatory diseases, or respiratory infections
  • Take erectile dysfunction medications 

Alpha Blocker Warnings

Do not stop taking an alpha blocker without consulting with your provider. Abruptly stopping these medications can increase your risk of heart attack and other serious health problems.

Side Effects of Alpha Blockers

Alpha blockers may cause low blood pressure when you first start taking them. Other potential side effects of alpha blockers include:

  • Dizziness
  • Headache
  • Pounding heartbeat
  • Weakness

Drug Interactions — Alpha Blockers

Alpha blockers can interfere with the effectiveness of other medications and vice versa. Combining beta blockers with other medications can also put you at a greater risk for side effects.

Alpha blockers may interact with:

  • Alternative alpha blockers
  • Antihistamines
  • Anxiolytics
  • Beta blockers
  • Calcium channel blockers
  • Erectile dysfunction drugs

Special Considerations — Alpha Blockers

Some research suggests that long-term use of alpha blockers can increase your risk of heart failure. You should discuss your personal risk and concerns with your provider. 

Calcium Channel Blockers

Calcium channel blockers lower blood pressure by helping the blood vessels to relax and open. These drugs work by preventing calcium from entering the cells of the heart and arteries. This prevents the arteries from contracting strongly and allows the blood vessels to remain relaxed.

Calcium channel blockers are also called calcium antagonists. These drugs can be short-acting or long-acting. They are sometimes prescribed alongside other high blood pressure drugs. 

Examples of calcium channel blockers include:

Contraindications (Who Should Not Take Them)

People with certain health conditions may experience additional risks or side effects when taking calcium channel blockers. Calcium channel blockers may be inappropriate for people who have congestive heart failure or structural heart problems.

Calcium Channel Blocker Warnings

Avoid consuming any grapefruit product while taking a calcium channel blocker. Grapefruit juice interacts with this drug and can affect your heart rate and blood pressure. This can cause headaches and dizziness.

Side Effects of Calcium Channel Blockers

Potential side effects of calcium channel blockers include:

  • Constipation
  • Dizziness
  • Fast heartbeat (heart palpitations)
  • Fatigue
  • Flushing
  • Headache
  • Nausea
  • Rash
  • Swelling in the feet and ankles

Drug Interactions — Calcium Channel Blockers

Calcium channel blockers can interfere with the effectiveness of other medications and vice versa. Combining beta blockers with other medications can also put you at a greater risk for side effects.

In addition to grapefruit products, calcium channel blockers may interact with:

  • ACE inhibitors
  • Alternative calcium channel blockers
  • Beta blockers
  • Atorvastatin
  • Diuretics
  • Digitoxin 
  • Diltiazem
  • Certain eye medications
  • Cortisone or corticosteroids
  • Large amounts of vitamin D or calcium supplements
  • Lovastatin
  • Medications used to treat arrhythmia
  • Simvastatin
  • Verapamil 

Special Considerations — Calcium Channel Blockers

Speak to your provider regarding any special considerations for your care while taking a calcium channel blocker.

Central Agonists

Central agonists, also called central-acting agents, lower blood pressure by lowering the heart rate and reducing the heart’s workload. They work by blocking signals from the brain that tell the nervous system to increase the heart rate and narrow blood vessels. This allows the heart rate to slow and blood to flow more easily throughout the body. 

Central agonists work on a different nerve pathway than alpha and beta blockers but achieve the same effect.

Example central acting agents include:

Contraindications (Who Should Not Take Them)

People with certain health conditions may experience additional risks or side effects when taking central agonists. 

Central agonists may be inappropriate for people who have:

  • Gynecomastia 
  • High prolactin levels in the blood
  • Parkinson’s disease

Central Agonist Warnings

Do not stop taking a central agonist without consulting with your provider. Abruptly stopping this medication can increase your risk of heart attack and other serious health problems.

Side Effects — Central Agonists

Some central agonists can cause a lower drop in blood pressure than other high blood pressure drugs. This may cause you to experience dizziness while standing or walking. Speak to your provider if this is a persistent symptom.

Potential side effects of central agonists include:

  • Slow heart rate
  • Constipation
  • Dizziness
  • Drowsiness
  • Dry mouth
  • Fatigue
  • Fever
  • Headache
  • Impotence

Drug Interactions — Central Agonists

Combining central agonists with other substances or medications can cause your blood pressure to drop too low. 

Do not take central agonists with:

  • Alcohol
  • Anxiety medications
  • Benzodiazepines and barbiturates
  • Medications for insomnia or sleeping pills

Special Considerations — Central Agonists

Methyldopa is commonly prescribed during pregnancy because this drug has limited effects on fetal development. Speak to your provider regarding any special treat, considerations while you’re taking a central agonist. 

Peripheral Adrenergic Inhibitors

Peripheral adrenergic inhibitors (PAIs) lower blood pressure by helping the blood vessels stay relaxed and open. They work by blocking neurotransmitters in the brain. They specifically prevent smooth muscles from receiving the message to constrict.

These drugs are typically only used when other medications are unable to lower blood pressure. PAIs are also prescribed for other health conditions. 

Examples of peripheral adrenergic inhibitors include:

Contraindications (Who Should Not Take PAIs)

People with certain health conditions may experience additional risks or side effects when taking a PAI. 

PAIs may be inappropriate for people who have:

  • Asthma
  • Depression 
  • Congestive heart failure
  • Fluid retention
  • Peptic ulcers
  • Pheochromocytoma
  • Ulcerative colitis
  • Vascular diseases 

PAI Warnings

Do not stop taking a PAI without consulting your provider. Abruptly stopping this medication can increase your risk of heart attack and other serious health problems.

Side Effects of PAIs

PAI side effects vary by individual medication. 

Potential side effects include:

  • Depression
  • Diarrhea
  • Fainting
  • Heartburn
  • Impotence
  • Lightheadedness or dizziness
  • Low blood pressure
  • Nasal congestion

Drug Interactions — PAIs

Combining PAIs with other substances or medications can interfere with effectiveness or lead to unwanted side effects.

PAIs may interact with:

  • Alcohol
  • Antidepressants 
  • Diuretics
  • Medications for asthma
  • Other high blood pressure medications

Special Considerations — PAIs

Speak to your provider regarding any special treatment considerations while taking a PAI.

Renin Inhibitor

Aliskiren (Tekturna) is currently the only FDA-approved renin inhibitor on the market.

This medication is similar to ACE inhibitors and ARBs. It works on the enzyme renin to prevent blood vessels from tightening. 

Contraindications (Who Should Not Take Aliskiren)

Do not take aliskiren/Tekturna if you’re pregnant or plan to become pregnant. This drug can harm a developing fetus. If you suspect you’re pregnant while taking this medication, stop taking the medicine right away and contact your doctor.

People with certain health conditions may experience additional risks or side effects when taking this drug. 

Aliskiren/Tekturna may be inappropriate for people who:

  • Are allergic to any heart or blood pressure medicine
  • Are breastfeeding
  • Hava heart disease
  • Have kidney disease
  • Eat a low-salt diet

Aliskiren/Tekturna Warnings

If you have diabetes, do not use aliskerin/Tekturna with certain heart or blood pressure medicines (ask your doctor). You should not take this medication while breastfeeding, pregnant, or trying to become pregnant. 

Side Effects of Aliskiren/Tekturna

Contact your provider or seek emergency medical assistance if you experience any symptoms of an allergic reaction while taking this medication. The most commonly reported side effect is diarrhea. 

Drug Interactions — Aliskiren/Tekturna 

This medication can interfere with the effectiveness of other medications and vice versa. 

Aliskiren may interact with:

  • Alcohol 
  • Heart medications
  • Other high blood pressure medications

Special Considerations — Aliskiren/Tekturna

Speak to your provider regarding any special treat, considerations while you’re taking this medication. 

Vasodilators

Vasodilators, also known as blood vessel dilators, lower blood pressure by helping blood to flow more easily through the body. They work by dilating (widening) the blood vessels. Most act directly on the smooth muscle cells lining the blood vessels.

Vasodilators more commonly prescribed for high blood pressure include:

Contraindications (Who Should Not Take Vasodilators)

People with certain health conditions may experience additional risks or side effects when taking vasodilators. These drugs may not be safe for pregnant women or who are planning to become pregnant. 

Vasodilators may be inappropriate for people who have:

  • Angina
  • Angioedema
  • Certain types of heart disease
  • Chronic obstructive pulmonary disease (COPD)
  • Low blood pressure

Vasodilator Warnings

You should not take erectile dysfunction medications with a vasodilator, as this can cause a life threatening drop in blood pressure.

Side Effects of Vasodilators

Vasodilator side effects vary by individual medication. 

Potential side effects include:

  • Headaches
  • Heart palpitations
  • Joint pain
  • Swelling around the eyes
  • Weight gain due to fluid retention

Drug Interactions — Vasodilators

Vasodilators can interfere with the effectiveness of other medications and vice versa. Combining vasodilators with other medications can also put you at a greater risk for side effects.

Vasodilators may interact with:

  • Diuretics
  • Erectile dysfunction medications 
  • Other high blood pressure medications

Special Considerations — Vasodilators

Speak to your provider regarding any special considerations for your care while taking a vasodilator. 

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The BidRx team is a group of professional medical and healthcare writers

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