Indians pop paracetamol like candies. A social media post to this effect by a US doctor on Wednesday elicited several humorous reactions from netizens, but it also raised questions on the use of paracetamols, the safety limit and whether other doctors also believe Indians abuse the use of paracetamols.

The post by Palaniappan Manickam, a gastroenterologist and health educator, on X raised questions about the use of paracetamol in a country where often the slightest hint of fever or headache is followed by the use of these medicines. Check out his post below:

Indians take Dolo 650 like it’s cadbury gems
— Palaniappan Manickam (@drpal_manickam) April 14, 2025

So what do experts say? Dr Shiba Kalyan Biswal, Clinical Director- Pulmonology, Marengo Asia Hospitals, Gurugram, shares his insights.

Do Indians Overuse Paracetamol?

Unfortunately, yes, says Dr Shiba Kalyan Biswal. He explains, “Most Indians are prone to overusing paracetamol for instant relief from fever or pain without medical guidance. It’s readily available over the counter and is hence often self-medicated. Excessive consumption, though, damages the liver and suppresses critical ailments. Awareness regarding its risks and safe use is needed to avoid long-term health problems.”

What Is Excessive Use Of Paracetamol: The Safe Limit

The safe dose for adults is a maximum of 4 grams of paracetamol per day, says Dr Biswal. However, the doctor adds that taking it for over 10-15 days a month or taking high doses regularly is overuse. “Exceeding this can increase the risk of liver and kidney damage. In chronic conditions, the dosage should be spaced out and under the supervision of a doctor to prevent toxicity, says Dr Biswal.

Impact Of Paracetamol Overuse And Why Self-Medication Is Risky

Paracetamol overuse results in liver injury, kidney failure, gastrointestinal disturbance, thrombocytopenia, and hypersensitivity reactions, says Dr Biswal. “It might also suppress the presence of dangerous underlying illnesses when used regularly. Prolonged or high-dose therapy may exhaust the liver’s function in metabolising the drug, which leads to toxicity. Symptoms develop late in most cases, which makes it difficult to diagnose early. Thus, self-medication without a medical prescription is risky,” says Dr Biswal.

I Don’t Have Fever, But A Headache. Is Paracetamol Consumption Safe?

Yes, it’s generally safe to take paracetamol on occasion for headaches without fever, particularly if the headache is mild to moderate, says Dr Biswal. “Still, it’s not to be taken continuously as a first-line painkiller without seeing a doctor about frequent headaches. Long-term use without a doctor’s visit could lead to dependency and strain on organs. With recurrent headaches, it’s advisable to consult a doctor to eliminate migraines or other underlying conditions,” Dr Biswal adds.

Consuming Paracetamol: Dos And Don’ts

Dr Biswal points out that it’s necessary to always have paracetamol with water or food to minimise the chance of stomach upset. “Care should be taken to strictly adhere to the recommended dosage guidelines as indicated by a doctor. Other medicines you may be consuming must also be carefully checked, since several cold, flu, or analgesic medicines contain paracetamol as well, so unintended overdose is always a probable danger. Use paracetamol only when needed, and not as an informal or routine remedy for any pain.”

The doctor also insists that one must never go over the daily dose limit of 4 grams since it can cause extensive liver damage. “Do not use paracetamol along with alcohol, as both can strain the liver and pose toxicity risks. Do not take it day after day for extended periods without a doctor’s intervention, as it might mask more severe underlying complications. Do not take it for ill-defined symptoms or minor pain unless instructed,” Dr Biswal adds.