Praxis Medical Insights

Est. 2024 • Clinical Guidelines Distilled

Made possible by volunteer editors from the University of Calgary & University of Alberta

Last Updated: 9/17/2025

Cold Medicines to Avoid with Trazodone and Lisinopril

Specific Contraindicated Cold Medications

  • Decongestants containing pseudoephedrine or phenylpropanolamine should not be taken with trazodone and lisinopril due to risk of significant blood pressure elevation and potential drug interactions 1
  • Decongestants (pseudoephedrine, phenylpropanolamine) should be avoided as they can cause mild to severe hypertension when taken with lisinopril, potentially counteracting its blood pressure-lowering effects 1, 2
  • Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen can antagonize the blood pressure-lowering effect of ACE inhibitors like lisinopril 1
  • Cold medications containing multiple ingredients (combination products) should generally be avoided unless specifically recommended by a healthcare provider, as they often contain decongestants that can interact with both medications 3

Medication-Specific Concerns

Lisinopril Interactions:

  • The combination of decongestants with ACE inhibitors like lisinopril can lead to unpredictable and potentially dangerous blood pressure elevations 1

Trazodone Interactions:

  • The combination of trazodone with other sedating medications found in cold products may increase drowsiness and impair coordination 3

Safer Alternatives for Cold Symptom Relief

  • Saline nasal sprays are safe alternatives for nasal congestion 4
  • Zinc lozenges may help reduce duration of cold symptoms and don't interact with these medications 4
  • Certain herbal products like BNO1016 (Sinupret) may help with cold symptoms without significant drug interactions 4

Important Precautions

  • Always check with your healthcare provider or pharmacist before taking any over-the-counter cold medication with trazodone and lisinopril 1
  • Be aware that even appropriate dosing of decongestants can cause idiosyncratic (unpredictable) severe hypertensive responses in some individuals 1
  • Monitor blood pressure more frequently if you must take a cold medication while on these drugs 2
  • Be particularly cautious with combination cold products that may contain multiple ingredients that could interact with your medications 3

Special Considerations

  • Patients with hypertension should generally avoid ephedra-containing supplements (ma huang), which can cause unpredictable blood pressure increases 1
  • If cold symptoms are severe and require medication, consult with your healthcare provider about temporarily adjusting your regular medication regimen 2