Sudafed vs. Nyquil for Nasal Congestion: Important Differences and Potential Risks.

Key takeaways

Sudafed (pseudoephedrine) and Nyquil Cold and Flu (acetaminophen/dextromethorphan/doxylamine) are both over-the-counter medications, but they serve different purposes and have different active ingredients. Sudafed is a decongestant that helps relieve nasal and sinus congestion by narrowing blood vessels, and it can be taken in various forms, including immediate-release and extended-release tablets. It can cause side effects like anxiety, headache, and difficulty sleeping. On the other hand, Nyquil Cold and Flu is a combination medication that includes a pain reliever (acetaminophen), a cough suppressant (dextromethorphan), and an antihistamine (doxylamine). It treats multiple cold and flu symptoms such as cough, sore throat, fever, and runny nose, and it can make you feel sleepy and dizzy. Unlike Sudafed, Nyquil Cold and Flu does not contain a decongestant and is available in both liquid and capsule forms. While Sudafed is restricted and must be purchased at the pharmacy counter, Nyquil Cold and Flu 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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Nyquil Cold and Flu

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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 Nyquil

Over-the-counter

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.

Indications for Nyquil

Temporarily relieves common cold and flu symptoms, including:

Cough
Sore throat
Headache
Minor aches and pains
Fever
Runny nose
Sneezing

Pros and Cons for Nyquil

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