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acetaminophen / dextromethorphan / doxylamine / phenylephrine

Generic
Used for Nasal Congestion, Pain, Cold Symptoms, Fever, Cough, Flu
Used for Nasal Congestion, Pain, Cold Symptoms, Fever, Cough, Flu

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.

Last reviewed on February 25, 2022
basics-icon

What is Tylenol Cold + Flu + Cough Night?

What is Tylenol Cold + Flu + Cough Night used for?

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

How Tylenol Cold + Flu + Cough Night works

Tylenol Cold + Flu + Cough Night is a combination of four medications.

  • Acetaminophen is an analgesic. It 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. It 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. It blocks histamine, a natural chemical in your body that causes congestion, sneezing, and wakefulness.

  • Phenylephrine is a decongestant. It works to clear your stuffy nose and sinuses by tightening your blood vessels, which causes less fluid to leak out.

Are you looking for information on NyQuil Cough (dextromethorphan / doxylamine) instead?

Drug Facts

Common BrandsTylenol Cold + Flu + Cough Nighttime, NyQuil Severe Cough and Flu, Cold and Flu Nighttime, Alka-Seltzer Plus Maximum Strength Night Cold and Flu
Drug ClassAnalgesic / Cough suppressant / Antihistamine / Decongestant
Controlled Substance ClassificationNot a controlled medication
Generic StatusLower-cost generic available
AvailabilityOver-the-counter
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What are the side effects of Tylenol Cold + Flu + Cough Night?

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

  • Drowsiness
  • Excitability in children

Serious Side Effects

Contact your healthcare provider immediately if you experience any of the following.
  • Signs of an overdose: seizures, heart rhythm problems, confusion, trouble urinating, blurred vision, hallucinations, trouble breathing, yellowing of the skin or eyes, stomach pain, loss of consciousness
  • Liver damage: nausea, vomiting, loss of appetite, severe stomach pain, yellowing of skin or eyes
  • Serotonin syndrome: fast heart rate, sweating, muscle stiffness or spasms, high fever, confusion

Source: DailyMed

pros-and-cons

Pros and cons of Tylenol Cold + Flu + Cough Night

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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

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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

pharmacist-tips

Pharmacist tips for Tylenol Cold + Flu + Cough Night

pharmacist
  • When taking the tablets or capsules, swallow them whole. Don't crush, chew, or dissolve them. This can cause the medication to not work as well.

    • If you're using the liquid, store the medication at room temperature (don't refrigerate). Shake the bottle well before using. Be sure to use the medication dose cup, spoon, or syringe that the product comes with to measure out your dose. Using household teaspoons might cause you to take the wrong amount of Tylenol Cold + Flu + Cough Night.

      • Avoid alcohol or other sedating medications. This can make you more drowsy and less alert when taking with Tylenol Cold + Flu + Cough Night. Be careful driving or doing anything that requires you to be alert until you know how this medication affects you. Alcohol can also raise your risk of liver damage when taking medications containing acetaminophen.

        • Don't use this medication to make your child sleepy. While Tylenol Cold + Flu + Cough Night 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.

          • Many over-the-counter and prescription medications contain acetaminophen, dextromethorphan, doxylamine, and phenylephrine. Check and make sure you aren't taking more than the recommended amounts of each medication to avoid overdose (hallucinations, breathing problems, yellowing of the skin or eyes, stomach pain, feeling tired, nausea, vomiting). Ask your healthcare provider if you aren't sure if any of these medications are already in medications you're currently taking. If you think you or your child has overdosed, call a Poison Control Center right away at (800) 222-1222.

            • Stop using Tylenol Cold + Flu + Cough Night and talk to your provider if your sore throat lasts for more than 2 days, or if it occurs with a fever, headache, rash, nausea or vomiting. In additon, if your cough, pain, or stuffy nose lasts longer than 7 days, your cough stops and returns or occurs with a rash or headache that lasts, or your fever gets worse or lasts for more than 3 days, contact your provider. These can all be signs of a more serious condition that Tylenol Cold + Flu + Cough Night won't be able to treat.

              • If you notice any mood changes, dizziness, trouble sleeping, redness, swelling, new symptoms, or any of your symptoms get worse, stop taking Tylenol Cold + Flu + Cough Night and contact your provider.

                faqs

                Frequently asked questions about Tylenol Cold + Flu + Cough Night

                Will Tylenol Cold + Flu + Cough Night make me sleepy?
                Sleepiness is a side effect of Tylenol Cold + Flu + Cough Night. This is due to the antihistamine (doxylamine), which can cause drowsiness. Be careful driving or doing anything that requires you to be alert until you know how this medication affects you.
                Can I drink alcohol while taking Tylenol Cold + Flu + Cough Night?
                No, it's recommended to avoid drinking alcohol while taking Tylenol Cold + Flu + Cough Night. This medication can cause drowsiness and make you less alert as a side effect, and drinking alcohol will make you more sleepy and even less alert. This can raise your risk of serious, accidental injuries, like falls and car accidents. Drinking alcohol while taking medications that contain acetaminophen can also raise your risk of liver damage.
                Is Tylenol Cold + Flu + Cough Night safe to use during pregnancy?
                There isn't enough information available to know if Tylenol Cold + Flu + Cough Night is safe to take during pregnancy. Since this combination medication contains four different medications, consider which symptoms are bothering you the most and if you really need all four medications. If you're currently pregnant, talk with your provider about the best treatment options for your symptoms and the risks and benefits to you and your unborn baby.
                Is it safe to take Tylenol Cold + Flu + Cough Night if I have high blood pressure?
                One of the medications in Tylenol Cold + Flu + Cough Night, phenylephrine, works to clear your sinuses and stuffy nose by tightening your blood vessels. As a side effect, this can lead to raised blood pressure. If you have high blood pressure, let your provider know and discuss if Tylenol Cold + Flu + Cough Night is the best option to treat your symptoms. Many cold and flu medications are available without decongestants like phenylephrine, such as Dayquil HBP Cold and Flu.
                Will Tylenol Cold + Flu + Cough Night affect my blood sugar?
                Some liquid forms of Tylenol Cold + Flu + Cough Night contain sugar and aren't recommended if you have diabetes. If you have blood sugar problems, look for a sugar-free liquid or take the capsules or tablets instead. The capsule and tablet forms of Tylenol Cold + Flu + Cough Night might not affect your blood sugar as much. If you're unsure which form of this medication is best for you, ask your provider or pharmacist.
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                What are the risks and warnings for Tylenol Cold + Flu + Cough Night?

                Tylenol Cold + Flu + Cough Night 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.

                risk-warning

                Liver damage

                • Risk factors: Drinking 3 or more alcoholic beverages a day | Taking with other acetaminophen-containing medications | History of liver disease

                  Taking too much acetaminophen causes liver damage that can be permanent and life-threatening. Avoid drinking alcohol when taking Tylenol Cold + Flu + Cough Night. Also avoid using Tylenol Cold + Flu + Cough Night if you already have liver problems, since it can cause further damage to your liver. Signs of liver problems can include dark urine, feeling tired, upset stomach or stomach pain, or yellowing of skin or eyes. If you notice any of these symptoms, call your provider right away.

                  risk-warning

                  Sleepiness and driving impairment

                  • Risk factors: Taking with alcohol | Taking other medications that make you less alert

                    Tylenol Cold + Flu + Cough Night can lower your ability to focus, think, and react. Your risk is higher when drinking alcohol or taking other medications that make you drowsy or less alert (e.g., benzodiazepines, opioids). Be careful and avoid activities that require you to be alert, such as driving a car or operating machinery, until you know how this medication affects you.

                    risk-warning

                    Dangerous for children under 4 years old

                    Tylenol Cold + Flu + Cough Night is not safe and shouldn't be used in children under 4 years old. Using this medication for children that young can cause serious problems, including trouble breathing and even death. There are other medications available that are safer for young children. Speak to your child's provider or your pharmacist to discuss alternatives.

                    risk-warning

                    Overdose and misuse

                    • Risk factors: Using other medications with similar ingredients

                      Taking too much Tylenol Cold + Flu + Cough Night can lead to serious problems, including seizures, heart rhythm problems (arrhythmias), loss of consciousness, and death. All the ingredients in Tylenol Cold + Flu + Cough Night (acetaminophen, dextromethorphan, doxylamine, and phenylephrine) are found in multiple cough, cold, and allergy products, so it's not recommended to take more than one of these products at a time.

                      It's especially important to keep track of how much acetaminophen you're taking throughout the day to avoid overdosing, which can lead to liver damage. For adults, the maximum amount of acetaminophen is 3 or 4 grams in a 24-hour period, depending on your provider's instructions. For children, ask your child's provider.

                      Some people, including adolescents, have been known to purposely misuse dextromethorphan. This can lead to an overdose and is why many retail stores require you to be over 18 years old to purchase products containing dextromethorphan.

                      It's always a good idea to keep all medications, even over-the-counter products, in a secure place out of the reach of children. If you suspect that you or someone you know have overdosed on Tylenol Cold + Flu + Cough Night, get medical help or contact a Poison Control Center (1-800-222-1222) right away.

                      risk-warning

                      Serotonin syndrome

                      • Risk factors: Taking other medications that can affect the 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 goes up if you use Tylenol Cold + Flu + Cough Night with other medications that affect serotonin levels (antidepressants, lithium, certain medications used to treat Parkinson's disease, MAOIs). Tell your provider about all medications and over-the-counter products you take before starting Tylenol Cold + Flu + Cough Night so they can check for any interactions. Symptoms of too much serotonin include a fast heart rate, sweating, muscle stiffness or spasms, fever, and confusion. Contact your healthcare provider or seek medical help right away if you have any of these symptoms.

                        risk-warning

                        Allergic skin reactions

                        Rarely, Tylenol Cold + Flu + Cough Night can cause serious skin reactions. If you notice a rash, blisters, or your skin turns red after taking this medication, stop using it and get medical attention right away.

                        risk-warning

                        Worsening of certain medical conditions

                        • Risk factors: Liver problems | Heart problems | High blood pressure | Thyroid problems | Diabetes | Glaucoma | Sodium-restricted diet | Trouble urinating | Long-term cough | Cough with too much mucus

                          Tylenol Cold + Flu + Cough Night shouldn't be used in people with certain medical conditions (for example, long-term coughing caused by conditions such as asthma, emphysema, smoking, and chronic bronchitis). If you currently have or have had liver problems, heart problems, high blood pressure, glaucoma, trouble urinating, diabetes, thyroid problems, or if you're on a sodium-restricted diet, speak to your provider first before using this medication. Tylenol Cold + Flu + Cough Night can worsen your condition and might not be right for you.

                          dosage

                          Tylenol Cold + Flu + Cough Night dosage forms

                          bottle of liquid
                          Bottle of liquid
                          DosageQuantityPrice as low asPrice per unit
                          325mg/10mg/6.25mg/5mg/15ml1 bottle$5.53$5.53

                          Typical dosing for Tylenol Cold + Flu + Cough Night

                          There are several manufacturers of this medication that might have slightly different dosing instructions.

                          Be sure to check the medication box for specific directions. Below are some examples of dosing instructions.

                          Capsules

                          • Each capsule contains 325 mg of acetaminophen, 10 mg of dextromethorphan, 6.25 mg of doxylamine, and 5 mg of phenylephrine.

                          • Adults and children 12 years and older: The typical dose is 2 capsules by mouth with water every 4 hours. Don't take more than 10 capsules in 24 hours.

                          • Children 11 years and younger: Don't use.

                          Tablets

                          • Each tablet contains 325 mg of acetaminophen, 10 mg of dextromethorphan, 6.25 mg of doxylamine, and 5 mg of phenylephrine.

                          • Adults and children 12 years or older: The typical dose is 2 tablets by mouth with water every 4 hours. Don't take more than 8 tablets in 24 hours.

                          • Children 4 to 11 years old: Ask your child's provider.

                          • Children 3 years and younger: Don't use.

                          Liquid

                          • Each 15 mL of medication contains 325 mg of acetaminophen, 10 mg of dextromethorphan, 6.25 mg of doxylamine, and 5 mg of phenylephrine.

                          • Adults and children 12 years or older: The typical dose is 30 mL (2 tablespoons) by mouth every 4 hours. Don't take more than 150 mL (10 tablespoons) in 24 hours.

                          • Children 11 years and younger: Ask your child's provider.

                          contraindications-icon

                          Tylenol Cold + Flu + Cough Night 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 Tylenol Cold + Flu + Cough Night will not be safe for you to take.
                          • Take with any other medication containing acetaminophen (prescription or nonprescription)

                          • Currently take or have taken an MAOI in the last 14 days

                          alternatives

                          What are alternatives to Tylenol Cold + Flu + Cough Night?

                          There are a number of medications that your doctor can prescribe in place of Tylenol Cold + Flu + Cough Night. Compare a few possible alternatives below.
                          Tylenol Cold + Flu + Cough Night
                          Used for:

                          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

                          $5.53 Lowest GoodRx priceView Prices
                          Used for:
                          • Cough

                          • Sore throat

                          • Headache

                          • Minor aches and pains

                          • Fever

                          • Runny nose

                          • Sneezing

                          $14.08 Lowest GoodRx priceView Prices
                          Used for:
                          • Short-term relief of symptoms from the common cold and flu:

                          $5.50 Lowest GoodRx priceView Prices

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