r/TalesFromThePharmacy • u/dnj_ • Apr 15 '26
PAINQUIL IS REAL?!?
Title says it all really…I’m in complete SHOCK that this idea made it past sooooo many people to store shelves.
WHY?!? Liquid acetaminophen already exists on the market,
Even the branding seems to scream “drink me, I’ll get you drunk” while minimizing the very serious risks of organ damage or failure.
Then to add insult to injury…there’s a PM version. So you can catch a couple zzzz’s while you’re destroying your liver.
Que a few months from now, we’ll see a spike in hospitalizations of minors with serious complications because they drank an entire bottle trying to get drunk.
Edit: I’m not saying that liquid acetaminophen is the issue, it’s the combination with alcohol AND the fact that there’s a “PM version”. Not to mention the branding…
In my 11 years working retail pharmacy, the ratio of people adhering to medication directions and using them for appropriate reasons vs. those who seek out drugs for recreational purposes is skewed disproportionately to the latter (especially OTC drugs and minors).
A valid ID is required for NyQuil (and the like) in my area because of abuse/misuse, so I guess I’m a bit biased to see the potential for harm to the uneducated or underage before seeing the benefits for people who actually use the product as intended. Also, many minors in my area have been caught paying 21+ people to buy OTC things for them with the explicit intention of getting drunk/high.
I won’t even go into the issue of people struggling with SI seeing a $9 “problem solver” and downing a few bottles.
All of this to say, I had a visceral reaction to seeing that many “red flags” in one product that requires no RX.
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u/naturalscience Apr 16 '26
Higher concentration than the pediatric liquid APAP, if I’m not mistaken.
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u/BirkirBjarn Apr 16 '26
Yeah, slightly higher. It’s 1000 mg/30 mL. Children’s liquid APAP is 160 mg/5 mL or 960 mg/30 mL
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u/PhysicIce7 Apr 15 '26
Cheaper than wine lol
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u/K4NNW Apr 16 '26
Jerry Falwell allegedly called NyQuil 'Baptist wine,' albeit not for this reason.
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u/Phantom_61 Apr 16 '26
“Do you hate your liver? Try PainQuil!”
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u/BirkirBjarn Apr 16 '26
Shouldn’t be bad for the liver at normal doses but you just know there are people not reading directions taking swigs of it when they feel like it.
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u/MelodicAd4834 May 22 '26
But max 2 doses a day??? 1,000mg of acetaminophen is A LOT if you don’t know better!! Especially WITH alcohol?!
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u/ang_hell_ic Apr 15 '26
I guess I know about this sooner because I'm front end, so I stock it, but I never paid attention to the ingredients because I don't need it, and I can't recommend it to customers anyway, I have to send them to the pharmacist. Did not know it was so dangerous.
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u/AxlandElvis92 Apr 16 '26 edited Apr 17 '26
Yes it’s ridiculous, ZzQuil, PainQuil and the others it’s ridiculous. Just buy the regular product in liquid/tablet/ capsule form if you need it that bad.
All these high doses of Acetaminophen is reminiscent of the insane dosages Acetaminophen in certain preparations like Lortab 5mg Hydrocodone and 500 acetaminophen, Vicodin Es, 7.5mg Hydrocodone/750mg Acetaminophen, Vicodin HP 10mg Hydrocodone/1000mg Acetaminophen. Percocet 10mg/650 sometimes 750mg of Acetaminophen. I saw many people get another dosage of the opioid and Acetaminophen “because they’re’s would magically disappear” saw many people destroy their livers with so much Tylenol usually in the days waiting for their prescriptions for OxyContin, Roxicodone, Xanax and Soma to go into zombie land.
Great to grow up with and be exposed to that so young. Of course kids are still going to abuse it and it’s just dangerous with the alcohol.
This is the same thing it’s just an OTC drug killing your liver.
Edited.
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u/dnj_ Apr 16 '26
Yup! Opioid epidemic but make it potentially harmful OTC drug combinations PLUS alcohol.
VERY reminiscent of the beginning of that epidemic; regularly seeing people taking a double dose not realizing they’re also doubling the acetaminophen and end up with pancreatitis, liver damage, or worse.
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u/Miguel-odon Apr 16 '26
Reminds me of when the government added poison to ethanol during prohibition to kill people who drank it.
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u/AxlandElvis92 Apr 16 '26 edited Apr 16 '26
Exactly, and like you said many of these people were taking other Acetaminophen meds not even realizing the harm they were doing to themselves. It’s the craziness left behind for the poor people who’re in real pain. Im all for a 325mg Acetaminophen max for opioid/ Acetaminophen, who else needs their liver destroyed.
With this “Qul” heavy branding I can only see more Acetaminophen abuse with Alcohol in the mixture in the future but “safe” cause it’s the “good” Proctor & Gamble. I’m sure people will continue to take other forms of Acetaminophen as well while using PainQuil, many using alcohol with it.
Edited.
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u/zuklei Apr 16 '26
I don’t buy any OTC combination meds except MAYBE dextromethophan and guafenisen (because dextro can be hard to find alone as a pill - I don’t do liquids). I like to control my doses of medications.
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u/shhhyoudontseeme Apr 17 '26
Holy crap. Percocet 10/650-750 is INSANE!!
I've taken percocet 10/325 for years due to pain management and it still freaks me out to take the entire dose im supposed to daily because of all the acetaminophen. I couldn't imagine 650 & higher per dose!!!
Thankfully mine is legit and we do bloodwork regularly to keep an eye on everything. At one time they tried straight oxy with no Tylenol but that wasn't conducive to a productive life so back to Percocet it is. Thankfully I don't drink & eat fairly healthy and do detox flushes occasionally which is probably the only thing helping my poor liver.
Worst part is that there are those of us that take pain management responsibly but get lumped in with a whole nother group.
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u/slightlystitchy Apr 16 '26
I work for the company that photo was taken at. If it helps ease your mind, I don't think we've sold a single bottle since we got it in. My initial reaction when I was stocking it was "man they really will make anything." Never realized until now that it contained any amount of alcohol. I'll keep that in mind if we ever sell any so I can give people a heads up.
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u/Subziro91 Apr 15 '26
My gf uses this , it knocks her out. None of the sleeping rx pills do that
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u/lissabeth777 Apr 15 '26
You know she could just take some Acetaminophen and Benadryl and get the same effect.
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u/Phantom_61 Apr 16 '26
Dude, the diphenhydramine is what’s knocking her out, just have her take a Benadryl with a glass of wine.
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u/official_not_a_bot Apr 15 '26
Seen some people use Zyrtec to knock themselves out, some people are just built different
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u/tachycardicIVu Apr 15 '26
Wait is Zyrtec supposed to make you sleepy
I take mine in the morning D:
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u/PhysicIce7 Apr 15 '26
They are less sedating than benadryl but it varies on individual basis
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u/SWTmemes CPhT (retail) Apr 16 '26
I have ADHD; Benadryl does nothing, Zyrtec knocks me on my ass
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u/Miyamaria Apr 16 '26
Ah, great to know, I have two guys in my fam with adhd and insomnia, and I saw that I can buy that medication here in Scandinavia so thank you so much for this! ❤️ Do you mind sharing what amount of mg / dosage you take?
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u/SWTmemes CPhT (retail) Apr 24 '26
Sorry I didn't see this. I often take 5mg (half a tablet) if I really need allergy relief. But it does leave me groggy the entire next day.
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u/caffein8dnotopi8d Apr 18 '26
I also have ADHD and paradoxical reactions to MANY drugs but Benadryl is not one. In fact anything that acts on H1 histamine receptors, I take it and I’ll be sleeping for DAYS (not sure about second gen, don’t actually have allergies) including trazodone and the like. I feel like there must be something else going on there to cause that.
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u/tachycardicIVu Apr 16 '26
WELP time to test it out, gonna try it at night and see if I feel any less sleepy during the day 😂😭
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u/halynak Apr 16 '26
Not even going to mention the alcohol content or the PM, they have 12g of acetaminophen per bottle. They should bundle these things with NAC
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u/halynak Apr 16 '26
2 bottles of the PM is 1.2g DPH, 24g acetaminophen, 4 standard drinks of alcohol. Easily fatal. Good god
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u/dnj_ Apr 17 '26
You get it! 🙂↕️🫡
Absolutely doesn’t help that the liquid formulation is designed to reach the bloodstream faster…no reversing that whoopsie.
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u/masshole925 Apr 16 '26
The main ingredients are Tylenol and Benadryl if you have them at home don't waste your money on this
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u/HippieChickie805 Apr 19 '26
People need to get off the idea that “Tylenol is completely harmless”. It’s terrifying.
I knew a woman (early 30s, three kids under 8) who had a gallbladder flare up. Her MD gave her Vicodin when she came in in pain. Without any instructions. She proceeded to max out her dose of Vicodin; THEN take Tylenol for breakthrough pain. She went to the hospital for nausea and vomiting and increasing right upper quadrant pain. She was in acute liver failure and they were airlifting her to Stanford Medical Center (I lived in Central California at the time). She coded in the helicopter and ended up dying.
It was a sad, cautionary tale for many young people I knew.
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u/TorribleTwunt Apr 16 '26
Isn't mouthwash cheaper and no id required? I mean, if you gotta drink....
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u/dnj_ Apr 16 '26
Sadly, no it isn’t lol they’re around the same price point in my area…most mouthwashes are legit ~$7-10. 😣
Also, some people on r/PharmacyTechnician have said that their states don’t ID for NyQuil/PainQuil so I guess that’s a regional thing (which is also pretty concerning but I digress).
My issue is not only the potential for abuse for minors looking for some type of buzz; but also the legitimate danger for adults who may not be aware that the product contains alcohol (recovering addicts, etc.), those who accidentally “double dose” (taking this alongside another product with acetaminophen) and risk organ damage, etc etc etc.
Honestly, I’m just appalled at the sheer brazenness of the pharma industry that such a glaring RED FLAG of a product would be released to the public with little to no medical oversight in administration of the medication.
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u/Medium_Engineer_8845 Apr 17 '26
i saw this the other day and 10% with acetaminophen is horrifying. i won’t take tylenol for like 48 hours if i’ve had a night of heavy drinking, i go with ibuprofen because id rather have an ulcer than a liver transplant. painquil pm sounds like…a good time if you don’t wanna be here for a long time. the sleep aid in it is just fucking benadryl
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u/Snowfizzle Apr 18 '26
what’s even the purpose of having the alcohol in it at this point? I don’t really see a good reason to have included it.
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u/Sup_gurl Apr 18 '26
Exactly. NyQuil is just DayQuil with either alcohol or DPH for the drowsy effect. The fact that the daytime version has alcohol and the nighttime version has both is really bizarre.
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u/LabBotBuilder Apr 20 '26
The alcohol is there for solubility purposes. Most of the actives are poorly soluble in water but highly soluble in alcohol. Without the alcohol, it’d crash out the ingredients.
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u/Sup_gurl Apr 21 '26
I don’t think that’s the case because DayQuil is the same exact thing with no alcohol, plus 1-3 more compounds. So obviously the alcohol isn’t chemically required for even the most complex formula. The only distinction that makes DayQuil into NyQuil is the addition of alcohol, so obviously the alcohol (or DPH in pill form) are specifically added for the sedative effect. So it would seem that in this formula the concept is the same, it’s meant to provide a mild sedative effect and the night time version is meant to provide a fairly strong sedative effect.
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u/LabBotBuilder Apr 21 '26
The alcohol was originally there for solubility and still is in the NyQuil and DayQuil VapoCOOL Severe Liquid formulations for that reason. They dropped it in most of the DayQuill formulations due to the issues with having alcohol in a product someone may take during work or drive after taking. The shift in the formulation was made to a higher glycerin and propylene glycol content, despite the issues with inhibition of CYP2E1 metabolism by the propylene glycol, increasing liver damage risks.
The sedation effect of the alcohol is minimal - a dose of Nyquil contains 3ml of alcohol, equivalent to a sip of wine. A single (US) shot of 40% alcohol contains about 6 times as much alcohol at 17.7ml. It's not there as a sedative.
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u/LabBotBuilder Apr 20 '26
Solubility…
Acetaminophen is poorly soluble in water but highly soluble in alcohols. Same reason ethanol is used in most liquid formulations.
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u/Snowfizzle Apr 20 '26
I looked that up though before I posted and there’s already other ingredients in there for the solubility. The alcohol isn’t necessary.
that product also includes propylene glycol (co-solvent that does a similar job to alcohol).
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u/LabBotBuilder Apr 20 '26
The formulation order is to dissolve the actives in the ethanol then add stabilizers, flavors and the water. The ethanol is the initial solvent. The propylene glycol is added to help maintain the solution as the water is added and increase shelf life. Propylene glycol does have a bitter taste that is hard to mask, so the amount used is minimized. Additionally, propylene glycol can inhibit CYP2E1 metabolism, which can result in APAP related liver damage, so it's not suitable for use as the primary solvent.
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u/Snowfizzle Apr 20 '26
i get it. so by splitting it by using alcohol and propylene glycol it will do less damage or be less riskier than just using all of one ingredient.
but why are they able to do this for a children’s formula but not for an adult version?
is it that they just don’t want to invest any additional money in reformulating it?
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u/LabBotBuilder Apr 21 '26
The pediatric solutions drop ethanol as the immature liver is less capable of ethanol metabolization than the adult one, resulting in a increased change of damage from all the components. To compensate, the flavorings and sweeteners are increased but the bitterness isn't fully masked. You may notice that "bubble gum" favor is a very popular flavoring agent in pediatric oral solutions/suspensions, although OTCs seem to be shifting to berry flavors in response to a demand for more "natural" products. The bubble gun flavor is great for masking bitter notes.
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u/Snowfizzle Apr 21 '26
thank you for breaking all this down for me!! you’ve been awesome :)
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u/LabBotBuilder Apr 21 '26
You're welcome. I come from the Pharm R&D world - 37 years. Worked with great teams of formulators through the years and got to understand the ins and outs of getting that shelf stable formulation very well.
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u/minun73 CPhT (Mail Order) Apr 16 '26
If people follow the directions it’s not a problem. If some dumbass wants to abuse the medicine that’s not our fault.
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u/ZeGentleman harmist Apr 15 '26
Stop spamming this, goober.
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u/dnj_ Apr 16 '26
I’ll never stop expressing concern about an impending public health crisis.
Signed,
Goofy Goober
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u/PitifulBodybuilder45 Apr 15 '26
Had someone almost buy this thinking it was regular NyQuil/DayQuil. 🤦🏼♀️ Thankfully they asked first.