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Updated on February 11, 2022

Nyquil and Alcohol Interactions

What is NyQuil?

Nyquil is an over-the-counter (OTC) medication. Its producer, Procter & Gamble, first introduced it in 1966.

Nyquil treats nighttime cold and flu symptoms. NyQuil has been linked to the relief of symptoms from asthma and chronic bronchitis. These include sneezing, sore throat, headache, minor aches and pains, fever, runny nose, and cough. It is also helpful for insomnia.

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 1

NyQuil is produced as a liquid cough syrup or liquicap (liquid inside capsule) form. There is also another formula of NyQuil available to treat advanced symptoms of the common cold and flu.

Procter & Gamble also produces DayQuil, a daytime cold medicine. Its formula is similar to NyQuil without the sedative effects.

Adults and children over the age of 12 should take one dose of Nyquil every 6 hours while symptoms last. People should not exceed four doses in 24 hours.

Is There Alcohol in NyQuil?

NyQuil Liquid contains 10 percent alcohol. 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
  • Propylene glycol
  • Sodium citrate
  • Flavor
  • High-fructose corn syrup.

Some varieties of NyQuil are alcohol-free. These include NyQuil LiquiCaps and Alcohol-Free NyQuil Cold & Flu Nighttime Relief Liquid.

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Can You Mix NyQuil and Alcohol?

NyQuil and alcohol should never be consumed together.

Procter & Gamble warns that severe liver damage can occur if NyQuil is taken with three or more drinks. This is a cause of the component acetaminophen, which can induce liver damage in toxic doses.

Due to the many short-term and long-term effects, 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 (drug interactions).

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.

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. 

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NyQuil Overdose Symptoms

Combining NyQuil and one or two drinks usually won't cause any serious issues.

But if you take more than the recommended amount of NyQuil, or drink a lot of alcohol, you may overdose.

If you have any of the following symptoms, contact 911 immediately for emergency help:

  • Rapid heart rate
  • Abdominal pain
  • Severe agitation or irritability
  • Seizures
  • Hallucinations
  • Severe confusion
  • Loss of appetite
  • Dark urine
  • Yellow color in your eyes or skin

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.

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Other Medications to Avoid While Taking NyQuil

Besides alcohol, there are other medications that should not be mixed with NyQuil. These include:

Drugs with Acetaminophen

NyQuil already contains acetaminophen. Taking other medications that contain the same drug may cause you to take more than the recommended daily dose. This increases your chances of liver damage.

Many over-the-counter and prescription drugs have acetaminophen in them. Paracetamol is another name for acetaminophen. Tylenol is the most common brand name for acetaminophen in the United States.

Common medications that may include acetaminophen and should not be mixed with NyQuil include:

Be sure to read the labels carefully before taking any medication in addition to NyQuil. If you have any questions or concerns contact your local pharmacy or healthcare provider.

Is NyQuil Addictive?

One of NyQuil's main ingredients is dextromethorphan or DXM. DXM is an addictive drug and is often abused for the euphoric effects it produces.

DXM is often abused in its original form or mixing it with soda and candy for flavor. This is 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.

In high doses, DXM produces a similar effect to hallucinogenic drugs like PCP or ketamine. It 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.

People develop an addiction over time and start to crave DXM.

Even users who use NyQuil for its intended purpose may develop a dependency or tolerance. If you develop a tolerance, you will need 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.

NyQuil is meant to treat short-term symptoms and not cure long-term health problems. You should not use it for more than 7 days. 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. Signs of a NyQuil dependency include being unable to sleep without NyQuil. 

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

Treatment Options for Alcohol Abuse & Addiction

Here are some of the best treatment options for alcohol use disorder (AUD):

Inpatient programs 

Inpatient treatment is an option for alcohol addiction treatment. These intensive programs are usually 30, 60, or 90 days. However, they can be longer in some instances.

Partial hospitalization programs (PHPs)

Partial hospitalization programs are also called intensive outpatient programs or IOPs. They're like inpatient programs, but you return home after each session.

Outpatient programs

Outpatient programs are less intensive and offer a more flexible treatment schedule. They're best for people who have responsibilities at work, home, or school and are highly motivated to achieve sobriety.

Medication-assisted therapy (MAT)

Certain people qualify for medication-assisted therapy. Medications can help you detox, reduce cravings, and normalize bodily functions.

MAT is most effective when combined with other treatment therapies.

Support groups

Support groups are peer-led groups that help people stay sober. They can be a first step in overcoming alcoholism or a component of an aftercare plan.

Many of them follow the 12-step approach. However, there are also secular options that don't follow the 12-step approach.

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Resources

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  1. Budnitz, Daniel S et al. “Emergency department visits for overdoses of acetaminophen-containing products.” American journal of preventive medicine vol. 40,6 : 585-92. doi:10.1016/j.amepre.2011.02.026 https://pubmed.ncbi.nlm.nih.gov/21565648/
  2. “Commonly Abused Drugs and Withdrawal Symptoms.” DrugAbuse.Gov/Researchers, National Institute on Drug Abuse, https://nida.nih.gov/sites/default/files/nida_commonlyabused_withdrawalsymptoms_10062017-508-1.pdf
  3. “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
  4. 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/
  5. “Drug Facts: Cough and Cold Medicine Abuse.” National Institute of Drug Abuse, U.S. Department of Health and Human Services, May 2014, https://nida.nih.gov/sites/default/files/drugfacts_cough_cold_meds.pdf
  6. “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
  7. Martinak, Bridgette et al. “Dextromethorphan in Cough Syrup: The Poor Man's Psychosis.” Psychopharmacology bulletin vol. 47,4 : 59-63. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5601090/
  8. May, Mary Elizabeth. Dextromethorphan, National Capital Poison Center, 1 Aug. 2019, https://www.poison.org/articles/2015-sep/dextromethorphan
  9. Mutschler, Jochen et al. “Dextromethorphan withdrawal and dependence syndrome.” Deutsches Arzteblatt international vol. 107,30 : 537-40. doi:10.3238/arztebl.2010.0537 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2925345/
  10. NIDA. "Over-the-Counter Medicines DrugFacts." National Institute on Drug Abuse, 17 Dec. 2017, https://nida.nih.gov/publications/drugfacts/over-counter-medicines Accessed 14 Oct. 2020.
  11. “Our Story - A Century of Powerful Relief and Caring.” Vicks, Procter & Gamble, tps://vicks.com/en-us/vicks-history
  12. “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
  13. Vicks NyQuil FAQ. https://vicks.com/en-us/safety-and-faqs/faqs/vicks-nyquil-faq

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