Can You Take Tylenol And Nyquil Together?

In this article, The pharmacist answers the question “Can You Take Tylenol And Nyquil Together?” He also explains how to space the two drugs in cases where you have to take them together. Read on for more details.

Can You Take Tylenol And Nyquil?

No, it is not recommended to take Tylenol and Nyquil together because both drugs contain the same active ingredient which is acetaminophen. Taking the two products together can result in acetaminophen overdose which can cause severe liver damage.

Nyquil has several products and each is designed to provide relief to a patient’s specific condition. Generally, Nyquil products offer relief to cough, fever, and symptoms of cold and flu such as sneezing, runny nose, watery eyes, nasal congestion, itching, etc. 

To be able to address these symptoms, Nyquil relies on 3 active ingredients.

Active Ingredients in Nyquil

The three main active ingredients in NyQuil Cough syrup are acetaminophen, dextromethorphan, and doxylamine succinate. 

Acetaminophen is a pain reliever and fever reducer. It can help provide relief to headaches, backaches, and minor pains, and also lower body temperature. Acetaminophen is also the active ingredient in Tylenol.

Dextromethorphan is a cough suppressant. It helps prevent cough by suppressing the part of the brain that controls the cough reflex. 

Doxylamine succinate is a first-generation antihistamine. It is incorporated into the formulation to relieve symptoms of colds and allergies like sneezing, watery eyes, runny nose, itching, etc. 

Just like every other first-generation antihistamine, doxylamine crosses into the brain and then binds to the histamine receptors located in the central nervous system. 

This action results in CNS depression, which then manifests as drowsiness, dizziness, and sedation. Hence, it is often advisable to take Nyquil products containing doxylamine succinate at night.

Other Nyquil products can contain additional ingredients other than the ones mentioned here. For example, Nyquil SEVERE contains phenylephrine as an additional ingredient. Phenylephrine is a nasal decongestant. It works by reducing the swelling of blood vessels in the nose, thereby giving more room for breathing. 

Why Taking Tylenol and Nyquil Can Result in Overdose

Just like Nyquil, Tylenol also has several formulations with different ingredients. The dose of acetaminophen in these other products may also vary, either below or above the regular 500 mg commonly encountered.

However, plain Tylenol products such as Tylenol Extra Strength intended for pain or fever relief usually contain acetaminophen at 500mg, and adults are recommended to take 2 tablets which is 1000 mg three times a day. 

The maximum daily dose for acetaminophen is 4000 mg. So taking Tylenol at the recommended dose of 1000 mg three times a day (adults) will leave you at a cumulative 3000 mg in 24 hours which is well below the maximum daily dose.

This is different for the following Tylenol products:  

• TYLENOL Regular Strength Liquid Gels 
• TYLENOL 8 HR Arthritis Pain, and 
• TYLENOL 8 HR Muscle Aches & Pain Caplets. 

TYLENOL Regular Strength Liquid Gels contain acetaminophen at 325 mg per liquid gels and you are not allowed to take more than 10 liquid gels (3,250 mg) in 24 hours.

Both Tylenol 8 HR Arthritis Pain and TYLENOL 8 HR Muscle Aches & Pain Caplets are extended-release formulations containing acetaminophen at 650 mg per caplet. They are dosed as 2 caplets (1,300 mg) every 8 hours; not to exceed 6 Caplets (3,900 mg) in 24 hours.

Each 30ml of Nyquil contains 650 mg of acetaminophen (Tylenol). Adults and children above 12 years are to take 30 ml every 4 hours and not to exceed 4 doses in 24 hours. This will amount to 2,600 mg of acetaminophen in 24 hours if taken as recommended.

So, if you are taking two Tylenol 500mg tablets three times a day (3000 mg in 24 hours), and 4 doses of Nyquil in a day which contains 650 mg of acetaminophen (2,600 mg). 

You end up taking a total of 5,600 mg of acetaminophen within the 24-hour period you used both drugs. This total dose exceeds the maximum daily dose of 4000 mg a day. 

Hence, this will be a clear case of overdose. It can lead to acetaminophen toxicity which may result in severe liver damage.

Pharmacist Recommendation

If you are experiencing headache, body ache, minor pain, or fever together with symptoms of cold and flu such as coughing, sneezing, watery eyes, runny nose, etc. 

Instead of using Tylenol and Nyquil together which is highly not advisable. It is recommended to set aside the Tylenol and then use the Nyquil alone. Nyquil is capable of handling minor pains, fever, and cold and flu symptoms. 

But if you are experiencing serious pain and you must take Tylenol, we recommend that you go for a Nyquil product without acetaminophen. 

An example is “NyQuil™ Cough DM + Congestion Maximum Strength Nighttime Relief Liquid” which contains Dextromethorphan (cough suppressant), Doxylamine succinate (sedating antihistamine), and Phenylephrine (nasal decongestant).

Taking Tylenol with the above Nyquil formulation will not put you at risk of overdose since it does not contain acetaminophen. 

How Long To Separate Tylenol From NyQuil

From a theoretical point of view, you can adjust the timing of the two drugs so that they do not overlap, while also ensuring that the maximum daily dose is not exceeded. 

The duration of action of acetaminophen is 4 to 6 hours. So for Tylenol product that is immediate-release, you should wait for at least 5 to 7 hours before taking Nyquil, while also ensuring that you do not exceed 4000 mg in 24 hours. For extended-release formulations, you have to wait for at least 9 hours before taking Nyquil.

While this may seem practical, I must warn that following this dosing pattern is still not recommended and is definitely not worth the risk. So, avoid the co-use of Tylenol and Nyquil completely.

You should always consult your doctor or check with your pharmacist before taking two medications with the same active ingredients. 

You can verify this by going through the label on the drug packet. If you have one or more ingredients in the two different products, reach out to your doctor or pharmacist for advice.

Final Thoughts

It is not recommended to take both Tylenol and Nyquil together since both of them contain acetaminophen and taking them can lead to overdose which may cause liver failure. Do not take two or more meds that contain similar ingredients without checking with your doctor.

References

• Gerriets V, Anderson J, Nappe TM. Acetaminophen. [Updated 2023 Jun 20]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK482369/ 
• Nyquil Official Website: Vicks.com