NyQuil With Trazodone Interaction
In our latest question and answer, the pharmacist discusses the interaction between NyQuil and trazodone.
I was prescribed trazodone for insomnia and it's been working well. I've recently come down with a cold and was considering NyQuil. Can I take it with Trazodone?
Apr 21, 2023- Both trazodone and NyQuil cause drowsiness, and taking them together can increase sedation and impair your coordination and motor skills.
- Taking trazodone with NyQuil may increase the risk of serotonin syndrome, a rare but potentially serious condition caused by excessive serotonin buildup in the brain.
- You should avoid combining these medications unless your doctor has specifically told you it's safe to do so.
Answer
There is an interaction between NyQuil and trazodone that is important to be aware of. In fact, there are two interactions between them.
First, both are sedating, and combining them can result in additive sedative effects (as well as related effects like impaired motor coordination).
Second, although the risk is low, combining trazodone and NyQuil increases the risk of serotonin syndrome, a potentially life-threatening condition that occurs when there is an excessive accumulation of serotonin in the brain.
Although there are situations where your doctor may recommend taking both medications, their combined use should generally be avoided unless you have specifically been directed to do so.
What Is Trazodone?
Trazodone is an antidepressant that affects the level of a number of different neurotransmitters in the brain, including serotonin. It is often prescribed 'off-label' for insomnia due to its sedative effects, an indication that many studies support.
What Is NyQuil?
NyQuil is a multi-ingredient product that is used to treat cough/cold symptoms. The 'original' NyQuil contains:
- Acetaminophen
- Doxylamine
- Dextromethorphan
Acetaminophen is a pain reliever and fever reducer. It is the active ingredient in Tylenol.
Doxylamine is a sedating antihistamine, very similar to diphenhydramine (the ingredient in Benadryl).
Dextromethorphan is a cough suppressant.
Interaction Details
As mentioned, there are two potential interactions between trazodone and NyQuil that individuals should be aware of.
The first interaction is the additive effect of central nervous system (CNS) depression and sedation. Trazodone can be very sedating and is often prescribed to treat insomnia, while NyQuil contains a sedating antihistamine (doxylamine).
When taken together, these medications can increase the risk of sedation and drowsiness, which can impair cognitive and motor function, and increase the risk of falls and accidents.
The second interaction is the potential of the rare but potentially life-threatening serotonin syndrome.
Trazodone increases the levels of serotonin in the brain while NyQuil contains dextromethorphan, an ingredient that can also increase serotonin levels.
While there is conflicting evidence regarding the extent of dextromethorphan's impact on serotonin, there have been reported cases where individuals were suspected of experiencing serotonin syndrome and dextromethorphan was found to be a contributing factor.
So, when trazodone and dextromethorphan (from NyQuil) are taken together, the concern is the additive effects on serotonin leading to an excessive accumulation of the neurotransmitter, which can cause serotonin syndrome.
Serotonin syndrome is a rare but serious condition that can cause a range of symptoms, including:
- Agitation
- Confusion
- Rapid heart rate
- High blood pressure
- Dilated pupils
- Muscle rigidity
- Fever
- Sweating
- Seizures in severe cases
How To Manage The Interaction
The combination of trazodone and NyQuil may be riskier for certain individuals than others, depending on their age, health status, and other medications they are taking.
For example, older adults and individuals with liver or kidney disease may be more susceptible to the sedative effects of these medications, which can increase the risk of falls and accidents.
Additionally, individuals who are taking other medications that affect serotonin levels, such as selective serotonin reuptake inhibitors (SSRIs) or monoamine oxidase inhibitors (MAOIs), may also be at increased risk of developing serotonin syndrome when taking trazodone and NyQuil together.
As a general rule of thumb, these medications shouldn't be taken together unless your doctor has specifically directed you to do so.
Final Words
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Video Summary
References & sources
Glossary — Terms in This Answer
- Antidepressant
- A medication used to treat depression by changing the levels of chemicals in the brain.
- Neurotransmitters
- Chemical messengers in the brain that transmit signals between nerve cells.
- Serotonin
- A neurotransmitter in the brain that affects mood, sleep, and other bodily functions.
- Antihistamine
- A medication that blocks histamine, a chemical in the body that causes allergy symptoms and drowsiness.
- Cough suppressant
- A medication that reduces the urge to cough.
- Central nervous system (CNS) depression
- A slowing down of brain and nervous system activity that can cause drowsiness and reduced alertness.
- Serotonin syndrome
- A dangerous condition caused by too much serotonin in the brain, which can cause agitation, confusion, and other serious symptoms.
- Selective serotonin reuptake inhibitors (SSRIs)
- A class of antidepressant medications that work by increasing serotonin levels in the brain.
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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