acetaminophen / dextromethorphan / phenylephrine
Dayquil Cold and Flu is a combination of three active ingredients: acetaminophen (an analgesic), dextromethorphan (a cough suppressant), and phenylephrine (a decongestant). Dayquil Cold and Flu helps treat symptoms from the common cold and flu in adults and children. It can relieve stuffy nose, cough, sore throat, headache, aches, and fever. Besides Dayquil Cold and Flu, this medication is available under many other brand names and as a generic. It's available as pills and a liquid that's typically taken every 4 hours. Side effects aren't common but can include stomach upset and nervousness.
What is Dayquil Cold and Flu?
What is Dayquil Cold and Flu used for?
Short-term relief of symptoms from the common cold and flu:
Minor aches and pains
Headache
Stuffy nose (nasal congestion)
Cough
Sore throat
Fever
How Dayquil Cold and Flu works
Dayquil Cold and Flu is a combination of three medications that work together to relieve symptoms caused by the common cold or flu.
Acetaminophen is an analgesic. It blocks inflammatory chemicals in your body to help relieve pain and lower fever.
Dextromethorphan is a cough suppressant that works in the brain to lower your urge to cough.
Phenylephrine is a decongestant that clears your sinuses to relieve stuffy nose and sinus pressure.
Drug Facts
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What are the side effects of Dayquil Cold and Flu?
Common Side Effects
Serious Side Effects
- Liver damage: severe stomach pain, yellowing of the skin or whites of the eyes, nausea, vomiting, loss of appetite
- Serious skin reaction: skin reddening, blisters, rash
- Serotonin syndrome: fast heart rate, sweating, muscle stiffness or spasms, high fever, confusion
- Accidentally taking too much medication: seizures, high blood pressure, fast heart rate, hallucinations, confusion, yellowing of the skin or eyes, stomach pain
Source: DailyMed
More on Dayquil Cold and Flu side effects
Pros and cons of Dayquil Cold and Flu
Pros
Can treat a wide variety of common cold or flu symptoms
More convenient to take three medications in a single dose
Available over the counter and as a lower-cost generic
Alcohol-free liquid forms of the medication are available
Cons
Might need to take as often as every 4 hours to relieve symptoms
More difficult to customize the dose since Dayquil Cold and Flu is a fixed combination of three medications
Might not be the best choice for people with certain medical conditions, such as high blood pressure
Might not be the best choice for people who drink alcohol regularly
Pharmacist tips for Dayquil Cold and Flu
You can take Dayquil Cold and Flu as needed for your cold and flu symptoms. But when you have symptoms that are currently bothering you, it's recommended that you take the medication on a scheduled basis by following the packaging directions or your healthcare professional's (HCP's) instructions. That way, you can get the most symptom relief from the medication.
For the liquid forms of Dayquil Cold and Flu: Use a medication dosing cup or an oral syringe to measure your dose. Ask your pharmacy if you need any extras. Don't use household spoons because they aren't accurate and might cause you to take the wrong dose.
You can take Dayquil Cold and Flu with or without food. If it upsets your stomach, try taking the medication with food.
Stop using Dayquil Cold and Flu and contact your HCP if any pain, cough, or nasal congestion gets worse or lasts more than a week; if your fever gets worse or lasts more than 3 days; or if your cough comes back or occurs with a rash or headache. Your HCP can check to see whether you need other treatment.
Stop taking Dayquil Cold and Flu and speak with your HCP if you have trouble sleeping; feel nervous or dizzy; or notice any redness, swelling, or any other new symptoms that appear while you're taking the medication. Your HCP can check to see whether Dayquil Cold and Flu is still appropriate and safe for you.
Speak to your primary care provider if you have severe sore throat pain; if your sore throat lasts for more than 2 days; or if you have a fever, headache, rash, nausea, or vomiting with or after your sore throat.
Tell your HCP and pharmacist about all the medications you're taking. Dayquil Cold and Flu can sometimes interact with other medications, such as warfarin (Coumadin), and raise your risk for side effects. Your HCP and pharmacist can make sure Dayquil Cold and Flu is safe for you to take with your other medications.
Talk with your HCP or pharmacist first before you start any new medications while you're taking Dayquil Cold and Flu. Avoid products that contain acetaminophen, other cough suppressants, or other decongestants while you're using Dayquil Cold and Flu. Since these medications have similar ingredients, taking them at the same time can raise your risk for serious side effects from accidentally taking too much medication.
Don't use Dayquil Cold and Flu if you're currently taking or have taken a monoamine oxidase inhibitor (MAOI), such as selegiline or phenelzine (Nardil), in the last 2 weeks. This combination can raise your risk for severe side effects. Contact your HCP for other options to treat your cold or flu symptoms.
Frequently asked questions about Dayquil Cold and Flu
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What are the risks and warnings for Dayquil Cold and Flu?
Dayquil 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 Dayquil Cold and Flu | History of liver problems
Taking too much acetaminophen (an ingredient in Dayquil Cold and Flu) can cause permanent and life-threatening liver damage. For adults, the maximum amount of acetaminophen is typically 4,000 mg in a 24-hour period. But it can be lower depending on your healthcare professional's (HCP's) instructions and your risk for liver damage. For children, ask your child's pediatrician.
Speak to your HCP before you use Dayquil Cold and Flu if you have liver problems because this medication can cause further damage to your liver. Limit or avoid drinking alcohol while taking you're this medication.
Call your HCP right away if you notice any symptoms of liver problems. These symptoms can include tiredness, dark urine, upset stomach, stomach pain, or yellowing of the skin or eyes.
Allergic skin reactions
Although rare, Dayquil Cold and Flu can cause serious skin reactions, like rash, blisters, skin reddening, or skin peeling. Stop using this medication and get medical help right away if you notice these types of changes in your skin.
Serotonin syndrome
Risk factors: Taking monoamine oxidase inhibitors (MAOIs) 14 days before starting Dayquil Cold and Flu | Taking other medications that raise serotonin levels in your brain
Serotonin syndrome is a rare, but potentially life-threatening condition that happens when there's too much serotonin in the brain. Serotonin is one of the chemicals in your brain that's responsible for your mood.
Your risk for this condition goes up if you use Dayquil Cold and Flu with other medications that affect serotonin levels, such as certain antidepressants, monoamine oxidase inhibitors (MAOIs), and migraine medications called triptans. Make sure your HCP and pharmacist know about all the medications (including over-the-counter medications and supplements) that you take or plan to take. They can check that Dayquil Cold and Flu is safe for you to take.
Get medical care right away if you have any symptoms of serotonin syndrome while you're taking Dayquil Cold and Flu. These symptoms can include fast heart rate, sweating, muscle stiffness or spasms, high fever, and confusion.
Accidentally taking too much medication
Dayquil Cold and Flu contains an analgesic (acetaminophen), a cough suppressant (dextromethorphan), and a decongestant (phenylephrine). These ingredients can also be found in many other over-the-counter products or prescription medications.
Using more than one medication containing acetaminophen, dextromethorphan, or a decongestant raises the risk that you might accidentally take too much of one of these ingredients. This can cause serious and sometimes life-threatening side effects, such as liver failure, seizures, high blood pressure, fast heart rate, hallucinations, or coma.
To lessen the risk of accidentally taking too much medication, read package labels carefully. Ask your pharmacist if you're not sure whether a product has any similar ingredients. Get medical help as soon as possible or contact a Poison Control Center at 1-800-222-1222 if you think you or a loved one accidentally took too much medication.
Worsening of certain medical conditions
Risk factors: Liver problems | Heart problems or high blood pressure | Thyroid problems | High blood sugar (diabetes) | Cough from smoking, asthma, or emphysema | Mucus-producing cough | Urinary conditions
Tell your HCP about all medical conditions you have or have had in the past before you start taking Dayquil Cold and Flu. It's possible that this medication can worsen your condition(s) and cause serious side effects. Your HCP can make sure that Dayquil Cold and Flu is appropriate for you and safe for you to take.
Dayquil Cold and Flu dosage forms
Typical dosing for Dayquil Cold and Flu
Note: This medication is made by several manufacturers. Some products might differ in dosage and directions. Check the product label or ask your pharmacist for directions specific to your medication and for how much you can take in a 24-hour period (typically 4 to 5 doses).
Below are examples of dosing instructions by product formulation and brand name.
Oral pills (e.g., DayQuil Cold and Flu, Tylenol Cold Max Day, generic formulations)
Each pill contains 325 mg of acetaminophen, 10 mg of dextromethorphan, and 5 mg of phenylephrine.
Adults and children 12 years and older: The typical dose is 2 pills by mouth every 4 hours while you're having symptoms.
Children under 12 years old: Ask your child's pediatrician.
Oral liquids (e.g., DayQuil Cold and Flu, Theraflu Severe Cold and Cough Daytime)
Each 15 mL (1 tablespoonful) contains 325 mg of acetaminophen, 10 mg of dextromethorphan, and 5 mg of phenylephrine.
Adults and children 12 years and older: The typical dose is 30 mL (2 tablespoonfuls) by mouth every 4 hours while you're having symptoms.
Children under 12 years old: Follow the directions on the product label or ask your child's pediatrician.
More on Dayquil Cold and Flu dosage forms
How much does Dayquil Cold and Flu cost?
Dayquil Cold and Flu contraindications
Take with any other medication containing acetaminophen
Currently take or have taken an MAOI in the last 2 weeks
Severe allergy to acetaminophen, dextromethorphan, or phenylephrine (or another decongestant)
What are alternatives to Dayquil Cold and Flu?
Short-term relief of symptoms from the common cold and flu:
Minor aches and pains
Headache
Stuffy nose (nasal congestion)
Cough
Sore throat
Fever
Sinus congestion and pressure
Stuffy nose
Headache
Minor aches and pains
Phlegm (mucus) in the lungs
Fever
Stuffy nose
Sinus congestion and pressure
Chest congestion
Cough
Sore throat
Minor aches and pains
Headache
Fever
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References
Best studies we foundGelotte, C. K., et al. (2015). Pharmacokinetics, safety, and cardiovascular tolerability of phenylephrine HCl 10, 20, and 30 mg after a single oral administration in healthy volunteers. Clinical Drug Investigation.
Haleon US Holdings LLC. (2024). Theraflu Expressmax Daytime Nighttime Value Pack- acetaminophen, dextromethorphan hbr, phenylephrine hcl and acetaminophen, diphenhydramine hcl, phenylephrine hcl kit [package insert]. DailyMed.
Johnson & Johnson Consumer Inc. (2024). Tylenol Cold Max Day- acetaminophen, dextromethorphan hydrobromide, and phenylephrine hydrochloride tablet, film coated [package insert]. DailyMed.
Oh, S., et al. (2023). Dextromethorphan. StatPearls.
Rite Aid. (2024). Multi-Symptom Cold and Flu Relief Daytime- acetaminophen 325 mg dextromethorphan hbr 10 mg phenylephrine hci 5 mg capsule, liquid filled [package insert]. DailyMed.
The Procter & Gamble Manufacturing Company. (2023). Vicks Dayquil Cold and Flu- acetaminophen, dextromethorphan hydrobromide, and phenylephrine hydrochloride capsule, liquid filled [package insert]. DailyMed.
Twycross, R., et al. (2013). Acetaminophen (paracetamol). Journal of Pain and Symptom Management.
U.S. Food and Drug Administration. (2016). FDA Drug Safety Communication: FDA warns of rare but serious skin reactions with the pain reliever/fever reducer acetaminophen.
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