Is There Anything Stronger Than NyQuil?

Henry D. asked

I have a really bad cold and can't find a medication that seems to help all that much. In addition, I still can't seem to sleep well. I have tried NyQuil but it isn't that effective. Is there a stronger version or something that works better?

Answer

I'm sorry to hear you're having such a difficult time finding a medication to help relieve your cold symptoms!

Now, when you ask if there is anything 'stronger' than NyQuil, I assume we are talking only about non-prescription (i.e. over the counter) products.

First and foremost, there are several products in the NyQuil family, and there is a 'stronger' version of it, known as NyQuil Severe.

'Regular' NyQuil contains all of the following medications:

• Acetaminophen (a pain reliever and active ingredient in Tylenol)
• Dextromethorphan (a cough suppressant)
• Doxylamine (a sedating antihistamine)

NyQuil Severe contains all of the above with the addition of the nasal decongestant phenylephrine.

So, if you are taking the regular version of NyQuil but are trying to relieve nasal congestion, it likely won't help all that much since it doesn't have a decongestant in it!

NyQuil aside, the best way to approach this question is to determine the exact symptoms you are suffering from that NyQuil isn't helping. This can help to narrow down the problems we need to focus on.

You mentioned that you aren't getting much sleep, but it is also important to know your other symptoms.

• Do you have a nagging cough?
• Is your nose running?
• Do you have a fever?
• Are you in pain?
• Do you have nasal congestion?
  
• Are you experiencing sinus pressure?
• Can you simply not fall asleep?

Once we know exactly what we are trying to treat, finding the right medication for you will be easier. Without this information though, it's difficult to give you a specific recommendation.

Now, let's just say you do have congestion and you are taking NyQuil Severe.

As mentioned above, NyQuil Severe contains phenylephrine.

However, phenylephrine isn't too well-absorbed when taken by mouth and actually isn't very effective at relieving congestion. Study after study, including one published in the Annals of Allergy, Asthma & Immunology, show that pseudoephedrine (the active ingredient in Sudafed) is the superior decongestant.

While you have to go to the pharmacy counter to get pseudoephedrine, it still is technically 'over the counter' and is a better choice if nasal congestion is an issue for you.

For another example, if you are experiencing sinus pressure, an analgesic like ibuprofen, which has anti-inflammatory actions, may be a better choice for you than acetaminophen.

Since I know sleep is a problem for you, let's discuss that for a moment.

There are two reasons NyQuil makes you tired:

• Doxylamine, the antihistamine contained in it, is sedating. It is a first-generation antihistamine similar to Benadryl (diphenhydramine).
• It contains 10% alcohol by volume (there are alcohol-free versions of NyQuil available).

I would assume your issues sleeping stem from cold symptoms. Therefore, treating those effectively will improve your sleep problems.

Nevertheless, in terms of alternative sleep medications (that are available over the counter at least), options are limited.

You could try plain Benadryl (diphenhydramine). In fact, diphenhydramine is the active ingredient in ZzzQuil, another product manufactured by the same folks that make NyQuil (Vick's). It is also the active ingredient in several other sleep medications, like Tylenol PM. As I stated though, diphenhydramine is very similar to doxylamine.

Aside from the use of a sedating antihistamine, you really only have melatonin or natural remedies, like valerian, to choose from.

Melatonin likely won't work all that well since most studies suggest it really is better suited if you are trying to restore a normal sleep-wake cycle after it has been disturbed, like if you are suffering from jet lag. It may be effective in some people for insomnia, but most studies suggest it isn't.

Valerian or related medicines may be helpful, but it's tough to say.

What you shouldn't do is combine these with NyQuil. You wouldn't want to take Benadryl with NyQuil for example, since they both contain sedating antihistamines.

As I mentioned, you likely will sleep better if you more effectively treat your cold symptoms, so I think that is key here.

Please feel free to write back in with more details about a symptom or symptoms you are having trouble controlling and I'm sure we can point you in the right direction.

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