Can I Take Mucinex, DayQuil or NyQuil With Amoxicillin?

For amoxicillin, the cold medicine box sets the rules. The amoxicillin and Augmentin labels do not name acetaminophen, dextromethorphan, guaifenesin, phenylephrine, pseudoephedrine or doxylamine. Those are the active ingredients in the main Mucinex, DayQuil and NyQuil products. Two other antibiotics change the answer: metronidazole and linezolid.

We read the FDA labels on DailyMed for amoxicillin and Augmentin (amoxicillin plus clavulanate). We also read the Drug Facts on eight NyQuil, DayQuil and Mucinex boxes. The NyQuil, DayQuil and Mucinex labels we checked do not mention antibiotics at all.

A national study of U.S. doctor visits in 2010 and 2011 found that sinusitis led to more antibiotic prescriptions than any other diagnosis.

This article provides general information about medication management and is not a substitute for professional medical advice. Consult your doctor or pharmacist for advice specific to your medications.

Can I Take Mucinex With Amoxicillin?

"Mucinex" covers very different products.

Plain Mucinex has one ingredient, guaifenesin. Its label says it "helps loosen phlegm (mucus) and thin bronchial secretions."

Other versions add more drugs:

• Mucinex DM adds dextromethorphan, a cough suppressant. The Mucinex DM label says not to use it if you take a prescription MAOI. On linezolid? See below.
• Mucinex D adds pseudoephedrine, a decongestant. The Mucinex D label says to ask a doctor first if you have heart disease, high blood pressure, thyroid disease or diabetes. The same goes for trouble urinating due to an enlarged prostate. On blood pressure pills? Our guide to cold medicine for high blood pressure goes through each decongestant.
• Mucinex Fast-Max Cold & Flu liquid adds acetaminophen, dextromethorphan and phenylephrine, per its label. That puts it in the same acetaminophen count as DayQuil and NyQuil.

Can You Take DayQuil or NyQuil With Amoxicillin?

The big check here is acetaminophen, the drug in Tylenol. One 30 mL dose of NyQuil Cold & Flu liquid has 650 mg of it. DayQuil Cold & Flu liquid has 325 mg in every 15 mL. Both labels say: "Do not use with any other drug containing acetaminophen (prescription or nonprescription)."

In a 2012 study of 500 adults, 45.6% would have overdosed by "double-dipping" with two acetaminophen products. If you also take Tylenol, see whether you can take Tylenol with NyQuil first.

NyQuil adds doxylamine, so its label warns "marked drowsiness may occur." DayQuil adds phenylephrine, a decongestant with the same high blood pressure list as Mucinex D.

On warfarin? Both labels say to ask a doctor or pharmacist before use "if you are taking the blood thinning drug warfarin." The amoxicillin label separately reports "abnormal prolongation of prothrombin time" with amoxicillin and blood thinners taken by mouth.

Switching? See how long after DayQuil you can take NyQuil.

Formulas change, so read your own box.

Can You Take Cold Medicine With Antibiotics?

Swap the antibiotic and the answer can change. We also read the labels for azithromycin (Z-Pak) and doxycycline. The azithromycin and doxycycline labels do not name those six cold medicine ingredients either. Two antibiotics are different.

Can You Take NyQuil With Metronidazole (Flagyl)?

Check the inactive ingredients first. The metronidazole label says: "Discontinue consumption of alcohol or products containing propylene glycol during and for at least three days after therapy with metronidazole." It warns of "abdominal cramps, nausea, vomiting, headaches, and flushing." The Flagyl label says the same. So does tinidazole's, for "preparations containing ethanol or propylene glycol."

NyQuil Cold & Flu liquid lists alcohol first among its inactive ingredients, and its bottle says "Alcohol 10%." It also lists propylene glycol. DayQuil Cold & Flu liquid is labeled "Alcohol Free," but it lists propylene glycol too. So do the NyQuil LiquiCaps, DayQuil LiquiCaps and Fast-Max liquid we read. The Mucinex, Mucinex DM and Mucinex D extended-release tablet labels we checked list neither alcohol nor propylene glycol.

The CDC sees alcohol differently. Its 2021 STI guidelines for bacterial vaginosis say "refraining from alcohol use while taking metronidazole (or tinidazole) is unnecessary." Our metronidazole and alcohol guide walks through that split. Follow the instructions your prescriber gave you, and ask the pharmacist to check your cold medicine's inactive ingredients.

Can You Take Mucinex With Linezolid (Zyvox)?

Ask first. The linezolid label says it "is a reversible, nonselective inhibitor of monoamine oxidase." Mucinex DM, Mucinex D, DayQuil and NyQuil say not to use them with a prescription MAOI. That runs "for 2 weeks after stopping the MAOI drug" too. Their examples are "certain drugs for depression, psychiatric or emotional conditions, or Parkinson's disease." Antibiotics aren't on that list. The same labels add: "If you do not know if your prescription drug contains an MAOI, ask a doctor or pharmacist before taking this product."

Decongestants are the clearest worry. The Zyvox label sets a limit. Unless blood pressure is monitored, linezolid "should not be administered" to people taking drugs like pseudoephedrine. It reports a study in healthy adults with normal blood pressure. Linezolid plus pseudoephedrine raised the top number by an average peak of 32 mm Hg (range 20 to 52). It adds: "A similar study has not been conducted in hypertensive patients." A published study of the pairing judged the effect "not to be clinically significant." Its authors added that people "sensitive to the effects of increased BP" should be treated cautiously. The label tells patients to tell their doctor about "cold remedies and decongestants" with pseudoephedrine.

For dextromethorphan, the label reports no serotonin syndrome signs in healthy people given two doses with linezolid. The cold medicine boxes still carry the MAOI line, so ask before taking any cough suppressant or decongestant on linezolid.

Cold Medicine With Amoxicillin and Prednisone

Were you also given prednisone, a steroid? The prednisone label says: "Concomitant use of aspirin (or other nonsteroidal anti-inflammatory agents) and corticosteroids increases the risk of gastrointestinal side effects."

Some cold products contain one of those pain relievers. Mucinex 12HR Cold & Fever Multi-Symptom, for example, lists naproxen sodium and labels it an NSAID. Its box says a "steroid drug" raises the chance of severe stomach bleeding. It says to ask a doctor before use if that applies to you. On prednisone, look at the Active ingredients line for ibuprofen, naproxen or aspirin.

Will Amoxicillin Help a Cold?

No. The amoxicillin label says antibacterial drugs "do not treat viral infections (e.g., the common cold)." The CDC puts it plainly: "Antibiotics don't work against viruses and won't help you feel better."

The CDC says "You do not need antibiotics for many sinus infections." In the 2010 to 2011 national study, acute respiratory conditions led to 221 antibiotic prescriptions per 1,000 people a year. Only 111 of them were estimated to be appropriate.

Whether you needed yours is a question for your prescriber, not a reason to stop. If you were given amoxicillin, the label says to take it "exactly as directed." It warns that "skipping doses or not completing the full course of therapy" may make the treatment work less well. It may also make it more likely that bacteria resist antibiotics later. If a dose slips while you're sick, see what to do about a missed dose of amoxicillin.

Still Sick After Amoxicillin? When It's Not the Cold Medicine

The NyQuil label says to stop and ask a doctor if:

• pain or cough "gets worse or lasts more than 7 days"
• fever "gets worse or lasts more than 3 days"
• "new symptoms occur"

DayQuil's label has the same fever and new-symptom lines. Both add: "These could be signs of a serious condition."

The CDC says to seek care for trouble breathing or dehydration. It also lists a fever that lasts longer than 4 days and symptoms that last more than 10 days without getting better. Symptoms that improve, then come back or get worse, are on the list too.

Two signs need a call:

• A new rash. Rash is one of the most common side effects on the amoxicillin label. The label also warns: "A high percentage of patients with mononucleosis who receive amoxicillin develop an erythematous skin rash." It says amoxicillin "should not be administered to patients with mononucleosis." Cold medicine can also be the cause. The DayQuil and NyQuil labels say acetaminophen "may cause severe skin reactions." They say "If a skin reaction occurs, stop use and seek medical help right away." For a rash, itching or hives, MedlinePlus says to "stop taking amoxicillin and call your doctor immediately or get emergency medical treatment."
• Watery and bloody stools. The label says these can show up "even as late as 2 or more months after having taken their last dose." Contact your doctor as soon as possible. For severe diarrhea, MedlinePlus gives the same stop-and-call advice.

How Pillo Helps

The amoxicillin label says it may be taken every 8 or 12 hours, depending on your dose. Add a cold medicine on its own clock and it's easy to slip. Pillo holds both schedules, and its persistent alarm keeps ringing until you deal with the dose. Dose spacing alerts flag two doses scheduled too close together.

Those alerts look at timing, not ingredients, so they won't catch a second acetaminophen product. A dose note helps: write which box you took and when, then check it before the next dose. Caring for a sick child or parent? You can add them as dependents, free for up to two. Pillo is free for unlimited medications, with ads.

Download Pillo on Google Play

FAQ

Does NyQuil's alcohol matter with amoxicillin?

The amoxicillin label does not mention alcohol. NyQuil Cold & Flu liquid is 10% alcohol, and NyQuil's own label says to "avoid alcoholic drinks." Follow that. On metronidazole, its label rules out alcohol and propylene glycol during treatment and for at least 3 days after. Tinidazole's says 3 days.

Can I take Sudafed with amoxicillin?

Pseudoephedrine, the decongestant in Sudafed, is one of the six ingredients we searched for in the amoxicillin label, with no match. The Sudafed label has its own list. Ask a doctor first if you have heart disease, high blood pressure, thyroid disease or diabetes. The same goes for trouble urinating due to an enlarged prostate. It also says not to use it with a prescription MAOI. On linezolid? Read the linezolid section above first.

Is the answer the same for Augmentin?

Yes, for these ingredients. Augmentin is amoxicillin plus clavulanate, and our label search included it. Its interaction list has the same four main entries. It adds that taking it with probenecid "is not recommended."

Can I take Tylenol with amoxicillin?

Acetaminophen, the drug in Tylenol, was part of the same amoxicillin label search, with no match. The catch is the cold medicine. DayQuil, NyQuil and Fast-Max already contain acetaminophen. Their labels say not to use them with any other acetaminophen product. In case of overdose, the labels say to "get medical help or contact a Poison Control Center right away." Then see what to do if you took too much Tylenol.

Can my child take cold medicine with amoxicillin?

Ask your child's doctor first. The CDC says over-the-counter cough and cold medicines "are not recommended for children younger than 6 years old." They "can result in serious and sometimes life-threatening side effects." The NyQuil liquid label says children 4 to under 12 should "ask a doctor." Children under 4 should not use it. For a missed antibiotic dose, see what to do when your child misses a dose.

This article is for informational purposes only and does not constitute medical advice.