Key takeaways:
NyQuil is a line of popular over-the-counter (OTC) products that help relieve cold and flu symptoms. Most NyQuil products contain active ingredients such as acetaminophen, dextromethorphan, and doxylamine.
Combining alcohol and NyQuil may worsen side effects such as dizziness and drowsiness. In severe cases, combining alcohol and NyQuil may lead to liver damage. It’s best to avoid the combination.
If you’re taking NyQuil, it’s best to talk with a healthcare professional before drinking alcohol — even if it’s just one drink. They can tell you if the combination is safe for you.
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The cold and flu viruses are different, but it’s easy to confuse the two. The common cold tends to be mild, with typical symptoms being cough, sneezing, and stuffy nose. The flu, on the other hand, tends to be more severe. Common complaints include fever, chills, and body aches.
For many people, treating cold and flu symptoms with over-the-counter (OTC) medications like NyQuil Cold & Flu (acetaminophen / dextromethorphan / doxylamine) is beneficial. But what happens when alcohol is added to the mix?
In this article, we’ll cover possible risks and side effects of combining alcohol and NyQuil.
What is NyQuil?
NyQuil helps relieve cold and flu symptoms. It’s available in various oral forms, including caplets, liquicaps, and a liquid. It’s often taken 4 to 6 times a day as needed for a short period of time.
NyQuil is actually a family of OTC products. It’s not one single medication. NyQuil usually contains acetaminophen (pain reliever), dextromethorphan (cough suppressant), and doxylamine (antihistamine). But there are other OTC medications found in some of them, including chlorpheniramine (antihistamine), diphenhydramine (antihistamine), and phenylephrine (decongestant).
Since NyQuil is available as many products, the best version depends on your symptoms. If you have any questions about the right form of NyQuil for your needs, talk with a pharmacist.
Can you take NyQuil with alcohol?
You should avoid the combination, if possible. Most versions of NyQuil could cause dizziness and drowsiness as a side effect. Drinking alcohol with NyQuil may worsen these side effects. Some NyQuil products also contain a small amount of alcohol as a solvent, which could further amplify these effects.
Plus, when you’re sick with a cold or the flu, alcohol can make your symptoms feel worse. It may amplify symptoms such as headache and fatigue. It can also contribute to dehydration.
Alcohol is also known to weaken your immune system. Drinking alcohol while you’re sick may cause you to feel sick longer. This is because your immune system isn’t able to fight off germs as effectively. It’s best to avoid drinking alcohol while you’re sick.
Is having 1 or 2 drinks OK?
NyQuil Cold & Flu’s labeling recommends avoiding alcohol altogether. It’s best to follow this advice if you can.
If you want to mix alcohol and NyQuil anyway, talk with a healthcare professional, such as your primary care provider or pharmacist, first. Everyone’s experience and tolerability with alcohol is different, so they can talk to you more about the risks of combining the two.
Are certain people more at risk when combining NyQuil and alcohol?
Again, alcohol affects everyone differently. The following people are thought to have a higher risk of side effects when combining NyQuil and alcohol:
Older adults: People age 65 and older may be more sensitive to alcohol’s effects. Compared to younger adults, older adults tend to break down (metabolize) alcohol slower. Older adults have a higher risk of side effects as a result.
People taking sedatives: NyQuil makes you feel tired. Sedative medications also cause drowsiness. There’s a risk of developing intense drowsiness when combining alcohol, NyQuil, and sedative medications. This includes barbiturates, benzodiazepines, nonbenzodiazepine hypnotics, and more.
People with liver conditions: The liver breaks down many of NyQuil’s components, such as acetaminophen. It also helps the body get rid of alcohol. People with liver dysfunction tend to have problems clearing these substances from the body when they’re consumed together. This worsens the risk of serious side effects.
Women: Women tend to have less body water content than men. This is why women tend to have higher blood alcohol concentration (BAC) after drinking. This also places women at a slightly higher risk of serious side effects when mixing alcohol and NyQuil.
Wondering how long NyQuil takes to kick in? Pharmacists share their insights on NyQuil’s onset time and offer helpful tips for getting the most out of this cold medicine.
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How does alcohol interact with NyQuil?
Alcohol interacts with NyQuil by increasing its sedative effects, which can make you feel more drowsy, dizzy, and unsteady. Alcohol and NyQuil can slow down your central nervous system, which is why their combined effects are stronger.
Additionally, because NyQuil contains acetaminophen, mixing it with alcohol increases the risk of liver damage — especially if you drink a lot or take more than the recommended dose of NyQuil within 24 hours.
Are there any serious risks or side effects?
When combining alcohol and NyQuil, the most concerning serious side effect is liver damage. This risk is higher in a few situations. This includes when people:
Take more than 4 doses of NyQuil within 24 hours
Take multiple medications that contain acetaminophen
Drink 3 or more alcoholic beverages every day while taking NyQuil
If you think you’re experiencing liver toxicity, seek medical attention. Symptoms of liver damage may include:
Dark urine
Nausea and vomiting
Upper right-sided stomach pain
Yellowing of skin and eyes (jaundice)
When is it safe to drink alcohol after taking NyQuil?
Again, try to avoid mixing alcohol and NyQuil. But it may be OK to drink alcohol after NyQuil exits your body.
How long does NyQuil stay in your system?
NyQuil products can take 2 days or more to fully leave your system. But how long NyQuil stays in your body can depend on the specific product, which may contain various combinations of the following OTC medications:
Acetaminophen: Acetaminophen is found in many cold and flu medications. Your body may need at least 24 hours to get rid of acetaminophen.
Chlorpheniramine: Of all the different NyQuil components, chlorpheniramine usually takes the longest to clear your body. Just one dose may take 120 hours (5 days) to fully leave.
Dextromethorphan: One dose of dextromethorphan may need about 55 hours (more than 2 days) to exit your system. But this timeframe may vary. Some estimates show that this clearance time could be as low as 12 hours or as long as about 4 days.
Doxylamine: Your body will generally need at least 50 hours (more than 2 days) to clear one dose of this medication.
Diphenhydramine: For many adults, one dose of diphenhydramine will likely leave your body within 60 hours (2.5 days).
Phenylephrine: For one dose of oral phenylephrine to clear your body, it may take at least 15 hours.
Factors such as age, underlying health conditions, and other medications may also affect how long NyQuil stays in your system. For more specific information, talk with a healthcare professional.
Are there any cold and flu medications that don’t interact with alcohol?
Several cold and flu medications don’t directly interact with alcohol. But drinking alcohol can still be risky. For example:
Ibuprofen (Advil, Motrin): Ibuprofen is commonly used to relieve fever and body aches. If you drink alcohol while taking ibuprofen, alcohol may raise the risk of stomach bleeding, kidney problems, and liver problems.
Pseudoephedrine (Sudafed): Pseudoephedrine is used to relieve a stuffy nose. But combining pseudoephedrine with alcohol may worsen headaches.
Tamiflu (oseltamivir) and Xofluza (baloxavir): These flu medications are used to treat and prevent the flu. These don’t interact with alcohol directly, but if you’ve ever had the flu, you know that it makes you feel pretty crummy. Drinking alcohol while you have the flu can make your symptoms even worse.
Before combining alcohol with any of these cold and flu medications, it’s best to check with a healthcare professional.
The bottom line
NyQuil is a line of over-the-counter (OTC) cold and flu medications. NyQuil products typically contain some combination of acetaminophen, dextromethorphan, and doxylamine. Combining alcohol and NyQuil may worsen side effects such as dizziness and drowsiness. In severe cases, drinking alcohol while taking NyQuil may lead to liver damage. It's best to avoid drinking alcohol while taking NyQuil.
Why trust our experts?
References
American Addiction Centers. (n.d.). Effects of alcohol on your body.
DailyMed. (n.d.). Search results for NyQuil.
Meier, P., et al. (2008). Age, alcohol metabolism and liver disease. Current Opinion in Clinical Nutrition and Metabolic Care.
National Institute on Aging. (2022). Flu and older adults.
National Institute of Diabetes and Digestive and Kidney Diseases. (2023). Symptoms and causes of cirrhosis.
National Institute on Alcohol Abuse and Alcoholism. (n.d.). Alcohol metabolism.
National Institute on Alcohol Abuse and Alcoholism. (n.d.). Harmful interactions.
National Institute on Alcohol Abuse and Alcoholism. (n.d.). Women and alcohol.
Oh, S. R., et al. (2023). Dextromethorphan. StatPearls.
The Procter and Gamble Manufacturing Company. (2024). Vicks Nyquil cold and flu nighttime relief - acetaminophen, dextromethorphan hydrobromide, and doxylamine succinate liquid [package insert]. DailyMed.
