Night Nurse Cold Remedy (Dextromethorphan Hydrobromide, Promethazine Hydrochloride, Paracetamol)

Night Nurse Cold Remedy, a combination of dextromethorphan, promethazine and paracetamol, is used to manage symptoms of upper respiratory infections and influenza.

• Cough: reduces the frequency and intensity of dry cough.
• Nasal congestion: alleviates blocked nose and sinus pressure.
• Headache/Fever: provides analgesic and antipyretic relief.
• Sore throat: soothes throat discomfort associated with a cold.
• General cold symptoms: improves overall comfort during viral upper respiratory illness.

• Dextromethorphan acts as a sigma‑1 receptor agonist and NMDA receptor antagonist to suppress the cough reflex, while promethazine blocks histamine H1 receptors and exerts anticholinergic activity to reduce nasal congestion and allergic symptoms. Paracetamol inhibits central cyclooxygenase enzymes, producing analgesic and antipyretic effects. The combined actions address multiple pathways involved in cold and flu symptomatology.

Night Nurse Cold Remedy may cause a range of adverse reactions, varying from mild to severe.

Common Side Effects

• Drowsiness or sedation.
• Dry mouth.
• Dizziness or light‑headedness.
• Nausea or mild gastrointestinal upset.
• Blurred vision.
• Constipation.

Serious or Rare Side Effects

• Severe allergic reaction (anaphylaxis) with rash, swelling or breathing difficulty.
• Respiratory depression, especially when combined with other depressants.
• Cardiac arrhythmias or palpitations.
• Seizures.
• Hepatic injury or elevated liver enzymes.
• Blood dyscrasias such as neutropenia or thrombocytopenia.

Before using Night Nurse Cold Remedy, consider the following precautions.

• Pregnancy: consult a healthcare professional before use.
• Alcohol: avoid concurrent consumption as it may increase sedation.
• Driving: do not operate machinery if drowsy or impaired.
• Medical conditions: use with caution in patients with liver disease, glaucoma, asthma, or urinary retention.
• Drug interactions: review all concomitant medications for potential interactions.
• Store at ambient temperature: keep in the original pack, protect from moisture and heat.

Night Nurse Cold Remedy can interact with other medicines; review the following categories.

Major Interactions (Avoid)

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

Moderate Interactions (Monitor Closely)

• Warfarin: paracetamol may enhance anticoagulant effect.
• Anticholinergic drugs: cumulative dry mouth, urinary retention.
• CYP2D6 inhibitors (e.g., fluoxetine): may increase dextromethorphan levels.