Advil Cold & Sinus (Pseudoephedrine and Ibuprofen) – Oral

What Is Advil Cold & Sinus?

Advil Cold & Sinus (pseudoephedrine and ibuprofen) is an over-the-counter (OTC) medication used to help relieve cold and flu symptoms. Advil Cold & Sinus is a combination product that contains pseudoephedrine and ibuprofen. 

Pseudoephedrine is a decongestant that influences chemical binding sites called alpha-adrenergic receptors. It narrows blood vessels in the nose, relieving stuffy-nose symptoms. Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that blocks unique proteins called cyclooxygenase-1 and cyclooxygenase-2 (COX-1 and 2). By blocking COX-1 and 2, ibuprofen relieves fever, inflammation, and pain.

Advil Cold & Sinus is available in tablet and capsule form.

Drug Facts

Generic Name: Pseudoephedrine and ibuprofen

Brand Name(s): Advil Cold & Sinus

Drug Availability: Over the counter

Therapeutic Classification: Analgesic/decongestant combination

Available Generically: Yes

Controlled Substance: No

Administration Route: Oral

Active Ingredient: Pseudoephedrine and ibuprofen

Dosage Form(s): Tablets, capsules

What Is Advil Cold & Sinus Used For?

Advil Cold & Sinus is a combination over-the-counter (OTC) medicine used to relieve cold and flu symptoms.

Although similar in some ways, the cold and flu are very different. The common cold is usually mild, with cough, congestion, and stuffy nose symptoms. The flu is typically more severe, with cough, fever, chills, body aches and pain, extreme tiredness, and headache symptoms.

How to Take Advil Cold & Sinus

Take one or two coated tablets or capsules of Advil Cold & Sinus every four to six hours as needed, for no longer than three days if treating a fever or longer than seven days if treating nasal congestion. If symptoms persist, the drug should be stopped, and a healthcare provider should be consulted.

Do not take more than six tablets or capsules in 24 hours. To prevent interfering with sleep, do not take the last dose within two hours of bedtime.

Advil Cold & Sinus can be taken with or without food. However, if you experience an upset stomach, take the medication with food or milk.

Storage

Keep your medications out of the reach of children and pets, ideally locked in a cabinet or closet.

Advil Cold & Sinus can be stored at room temperature, between 68 degrees to 77 degrees F. Don't store Advil Cold & Sinus in a hot environment (above 104 degrees.

Although Advil Cold & Sinus is an OTC medication, it is usually stored behind the pharmacy counter because the product contains pseudoephedrine, which is an ingredient that can be used to make the illegal drug called methamphetamine (meth).

Due to this, there are limits to how much you can buy per day and month. However, if you have a prescription for Advil Cold & Sinus, your healthcare provider may authorize higher quantities.

Some countries may treat Advil Cold & Sinus as a controlled medication; therefore, you may need an official letter from your healthcare provider for your Advil Cold & Sinus. Some countries may also require a copy of a prescription for your Advil Cold & Sinus.

If you plan to travel with Advil Cold & Sinus, become familiar with your final destination's regulations. If possible, keep your medication in its original container from your pharmacy with your name on the label, if you have gotten it by prescription. Ask your pharmacist or healthcare provider any questions you may have about traveling with your medicine.

Discard all unused and expired drugs, but do not pour them down the drain or toilet. Ask your pharmacist or medical provider about the best ways to dispose of this medicine, and look into drug take-back programs in your area.

How Long Does Advil Cold & Sinus Take to Work?

You may notice relief of your stuffy nose symptoms in 15 to 30 minutes. You may see an improvement within 30 to 60 minutes for fever and pain.

What Are the Side Effects of Advil Cold & Sinus?

This is not a complete list of side effects, and others may occur. A healthcare provider can advise you on side effects. If you experience other effects, contact your pharmacist or healthcare provider. You may report side effects to the Food and Drug Administration (FDA) at fda.gov/medwatch or 800-FDA-1088.

Although Advil Cold & Sinus is an OTC medication, side effects are still possible.

Common Side Effects

Common side effects of Advil Cold & Sinus include:

Severe Side Effects

Contact your healthcare provider immediately if you develop any signs of a severe reaction. Call 911 if your symptoms feel life-threatening.

Talk with your healthcare provider or seek medical attention if you experience seizures or the following severe symptoms—which may be due to heart problems, stomach bleeding, or a stroke:

  • Blood in vomit
  • Bloody or black stools
  • Breathing troubles
  • Chest pain
  • Fainting feeling
  • Leg swelling
  • Slurred speech
  • Stomach pain that doesn’t go away
  • Weakness on one side of the body

Long-Term Side Effects

Advil Cold & Sinus is relatively well tolerated when used as directed.

Long-term use of Advil Cold & Sinus may lead to the following side effects:

Report Side Effects

Advil Cold & Sinus may cause other side effects. Call your healthcare provider if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your provider may send a report to the FDA's MedWatch Adverse Event Reporting Program or by phone (800-332-1088).

Dosage: How Much Advil Cold & Sinus Should I Take?

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The dose of this medicine will be different for different people. Follow your healthcare provider's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your healthcare provider tells you to.

The amount of medicine you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

For symptoms of cold or flu:

For oral dosage form (liquid-filled capsules):

  • Adults and children 12 years and older—1 to 2 capsules every 4 to 6 hours a day. Do not take more than 6 capsules per day. Each capsule contains 200 milligrams (mg) of ibuprofen and 30 milligrams (mg) of pseudoephedrine.
  • Children younger than 12 years—Use is not recommended.

For oral dosage form (tablets):

  • Adults and children 12 years and older—1 to 2 tablets every 4 to 6 hours a day. Do not take more than 6 tablets per day. Each tablet contains 200 milligrams (mg) ibuprofen and 30 milligrams (mg) pseudoephedrine.
  • Children younger than 12 years—Use is not recommended.

Modifications

Advil Cold & Sinus is available as a tablet or capsule with 200 milligrams (mg) of ibuprofen and 30 milligrams (mg) of pseudoephedrine. The following modifications (changes) should be kept in mind when using Advil Cold & Sinus:

Severe allergic reaction: Avoid Advil Cold & Sinus if you have a known allergy to it or its ingredients. Ask your pharmacist or healthcare provider for a complete list of the ingredients if you're unsure.

Pregnancy: If possible, avoid using Advil Cold & Sinus during pregnancy. During early pregnancy (the first 12 weeks or so), the pseudoephedrine in Advil Cold & Sinus might lead to adverse effects in the fetus. At 20 weeks or later in pregnancy, ibuprofen may harm the fetus. Discuss with your healthcare provider if you are or plan to become pregnant, and weigh the benefits and risks of taking Advil Cold & Sinus during your pregnancy.

Breastfeeding: While ibuprofen is advised to relieve pain and inflammation in breastfeeding parents, pseudoephedrine can cause irritability in nursing infants. Pseudoephedrine may also decrease breast milk supply. Talk with your healthcare provider if you plan to breastfeed, to weigh the benefits and risks of taking Advil Cold & Sinus while nursing and the different ways to feed your baby.

Adults over 65: Caution is advised when taking this product by people age 65 years and older, especially those with kidney or liver concerns. In addition, in older adults, high doses of pseudoephedrine may lead to depression, hallucinations, seizures, and death. Older adults also have a higher risk of stomach bleeding with ibuprofen.

Children: Since Advil Cold & Sinus contains pseudoephedrine, the combination OTC product isn't recommended for children under 12 years old. When taking pseudoephedrine, children may experience agitation, fast heart rate, hallucinations, and sleep troubles. There may be a connection between pseudoephedrine and the unexpected death of children under two years of age.

Kidney or liver problems: If you have kidney and/or liver problems, speak with your healthcare provider first and take Advil Cold & Sinus with caution.

Missed Dose

Advil Cold & Sinus may be taken as needed for no longer than three days if treating a fever, or no longer than seven days if treating nasal congestion. If symptoms persist, the drug should be stopped, and a healthcare provider should be consulted.

Missing a dose doesn't typically cause side effects. If a high dose of Advil Cold & Sinus is taken for long periods, then missed doses might lead to what's known as pseudoephedrine discontinuationor withdrawal symptoms that include depression, hallucinations, and tiredness.

Please take it as soon as you remember. If it's already close to your next scheduled dose, skip the missed dose and take the following dose at your next scheduled dosing time. Don't try to double up to make up for the missed dose.

Overdose: What Happens If I Take Too Much Advil Cold & Sinus?

Although overdose symptoms vary by person, some symptoms may include the following:

  • Anxiety
  • Blood pressure changes
  • Chest pain
  • Coma
  • Concentration difficulties
  • Dizziness
  • Extreme thirst
  • Fast heartbeat
  • Hallucinations
  • Headaches
  • Nausea and vomiting
  • Ringing ears
  • Seizures
  • Sleepiness or sleeping troubles
  • Slowed breathing
  • Urinating difficulties
  • Vision changes

If you experience these symptoms or see someone else experiencing them after taking Advil Cold & Sinus, contact a poison control center immediately. The sooner that overdose symptoms are treated, the less likely complications will occur.

What Happens If I Overdose on Advil Cold & Sinus?

If you think you or someone else may have overdosed on Advil Cold & Sinus, call a healthcare provider or the Poison Control Center (800-222-1222).

If someone collapses or isn't breathing after taking Advil Cold & Sinus, call 911 immediately.

Precautions

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You and your healthcare provider must check your or your child's progress at regular visits to ensure that this medicine is working correctly and for unwanted effects. Regular checks will also allow your healthcare provider to see if your treatment is working properly and to decide if you or your child should continue to use it.

If your or your child's symptoms don't improve within a few days or if they become worse, check with your healthcare provider.

Using this medicine during late pregnancy can harm your fetus. Tell your healthcare provider immediately if you've become pregnant while using the medicine.

Do not take ibuprofen and pseudoephedrine with or within two weeks of taking a drug with monoamine oxidase (MAO) inhibitor activity (e.g., isocarboxazid [Marplan®], phenelzine [Nardil®], procarbazine [Matulane®], selegiline [Eldepryl®], or tranylcypromine [Parnate®]). If you do, you may develop extremely high blood pressure.

This medicine may cause a severe allergic reaction, which can be life-threatening and requires immediate medical attention. Tell your healthcare provider immediately if you have a rash, itching, hoarseness, trouble breathing, trouble swallowing, or any swelling of your hands, face, or mouth after using this medicine.

This medicine may cause bleeding in your stomach or bowels. These problems can happen without warning signs. This is more likely if you have had a stomach ulcer in the past, if you smoke or drink alcohol regularly, are over 60 years of age, are in poor health, or using certain other medicines (e.g., NSAIDs, steroids, blood thinners). Call your healthcare provider immediately if you have severe stomach pain, black, tarry stools, or if you are vomiting blood or material that looks like coffee grounds.

This medicine may increase your risk of heart attack, heart failure, or stroke. This is more likely in people who already have heart disease. People who use this medicine for a long time might also have a higher risk. Some signs of severe heart problems are chest pain or tightness, fast or irregular heartbeat, or unusual flushing or warmth of the skin. Check with your healthcare provider immediately if you notice any warning signs.

Don't take other medicines unless they've been discussed with your healthcare provider. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal (e.g., St. John's wort) or vitamin supplements.

What Are Reasons I Shouldn’t Take Advil Cold & Sinus?

Avoid using it if you're allergic to Advil Cold & Sinus or its ingredients. Ask your pharmacist or healthcare provider for a complete list of the ingredients if you're unsure.

Don't take Advil Cold & Sinus if the following applies to you:

  • Allergic reaction to aspirin, ibuprofen, and similar medications
  • Before or right after heart surgery
  • Children under 12 years old
  • Monoamine oxidase inhibitor (MAOI) medication use within the last 14 days

Advil Cold & Sinus might worsen the following conditions. So, talk with your healthcare provider before taking this OTC product.

What Other Medications Interact With Advil Cold & Sinus?

Use caution when taking the following medications with Advil Cold & Sinus:

  • Alcohol: Mixing alcohol with the pseudoephedrine in Advil Cold & Sinus may lead to psychosis, including hallucinations. Alcohol may also raise stomach bleeding risk due to its interaction with the ibuprofen in Advil Cold & Sinus.
  • Caffeine: Combining caffeine with pseudoephedrine may cause high blood pressure, fast heart rate, high blood sugar, and body temperature.
  • Blood pressure medications: Side effects—like high blood pressure—with pseudoephedrine typically occur within five days of treatment. Therefore, many pharmacists don’t recommend pseudoephedrine for longer than a few days, especially in people with uncontrolled blood pressure. On the other hand, ibuprofen tends to lower the effectiveness of blood pressure medications, such as diuretics (water pills) and angiotensin-converting enzyme (ACE) inhibitors.
  • Lithium: Ibuprofen may lower the kidneys’ ability to clear lithium. Higher amounts of lithium in the body raise the risk of side effects.
  • Monoamine oxidase inhibitors (MAOIs): If you have taken an MAOI within the last 14 days, avoid taking Advil Cold & Sinus. There is a high risk of severe high blood pressure when combining MAOIs with the pseudoephedrine in Advil Cold & Sinus.
  • Medications that affect heart rhythm or raise blood pressure: Since pseudoephedrine may affect heart rhythm and increase blood pressure, pseudoephedrine may have additive effects with medications that have similar effects. Examples of these medications include digoxin, caffeine, green tea, and guarana. 
  • Medications that turn your urine more basic: Medications—like an antacid called sodium bicarbonate— that turn your urine to more basic will make your body hold onto pseudoephedrine. Higher amounts of pseudoephedrine in the body raise the risk of side effects.
  • Methotrexate: Ibuprofen may slow the kidneys’ ability to clear out methotrexate. Higher levels of methotrexate in the body can increase side effects.
  • Tricyclic antidepressants (TCAs): Taking TCAs along with pseudoephedrine raises the risk of high blood pressure and abnormal heart rhythm.
  • Warfarin: There may be a higher bleeding risk when warfarin (brand names Coumadin and Jantoven) is taken with ibuprofen.

Talk with your pharmacist or healthcare provider for more detailed information about medication interactions with Advil Cold & Sinus.

And be sure to talk with your healthcare provider about any other medicines you take or plan to take, including OTC, nonprescription products, vitamins, herbs, or plant-based medicines.

What Medications Are Similar?

In addition to Advil Cold & Sinus, there are other medications that may relieve cold and flu symptoms. Of the available cold and flu medications, the following are the most similar to Advil Cold & Sinus.

  • Aleve (naproxen): Like ibuprofen, naproxen is also an NSAID that may relieve fever, inflammation, and pain symptoms.
  • Tylenol (acetaminophen): Although acetaminophen is thought to work differently than ibuprofen, acetaminophen—like ibuprofen—relieves fever and pain symptoms.
  • Sudafed PE (phenylephrine): Like pseudoephedrine, phenylephrine also helps relieve stuffy nose symptoms.

Since these medications are similar to Advil Cold & Sinus, they’re not typically taken together. There are many cold and flu medications. The best product, however, depends on your symptoms, other medical conditions, and other medicines that you may be taking.

Ask your healthcare provider and pharmacist to help you find the best cold and flu medicine for you. Since some of these cold and flu products may have similar or the exact same components, your pharmacist may also prevent medication duplications.

This list includes drugs also prescribed for the targeted condition(s). It is not a list of medicines recommended to take with Advil Cold & Sinus. It would be best if you did not take some of these drugs together. Ask your pharmacist or a licensed healthcare provider if you have questions.

Frequently Asked Questions

  • Which one is better for cold and flu symptoms: acetaminophen or ibuprofen?

    Both acetaminophen and ibuprofen are effective options to help relieve cold and flu symptoms such as fever and body aches. However, one option may be preferred over the other due to interactions with other drugs you take, your medical conditions, and side effects experienced. 
    Some people switch back and forth between taking acetaminophen and ibuprofen every four to six hours. Combining acetaminophen and ibuprofen, however, may raise the risk of stomach bleeds.

  • Which one is better for cold and flu symptoms: ibuprofen or naproxen?

    Since ibuprofen and naproxen are both NSAIDs, they are effective in relieving fever and pain symptoms. One option, however, may be preferred over the other due to dosing preferences and side effects.

  • Which one is better for cold and flu symptoms: phenylephrine or pseudoephedrine?

    Although Sudafed (phenylephrine) and pseudoephedrine are OTC options that may relieve a stuffy nose, many people prefer the more effective pseudoephedrine. Since pseudoephedrine has unfortunately been used to make the illegal drug meth, purchasing this medicine can involve more steps compared to phenylephrine.

How Can I Stay Healthy While Taking Advil Cold & Sinus?

To stay healthy while you’re not feeling well, it is essential to take Advil Cold & Sinus, as directed by your healthcare provider.

Since there are so many OTC medications to help relieve cold and flu symptoms, consider talking with your pharmacist to prevent taking several doses of the same type of drug, limit drug interactions, and find the best product for you based on your symptoms, medical conditions, and other medications that you may take. 

While taking Advil Cold & Sinus, notify your healthcare provider if you experience any of the following:

  • Cold and flu symptoms that worsen or that don’t go away
  • Dizziness
  • Fever that worsens or lasts more than three days
  • Nervousness
  • New symptoms
  • Redness or swelling in a painful area
  • Sleep troubles
  • Stuffy nose that lasts more than seven days

Since the common cold and flu are contagious, consider the following measures to prevent getting or spreading the cold or flu:

Medical Disclaimer

Verywell Health's drug information is meant for educational purposes only and is not intended to replace medical advice, diagnosis, or treatment from a healthcare provider. Consult your healthcare provider before taking any new medication(s). IBM Watson Micromedex provides some of the drug content, as indicated on the page.

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By Ross Phan, PharmD, BCACP, BCGP, BCPS
Ross is a writer for Verywell with years of experience practicing pharmacy in various settings. She is also a board-certified clinical pharmacist and the founder of Off Script Consults.