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Sudafed vs. Acetaminophen / dextromethorphan / doxylamine / phenylephrine

Head-to-head comparisons of medication uses, side effects, warnings, and more.

Key takeaways

Sudafed (pseudoephedrine) and Alka-Seltzer Plus Severe Cold and Flu (acetaminophen/chlorpheniramine/dextromethorphan/phenylephrine) are both over-the-counter medications used to relieve symptoms of the common cold, but they have different uses and ingredients. Sudafed is a decongestant that works by narrowing blood vessels to reduce nasal and sinus congestion. It is available in both immediate-release and extended-release forms. On the other hand, Alka-Seltzer Plus Severe Cold and Flu is a combination medication that includes an analgesic (acetaminophen), an antihistamine (chlorpheniramine), a cough suppressant (dextromethorphan), and a decongestant (phenylephrine). This combination helps relieve a wider range of symptoms, including pain, fever, and cough. Studies show oral phenylephrine is not an effective decongestant. For this reason, Alka-Seltzer Plus Severe Cold and Flu may not be the best option to relieve congestion. Sudafed can cause side effects like anxiety and difficulty sleeping, while Alka-Seltzer Plus can cause drowsiness and dry mouth. Additionally, Sudafed is restricted and must be purchased at the pharmacy counter, whereas Alka-Seltzer Plus is more readily available on store shelves. Both medications should not be taken with monoamine oxidase inhibitors (MAOIs), such as selegiline (Zelapar), and have specific age restrictions for children.

Sudafed

(pseudoephedrine)

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Tylenol Cold + Flu + Cough Night

 

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Summary for Sudafed

Over-the-counter

Sudafed (pseudoephedrine) is a non-drowsy decongestant taken by mouth to treat nasal and sinus congestion from allergies and the common cold. It's available in a short-acting version that's taken once every 4 to 6 hours. It also comes in longer-acting versions that are taken every 12 or 24 hours, depending on the dose. Side effects of Sudafed (pseudoephedrine) include anxiety and headache. This medication might also keep you awake at night if you take it too close to bedtime. Sudafed (pseudoephedrine) is an OTC medication, but it's restricted, so you can only purchase it at the pharmacy counter.

Indications for Sudafed

  • Short-term relief of nasal and sinus congestion and pressure

Pros and Cons for Sudafed

Pros

  • Works well to treat congestion
  • Available in longer-acting versions that last 12 hours or 24 hours
  • Children's oral liquids can be taken by kids as young as 4 years old
  • Available as lower-cost generics

Cons

  • Several products have different age cut-offs for use in children, so can be confusing
  • Might make it hard for some people to sleep
  • Can raise blood pressure and heart rate
  • Not recommended during pregnancy

Common Side Effects for Sudafed

  • Sweating
  • Nervousness
  • Excitability
  • Difficulty sleeping
  • Low appetite
  • Difficulty urinating

Warnings for Sudafed

  • Fast heart rate and high blood pressure
  • Worsening of medical conditions
  • Accidental overdose

Summary for Acetaminophen / dextromethorphan / doxylamine / phenylephrine

Over-the-counter

Tylenol Cold + Flu + Cough Night is a combination medication containing acetaminophen, dextromethorphan, doxylamine, and phenylephrine. It's used to treat cold and flu symptoms, like sore throat, fever, cough, runny nose, sneezing, stuffy nose, and minor aches. Since it can make you sleepy, it's meant to be taken at nighttime. Tylenol Cold + Flu + Cough Night is available over the counter.

Indications for Acetaminophen / dextromethorphan / doxylamine / phenylephrine

Temporarily relieves common cold and flu symptoms, including:

  • Cough
  • Sore throat
  • Headache
  • Minor aches and pains
  • Fever
  • Runny nose
  • Sneezing
  • Nasal congestion (stuffy nose)
  • Sinus congestion and pressure

Pros and Cons for Acetaminophen / dextromethorphan / doxylamine / phenylephrine

Pros

  • Works within 30 minutes to relieve cold and flu symptoms
  • Combines four medications for convenience
  • Available in capsules, tablets, and a liquid
  • Available over the counter

Cons

  • Needs to be taken multiple times per day
  • Can cause drowsiness
  • Can't be used in children under 12 years old (depending on the product)
  • Not meant for long-term use

Common Side Effects for Acetaminophen / dextromethorphan / doxylamine / phenylephrine

  • Drowsiness
  • Excitability in children

Warnings for Acetaminophen / dextromethorphan / doxylamine / phenylephrine

  • Liver damage
  • Sleepiness and driving impairment
  • Dangerous for children under 4 years old
  • Overdose and misuse
  • Serotonin syndrome
  • Allergic skin reactions
  • Worsening of certain medical conditions

Prices with our coupons for Sudafed vs. Acetaminophen / dextromethorphan / doxylamine / phenylephrine

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Pseudoephedrine24 tablets / 30mg
$5.14$10.26
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Price Card Drug Icon
Acetaminophen/Dextromethorphan/Doxylamine/Phenylephrine1 bottle / 237ml of 325mg/10mg/6.25mg/5mg/15ml
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