Can you take NyQuil and Tylenol together?
In our latest question and answer, the pharmacist discusses if it is safe to combine acetaminophen and NyQuil.
Can acetaminophen 500mg and NyQuil Severe liquid be taken at the same time? I took both by accident.
May 21, 2021- Many NyQuil formulations contain acetaminophen, so check the label to see if yours does before taking it with Tylenol. Taking both together or routinely combining them can cause you to exceed the safe daily limit of acetaminophen and lead to liver damage. If you took both as a single dose and have no liver problems, you're likely fine, but if you've been taking this combination regularly over several days you should seek emergency care.
Hi Mary and thanks for writing to us.
Tylenol (or by the generic acetaminophen) is a commonly used over-the-counter drug that has been used for decades to help relieve pain and fever.
NyQuil is a combination medication used to treat a handful of cough and cold symptoms.
Now, NyQuil It has several different formulations available, and most contain a combination of doxylamine, (a sedating antihistamine to dry out the nose and cause drowsiness), dextromethorphan (to suppress cough), and acetaminophen (for pain or fever). Some formulations may contain other ingredients as well.
Look on the back of your NyQuil bottle at the active ingredients. Do you see acetaminophen? If you see acetaminophen listed anywhere, then you should avoid taking it or the acetaminophen tablets. It should be fine to take one or the other, but definitely don’t take both.
If you routinely take both NyQuil and acetaminophen tablets, you will probably exceed the maximum recommended daily dose of acetaminophen, 3250mg. If you regularly exceed this, or take a much higher dose over the course of a day, this can lead to acetaminophen toxicity and liver failure.
If you took this once, as a single dose, and don’t have any liver issues, then you probably don’t have anything to worry about. However, if you have been taking this medication combination routinely (over 3250mg of acetaminophen, every day, over the course of several days), have problems with your liver, or consume a lot of alcohol while taking this combination, then you might have taken too much acetaminophen, and you should go to your nearest emergency department as soon as possible.
Acute acetaminophen overdose is reversible for about 36 hours, but after that can cause permanent damage or even death at very high doses.
Unfortunately, many over-the-counter cough and cold medications contain acetaminophen. Many prescription medications contain it as well. Every year, I encounter at least one or two people who unknowingly consumed too much acetaminophen.
It’s a very easy to make and potentially dangerous medication error. In the future, please double check the active ingredients in your over-the-counter medications. If you see any duplicate medications, you should probably avoid it.
I hope this clears things up and that you didn’t take more than a single dose. Feel free to write back to us in the future.
References & sources
- Drug Interaction Report — Lexicomp (Subscription Required)
- NyQuil product information page — Vicks.com
- Acetaminophen overdose. 662 cases with evaluation of oral acetylcysteine treatment — Archives of Internal Medicine
Glossary — Terms in This Answer
- Acetaminophen
- A common pain reliever and fever reducer found in many over-the-counter and prescription medications.
- Doxylamine
- A sedating antihistamine that dries out the nose and causes drowsiness.
- Antihistamine
- A medication that reduces the effects of histamine in the body to relieve allergy and cold symptoms.
- Dextromethorphan
- A cough suppressant used in many over-the-counter cold and cough medications.
- Active ingredients
- The specific chemical compounds in a medication that produce the intended therapeutic effect.
- Acetaminophen toxicity
- Poisoning from taking too much acetaminophen, which can damage the liver.
- Liver failure
- A serious condition where the liver stops functioning properly and cannot perform its vital roles.
- Acute acetaminophen overdose
- A sudden instance of taking a toxic amount of acetaminophen, which can be reversed if treated within about 36 hours.
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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