Dangers of Mixing Alcohol and NyQuil

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NyQuil is a commonly used medicine that can be obtained without a prescription and is easy for most people to attain. It is not a controlled substance, although it does have the potential for misuse and psychoactive effects in high doses. Similarly, alcohol is also legal and readily accessible, at times, even for minors. For these reasons, misusing Nyquil with alcohol is relatively effortless and appealing for young people, often with little regard for the inherent dangers of combining two inebriating and sedating agents.

When someone misuses NyQuil and alcohol, they are at significant risk for severe side effects, drug interactions, overdose, and death. Along with intoxication and the physical and mental impairments accompanying it, individuals under the influence face the same perils of being drunk, high, or both. These include sustaining injuries, making poor decisions, and engaging in activities like driving that can be life-threatening to everyone involved.

If you or someone you know are misusing NyQuil, another DXM product, and alcohol, you are urged to consider seeking professional help. Guardian Recovery is a licensed, accredited addiction treatment center that offers a variety of evidence-based rehab programs that help individuals enact the changes they need to stop the cycle of substance misuse, prevent relapse, and rebuild their lives.

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What Is NyQuil?

NyQuil is the brand name for over-the-counter medicine containing acetaminophen, dextromethorphan (DXM), and doxylamine. Together, these ingredients are intended to treat cold and flu symptoms, such as fever, cough, runny nose, sore throat, sneezing, body aches, and insomnia. Although a prescription is not needed to obtain this product legally, recently, many states have enacted laws restricting its sale. In Florida, for example, products containing DXM are illegal for persons under 18 to purchase and for retailers, such as pharmacies, to sell to a minor. (1)

These official precautions have been taken because an active ingredient in NyQuil, DXM, has the potential for misuse and overdose. Although it has a valid medical purpose and is an effective cough suppressant, when misused, it can also cause psychoactive or “high” effects, which users perceive as being anywhere from pleasant to terrifying. Most people who misuse NyQuil are teenagers, but it can happen to anyone. (2)

Misusing NyQuil/DXM

NyQuil is considered relatively safe and free of severe side effects when used as directed. However, depending on the dose, DXM can induce effects similar to marijuana or ecstasy. Moderate to high doses can cause dissociative, depersonalized experiences mimicking those of ketamine or PCP. Some of these effects may be sought by the user, but many can be perceived as undesirable or frightening.

NyQuil/DXM can be misused in several ways. While the traditional method was to drink the liquid formula in excess, users can now consume large quantities of capsules or tablets. Unfortunately, the ease with which this form of NyQuil can be ingested could further promote excessive use. A powder form of DXM, which can be snorted, can be obtained on the Internet. However, drugs purchased this way may be marketed fraudulently, and the actual ingredients can be unpredictable and dangerous.

The amount of NyQuil/DXM required to induce a high depends on individual factors such as sex, weight, health status, etc. While the recommended dosage of DXM for adults is 15⁠-⁠30 mg 3-4 times a day, misuse for the purpose of intoxication can consist of taking 250⁠-1,500 mg in a single dose. According to the DEA, ingesting excessive amounts of DXM can cause euphoria, hallucinations, distorted perceptions, out-of-body sensations, and other serious effects. (3) DXM can cause complete disassociation and coma in amounts above 600 mg. (4)

Side Effects of NyQuil/DXM Include:

  • Agitation and paranoia.
  • Confusion and inappropriate laughter.
  • Sensory changes.
  • Overexcitability.
  • Slurred speech.
  • High blood pressure.
  • Nausea and vomiting.
  • Involuntary eye movements.

Symptoms of NyQuil/DXM Overdose Include: (5)

  • Extreme excitement, irritability, and nervousness.
  • Shakiness and unsteadiness.
  • Blurred vision.
  • Drowsiness.
  • Nausea and vomiting.
  • Seizures.
  • Tachycardia.
  • Confusion
  • Psychosis.
  • Breathing difficulties.
  • Rhabdomyolysis.
  • Difficult urination.
  • Kidney failure.

In most cases, emergency care results in the successful treatment of DXM overdoses. Notably, most DXM-related fatalities occur when the user ingests alcohol or other psychoactive substances.

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Risks & Side Effects of Combining Alcohol & NyQuil

According to the DEA, “use of high doses of DXM in combination with alcohol or other drugs is particularly dangerous, and deaths have been reported.” (6). There are many potential adverse effects of mixing NyQuil/DXM and alcohol, including cognitive and functional impairments, dangerous intoxication levels, extreme moods, and mental states, life-threatening health complications, and addiction.

Alcohol & NyQuil Side Effects

NyQuil and alcohol misuse have many side effects, which can be amplified with concurrent use. For example, some NyQuil ingredients (e.g., doxylamine succinate) and alcohol can induce sedation, slowing activity in the central nervous system (CNS). As such, combined misuse can result in severe, life-threatening CNS depression.

Combined Side Effects of NyQuil & Alcohol Include:

  • Profound drowsiness.
  • Dizziness.
  • Confusion.
  • Impaired coordination.
  • Impaired judgment.
  • Drug or alcohol dependence.

There is also an increased risk of overdose, which is a life-threatening emergency when NyQuil is combined with alcohol. If you suspect you or someone you know is overdosing on NyQuil, alcohol, or both, call 911 immediately.

Combined NyQuil & Alcohol Overdose Symptoms Include:

  • Severe confusion.
  • Very rapid heart rate.
  • Stomach pain.
  • Hallucinations.
  • Seizures.

Severe Liver Damage

Vicks, the makers of NyQuil, warns that severe liver damage can occur if you: (7)

  • Take more than four doses of NyQuil within 24 hours.
  • Take NyQuil with other drugs containing acetaminophen.
  • Consume three or more alcoholic drinks every day while taking NyQuil.

Both alcohol and NyQuil can cause liver damage and even acute failure. As noted, the main ingredient in NyQuil responsible for this risk is not DXM but acetaminophen. Both substances damage the liver due to the harmful byproducts they produce through metabolism. For alcohol, this chemical is called acetaldehyde, which is highly toxic to the entire body, even in low concentrations. (8) NAPQI is the offending metabolite for acetaminophen, as it is also toxic to the liver in excessive amounts. (9)

When the liver is exposed to NAPQI, it usually produces the antioxidant glutathione (GSH), which neutralizes it. Under normal circumstances, this function can be very beneficial. However, alcohol inhibits the liver’s ability to produce GSH—a compounded effect that can rapidly lead to severe liver damage and failure. (10)

Alcohol & NyQuil/DXM Addiction

Addiction, as applied to intoxicants such as alcohol, is a complex brain disease that affects an individual’s thinking and behavior and leads to an inability to control substance use. It’s triggered by chemicals that induce feelings of pleasure and reward, eventually resulting in the compulsive need to drink or use drugs despite experiencing adverse effects.

Alcohol’s potential for dependence and addiction is well-established. An estimated 14.5 million Americans 12 years or older have an alcohol use disorder. (11) The rate and extent to which a person becomes dependent on alcohol hinge on many factors, such as their frequency and intensity of use, medical and mental health status, genetic predisposition, and family history.

Because NyQuil contains ingredients like DXM that affect the brain’s reward center, there is some potential for addiction, primarily when consumed in high doses. According to the DEA, chronic misuse of DXM has been associated with severe psychological dependence. (12)

Teenagers and young adults are the most common misusers of NyQuil/DXM. Unfortunately, the brains adolescents are not fully developed, especially the regions associated with impulse control and risk assessment. (13) Moreover, young people tend to be more vulnerable to using substances and, as such, are more likely to develop dependence and addiction.

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If you’ve struggled to overcome NyQuil or alcohol dependence and feel you would benefit from professional help, reach out to us today. You’ll be connected to an experienced Treatment Advisor who can explain our straightforward admissions process and provide you with a free, no-obligation assessment and health benefits check. As soon as you’re ready, we can help you begin your recovery journey and restore the healthy, substance-free life you deserve.


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(1) https://www.flsenate.gov/Session/Bill/2016/938/?Tab=BillText (2)(3)(6)(12) https://www.dea.gov/sites/default/files/2020-06/DXM-2020.pdf (4) https://www.ncbi.nlm.nih.gov/books/NBK538502/ (5)https://www.mayoclinic.org/drugs-supplements/dextromethorphan-oral-route/side-effects/drg-20068661 (7) https://vicks.com/en-us/safety-and-faqs/faqs/vicks-nyquil-faq (8) https://pubs.niaaa.nih.gov/publications/arh21-1/05.pdf (9) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2836803/ (10) https://pubmed.ncbi.nlm.nih.gov/8869667/ (11) https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/alcohol-facts-and-statistics (13) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4182916/

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Reviewed professionally for accuracy by:

Ryan Soave


Ryan Soave brings deep experience as a Licensed Mental Health Counselor, certified trauma therapist, program developer, and research consultant for Huberman Lab at Stanford University Department of Neurobiology. Post-graduation from Wake Forest University, Ryan quickly discovered his acumen for the business world. After almost a decade of successful entrepreneurship and world traveling, he encountered a wave of personal and spiritual challenges; he felt a calling for something more. Ryan returned to school and completed his Master’s Degree in Mental Health Counseling. When he started working with those suffering from addiction and PTSD, he found his passion. He has never looked back.

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Cayla Clark

Cayla Clark grew up in Santa Barbara, CA and graduated from UCLA with a degree in playwriting. Since then she has been writing on addiction recovery and psychology full-time, and has found a home as part of the Guardian Recovery team.

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