Is DayQuil and NyQuil safe during pregnancy?

What does the evidence say about DayQuil and NyQuil during pregnancy?

1. Acetaminophen is still the pain reliever and fever reducer most healthcare providers reach for first in pregnancy, and it hasn't been shown to raise the chance of birth defects at recommended doses. 1
2. Dextromethorphan, the cough suppressant in both DayQuil and NyQuil, is not expected to raise the chance of birth defects when taken as directed, but some liquid formulations contain alcohol, and alcohol isn't recommended at all during pregnancy. 2
3. Phenylephrine, the decongestant in DayQuil, didn't show an increased chance of birth defects overall in studies of more than 1,500 women, though one study of 1,249 women found a slightly higher chance of minor eye or ear differences after first-trimester use. Whether it affects preterm delivery or low birth weight is still unknown. 3
4. Doxylamine succinate, the antihistamine that makes NyQuil sedating (DayQuil skips it), has been studied in hundreds of thousands of pregnancies through the combination medication Diclegis, which pairs it with vitamin B6, without an increased chance of birth defects, miscarriage, preterm delivery, or low birth weight. 4
5. Alcohol is sometimes an ingredient in over-the-counter medications like cough syrup, and current guidance is to avoid all alcohol during pregnancy since no safe amount or timing has been established. That matters directly for original liquid NyQuil, which lists Alcohol 10 percent on the label. 5

Is DayQuil and NyQuil safe in each trimester?

• First trimester. The first trimester is when splitting these products into single ingredients matters most. One large study found a slightly higher chance of minor eye or ear differences after first-trimester phenylephrine use, and this is also when avoiding alcohol matters most. Acetaminophen and dextromethorphan alone have the most reassuring data, so if only one symptom is bothering you, address just that symptom and skip the rest.
• Second trimester. By the second trimester, dextromethorphan and acetaminophen still show no increased chance of birth defects in the studies reviewed. Doxylamine succinate, the ingredient that makes NyQuil sedating, has been studied in hundreds of thousands of pregnancies as part of an anti-nausea medication without added risk. What's still unclear is whether stacking three drugs together, or three drugs plus alcohol, changes things versus taking them one at a time, so ask your prenatal care provider rather than relying on the label.
• Third trimester. Third-trimester use carries the same profile as earlier in pregnancy, with no new caution for acetaminophen, dextromethorphan, or doxylamine succinate on their own. There's still no established safe amount of alcohol in pregnancy, so choose an alcohol-free capsule or single-ingredient option instead of liquid NyQuil whenever you can.