NyQuil = Medinait? The results are in!

by Christina Geyer on May 24, 2007 · 13 comments

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It comes up regularly on blogs and message boards, Wick Medinait, the German version of Vicks NyQuil, just doesn’t stack up with the original. I always wrote that talk off to psychology, we’re just more comfortable with what we’re used to. Personally, the couple times I used the German version, I didn’t really noticed a difference in the reduction of my symptoms, but I brought NyQuil from the US simply because you can buy it in a much bigger bottle!

So what is the truth? Are they the same? Are they different? I finally decided to put it to the test.

Wick Medinait Active Ingredients in each 30 ml dose:
– 8,0 mg Ephedrinhemisulfat (Decongestant)
– 7,5 mg Doxylaminhydrogensuccinat (Antihistamine/sedative)
– 15,0 mg Dextromethorphanhydrobromid (Cough suppressant)
– 600,0 mg Paracetamol (Pain reliever/fever reducer)
– 4,3 g Alcohol (18%)

Vicks NyQuil Active Ingredients in each 30 ml dose:
– Acetaminophen 1000 mg
– Dextromethorphan HBr 30 mg
– Doxylamine succinate 12.5 mg
– Alcohol content is never declared, but several pharmacy websites claim it is 10%

And what do you know? They are actually different! NyQuil does not contain a decongestant and has a lower alcohol content. Apparently, Vicks stopped including pseudoephedrine in Nyquil after the passage of the Combat Methamphetamine Epidemic Act, because it can by used in the manufacture of crystal meth, much to the chagrin of the blogger who posted back in 2005 when the change occurred that The New Dayquil (and NyQuil) Blows … A Lot.

But how significant are these differences really?

According to the Wikipedia page, the cough suppressant Dextromethorphan is effective in doses between 10mg and 30mg. I looked for dose escalation studies to see if there was a significant anti-tussive difference between a 15mg and a 30mg dose, but was not able to find any online and available to the public (I’m not paying $25 bucks for one day of access to a pharma journal, thank you very much). I did find an abstract of an article that finds that a 30 mg dose is more effective than placebo though.

Without access to studies to read for myself, what was I to do? I contacted one of Rainer’s college buds, Sascha, a German professor of pharmacology. Here’s what he had to say:

my opinion is:
The German version is much worse!
The important ingredients are underdosed. Especially ephedrin is only about 6,2 mg per Single-Dose and thus a kind of homeopathic that you can neglect! (You need about 25 – 50 mg of ephedrin base to realize an effect!)
The American version is about double dosed concerning the decisive ingredients – Much better!

But generally spoken I do not like combination drugs with more than 2 ingredients. Although is easy for the patient you will never know what component was responsible for side effects!

Surprise, surprise, surprise! It seems my psychology theory has been blown out the window and all those bloggers were right. So keep importing that NyQuil if it’s your favorite cold medicine.

And just to be sure, I’ll ask my American pharmacist reader if she’ll offer an opinion as well. Grafs – any thoughts?

  • Rositta

    I took Nyquil once and had incredibly bad nightmares. Now since I generally don’t dream or at least don’t often remember dreaming I blamed those nightmares on the Nyquil. I haven’t taken it since, oh well…ciao

  • Grafs

    I’m not all too familiar with foreign monikers for medications, though I do know that paracetamol is British for acetaminophen. Would this be pure ephedrin (not pseudoephedrine or phenylephrine)that is in the German version?! In any case, people should go with what makes them feel better and some people need higher doses of things than others. Incidentally, in the US they have replaced pseudoephedrine with phenylephrine which is relatively weak. So stupid.

  • Christina

    @rositta: Sounds like a good choice. If it doesn’t work for you the way you expect it to, don’t take it 😉

    @grafs: I haven’t managed to find exactly what the 8mg Ephedrinhemisulfat (or Ephedrin Hemisulfat – it’s written both ways), translates to in English, but it does seem to end up that you get a 6.2mg dose of pure Ephedrin out of this. Acetominophen = Paracetamol, and I believe the other two ingredients are the same in both versions (just the dosage is different). (Forgot to add that Germans use commas instead of decimal points, so “15,0 mg” is 15.0 mg).

  • Debbie

    This has been my opinion on many many German medications I’ve tried. They are often in dinky packages, very overpriced (like 12 Euros for 30 naproxen pills – wtf?) and many do virtually nothing, like your underdosed Nyquil example. We haven’t been back to the US for a year now and will finally go in November. Believe me, I’m bringing back whopping big bottles of Aleve, vitamins and probably some other stuff, too =;-) I guess the placebo effect works better on Germans.

  • Christina

    @debbie: I can see the German point of view as well though. Maybe it’s better to be a bit undermedicated than over – well, depending on the condition anyway.

  • Aine

    I have taken both. They are both fine products. The big difference is cost. You spend like 10 euro for a tiny bottle in Germany (albeit with more alchohol), while you can get a generic version of a large bottle in the US for $5.

  • Luigi

    When I used to live in Switzerland i’d take MediNait when I needed it, but since I moved to the US I found out that NyQuil is much more efficent (to me at least).
    As for the cost, every country in Europe have different prices because it goes based on the purchasing power. E.g. a box of ibuprofin (30 pieces, 400mg) in Italy cost 12 Euros, while the same box but with 600mg in Spain is 2 Euros.

  • zak

    I live in Austria. I have used Nyquil and find it works too well at giving me a good nights rest when i have a cold or flue. So I have banned the sale of Nyquil in Austria. I use alternatives from Vicks (called Wick in Austria because they cannot pronounce V letter here) which do not work as well as Nyquil and come in very small bottles, so buy many! Then thow them in the trash and wish you had Nyquil. HAHAHAHAHA

  • BizDevCon

    They rebranded it as “Wick Erkältungssaft” but my pharmacist immediately recognised “Medinait.” As I never drink alcohol, the once per year use of Wick really puts me into a hibernation mode immediately. Will be interesting to test the differences myself!

    On my next visit I’ll grab 1-2 bottles at Walgreens for sure. Thanks for pointing this out. (Btw, if you open the bottle it stays okay up to four years!)

    Greetings from Austria as well.

  • FJB

    I used to live about 20 years ago in the sttates. There’s were I met Nyquil and learned, that it works better than Wick Medinait. Sometimes In thought its psycological. But it always helped better and still, if I get the Chance to get it here, I do so.
    Greetings from Germany

  • Alberto

    When I was in US a dose of Nyquil was sufficient to clear up cold and flu symptoms. Back to Italy, a bottle of Medinite is just like fresh water to me. Thanks to the article, I thought there was something wrong with me!

  • Suzanne

    Many people, that are descended from families with fair skin and fair hair (that also lack melanin) are considered “slow metabolizers”; meaning it takes less of certain/most medications for them to metabolize them properly. This may be why OTC’s in N Eu countries seem wimpier. They target the population they serve. If you need to double up on certain meds to get the same effect; just be sure you aren’t over taking any one substance and you should be fine. Erring on the side of caution is never a bad idea before you know how a medication will effect you. Good luck!

  • http://www.amiexpat.com Christina Geyer

    I don’t think fair complexion is the reason. CYP2D6 allele is responsible for this poor metabolism and nonfunction of CYP2D6 only occurs in 6-10% of the white population (it is lower in Asians and higher in African Americans). Reduced CYP2D6 function is present in 29% of Caucasians, but in 50% of people of Asian and African descent. [Source: Pharmacogenomics, Vol. 3, No. 2, Pages 229-243]. So underdosing in Europe does not seem to correlate to lower CYP2D6 function in the population.

    If anyone feels their medication is underdosed, speak with your doctor about a change in medication or increase in dosage, please.

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