What is NyQuil?

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Nyquil is an over-the-counter medication produced by Procter & Gamble that was first introduced in 1966. Nyquil is intended to treat nighttime cold and flu symptoms, including sneezing, sore throat, headache, minor aches and pains, fever, runny nose, and cough. Procter & Gamble recommends that adults and children over the age of 12 take one dose of Nyquil every 6 hours while symptoms last. Patients should not exceed four servings in 24 hours.

NyQuil has three active ingredients: 

  • acetaminophen (a pain reliever/fever reducer)
  • dextromethorphan HBr (a cough suppressant)
  • doxylamine succinate (an antihistamine). 

Doxylamine succinate, like many antihistamines, is a depressant and has a sedative effect.

NyQuil is produced as a liquid cough syrup as well as in liquicap (liquid inside capsule) form. There is also a severe formula of NyQuil available to treat advanced symptoms of the common cold and flu. Procter & Gamble also produces DayQuil, a daytime cold medicine containing a similar formula to NyQuil without the sedative effects.

Nyquil

Is There Alcohol in NyQuil?

NyQuil Liquid contains 10 percent alcohol. According to Procter & Gamble, the alcohol in NyQuil is used as a solvent to keep the top three ingredients in liquid form.

Other ingredients in NyQuil include polyethylene glycol and propylene glycol, sodium citrate, flavor, and high-fructose corn syrup.

Other varieties of NyQuil are alcohol-free, including NyQuil LiquiCaps and Alcohol-Free NyQuil Cold & Flu Nighttime Relief Liquid.

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Is NyQuil Addictive?

One of NyQuil's main ingredients is dextromethorphan or DXM.  Some people abuse DXM for recreation. Abusers swallow DXM in its original form or mix it with soda and candy for flavor, called "robo-tripping," "skittling," or "dexing."  It can also be snorted or injected. Abusers of DXM often combine it with other drugs such as alcohol and marijuana.

DXM produces a similar effect to that of hallucinogenic drugs like PCP or ketamine when taken in high doses. It indirectly causes a pleasurable increase in the amount of dopamine in the brain's reward pathway. Users describe effects ranging from mild stimulation to alcohol- or marijuana-like intoxication. At high doses, users report feeling sensations of physical distortion and hallucinations. Individuals develop an addiction when craving and repeatedly seeking to experience those feelings.

Even users who use NyQuil for its intended purpose may develop a dependency on the drug. Signs that the user has developed a tolerance to the drug include needing to take a larger amount or more frequent doses to achieve the same effect. 

Symptoms of NyQuil addiction include:

  • A strong desire or compulsion to take NyQuil
  • Reduced ability to control the use of the drug
  • Physical withdrawal symptoms when attempting to reduce the use of NyQuil which resolves when NyQuil use is resumed
  • Increased tolerance
  • Neglecting other areas of life due to NyQuil use

Misuse of NyQuil also includes taking too much of it or taking it for the wrong reasons, such as treating asthma, insomnia, or chronic bronchitis. NyQuil is meant to treat short-term symptoms and is not a cure for long-term health problems. NyQuil is not a safe treatment for insomnia and should not be used as a sleep aid.

Individuals can develop a dependency on NyQuil and may experience withdrawal symptoms when trying to cut back on use. Signs of a NyQuil dependency include being unable to sleep without NyQuil long after the cold or flu symptoms have passed. 

Symptoms of NyQuil withdrawal may include:

  • Tremors
  • Seizures
  • Anxiety
  • Agitation
  • Depression
  • Insomnia
  • Overactive reflexes
  • Increased heart rate, blood pressure, and temperature
  • Excessive sweating
  • Nausea
  • Hallucinations
  • Severe cravings for NyQuil or other medications with similar ingredients

Can You Mix NyQuil and Alcohol?

NyQuil and alcohol should never be consumed together. Procter & Gamble warns that severe liver damage may occur if NyQuil is taken with three or more alcoholic beverages. However, due to the many short-term side effects and long-term risks, consuming any amount of alcohol with NyQuil is not recommended.

NyQuil and Alcohol Side Effects

Mixing NyQuil with alcohol produces a variety of side effects. Because NyQuil and alcohol cause many of the same side effects, including sedation, coordination issues, and elevated heart rate. Combining the two substances can cause these side effects to be more substantial.

The short-term side effects of mixing NyQuil and alcohol include:

  • Increased sedation and drowsiness
  • Coordination issues
  • Elevated heart rate
  • Dizziness
  • Upset stomach

Alcohol also impairs the body's immune system, making it harder for the body to recover from illness. An impaired immune system can cause NyQuil to be ineffective at treating cold symptoms, leading to further infection.

Long-term consequences of mixing NyQuil and alcohol include liver damage and addiction.

At high doses, drinking alcohol with NyQuil is extremely dangerous and can lead to overdose and death. 

Dangers of Mixing NyQuil and Alcohol

Mixing NyQuil and alcohol is very dangerous. The risks of mixing NyQuil and alcohol include:

  • Addiction
  • Impaired immune system
  • Liver damage or failure
  • Increased risk for overdose
  • Increased risk of accidental death

NyQuil contains acetaminophen, which is hard on the liver. Alcohol is also toxic to the liver, and combining the two can cause severe damage or lead to overdose.

Treatment for Alcohol and NyQuil Addiction

Treatment options for alcohol and NyQuil addiction include inpatient, outpatient, and partial hospitalization programs. The right program depends on the severity of the addiction. These programs may use behavioral therapies, such as cognitive-behavioral therapy and contingency management to treat alcohol and NyQuil addiction.

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Resources +

Budnitz, Daniel S et al. “Emergency department visits for overdoses of acetaminophen-containing products.” American journal of preventive medicine vol. 40,6 (2011): 585-92. doi:10.1016/j.amepre.2011.02.026 https://pubmed.ncbi.nlm.nih.gov/21565648/

“Commonly Abused Drugs and Withdrawal Symptoms.” DrugAbuse.Gov/Researchers, National Institute on Drug Abuse, https://www.drugabuse.gov/sites/default/files/nida_commonlyabused_withdrawalsymptoms_10062017-508-1.pdf

“DEXTROMETHORPHAN (Street Names: DXM, CCC, Triple C ...” Diversion Control Division, Drug Enforcement Administration, Dec. 2019, https://www.deadiversion.usdoj.gov/drug_chem_info/dextro_m.pdf

Di Justo, Patrick. “What's Inside: NyQuil, Fortified With Powerful Narcotics!” Wired, Conde Nast, 5 June 2017, https://www.wired.com/2007/10/st-nyquil/

“Drug Facts: Cough and Cold Medicine Abuse.” National Institute of Drug Abuse, U.S. Department of Health and Human Services, May 2014, https://www.drugabuse.gov/sites/default/files/drugfacts_cough_cold_meds.pdf

“Drugs of Abuse.” Drug Enforcement Administration, U.S. Department of Justice, 2017, https://www.dea.gov/sites/default/files/2018-06/drug_of_abuse.pdf

Martinak, Bridgette et al. “Dextromethorphan in Cough Syrup: The Poor Man's Psychosis.” Psychopharmacology bulletin vol. 47,4 (2017): 59-63. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5601090/

May, Mary Elizabeth. Dextromethorphan, National Capital Poison Center, 1 Aug. 2019, https://www.poison.org/articles/2015-sep/dextromethorphan

Mutschler, Jochen et al. “Dextromethorphan withdrawal and dependence syndrome.” Deutsches Arzteblatt international vol. 107,30 (2010): 537-40. doi:10.3238/arztebl.2010.0537 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2925345/

NIDA. "Over-the-Counter Medicines DrugFacts." National Institute on Drug Abuse, 17 Dec. 2017, https://www.drugabuse.gov/publications/drugfacts/over-counter-medicines Accessed 14 Oct. 2020.

“Our Story - A Century of Powerful Relief and Caring.” Vicks, Procter & Gamble, tps://vicks.com/en-us/vicks-history

“Prescription for Disaster: How Teens Misuse Medicine.” Get Smart About Drugs: A DEA Resource for Parents, United States Drug Enforcement Administration, 2018, https://www.dea.gov/sites/default/files/2018-11/DEA_PrescriptionForDisaster-2018ed_508.pdf

Vicks NyQuil FAQ. https://vicks.com/en-us/safety-and-faqs/faqs/vicks-nyquil-faq

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