Why is this cold medicine forbidden for patients with hypertension and heart disease?

A few days ago, a patient with high blood pressure came to the pharmacy clinic for consultation. He said he had a cold, and the doctor prescribed him ammonia-metamin tablet (II). After receiving the medicine, the patient checked the instructions for the medicine and found that the [Contraindications] column said: Patients with high blood pressure or heart disease are prohibited from using it. So he asked the pharmacist: "The instructions for the medicine say that patients with high blood pressure are prohibited from using it, so does that mean I can't use it?"

First of all, I would like to praise this patient for reading the drug instructions carefully. This is a very good medication habit!

Drug instructions are the legal basis for doctors, pharmacists and nurses to use drugs. The drug instructions for Aminomemin Tablets (II) clearly state in the [Contraindications] column that "patients with hypertension or heart disease are prohibited from taking this drug." Therefore, in general, patients with hypertension or heart disease should not take this drug according to the requirements of the instructions.

So, why is there this taboo? Let’s analyze it carefully below.

Pseudoephedrine is the key

Aminomemin Tablets (II) are compound preparations. The main components and pharmacological effects of each tablet are as follows:

After consulting relevant literature, we analyzed that the main ingredient that affects blood pressure or heart is pseudoephedrine. Pseudoephedrine has the effect of constricting blood vessels, accelerating heart rate, and raising blood pressure. For patients with hypertension and heart damage, if they take drugs containing this ingredient, their blood pressure may rise, which may easily induce angina pectoris and even stroke.

This is the main reason why patients with high blood pressure or heart disease should not use this drug.

Pseudoephedrine can relieve the symptoms of nasal congestion. Many cold medicines contain pseudoephedrine, such as the previously mentioned Amine Ephedrine Tablets (II), Amine Pseudoephedrine Tablets II/Amine Ephedrine Tablets and Phenol Ephedrine Tablets.

Don't use cold medicine randomly

So, how should patients with high blood pressure or heart disease use medication to relieve symptoms such as headache, runny nose, and sneezing when they have a cold?

When patients with hypertension or heart disease catch a cold, they can choose cold medicines that do not contain pseudoephedrine, such as compound acetaminophen zinc gluconate tablets and compound acetaminophen amantadine tablets. The instructions for these two medicines do not mention that they are prohibited for patients with hypertension or heart disease.

You can also choose Chinese patent medicine preparations with heat-clearing, antiviral and other therapeutic effects according to the symptoms. For example, the patient with hypertension mentioned at the beginning of the article, the doctor finally helped him change to a Chinese patent medicine antiviral mixture to avoid the possible impact of the drug on his blood pressure.

Cold medicine should not be used casually, and patients with hypertension or heart disease should be more careful.

Note: This article only discusses the effects of cold medicine on high blood pressure or heart disease. The effects on other diseases should also be noted, but they are not discussed in this article.

Author: Fan Qingqing, Chief Pharmacist of the Pharmacy Department of Xi'an First Hospital

Review expert: Wang Baoxin, deputy director and pharmacist of the Pharmacy Department of Peking University First Hospital