Suffering from a cold or the flu? One of the worst parts of having a virus is the lack of sleep. So it’s not surprising that many people in this situation turn to Night Nurse, which provides ‘symptom relief to aid restful sleep.
But what exactly is Night Nurse and how does it work? In this article, we’ll take a look at the main active ingredients and explore some of the common side effects. We’ll also take a look at who should avoid it altogether and who should exercise caution around use.
We’ll answer some common questions, like how long does it take before you’re drifting off to sleep and how will you feel the next day? Next, we’ll cover the potential for addiction when it comes to Night Nurse and shows you how to tell if you’re addicted.
What is Night Nurse?
When you are feeling run down with a cold or flu, getting sleep can be a challenge. Whether it’s being woken up by an irritating dry cough or not being able to breathe properly thanks to congestion, getting unbroken, high-quality sleep can be hard to come by when you’re feeling poorly. Yet ironically, rest is vital for recovery to take place.
This is why Night Nurse is a popular option for people dealing with colds and flu in the UK. It provides relief to common cold and flu symptoms, and makes you drowsy, making a good night’s sleep much more possible.
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What Actually Is Night Nurse?
Night Nurse is available in two formulations:
- Night Nurse Liquid
- Night Nurse Capsules
The nighttime versions have three ingredients. Paracetamol to reduce pain and fever, dextromethorphan to suppress a cough, and promethazine which can stop a runny nose and help you get to sleep.
You can also find a Day Nurse version, which doesn’t have the promethazine which makes you sleepy.
What Is Night Nurse Used For?
Night Nurse is used to helping with the symptoms of colds and flu. While it won’t cure you of your cold or flu, or get rid of it any quicker, it can help you to ease your symptoms and get adequate rest. Symptoms it can help with include:
- Tickly or dry cough
- Sore throat
- Aches
- Headache
- Fever
- Sinus pain
- Runny nose
While it can help with all of the above symptoms, Night Nurse is particularly popular for the promethazine it contains, which will make you drowsy and make sleep easier to come by.
What Does Night Nurse Contain?
There are three active ingredients that together make Night Nurse work efficiently at helping people dealing with colds and the flu to sleep better: paracetamol, dextromethorphan, and promethazine. Below you’ll find more information on what each ingredient is and how it works.
Paracetamol
Paracetamol is a popular painkiller and many people’s first port of call when it comes to pain relief. It can be helpful for mild to moderate pain, including muscular aches and pains that often accompany a cold or flu. Many people dealing with a cold or flu also run a high temperature, and paracetamol can be used to bring this down which can stop you from feeling uncomfortably hot.
Dextromethorphan
Dextromethorphan is used to suppress coughs. It’s important to note that this won’t work with a cough where you are coughing up phlegm, only with dry coughs where nothing comes up when you cough (often called an ‘unproductive’ cough). Dextromethorphan works by dialling down the signals sent between the muscles that cause the cough and the part of the brain that controls coughing.
Promethazine
Promethazine is an antihistamine that helps with cold symptoms like a runny nose or coughing. It is sedating, so it can also make you feel sleepy. While people looking for relief from allergies may not want this side effect, it can actually be useful for people looking for a good night’s sleep during a cold or flu.
Where Can You Buy Night Nurse?
Night Nurse is available at supermarket pharmacies including Tesco, Sainsbury’s, ASDA, Morrisons and Co-operative. You can also buy it at pharmacies including Boots, Superdrug, and Lloyds Pharmacy.
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What Are the Side Effects of Night Nurse?
Like all medication, Night Nurse comes with the possibility of experiencing a side effect. Medicines affect people differently, so you may experience one of the side effects listed below or you may not.
Common Side Effects of Night Nurse
- Headache
- Vision issues
- Inability to concentrate
- Feeling dizzy
- Dry mouth
Other Side Effects of Night Nurse
- Confusion
- Restlessness
- Gastrointestinal problems
- Rash
- Issues peeing
- Anaphylaxis
- Drug dependence
Who Shouldn’t Use Night Nurse?
Like all medications, Night Nurse isn’t suitable for everyone. The following people should not take Night Nurse:
- Anyone under the age of 16
- People with respiratory issues e.g. asthma, pneumonia or chronic bronchitis
- Anyone with bronchiectasis
- People who are on antidepressants including phenelzine, tranylcypromine, isocarboxazid or moclobemide
- Anyone taking the anti-Parkinson’s medicines selegiline or rasagiline
Who Should Be Careful About Night Nurse Use?
If you fall into any of the below categories, you should use Night Nurse with caution and only after discussing the risks with a healthcare professional.
You will need to be careful when using Night Nurse if you are over 65 or have:
- Liver problems
- Kidney problems
- Heart disease
- Epilepsy
- Glaucoma
- Asthma
- Diabetes
- Glutathione depletion because of metabolic deficiencies
- Issues emptying your bladder
- A low-sodium diet
- A history of drug or alcohol misuse
What Does Night Nurse Do?
Night Nurse uses paracetamol, promethazine, and dextromethorphan to relieve the major symptoms of colds and flu and help you get a better night of sleep.
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Is There Anything I Shouldn’t Do While on Night Nurse?
Because Night Nurse can cause you to become drowsy (along with other side effects including dizziness, impaired vision, and cognitive and motor impairment), you shouldn’t drive or operate machinery while you’re using it.
This class of medicine is included in the list of drugs listed in the regulations under 5a of the Road Traffic Act 1988. That means that you should be made aware:
- The medicine will likely impact your ability to drive
- It’s an offence to drive under the influence of this medicine
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How Long Does a Night Nurse Take To Make You Sleep?
Night Nurse will take effect within 20 to 30 minutes. Take your one-off dose about 20 minutes before you plan to get into bed. This way you’ll have time to complete your usual pre-bed routine before the promethazine will start to make you feel sleepy.
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Can Night Nurse Make You Tired the Next Day?
The side effects of promethazine, including drowsiness, should wear off in about 12 hours. However, it’s possible you may still feel the effects for longer than this.
How Long Does Night Nurse Take To Kick In?
Most people will feel the drowsiness side effects of the promethazine within about 20 minutes. Meanwhile, the pain relief and temperature-lowering effects of paracetamol typically take around 30 minutes to kick in.
Are Night Nurse Tablets Addictive?
Yes, it is possible to develop an addiction to Night Nurse tablets or liquids. Cases of dextromethorphan abuse and dependence have been reported and as such, healthcare professionals have been advised to be especially vigilant around giving Night Nurse to young people, as well as anyone with a history of drug or alcohol misuse.
The electronic medicines compendium states:
“For all patients, prolonged use of this product may lead to drug dependence (addiction), even at therapeutic doses. The risks are increased in individuals with current or past history of substance misuse disorder (including alcohol misuse) or mental health disorder (e.g., major depression).”
How Do I Know if I Am Addicted to Night Nurse?
You might be addicted to Night Nurse if you find yourself compelled to take it in the absence of any cold or flu symptoms. You could also be dealing with an addiction if you experience any symptoms when you try to stop taking it. These could include:
- Restlessness
- Chills
- Sweating
- Palpitations
- Insomnia
- Agitation
- Anxiety
- Tremors
- Weakness
- Stomach pain
- Nausea
- Sickness
- Diarrhoea
- Increased blood pressure
- Increased heart rate
How Much Night Nurse Is Dangerous to Take?
It is important you do not exceed the maximum dose. Doing so can be very dangerous and lead to an overdose. This can cause major damage to your liver and kidneys.
Night Nurse is not suitable for children. For those aged 16 and over:
- Do not take more than one dose of Night Nurse per night. That is either two capsules or one 20mls dose of the liquid.
- Do not take any Night Nurse if you have already taken four doses of paracetamol, or medicine containing paracetamol, that day.
- Ensure that you leave at least four hours after taking your last paracetamol-containing medicine and your Night Nurse dose.
- Do not take Night Nurse for more than three nights in a row without getting further advice from your doctor, pharmacist or healthcare professional.
Can I Overdose on Night Nurse?
Yes, it is possible to overdose on Night Nurse. Avoid this by sticking to the maximum dose and not taking it more than three nights in a row.
Paracetamol Overdose
Liver damage can happen when an adult takes 10g or more of paracetamol. Problems may occur at 5g if you:
- Are an on a long-term treatment plan with carbamazepine, phenobarbitone, phenytoin, primidone, rifampicin, St John’s Wort, or any other drugs that produce liver enzymes
- Regularly drinking alcohol in excessive amounts
- Are low in glutathione e.g. HIV infection, eating disorder, cystic fibrosis
Within the first 24 hours of a paracetamol overdose, you may notice:
- Pale skin
- Nausea
- Sickness
- Abdominal pain
Liver damage could become apparent from 12 hours to two days after you have taken over the recommended amount.
If you suspect you have overdosed, you need to access immediate treatment. Symptoms may not progress initially beyond feeling or being sick, which can easily be dismissed. But in some cases, despite a lack of symptoms, the overdose can be causing serious internal problems including the risk of organ damage. If you in any way suspect an overdose, call 999 or get straight to A&E.
Promethazine Overdose
Promethazine overdose may include the following symptoms:
- Delirium
- Agitation
- Hallucinations
- Hypotension
In particularly large overdoses it could also cause:
- Convulsions
- Toxic psychosis
- Arrhythmias
- Coma
- Cardiorespiratory depression
Again, if you suspect an overdose, call 999 or get yourself to A&E immediately.
Dextromethorphan Overdose
Any effects of a dextromethorphan overdose will be increased if you have mixed Night Nurse with alcohol or psychotropic drugs. Symptoms of dextromethorphan overdose could include:
- Nausea
- Vomiting
- Agitation
- Confusion
- Stupor
- Toxic psychosis
- Visual hallucinations
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In the event of a large overdose, you might have the following symptoms:
- Coma
- Respiratory depression
- Convulsions
If you suspect an overdose, call 999 or make your way to A&E as soon as possible.
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Can You Take Night Nurse When Pregnant?
It is not recommended that pregnant women take Night Nurse. Paracetamol is considered safe in pregnancy, so long as it’s used at the recommended dosage. However, there isn’t enough data on dextromethorphan and promethazine to establish the safety of either of these drugs during pregnancy. As such, it should only be used when considered essential by a medical professional.
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Can I Take a Night Nurse While Breastfeeding?
It’s advised that you avoid Night Nurses while breastfeeding. Promethazine may be excreted in breast milk, and its safety during breastfeeding isn’t known. As such, it should only be used under the guidance of a licensed medical professional.
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Can You Mix Night Nurse With Antibiotics?
You can usually take Night Nurse with antibiotics, but be sure to check with the doctor or nurse who prescribed them to you. If you are taking antibiotics for a chest infection, it’s important that you do not take them alongside Night Nurse.
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Can You Mix Night Nurse With Other Pain Relief?
You can take Night Nurse alongside ibuprofen or aspirin. However, you should not take them alongside any paracetamol or paracetamol-containing medications, such as co-codamol, co-dydramol or Tramacet.
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Can You Mix Night Nurse With Alcohol?
You can take Night Nurse alongside ibuprofen or aspirin. However, you should not take them alongside any paracetamol or paracetamol-containing medications, such as co-codamol, co-dydramol or Tramacet.
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Can You Take Night Nurse While on Antidepressants?
If you are currently taking an antidepressant, you will need to be very careful when it comes to taking cold medication like Night Nurse. You should avoid it if you have taken antidepressants including phenelzine, tranylcypromine, isocarboxazid, or moclobemide in the last two weeks.
You should seek further medical advice if you are currently taking any selective serotonin reuptake inhibitors (SSRI), such as citalopram or sertraline before you take Night Nurse.
This is because serotonergic effects, including developing potentially life-threatening serotonin syndrome, have been reported when dextromethorphan is taken alongside serotonergic agents, such as selective serotonin reuptake inhibitors (SSRIs). This can also happen with any drugs that interfere with the metabolism of serotonin, like monoamine oxidase inhibitors and CYP2D6 inhibitors.
Serotonin syndrome symptoms may include a change in mental status, autonomic instability, neuromuscular abnormalities, and gastrointestinal symptoms. If you have any of these symptoms, it’s important to stop taking Night Nurse and consult your doctor.
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Can You Take Night Nurse With a Chest Infection?
You should not take this medication if you currently have a chest infection.
