Conventional medical therapies
- Calcium channel blockers – Help decrease blood pressure (appropriate only for a minority of patients who demonstrate favorable responses to vasodilator testing at the time of heart catheterization.)
- Digoxin: Assists the pumping of the heart
- Diuretics: Eliminates excess fluid that puts pressure on the heart
- Oxygen: Inhaled via nasal cannula or face mask. Learn more about inhaled oxygen.
- Warfarin (Coumadin): Prevents blood from clotting.
Endothelin receptor antagonists help prevent blood vessels from narrowing.
Phosphodiesterase inhibitors (PDE 5 inhibitors) allow the lungs to produce more of its own natural vasodilators.
Prostacyclin Analogue allows the blood vessels in the lungs relax
Selective IP receptor agonist targets and activates a prostacyclin receptor which helps the blood vessels in the lungs relax.
Soluble guanylate cyclase stimulators increase the interaction of the sGC enzyme with another chemical (nitric oxide) to help the blood vessels in the lungs relax.
Inhaled treatment options, including prostacyclins, relieve shortness of breath.
Subcutaneous treatment options are delivered through a portable infusion pump to open up the blood vessels and ease the symptoms of PH.
Intravenous treatment options open up the blood vessels and help ease symptoms of PH, including chest pain and shortness of breath.
Over-the-counter medications and supplements
While they don’t require prescriptions, over-the-counter medications and herbal supplements should be used cautiously if you have pulmonary hypertension.
Certain ingredients in these drugs can affect the heart and lungs or interact with medications commonly prescribed for PH. As with prescription drugs, talk to your PH doctor before taking anything new. Here are a few important interactions you should know about:
Avoid decongestants and medications that contain stimulants such pseudoephedrine or ephedrine, which are found in cold, flu, sinus, allergy and headache medications. Those medications cause blood vessels to constrict, which can worsen PH and increase blood pressure and heart rate. Those medications also can cause palpitations and irregular heart rhythms.
Medications that contain antihistamines (diphenhydramine, Benadryl, Claritin, Zyrtec, Allegra) can be used to treat cold symptoms, allergies and hay fever, as long as they don’t contain decongestants (Claritin D, Zyrtec D or Allegra D).
Avoid non-steroidal anti-inflammatory medications, such as ibuprofen (Advil, Motrin) and naproxen (Aleve). NSAIDs can cause swelling and fluid retention, harm your kidneys, and increase blood pressure and bleeding from your stomach, particularly when taken in combination with blood thinners such as warfarin, Eliquis, Xarelto, Pradaxa. Acetaminophen (Tylenol) generally is safe, but people with liver disease should use cautiously. Speak to your PH specialist before taking over-the-counter medications.
Herbal therapies should be viewed as drugs, not simply “natural supplements.” Discuss these therapies with your PH specialist before taking anything new.
Any ingredient contraindicated for people with high blood pressure, as a general rule, also is contraindicated for people with PH. If you’re uncertain about the contents of a specific medication, ask your PH pharmacist.
Research and clinical trials
Read about participating in research and clinical trials.
Visit our lung transplantation section.