General Rules
Most multi-symptom cold and cough medications should not be combined with each other. If you need to take more than one medication at a time, always check the labels and be sure you aren’t taking multiple medications with the same or similar active ingredients.
If you are taking single symptom medications, in general, it is OK to take several medications as long as they do different things. For example, taking a decongestant, expectorant, and pain reliever would be OK, but taking two decongestants would not.
To help make it a little simpler, the following is a list of some of the most common OTC cold and flu medications that are available in the U.S. Review which ones can safely be combined and which ones you shouldn’t mix. If you don’t see the medications you want to take on the list, talk to your healthcare provider or pharmacist to ensure it’s safe to combine with others.
Pain Relievers/Fever Reducers
Possible active ingredients:
AcetaminophenIbuprofenAspirinNaproxen
Tylenol (Acetaminophen)
Tylenol should not be combined with other pain relievers/fever reducers unless you are specifically instructed to do so by a healthcare provider. Alternating with ibuprofen is OK as long as you are not taking more acetaminophen than is recommended in a 24-hour period or with each dose.
Many multi-symptom medications also contain acetaminophen and should not be taken with Tylenol or generic acetaminophen. To name just a few: Vicks DayQuil Cold & Flu, Theraflu Severe Cold & Cough, NyQuil, Coricidin HBP Cold & Flu, and Alka-Seltzer Plus Cold & Flu.
Always read the ingredient label on the medications you are taking. Do not take more than one medication that contains the active ingredient acetaminophen.
Motrin/Advil (Ibuprofen)
Ibuprofen should not be combined with other pain relievers/fever reducers unless specifically instructed by a healthcare provider. Alternating with acetaminophen is OK as long as you are not taking more than is recommended of each medication in a 24-hour period or with each dose.
There are not as many multi-symptom medications that contain ibuprofen as compared to acetaminophen, but you should always review the labels anyway.
Some multi-symptom medications that may contain ibuprofen include Advil PM, Duexis, Ibudone, and Vicoprofen.
Aspirin (Acetylsalicylic Acid, ASA)
Aspirin should not be combined with other pain relievers unless specifically instructed by a healthcare provider.
Do not take aspirin when you are also taking other products that contain aspirin such as Alka-Seltzer, BC Powder, Excedrin, Goody’s, Lortab, and Vanquish. Pepto-Bismol also contains a derivative of aspirin and should be used with caution if you are taking aspirin.
Medications containing aspirin and salicylates should never be given to a child or teen under age 19 unless specifically instructed by their healthcare provider. When taken during a viral illness, it can cause Reye’s syndrome and harm the liver and brain.
Aleve (Naproxen)
Naproxen should not be combined with other pain relievers unless specifically directed by your healthcare provider.
There are not many multi-symptom medications that contain naproxen, but you should use caution and consult your healthcare provider if you are taking multi-symptom medications that contain any type of pain reliever/fever reducer—especially if it is another NSAID such as ibuprofen or aspirin.
Products that contain naproxen include Aleve PM, Treximet, and Vimovo.
Cold and Cough Relievers
Possible active ingredients:
Dextromethorphan, a cough suppressantGuaifenesin, an expectorant
Robitussin Long-Acting Cough & Cold (Dextromethorphan)
The active ingredient in Robitussin is dextromethorphan. How well this medication works is debatable, but it should not be combined with other medications that contain a cough suppressant. Always read the label of every medication you take.
Other medications that contain dextromethorphan include Alka-Seltzer Plus Cold and Cough Formula, Children’s Dimetapp Cold & Cough, Vicks DayQuil Cough, Delsym, Mucinex DM, Pediacare Children’s Cough & Congestion, Robitussin Cough & Cold CF, Sudafed PE Cold + Cough, Theraflu Cold & Cough, Triaminic Cold and Cough, Tylenol Cold + Cough, Vicks NyQuil Cough, among many others.
Mucinex (Guaifenesin)
Many multi-symptom cold and cough remedies contain guaifenesin—the active ingredient in Mucinex. Read labels carefully and do not take more than one product containing guaifenesin.
Some common medications that contain guaifenesin include Tussin, Equate Tussin DM, Robitussin Cough + Chest Congestion DM, Vicks DayQuil, and Zicam. There are many others.
Decongestants and Antihistamines
Possible active ingredients:
Phenylephrine, a decongestantPseudoephedrine, a decongestantDiphenhydramine, an antihistamine
Sudafed (Phenylephrine or Pseudoephedrine)
Always look at the active ingredients and do not combine Sudafed with other medications containing phenylephrine, pseudoephedrine, or decongestants.
Examples include NyQuil, Tylenol Cold Multi-Symptom, Alka-Seltzer Plus, and Robitussin Multi-Symptom, among many others.
Benadryl (Diphenhydramine)
Benadryl should not be combined with other antihistamines unless specifically instructed by your healthcare provider. Additionally, it should not be combined with topical Benadryl cream.
Other antihistamines and medications containing antihistamines include Claritin (loratadine), Zyrtec (cetirizine), Allegra (fexofenadine), Advil PM (as well as any other “PM” medication), PediaCare Children’s Allergy & Cold, and Sudafed PE.
Always look at the active ingredients and do not combine medications that contain diphenhydramine or other antihistamines.
A Word From Verywell
If you aren’t sure what to take, or what can safely be combined, talk to your pharmacist or healthcare provider. If you have chronic medical conditions or you are taking other medications, talk to your pharmacist to be sure there are no interactions or adverse reactions that you need to know about.
It is generally not recommended to take multiple over-the-counter pain relievers at the same time. However, in some cases, your healthcare provider may recommend alternating between acetaminophen and ibuprofen in three-hour intervals.
