BOSTON —Few people who take over-the-counter decongestants heed the warning label: “Do not use this product if you have heart disease, high blood pressure, thyroid disease, diabetes, or difficulty in urination due to enlargement of the prostate gland unless directed by a doctor.” New changes in many cold medicines make this a particularly good time to start paying attention to it, notes the November issue of the Harvard Heart Letter.

Pseudoephedrine Decongestants

Pseudoephedrine, the old standby found in Sudafed and hundreds of other over-the-counter decongestants, can raise blood pressure. In most people the increase is small, and millions of people use it each year with no trouble. Over the years, though, there have been reports of heart attacks, strokes, disturbed heart rhythms, and other cardiovascular problems with use of pseudoephedrine. Now, in response to laws that make it less convenient to buy pseudoephedrine, some companies are replacing this ingredient with phenylephrine, a decongestant traditionally used in nasal sprays. Few studies have looked at the impact of phenylephrine on the heart and blood pressure, and its effect on the heart remains to be seen, says the Heart Letter.

Most people can take an over-the-counter decongestant without a hitch. If you have high blood pressure or heart disease, talk with your doctor first, or try a remedy that doesn’t contain decongestants, says the Harvard Heart Letter.

Phenylephrine decongestant alternatives include:

antihistamines such as diphenhydramine (Benadryl), chlorpheniramine (Chlor-Trimeton, Coricidin HBP), cetirizine (Zyrtec), and loratadine (Claritin) Breathe Right nasal strips a steamy shower or a hot towel wrapped around the face drinking plenty of fluids, especially hot beverages. Related Information 12 tips for remembering to take your medications New heart failure drug approved for African-Americans may work for others too Is flaxseed oil as good a source of omega-3 fats as fish or fish oil?