acetaminophen / dextromethorphan / doxylamine
Nyquil Cold and Flu is a combination medication containing acetaminophen (a pain reliever), dextromethorphan (a cough suppressant), and doxylamine (an antihistamine). It's used to treat cold and flu symptoms, like sore throat, fever, cough, runny nose, sneezing, and aches, in adults and children. Nyquil Cold and Flu is available as pills and a liquid. This medication can make you feel sleepy and dizzy as side effects.
What is Nyquil Cold and Flu?
What is Nyquil Cold and Flu used for?
Temporarily relieves common cold and flu symptoms, including:
- Cough
- Sore throat
- Headache
- Minor aches and pains
- Fever
- Runny nose
- Sneezing
How Nyquil Cold and Flu works
Nyquil Cold and Flu is a combination of three medications:
- Acetaminophen is an analgesic that relieves pain and lowers fever by stopping the production of certain chemicals in the brain that cause both pain and fever.
- Dextromethorphan is a cough suppressant that works in the part of your brain that makes you cough, calming it down and telling your body to cough less.
- Doxylamine is an antihistamine that works by blocking histamine, a natural chemical in your body that causes congestion, sneezing, and wakefulness.
Drug facts
Side effects of Nyquil Cold and Flu
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
- Sleepiness
- Dizziness
- Dry mouth
Less Common Side Effects
- Blurry vision
- Trouble urinating
Nyquil Cold and Flu serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Allergic reactions: rash; hives; difficulty breathing; swelling of face, lips, tongue, or throat
- Serious skin reaction: skin reddening, blisters, rash
- Liver damage: severe stomach pain, yellowing of skin or whites of the eyes, nausea, vomiting, loss of appetite
- Excessive sleepiness or dizziness
- Serotonin syndrome: fast heart rate, sweating, muscle stiffness or spasms, high fever, confusion
The following Nyquil Cold and Flu side effects have also been reported
Side effects that you should report to your care team as soon as possible:
- Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
- Liver injury—right upper belly pain, loss of appetite, nausea, light-colored stool, dark yellow or brown urine, yellowing skin or eyes, unusual weakness or fatigue
- Redness, blistering, peeling, or loosening of the skin, including inside the mouth
- Sudden eye pain or change in vision such as blurry vision, seeing halos around lights, vision loss
- Trouble passing urine
Side effects that usually do not require medical attention (report these to your care team if they continue or are bothersome):
- Confusion
- Constipation
- Dizziness
- Drowsiness
- Dry mouth
- Fatigue
- Headache
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Pros and cons of Nyquil Cold and Flu
Pros
- Available over the counter
- Works within 30 minutes to relieve cold and flu symptoms
- Available in capsules and a liquid
- Combines three medications in one product for convenience
- Available as a lower-cost generic
Cons
- Needs to be taken multiple times per day
- Can cause extreme sleepiness
- More difficult to customize the dose since it's a fixed combination of three medications
- Need to avoid alcohol while taking it
- Not meant for long-term use
Pharmacist tips for Nyquil Cold and Flu
- You can take Nyquil Cold and Flu with or without food. If it upsets your stomach, try taking the medication with food.
- Nyquil Cold and Flu is only meant to be used short-term. You should stop using this medication and talk to your provider if your pain or cough lasts longer than a week or stops and returns, or fever that worsens or lasts for more than 3 days. These can be signs of a more serious condition that Nyquil Cold and Flu won't be able to treat.
- Nyquil Cold and Flu can make you sleepy or dizzy during the day, which can affect your ability to focus, think, or react. Don't drive until you know how the medication affects you. To prevent daytime sleepiness, it might help to take the least amount of medication possible (that will still relieve your symptoms) at night.
- While Nyquil Cold and Flu usually makes adults sleepy, it's possible for children who use this medication to become overly excited or energetic. If this happens to your child, speak to your child's provider. They can recommend other treatment options.
- Tell your provider or pharmacist about all the medications you're taking so they can check for interactions. For example, the acetaminophen in Nyquil Cold and Flu can interact with warfarin (Coumadin) and raise your risk for bleeding. Also, the doxylamine in Nyquil Cold and Flu can interact with sleep or anxiety medications and make you more sleepy.
- Don't start any new medications while taking Nyquil Cold and Flu, especially other medications containing acetaminophen, other cough suppressants, or other antihistamines, without talking to your provider or pharmacist first. Doing so can raise your risk of overdose and severe side effects.
- Don't take Nyquil Cold and Flu with a monoamine oxidase inhibitor (MAOI), such as selegiline or phenelzine (Nardil). This combination can raise your risk for severe side effects (e.g., serotonin syndrome, dizziness). If you're currently taking or have taken an MAOI in the last 2 weeks, don't use Nyquil Cold and Flu. Contact your provider for other options to treat your cold or flu symptoms.
More tips for Nyquil Cold and Flu liquid form:
- The liquid products might contain 10% of alcohol. But there are alcohol-free alternatives available, such as Vicks Nyquil Alcohol Free or Coricidin-Maximum Strength Multi-Symptom Flu.
- Some liquid products contain sodium. Ask your provider if it's okay to use a product with sodium if you have a history of heart problems and you're on a low-salt diet.
- Use a medication dose cup or an oral syringe to measure your dose of Nyquil Cold and Flu. Don't use household spoons because they aren't always accurate and might cause you to take the wrong dose.
- Store at room temperature in the original bottle it came from and protect it from light.
More on Nyquil Cold and Flu tips
Common questions about Nyquil Cold and Flu
Yes, Nyquil Cold and Flu contains doxylamine, an antihistamine that can make you feel sleepy. If you're feeling too sleepy to get through your day, let your provider know and they can talk with you about other options for your symptoms.
Nyquil Cold and Flu typically starts to work within 30 minutes and lasts for about 6 hours.
Adults and children ages 12 years and older can take up to 2 capsules (or 2 tablespoonfuls for the liquid) of Nyquil Cold and Flu every 6 hours. But don't take more than 4 doses in a 24-hour period. If your provider specifically recommended you to take Nyquil Cold and Flu, it's possible they might give you different instructions than what's written on the manufacturer's box; follow your provider's directions in that case. Ask your provider or pharmacist if you're not sure how much Nyquil Cold and Flu you can take and how often you should take the medication.
If you're pregnant, talk with your provider before taking Nyquil Cold and Flu. In general, the three active ingredients in Nyquil Cold and Flu (acetaminophen, dextromethorphan, doxylamine) are generally considered safe to take during pregnancy. But keep in mind that some liquid forms of Nyquil Cold and Flu contain alcohol, which should be avoided.
Maybe; it depends on which Mucinex product you choose. Mucinex is a branded line of products. Many of their products already contain acetaminophen, dextromethorphan, or doxylamine, the active ingredients in Nyquil Cold and Flu. Taking Nyquil Cold and Flu with other medications that contain the same or very similar ingredients can raise your risk of side effects, such as extreme sleepiness or liver problems. Check the label of all the cold and flu medications you're taking to make sure you're not taking more than the recommended dose of any particular active ingredient. Ask your provider or pharmacist if you aren't sure if a particular medication is similar to an active ingredient in Nyquil Cold and Flu.
No. Nyquil Cold and Flu already contains acetaminophen (Tylenol) and taking too much acetaminophen (Tylenol) can cause severe liver damage. Talk to your provider or pharmacist for available options if you're still having pain while taking Nyquil Cold and Flu.
Yes, you can safely take Nyquil Cold and Flu with amoxicillin. There are no known medication interactions between both medications.
No, Nyquil Cold and Flu doesn't contain a decongestant. But there might be other Nyquil products that contain a decongestant, like phenylephrine. Make sure you read the label of your specific Nyquil product to see what the active ingredients are. Talk to your provider or pharmacist if you need help finding an OTC medication to treat sinus pressure or stuffy nose.
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Risks and warnings for Nyquil Cold and Flu
Nyquil Cold and Flu can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Liver damage
- Risk factors: Drinking three or more alcoholic beverages a day | Taking other medications containing acetaminophen | Taking too much Nyquil Cold and Flu | History of liver disease
Taking too much acetaminophen can cause permanent and life-threatening liver damage. For adults, the maximum amount of acetaminophen that can be taken is 3 or 4 grams in a 24-hour period, depending on your provider's instructions. For children, ask your child's provider.
Speak to your provider before using Nyquil Cold and Flu if you have liver problems, since it can cause further damage to your liver. Avoid drinking alcohol while taking this medication.
Signs of liver problems include dark urine, fatigue, stomach pain, or yellowing of skin or eyes. If you notice any of these symptoms, call your provider right away.
Serotonin syndrome
- Risk factors: Taking monoamine oxidase inhibitors (MAOI) 14 days before starting Nyquil Cold and Flu | Taking other medications that raise serotonin levels in your brain
Serotonin syndrome is a rare, but potentially life-threatening condition where there's too much serotonin in the brain. Serotonin is one of the chemicals in your brain responsible for your mood. Your risk for this condition goes up if you use Nyquil Cold and Flu with other medications that affect serotonin levels, such as antidepressants (e.g., sertraline (Zoloft), duloxetine (Cymbalta)), MAOIs (e.g., phenelzine (Nardil)), lithium, and certain migraine medications (e.g., sumatriptan (Imitrex)). Make sure your provider knows about all the medications you take (including over-the-counter medications and supplements) before starting Nyquil Cold and Flu so they can check that your medications are safe for you. Symptoms of serotonin syndrome include fast heart rate, sweating, muscle stiffness or spasms, high fever, and confusion. Get medical help right away if you have any of these symptoms.
Accidental overdose
Nyquil Cold and Flu contains an analgesic (acetaminophen), a cough suppressant (dextromethorphan), and an antihistamine (doxylamine), which can be found in many other over-the-counter products. Using more than one medication containing acetaminophen, dextromethorphan, doxylamine, can lead to an accidental overdose and cause serious side effects. These serious side effects include liver failure, seizures, hallucinations (seeing things that aren't real), or even death. To prevent an accidental overdose, read package labels carefully. If you're not sure if a product has any similar ingredients, ask your pharmacist. If you or your loved one experiences an accidental overdose, get medical help as soon as possible or contact a poison control center at 1-800-222-1222.
Worsening of medical conditions
- Risk factors: Liver disease | Glaucoma | Cough from asthma or another breathing problem | Mucus-producing cough | Breathing problems (e.g., emphysema, long-term bronchitis) | Enlarged prostate gland
Don't take Nyquil Cold and Flu if you have any of the risk factors listed above unless your provider said it's safe to do so. Taking this medication can worsen your condition(s) and cause serious side effects. Make sure your provider knows about all medical conditions you have or have had in the past before starting Nyquil Cold and Flu.
Allergic skin reactions
Although rare, Nyquil Cold and Flu can cause serious skin reactions, such as rash, blisters, skin reddening, or skin peeling. If you notice changes in your skin, stop using Nyquil Cold and Flu and get medical attention right away.
Nyquil Cold and Flu dosage
Typical dosage for Nyquil Cold and Flu
Nyquil Cold and Flu and its generics might come in different strengths and have different dosing directions. Read the manufacturer's label for instructions specific for your medication. Some examples include:
Nyquil Cold and Flu liquid: Each 30 mL dose cup contains 650 mg of acetaminophen, 30 mg of dextromethorphan, and 12.5 mg of doxylamine.
- Adults and children 12 years and older: The typical dose is 30 mL (2 tablespoons) by mouth every 6 hours. Don't take more than 120 mL (8 tablespoons) in a 24-hour period unless your provider specifically told you to do so.
- Children 4 to 11 years old: Ask your child's provider.
- Children 3 years and younger: Don't use.
Nyquil Cold and Flu capsules: Each capsule contains 325 mg of acetaminophen, 15 mg of dextromethorphan, and 6.25 mg of doxylamine.
- Adults and children 12 years and older: The typical dose is 2 capsules by mouth with water every 6 hours. Don't take more than 8 capsules in a 24-hour period unless your provider specifically told you to do so.
- Children 4 to 11 years old: Ask your child's provider.
- Children 3 years and younger: Don't use.
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Nyquil Cold and Flu contraindications
Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Nyquil Cold and Flu will not be safe for you to take.
- Taking Nyquil Cold and Flu with any other medication containing acetaminophen
- Currently take or have taken an MAOI in the last 2 weeks
- Using to make a child sleep
What are alternatives to Nyquil Cold and Flu?
Temporarily relieves common cold and flu symptoms, including:
News about Nyquil Cold and Flu
Nyquil Cold and Flu images
