Can I take Theraflu with ibuprofen?

What is in Theraflu?

Theraflu is a family of products, not one formula, so check the Drug Facts box on your box or packet. The common hot liquid powders, per their DailyMed labels, contain:

• Theraflu Daytime Severe Cold and Cough (packet): acetaminophen 650 mg, dextromethorphan HBr 20 mg (cough), phenylephrine HCl 10 mg (decongestant).
• Theraflu Nighttime Severe Cold and Cough (packet): acetaminophen 650 mg, diphenhydramine HCl 25 mg (antihistamine, causes drowsiness), phenylephrine HCl 10 mg.
• Theraflu ExpressMax Severe Cold and Flu syrup (30 mL): acetaminophen 650 mg, dextromethorphan 20 mg, guaifenesin 400 mg, phenylephrine 10 mg.
• None of these list ibuprofen, naproxen, or aspirin as an active ingredient.

Why can ibuprofen go with Theraflu?

Ibuprofen is an NSAID. Theraflu's pain and fever ingredient is acetaminophen, which is a different kind of medicine. The NHS says adults can take ibuprofen at the same time as paracetamol (the UK name for acetaminophen) if needed, and suggests trying each alone first to see if one is enough.

That does not make the pair right for everyone. The Advil label says to ask a doctor or pharmacist before use if you take any other drug, and to ask a doctor first if you have high blood pressure, heart disease, kidney disease, liver cirrhosis, asthma, stomach problems such as heartburn, or have had a stroke. Theraflu's label lists its own conditions, covered below.

• Use the label dose of each. Advil: 1 tablet every 4 to 6 hours (2 if 1 does not help), no more than 6 tablets in 24 hours unless a doctor directs.
• Theraflu packets: 1 every 4 hours, no more than 5 packets in 24 hours unless a doctor directs. ExpressMax syrup: 30 mL every 4 hours, no more than 5 doses in 24 hours.
• Take ibuprofen with food or milk if it upsets your stomach.

What should you not add to Theraflu?

The Theraflu label says do not use it with any other drug containing acetaminophen, prescription or nonprescription. Severe liver damage may occur with more than 4,000 mg of acetaminophen in 24 hours, with other acetaminophen products, or with 3 or more alcoholic drinks a day. Five packets, the daily maximum, already add up to 3,250 mg.

• No Tylenol or any other product with acetaminophen. Many other cold and flu remedies contain it, so check the Drug Facts label of anything else you take.
• No second cough medicine with dextromethorphan if your Theraflu already has it.
• No second decongestant such as Sudafed (pseudoephedrine) or another phenylephrine product.
• No Benadryl with Nighttime Theraflu. Its label says not to use it with any other product containing diphenhydramine, even one used on the skin.
• Only one NSAID. If you take ibuprofen, do not also take Aleve (naproxen) or aspirin for pain. The NHS says not to take ibuprofen with other NSAIDs.

Who should ask before taking Theraflu and ibuprofen?

Theraflu's label says to ask a doctor before use if you have liver disease, heart disease, high blood pressure, thyroid disease, diabetes, or trouble urinating from an enlarged prostate. The Daytime and ExpressMax labels also list a cough with a lot of mucus or a long-term cough, such as from smoking, asthma, or emphysema. The Nighttime label adds glaucoma and breathing problems such as emphysema or chronic bronchitis. All three list the blood thinner warfarin as a reason to ask a doctor or pharmacist first.

Do not use Theraflu if you take a prescription MAOI (certain drugs for depression, psychiatric or emotional conditions, or Parkinson's disease) or within 2 weeks of stopping one. If you are not sure whether a prescription contains an MAOI, ask a doctor or pharmacist. Theraflu is not for children under 12.

Ibuprofen has its own cautions. The Advil label warns that NSAIDs, except aspirin, increase the risk of heart attack, heart failure, and stroke. Stomach bleeding risk is higher if you are 60 or older, have had ulcers or bleeding problems, take a blood thinner or steroid, take another NSAID, or have 3 or more drinks a day. If you take aspirin for your heart, ask first, because ibuprofen may reduce that benefit.

Does Theraflu Nighttime change anything?

Ibuprofen works the same way with the Nighttime formula. The difference is diphenhydramine, which can cause marked drowsiness. The label says to avoid alcohol, that sedatives and tranquilizers may increase drowsiness, and to be careful driving or using machinery. Ask a doctor or pharmacist first if you take sedatives or tranquilizers.

Does the phenylephrine in Theraflu work?

In November 2024 the FDA proposed removing oral phenylephrine as a nasal decongestant ingredient, based on its finding that phenylephrine taken by mouth is not effective for nasal congestion. The FDA said it found very few serious side effects when it is used as directed, and that products with oral phenylephrine can still be sold until it issues a final order. Check the FDA's site for the latest status. This does not affect the acetaminophen or the cough ingredient. If congestion is your main problem, ask a pharmacist about other options that fit your health history.