Feeling Dizzy When You Stand Up? Your Medicine Could Be Part of the Reason

Have you ever stood up and suddenly felt dizzy, lightheaded, weak, or like you might pass out?

 

That can happen when your blood pressure drops too much when you change positions, especially when going from sitting or lying down to standing. This is called orthostatic hypotension.

 

In plain English: Your blood pressure falls when you stand up, and your brain may not get enough blood for a few seconds.

 

Common symptoms

You may feel:

• Dizzy
• Lightheaded
• Weak
• Blurry vision
• Unsteady on your feet
• Like you might faint
• Confused for a moment
• Tired after standing

 

This can be dangerous because it may lead to falls, especially in older adults.

 

Why does this happen?

When you stand up, gravity pulls blood down toward your legs. Normally, your body quickly tightens your blood vessels and speeds up your heart a little to keep blood flowing to your brain.

 

Some medicines can interfere with that process.

 

They may:

• Lower your fluid level
• Relax your blood vessels too much
• Slow your heart down
• Reduce your body’s ability to respond quickly when you stand

 

Medicines that can make this worse

Water pills, also called diuretics

Examples include:

• Furosemide
• Torsemide
• Hydrochlorothiazide

 

These medicines help your body get rid of extra fluid. That can be helpful for blood pressure, heart failure, or swelling.

 

But sometimes they can remove too much fluid, leaving you dehydrated or with less blood volume. Less fluid in the body can mean lower blood pressure when standing.

 

Prostate and bladder medicines

Examples include:

• Tamsulosin
• Alfuzosin
• Terazosin

 

These medicines relax muscles around the prostate and bladder to help with urination. But they can also relax blood vessels, which may drop blood pressure, especially when standing up.

 

Blood pressure and heart medicines

Some blood pressure medicines can contribute to dizziness when standing.

 

Examples include:

• Beta blockers, such as propranolol, metoprolol, atenolol
• ACE inhibitors, such as lisinopril
• ARBs, such as valsartan or losartan
• Calcium channel blockers, such as diltiazem, verapamil, amlodipine
• Clonidine

 

These medicines can be very important and should not be stopped suddenly. But in some people, the dose may be too strong, or the combination of medicines may lower blood pressure too much.

 

Chest pain medicines and blood vessel relaxers

Examples include:

• Nitroglycerin
• Hydralazine
• Sildenafil, also known as Viagra
• Tadalafil, also known as Cialis

 

These medicines relax blood vessels. That can lower blood pressure.

 

A special warning: Do not mix nitroglycerin with sildenafil or tadalafil unless your doctor specifically says it is safe. This combination can cause a dangerous blood pressure drop.

 

Depression, sleep, and nerve pain medicines

Examples include:

• Trazodone
• Amitriptyline
• Paroxetine

 

Some antidepressants and sleep medicines can make it harder for your body to control blood pressure when you stand. They may also cause sleepiness, which increases fall risk.

 

Antipsychotic medicines

Examples include:

• Quetiapine
• Risperidone
• Olanzapine
• Chlorpromazine

 

These medicines can relax blood vessels and affect the nervous system. Dizziness when standing can happen, especially when starting the medicine or increasing the dose.

 

Diabetes medicines called SGLT2 inhibitors

Examples include:

• Empagliflozin
• Canagliflozin
• Dapagliflozin

 

These medicines help remove sugar through the urine. They can also make you urinate more, which may lower body fluid levels and contribute to dehydration or dizziness.

 

What you can do at home

Try these steps:

1. Stand up slowly.
   Sit at the edge of the bed for a minute before standing.
2. Drink enough water, unless your doctor told you to limit fluids.
3. Avoid standing up quickly after a hot shower.
   Heat can relax blood vessels and make dizziness worse.
4. Be careful after alcohol.
   Alcohol can lower blood pressure and cause dehydration.
5. Use support.
   Hold onto a chair, wall, walker, or cane when getting up.
6. Check your blood pressure at home.
   Take it while lying or sitting, then again after standing for 1 to 3 minutes. Write the numbers down.

 

When to call your doctor

Call your doctor if:

• You feel dizzy often when standing
• You have fallen or almost fallen
• You fainted
• Your blood pressure is very low
• Symptoms started after a new medicine
• Symptoms started after a dose increase
• You are taking several blood pressure medicines

 

When to seek urgent help

Get urgent medical care if dizziness comes with:

• Chest pain
• Shortness of breath
• Weakness on one side of the body
• Trouble speaking
• New confusion
• Passing out
• A serious fall or head injury

 

Important: Do not stop your medicines on your own

Even if you think a medicine is causing dizziness, do not stop it suddenly without talking to your doctor. Some medicines can cause serious problems if stopped too fast.

 

Instead, bring your medicine list to your visit. Your doctor may adjust the dose, change the timing, switch medications, or check for dehydration or other causes.

 

Bottom line

Dizziness when standing is common, but it should not be ignored. Many medicines can contribute to it, especially water pills, blood pressure medicines, prostate medicines, antidepressants, antipsychotics, nitroglycerin-type medicines, and some diabetes medicines.

 

The goal is not to blame the medicine. The goal is to find the safest balance so you can treat your health problems without increasing your risk of falls or fainting.

 

 

Disclaimer

This content is provided for educational and informational purposes only and does not constitute medical advice, diagnosis, or treatment. Reading this article does not establish a physician-patient relationship. Treatment decisions should always be made in consultation with a qualified licensed healthcare professional. If you are experiencing a medical emergency, call 911 immediately.