Accidentally Took NyQuil And Drank Alcohol
In our latest question and answer, our pharmacist discusses the safety of taking NyQuil after having some alcoholic beverages.
Tonight I forgot that you are not supposed to take NyQuil with alcohol. I had four glasses of wine over the course of maybe five hours and wasn’t very drunk, then took the NyQuil maybe an hour later. I feel fine and both should be out of my system by now, but should I still be concerned about liver failure in the coming days? Should I see a doctor?
Sep 10, 2022- Accidentally taking NyQuil with alcohol one time is unlikely to cause long-term harm, but you should avoid making it a habit. The main concern with mixing them is increased dizziness and sedation from the doxylamine antihistamine in NyQuil combining with alcohol's effects on the central nervous system. Regularly combining NyQuil and alcohol increases your risk of liver damage since both acetaminophen and alcohol can be toxic to the liver over time.
Thanks so much for your question!
Although you generally shouldn't combine alcohol and NyQuil together due to the risk of additive side effects (such as dizziness and sedation), accidentally doing this one time shouldn't cause any long-term problems.
Alcohol In NyQuil
NyQuil does contain alcohol, at a concentration of 10% (20 proof). This is about the amount of alcohol contained, on average, in wine. Some craft beers also have an alcohol percentage this high, but it's not overly common.
The usual dose of NyQuil for adults is 30mL (two tablespoonfuls). Considering the fact that 'one shot' of liquor is about 44mL (depending on the size of the shot glass of course), taking a dose of NyQuil contains less alcohol than a single shot of wine.
So, it really isn't the alcohol in NyQuil that is a concern in regard to drinking alcoholic beverages, but more so, the drugs contained in it.
What Is The Concern With Drinking Alcohol With NyQuil?
NyQuil contains three drugs:
- Acetaminophen
- Dextromethorphan
- Doxylamine
NyQuil Severe adds in guaifenesin as well (an expectorant).
Doxylamine is a very sedating antihistamine, similar to Benadryl. Since alcohol has sedating and CNS (central nervous system) depressant effects, combining it with a sedating antihistamine like doxylamine will make these effects more pronounced.
Additionally, we have another drug of concern here, acetaminophen, which is the active ingredient in Tylenol.
Acetaminophen is very well known to be toxic to the liver at high doses, and 650mg is contained in NyQuil per dose. This is well within the recommended amount of acetaminophen for a single dose though. Of course, alcohol has a concern with liver toxicity as well with long-term consumption.
You shouldn't make it a habit to mix alcohol and acetaminophen. Doing so greatly increases your risk of liver injury.
In your case, however, having a few drinks and taking a dose of NyQuil as a one-time thing, unless you have a pre-existing liver problem, there isn't much concern here. You haven't taken too much acetaminophen at one time, and as long as you are not a heavy drinker overall, you should be safe.
It's certainly true that very heavy drinking of alcohol at one time can cause acute liver injury, but most often, it is the consumption of a large quantity of alcohol over a prolonged period of time.
So, again, the primary concern with combining NyQuil and a few alcoholic drinks is the risk of the additive and perhaps more pronounced side effects, not acute liver injury for the vast majority of individuals. If you did this consistently over a long period of time though, you would be more at risk of causing liver damage.
Final Words
Thanks again for your question and feel free to reach back out anytime!
References & sources
Glossary — Terms in This Answer
- Acetaminophen
- A common pain reliever and fever reducer found in medications like Tylenol and NyQuil.
- Dextromethorphan
- A cough suppressant ingredient found in NyQuil that helps reduce coughing.
- Doxylamine
- A sedating antihistamine in NyQuil that causes drowsiness to help you sleep.
- Antihistamine
- A type of drug that reduces the effects of histamine in the body and can cause drowsiness.
- CNS depressant
- A substance that slows down brain and nervous system activity, causing drowsiness and reduced alertness.
- Guaifenesin
- An expectorant ingredient that helps thin mucus and make coughs more productive.
- Additive side effects
- Unwanted effects that become stronger when two or more drugs with similar effects are combined together.
- Acute liver injury
- Sudden, severe damage to the liver that occurs quickly rather than developing slowly over time.
Dr. Brian Staiger, PharmD
Doctor of Pharmacy, board certified clinical pharmacist (BCPS), American Herbalist Guild, Medication Therapy Management certified
Brian Staiger, PharmD, BCPS, is a licensed pharmacist with more than 13 years of experience across retail pharmacy, clinical pharmacy, medication safety, pharmacy program development, and healthcare administration. He is the founder of HelloPharmacist.com, where he helps patients...
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