NyQuil



NyQuil, produced by the Vicks company, is the brand name of a family of cold medicine designed to help relieve many symptoms of the common cold. Because all of the medications within the NyQuil imprint contain sedating antihistamines and/or hypnotics, they are typically taken at night, just before bedtime. Its daytime counterpart is DayQuil, which does not contain sedating antihistamines and is not intended to induce drowsiness.

NyQuil comes in both liquid form and packaged in capsules (LiquiCaps). The liquid form was introduced in the fall of 1968 (with numerous magazine ads and television commercials), while the capsules were introduced in the late 1980's.

NyQuil Cold/Flu Multisymptom Relief
NyQuil Cold/Flu Multisymptom Relief is available in both syrup and LiquiCap form. It previously contained pseudoephedrine, a decongestant, but this was removed for the reasons discussed below.

The liquid version of NyQuil Cold/Flu Multi-symptom Relief has the following active ingredients (15mL is one tablespoon, which is half the recommended adult dose):


 * Acetaminophen (500 mg/15mL) (pain reliever/fever reducer)
 * Dextromethorphan (15 mg/15mL) (cough suppressant)
 * Doxylamine succinate (6.25 mg/15mL) (antihistamine/hypnotic)

The pill (Liquicap) version has less Acetaminophen per dose. The following is the active ingredients for one pill, which is half the recommended adult dose:


 * Acetaminophen (325 mg/pill) (pain reliever/fever reducer)
 * Dextromethorphan (15 mg/pill) (cough suppressant)
 * Doxylamine succinate (6.25 mg/pill) (antihistamine/hypnotic)

NyQuil Cough
Nyquil Cough's active ingredients are:


 * Dextromethorphan (cough suppressant)
 * Doxylamine succinate (antihistamine/hypnotic)

NyQuil Cough is available in syrup form only to help prevent abuse of both the hypnotic (from Doxylamine succinate) and dissociative (from Dextromethorphan) features of the syrup.

NyQuil Sinus
Nyquil Sinus' active ingredients are:


 * Acetaminophen (pain reliever/fever reducer)
 * Doxylamine succinate (antihistamine/hypnotic)
 * Phenylephrine (nasal decongestant)

Nyquil Sinus is available as LiquiCaps only.

Reformulation
Previously, NyQuil Cold/Flu Multisymptom Relief and NyQuil Sinus contained pseudoephedrine (30 mg/15mL), another nasal decongestant that also formed the active ingredient in Sudafed. Following the passage of the Combat Methamphetamine Epidemic Act in 2006, all pseudoephedrine-containing medications must be kept behind a pharmacy counter and all purchases must be logged.

Vicks chose to sidestep these requirements and keep its products more easily accessible by reformulating NyQuil Sinus, replacing pseudoephedrine with phenylephrine. Some experts belive that phenylephrine is no more effective than a placebo. Production difficulties related to the reformulation caused occasional supply shortages in some parts of the U.S. in 2006.

For those that want to have the same active ingredients as the older version of Cold/Flu, they can take Pseudoephedrine (Sudafed) at the same time they take the new formulation of Nyquil.

NyQuil Children's
NyQuil Children's active ingredients are:


 * Chlorpheniramine (antihistamine)
 * Dextromethorphan (cough suppressant)

NyQuil Children's is unique among the NyQuil line in that it contains no alcohol. It is available in the syrup form only.

Warnings and contraindications
As with most OTC cold and allergy medications, there are populations for whom treatment with NyQuil is inappropriate. NyQuil should not be taken with medications that contain other antihistamines or cough suppressants. People with certain other diseases, such as diabetes mellitus, glaucoma, asthma, chronic cough, excess mucus production, enlarged prostate, or high blood pressure should consult a physician or pharmacist to ensure that NyQuil will not interact negatively with their disease states. Additionally, concurrent use of NyQuil with monoamine oxidase inhibitors (MAOIs) or other drugs containing acetaminophen is contraindicated. Another concern with Nyquil of any formulation is that it contains acetaminophen (also known as Tylenol). It is essential to avoid excessive amounts of acetaminophen as this may cause damage to the liver. This risk is additive when separate co-ingestion of acetaminophen is used. The normal maximum for acetaminophen per day is 65 mg/kg/24hrs or 4g/day, whichever is less. Certain patients such as those on medications processed by the liver or diseases of the liver (eg Hepatitis A,B,C) should consult their physician.