For most Indian households, paracetamol is as common as kitchen salt. Whether it’s Dolo 650 or Crocin, these tablets are taken for fevers, body aches, headaches, sinus discomfort, and even post-vaccine blues.
So, are we consuming these pills too casually? The short answer: Yes. And the consequences can be more serious than many realise.
Recently, a tweet by US-based gastroenterologist Dr Palaniappan Manickam, popularly known as Dr Pal, stirred up the Internet. “Indians take Dolo 650 like it’s Cadbury Gems,” he wrote, echoing a truth many know but few question. The viral tweet became a mirror to our growing dependency on paracetamol—and raised urgent questions about its risks when taken too frequently.
According to Dr Kapil Adwani, clinical pharmacist, Drug Information Centre, Kokilaben Dhirubhai Ambani Hospital, “People pop paracetamol thinking it’s completely harmless because it’s available over-the-counter. But the body remembers. Regular intake can silently damage the liver, strain the kidneys, and even mess with your blood pressure.”
An overdose of paracetamol can severely damage the liver, potentially leading to acute liver failure.
Why this ‘safe’ pill can be dangerous
Paracetamol is one of the most widely used medications in the world. The adult upper limit is four grams per day (roughly eight 500-mg tablets). But that’s a daily maximum, not a suggestion for daily use. Unfortunately, many take it multiple times a week without giving it much thought.
As per a 2019 study, long-term use—even within recommended limits—can increase liver enzyme levels, indicating liver stress. Liver damage is a serious risk for people who drink alcohol, have pre-existing liver conditions, or are underweight.
A 2022 study revealed that two weeks of paracetamol at 4g/day raised blood pressure in those with existing hypertension, according to Dr Adwani. He quoted an older 2015 study also linked regular use (two–four g/day) to stomach upset, and doses over three grams were associated with a higher risk of gastric bleeding.
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More alarmingly, long-term usage has now been connected to higher chances of heart attacks and strokes, especially in people with heart conditions. Kidney damage is another hidden risk, confirmed by research in 2019.
Who should be extra cautious?
While paracetamol seems universally safe, certain groups need to tread with caution:
- People with liver disease or those who consume alcohol frequently: even normal doses can be risky.
- Underweight individuals (<50 kg): standard doses may be excessive.
- People with kidney conditions: more prone to cumulative damage.
- Pregnant women: prolonged use has been associated with potential risks to the baby’s heart development (2019 study).
- Patients on blood thinners (like warfarin): long-term use may raise bleeding risk.
If you’re managing long-term pain, explore safer, non-pharmaceutical options
The hidden doses in everyday medicines
One big issue in India is hidden paracetamol. It’s included in many cold and flu meds, so without realising, you may be doubling or tripling your daily dose. According to a 2021 review, Dr Adwani said paracetamol doesn’t even work well for chronic issues like back or joint pain—yet people continue using it for these conditions, ignoring better alternatives.
So, what should you do? Dr Adwani advises, “Only take paracetamol when you really need it. For most common fevers and aches, rest, hydration, or even herbal teas can be enough.”
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If you’re managing long-term pain, explore safer, non-pharmaceutical options: physiotherapy, yoga, gentle exercise, or doctor-approved supplements. Always read medication labels and consult your doctor if you’re already managing other health conditions.
So the next time you reach for that Dolo strip, pause. Ask yourself: Do I really need this? Or is my body asking for something else entirely—like rest, water, or patience?
DISCLAIMER: This article is based on information from the public domain and/or the experts we spoke to. Always consult your health practitioner before starting any routine.
