27
Table 11. Selected List of Frequently Used Medications and
Other Substances That May Cause Elevated Blood
Pressure With Recommendations for Management*
(cont'd)
Agent Possible Management Strategy
Prescription drugs (cont'd)
Atypical antipsychotics
†
(eg,
risperidone, olanzapine)
Discontinue or limit use when possible
Consider behavior therapy where appropriate
Recommend lifestyle modification (Section 5.1)
Consider alternative agents associated with
lower risk of weight gain, diabetes, and
dyslipidemia
Immunosuppressants
†
(eg,
cyclosporine)
Consider converting to tacrolimus, which may
be associated with fewer effects on BP
Oral contraceptives
†
Use low-dose (eg, 20–30 mcg ethinyl
estradiol) agents or a progestin-only form of
contraception, or consider alternative forms
of birth control where appropriate (eg, barrier,
abstinence, nonhormonal IUD)
Avoid use in women with uncontrolled
hypertension
Systemic corticosteroids
†
(eg,
dexamethasone, fludrocortisone,
methylprednisolone, prednisone,
prednisolone)
Avoid or limit use when possible
Consider alternative modes of administration
(eg, inhaled, topical) when feasible
Angiogenesis inhibitor
†
(eg,
bevacizumab) and tyrosine kinase
inhibitors (eg, sunitinib, sorafenib)
Avoid or limit use when possible
Androgen deprivation therapy
†
such
as CYP 17 inhibitors (eg, abiraterone,
orteronel) or androgen receptor
antagonist (eg, enzalutamide)
Avoid or limit use when possible
Consider alternative chemotherapy
* List is not all inclusive.
†
In specific cases when a specific therapy is needed or the best option for the patient, it is
reasonable to continue the medication and initiate or intensify antihypertensive therapy.
ADHD indicates attention-deficit/hyperactivity disorder; IUD, intrauterine device; MAOI,
monoamine-oxidase inhibitors; MDPV, methylenedioxy pyrovalerone; SNRI, serotonin
norepinephrine-reuptake inhibitor; SSRI, selective serotonin-reuptake inhibitor; and TCA,
tricyclic antidepressant.
Modified with permission from Whelton et al. Copyright © 2018 American College of
Cardiology Foundation and American Heart Association, Inc.
