Nyquil and Acute Hepatic Necrosis

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Abstract
To the Editor: Nyquil, a common over-the-counter cold remedy, has not been recognized as a cause of hepatic injury. Nyquil contains a combination of ephedrine, doxylamine, promethazine, dextromethorphan, and 700 mg of acetaminophen per ounce (30 ml) of a 25 per cent alcohol elixir. This high level of alcohol led an alcoholic but otherwise healthy 45-year-old man to consume 12 oz (360 ml) of the elixir over a 12-hour period, causing massive hepatic necrosis.When he had last been seen for inebriation in the emergency room, his laboratory values had been normal except for a slightly elevated level of aspartate . . .

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