7 Types of Medication That Cause Bloating

Feeling puffy, swollen and bloated? Give yourself a gut check: You may be taking drugs known to cause constipation, gas

Denise Maher,

AARP

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En español

Published June 20, 2023

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Just when you feel that relief, like you’ve finally figured out how to keep bothersome bloating at bay, it comes back again. And again.

Suspicious foods that can bloat your belly, such as beer, beans or dairy, are not hard to spot — and avoid — once you’ve tracked your meals in a diet journal or app.

But food isn’t the only reason for blowing up. If you’re still wondering why your waistband is bursting, consider the culprits in your medicine cabinet. According to Maria Cardinale-King, a clinical assistant professor of pharmacy practice and administration at Rutgers University, some prescription and over-the-counter drugs may cause or worsen the constipation, gas or irritation that leads to bloat.

“When you are in your 50s and 60s, certain medications, when combined with the other normal changes, like changes in metabolism, can make you more vulnerable to bloating,” she says. “It’s good to consider all the foods you have eaten, but don’t forget any prescription or OTC medications you’ve recently taken.”

Medications That Cause Bloating

Ibuprofen (Advil), naproxen (Aleve) and other nonsteroidal anti-inflammatory pain relievers
Statins
Antidepressants, some used for depression and certain types of pain
Blood pressure-lowering medication
Anticholinergics
Antibiotics
Opioid pain medication

There’s a decent chance constipation plays a role in your discomfort. Certain medications may cause constipation and, by extension, bloating, according to Spencer Dorn, M.D., vice chair and professor in the division of gastroenterology and hepatology at the University of North Carolina School of Medicine in Chapel Hill. The symptoms are common, often multifactorial and incompletely understood. Various issues, or a combination of them, including a lack of fiber in your diet, contribute to gas and bloating problems, especially if you are already prone to them, Dorn points out.

Take a look at these medications and consider if any of them may be one of the root causes of your digestive distress.

1. Common pain medication

Prescribed or used for: Relief of fever, pain and inflammation from headaches, muscle aches, arthritis, colds and toothaches

Examples: Aspirin (Bayer, Alka-Seltzer Original)

How they contribute to bloating: Nonsteroidal anti-inflammatory drugs (NSAIDs) work by stopping the body’s production of pain-triggering prostaglandins. But they may also suppress beneficial chemicals that help protect the intestinal tract. “These drugs irritate the lining of the stomach, which can cause changes that can result in bloating,” says Cardinale-King at Rutgers University.

Tips: Consider integrative therapies such as heat, cold, acupuncture or exercise to help reduce musculoskeletal pain and the amount of medicine you need. Use NSAIDs only when necessary; follow the instructions and take the lowest effective dose, recommends the International Foundation for Gastrointestinal Disorders. Ask your doctor if alternatives such as lidocaine cream or patches or acetaminophen are appropriate for you and your specific problem. In some cases, taking NSAIDs with food, milk or antacids may help prevent GI side effects, according to the Cleveland Clinic.

2. Statins

Prescribed or used for: Lowering cholesterol levels in the blood

Examples: Atorvastatin, fluvastatin, rosuvastatin (Crestor or Ezallor), lovastatin (Mevacor or Altoprev), pitavastatin (Livalo or Zypitamag), pravastatin, simvastatin (FloLipid or Zocor)

How they contribute to bloating: “The mechanism that connects statins to bloating and gas is not well understood,” says Sherry Torkos, author of The Canadian Encyclopedia of Natural Medicine. One theory, she says, is that statins act on the nerves in the colon, making muscle contractions less effective and, in turn, causing slowed digestion. “When food remains in the colon longer, it can ferment and produce gas and bloating,” she explains.

Tips: Talk to your doctor. People experiencing bloating after starting a medication may want to switch to a different one, according to Dorn. Try taking a walk. “Exercise strengthens muscles in the gut, which improves contractions and stimulates the movement of waste through the colon,” aiding digestion and relieving gas and constipation, says pharmacist Torkos.

3. Tricyclic and other antidepressants

Prescribed or used for: Treating depression, anxiety, some types of pain

Examples: Many antidepressants are associated with constipation or bloating. These include older drugs known as tricyclic antidepressants, such as desipramine (Elavil) and nortriptyline (Pamelor); atypical antidepressants, such as mirtazapine; and selective serotonin reuptake inhibitors (SSRIs), such as escitalopram, fluvoxamine and sertraline.

How they contribute to bloating: In addition to working on receptors in the brain that modulate mood, antidepressants affect receptors in the gut where they can reduce gastric motility (movement through the digestive tract) and cause bloating, Torkos says. Each type, class and brand of antidepressant comes with different potential side effects, and a review published in Progress in Neuro-Psychopharmacology & Biological Psychiatry in 2021 shows that many antidepressant treatments are linked to gastrointestinal side effects. Research published in Primary Care Companion in 2021 suggests that people taking SSRIs may be more likely to experience flatulence.

Tips: Various antidepressant drugs with different potential side effects may be used to treat medical issues, including migraine and other chronic pain, anxiety and major depression. If you experience bothersome bloating, gas or constipation after starting a medication, try exercise, drinking more water and eating high-fiber foods. Also talk to your doctor about specific issues.

4. Antibiotics

Prescribed or used for: Treatment of urinary tract, respiratory and other bacterial infections, or pneumonia

Examples: Amoxicillin, azithromycin, cephalexin

How they contribute to bloating: When these powerful drugs attack bacteria in your system, such as your urinary tract or lungs, they also attack your gut — and destroy the beneficial bacteria in it. Once the intestinal flora is disrupted, digestion is disturbed.

Tips: Read the prescription drug label carefully to make sure you are taking the antibiotics as directed. Some antibiotics should be taken with food, some without. If your GI symptoms are extreme, call your doctor.

If your symptoms are mild, self-care might get you back on track. You can help restore gastrointestinal health by eating probiotic-rich foods such as yogurt. “Take care of your gut by putting the right bacteria in it,” says Sandra J. Arévalo Valencia, director of community health and wellness at Montefiore Nyack Hospital. “I tell people to start by eating one yogurt a day to start changing their gut bacteria.”

5. Common pain, allergy and cold medications called anticholinergics

Prescribed or used for: Relief or prevention of allergy symptoms; relief of overactive bladder and urge incontinence symptoms.

Examples: Antihistamines such as brompheniramine (Dimetane), chlorpheniramine (Chlor-Trimeton), diphenhydramine (Benadryl) or clemastine (Tavist); urinary incontinence drugs including darifenacin (Enablex), oxybutynin (Ditropan XL), tolterodine (Detrol), trospium (Sanctura) and solifenacin (VESIcare)

How they contribute to bloat: These medications block the activity of acetylcholine, a neurotransmitter that helps with many body functions, including muscle movement and memory. Action on the acetylcholine receptors in the gut can weaken muscles and slow down digestion, which can lead to constipation, bloating and gas. There is another side effect to consider: memory and cognition problems.

Tips: Make sure you know how much antihistamine you are taking. It is easy to overdo cold and allergy drugs if you don’t realize they are in multi-symptom products (Advil Cold & Flu, Theraflu Nighttime Severe Cold & Cough) as well as allergy medication.

Consult your doctor to see if alternatives for seasonal allergies make sense. Second-generation antihistamines such as loratadine (Claritin) and cetirizine (Zyrtec) have only minimal anticholinergic effects; inhaled steroids may be a good option, too. Have you been taking an over-the-counter antihistamine such as Benadryl on a regular basis, on your own accord? Talk to a doctor to confirm that it is the right medication for you and your problem. An official diagnosis often leads to better treatment. If you are dealing with bladder problems, ask your doctor about other forms of the drug (such as extended-release) or other medications that might cause fewer side effects.

6. Calcium channel blockers

Prescribed or used for: Lowering high blood pressure (hypertension)

Examples: Amlodipine (Norvasc), diltiazem (Cardizem, Tiazac), felodipine, isradipine, nicardipine, nifedipine (Procardia), nisoldipine (Sular), Verapamil (Calan SR, Verelan)

How they contribute to bloating: Calcium channel blockers help lower blood pressure by relaxing the blood vessel muscles. If the medications relax intestinal muscles, constipation, and the bloating it causes, may result.

Tips: You’ve heard it before: Under no circumstances should you stop your blood pressure medication without consulting your doctor. Once you tell her about problems you are having, she can work with you to find the best medicine, stresses the FDA’s high blood pressure medication guide. Consider also gradually adding foods with more fiber, staying well-hydrated and exercising regularly to help keep things moving.

7. Opioid or opiate painkillers

Prescribed or used for: Pain relief

Examples: Hydrocodone (Vicodin), oxycodone (OxyContin, Percocet), morphine (Kadian, Avinza)

How they contribute to bloating: Opioids slow movement of stool through the intestines, which gives the bowel more time to absorb water from the stool. Hard stool leads to constipation, which often leads to bloating and abdominal pain.

Tips: Talk to your doctor and learn how to prevent constipation. Once opiate-induced constipation develops, it is very difficult to get digestion back to normal. For this reason, doctors often start patients on laxatives at the same time treatment with opioids begins. Eating fiber-rich foods, drinking water and exercising can help prevent the hardening of stool.

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Denise Maher is a reporter, writer and editor who covers integrative medicine, reproductive health, chronic pain, autoimmune disease and other consumer health topics. Her work has been published in Everyday Health, HealthCentral, Reader’s Digest, Men’s Health, Self and more.

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