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Key takeaways
Trazodone is an antidepressant, and NyQuil is a nighttime cold and cough reliever. They both cause drowsiness and alter serotonin levels.
Trazodone and NyQuil can be taken together in some cases, if approved by your healthcare provider, but there is potential for dangerous drug interactions.
Healthcare providers suggest taking NyQuil alone if managing cough and cold symptoms, but it’s always best to check with your healthcare provider for individualized recommendations.
When it comes to nighttime relief from cold and flu symptoms, many people turn to NyQuil for relief. It’s available over the counter without a prescription and has active ingredients that not only relieve congestion and cough but also cause drowsiness. But NyQuil isn’t safe for everyone, and it may interact with other medications, including trazodone. Read on for what experts say about taking trazodone and NyQuil together.
About trazodone and NyQuil
Trazodone is an antidepressant medication primarily prescribed for the treatment of major depressive disorder (MDD), or depression. It’s a generic medication that is also known by the brand name Desyrel (which is no longer available in the United States as a brand-name drug). Trazodone is classified as a serotonin antagonist and reuptake inhibitor (SARI). It works by affecting serotonin levels in the body. Due to its sedating properties, healthcare providers may also prescribe trazodone off-label for patients who experience both depression and sleep difficulties.
NyQuil is an OTC medication that relieves nighttime cough and cold symptoms. One of its active ingredients is doxylamine, an antihistamine that causes drowsiness. Doxylamine is in the same class of drugs as Benadryl (diphenhydramine), which can also cause drowsiness. Most forms of NyQuil also contain acetaminophen, the active ingredient in Tylenol that relieves pain and reduces fever, and dextromethorphan, a cough suppressant. When people develop a cold or the flu, healthcare providers may recommend NyQuil to help them rest while dealing with cough and congestion.
Can you take trazodone and NyQuil together?
“For young, healthy individuals taking trazodone as directed, using cold medications like NyQuil is generally not a major concern. If they are also on other antidepressants, their body can typically tolerate the additional cold medication. However, it is always wise to consult a doctor if there are any uncertainties,” says Ryan Sultan, MD, psychiatrist and Professor of Clinical Psychiatry at Columbia University.
Taking NyQuil with trazodone may not be safe for everyone. Both drugs have sedative effects and can influence serotonin levels in the body, causing possible serious side effects. Currently, there are no clinical studies or clinical dosing guidelines for their combined use. Always consult your healthcare provider before combining these medications.
Side effects of taking NyQuil with trazodone
Taking trazodone and NyQuil together can potentially lead to several concerning drug interactions because of their actions on serotonin levels and their sedating effects.
“One concern is the potential for serotonin syndrome, a condition when a combination of medications taken at certain dosages increases the levels of serotonin in the body to dangerous levels,” explains Sean Conrin, MD, a psychiatrist at Cook County Health. Symptoms of serotonin syndrome include:
- Sweating
- Anxiety
- Confusion
- High blood pressure
- Elevated heart rate
- Muscle rigidity
- Dry mouth
- Agitation
- Gastrointestinal upset
Dr. Conrin warns that serotonin syndrome can progress to dangerous symptoms, “including irregular heartbeat, high fever, seizure, unconsciousness, and death.”
Both medications can cause drowsiness, which can pose some safety risks for certain populations, including:
- Reduced ability to respond to emergencies, which may be a problem for parents of young children
- Impaired ability to wake up in dangerous situations (for example, sleeping through a fire alarm)
- Increased risk of accidents if driving or operating heavy machinery is necessary
- Higher risk of falls when getting up at night
Dr. Sultan notes that taking these medications together can also lead to constipation, urinary retention, and confusion.
Taking trazodone and NyQuil together
Although trazodone is approved by the FDA for the treatment of MDD, it’s also prescribed off-label for insomnia and anxiety. Prescribers can modify trazodone dosage to treat each condition differently. Dr. Conrin says that trazodone may be used as a sleep aid at lower doses (25–50 mg taken at bedtime) and as an antidepressant at higher doses (50–100 mg taken two to three times a day).
Healthcare providers say that trazodone and NyQuil may be taken together under most circumstances, but this advice may not apply to everyone, depending on their medical conditions. Doctors Conrin and Sultan both recommend trying NyQuil alone first if dealing with cold symptoms. “For the vast majority of people who are just taking a low dose of trazodone and who want to use the recommended dose of NyQuil, there should not be too much to worry about. You might skip the trazodone that night and see if the NyQuil is sufficient on its own to help you sleep,” suggests Dr. Conrin. He further shares, “If they still can’t sleep, a low dose of trazodone is probably safe. If patients have other medical conditions or are taking other medications, I would have to adjust this advice and might suggest they try something with less risk, like an OTC melatonin supplement.”
For those concerned about combining NyQuil and trazodone, there are several alternatives to manage cold symptoms. “Patients can consider safer alternatives to NyQuil, such as acetaminophen for pain or fever, saline nasal sprays, guaifenesin for mucus relief, or second-generation antihistamines like Zyrtec (cetirizine). These options are less sedating and help manage symptoms effectively,” Dr. Sultan says.
Always consult with your healthcare provider before combining medications. “As a rule, I ask my patients to run any OTC medications or supplements by me before they take them. Similarly, I ask my patients to inform me whenever they are placed on a new medication,” Dr. Conrin says. Your healthcare provider can consider your medical history, medication list, and lifestyle to provide personalized medical advice.
NyQuil and trazodone comparison
NyQuil and trazodone are taken for different reasons, but they can have similar effects to help people get to sleep. Both medications can make you dizzy and drowsy and can’t be combined with monoamine oxidase inhibitor (MAOI) medications such as Nardil (phenelzine) and Parnate (tranylcypromine).
Trazodone is available as an immediate-release tablet. NyQuil is sold in various forms, including liquid, liquid capsule, and powder that dissolves in hot drinks. Not all NyQuil formulations contain the same active ingredients, so check with your healthcare provider or pharmacist to make sure the formulation you choose can be taken with trazodone.
Without insurance, the cost of NyQuil is typically more affordable than a 30-day supply of trazodone. A box or bottle of NyQuil costs between $11 and $24 on average, while 30 tablets of 50 mg trazodone is $35 on average. These medications may cost less if you’re using your insurance benefits or your SingleCare prescription discount card. (If you choose to use your SingleCare card for NyQuil, ask your healthcare provider for a prescription first.)
NyQuil vs. trazodone: Comparison |
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|---|---|---|
| NyQuil | Trazodone | |
| Active ingredients | Acetaminophen (fever reducer/pain relief), dextromethorphan HBr (cough suppressant), doxylamine succinate (antihistamine) | Trazodone HCl (serotonin antagonist and reuptake inhibitor) |
| Standard adult dosage and forms | Liquid capsules (LiquiCaps): 2 capsules every 6 hours
Liquid: 30 mL every 6 hours |
Tablets: 50–100 mg two to three times daily for MDD, 25–50 mg at night before bedtime for insomnia, dosage for anxiety varies |
| Risks and restrictions to consider |
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| Common side effects |
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| Average cost without insurance* | $11 per 1, 16 capsule-box of NyQuil Cold & Flu Night
$24 per 1, 354 mL of NyQuil Severe Cold/Flu liquid $10 per 1, 354 mL bottle of NyQuil Cough liquid |
$34 per 30, 50 mg tablets |
| SingleCare cost* | $3–$7 | $4 |
| How to save | Get coupon | Get coupon |
| Learn more | More details about NyQuil Cold & Flu Night | More trazodone details |
*Cost at time of publication. Prices fluctuate and vary by pharmacy.
Bottom line
If you’re taking trazodone for MDD, anxiety, or insomnia and looking for nighttime relief from cold symptoms, you may be able to take NyQuil safely. Healthcare professionals recommend first skipping your nighttime trazodone dose if you try NyQuil. Taking the medications together can increase sedation and can increase the risks of side effects and drug interactions, especially at higher doses of trazodone. Individual factors like age, medical conditions, and other medications being taken can affect how someone responds to taking trazodone and NyQuil together.
Always consult your healthcare provider before combining trazodone and NyQuil, as they can evaluate your specific situation, including your medical history, current medications, and individual risk factors.
Sources
- Trazodone, DailyMed (2024)
- Label: Vicks NyQuil Cold and Flu (2024)
- Desyrel, PDR