Night Nurse (Dextromethorphan Hydrobromide, Promethazine Hydrochloride, Paracetamol)

Night Nurse is a combination oral liquid that addresses multiple symptoms of upper respiratory infections and flu.

• Cough: reduces cough frequency and intensity.
• Nasal congestion: eases blocked nose and improves breathing.
• Sore throat: soothes throat irritation and pain.
• Headache: provides analgesic relief.
• Fever: lowers elevated body temperature.
• Sleep disturbance: promotes rest by alleviating discomfort and inducing mild sedation.

• Dextromethorphan acts as a sigma‑1 receptor agonist and NMDA receptor antagonist to suppress the cough reflex. Promethazine blocks H1 histamine receptors and exhibits anticholinergic and sedative activity, reducing nasal secretions and promoting sleep. Paracetamol inhibits central cyclooxygenase enzymes, producing analgesic and antipyretic effects without significant peripheral anti‑inflammatory activity.

Night Nurse may cause a range of adverse reactions, most of which are mild and transient.

Common Side Effects

• Drowsiness: feeling unusually sleepy.
• Dry mouth: reduced salivation.
• Dizziness: light‑headed sensation.
• Blurred vision: temporary visual disturbance.
• Nausea: mild stomach upset.
• Constipation: reduced bowel movements.

Serious or Rare Side Effects

• Allergic reactions: rash, itching, swelling, or difficulty breathing.
• Severe drowsiness: excessive sedation interfering with daily activities.
• Respiratory depression: slowed breathing, especially when combined with other depressants.
• Hallucinations or confusion: rare central nervous system effects.
• Seizures: infrequent but serious neurological events.

Before using Night Nurse, consider the following safety measures.

• Do not exceed the recommended dose: follow prescriber or label instructions.
• Avoid alcohol: may increase drowsiness and respiratory depression.
• Use caution in liver disease: paracetamol is metabolised hepatically.
• Avoid operating machinery if drowsy: sedation can impair alertness.
• Consult a healthcare professional if pregnant or breastfeeding: safety data are limited.
• Store at room temperature: keep in the original container, protect from moisture and direct sunlight.

Night Nurse can interact with several medicines; awareness helps prevent adverse outcomes.

Major Interactions (Avoid)

• Monoamine oxidase inhibitors (MAOIs): risk of serotonin syndrome with dextromethorphan.
• Central nervous system depressants (e.g., benzodiazepines, opioids): additive sedation and respiratory depression.
• Alcohol: enhances drowsiness and depressant effects.

Moderate Interactions (Monitor Closely)

• Anticholinergic drugs: may increase dry mouth and constipation.
• Other antihistamines: can cause excessive sedation.
• Warfarin: paracetamol may potentiate anticoagulant effect, requiring INR monitoring.