Paracetamol: Dose and side effects of Dolo-65

When it comes to fever and pain in any part of the body, Dolo-650 is India’s go-to medicine. While some take it after consulting a doctor, others pop it without checking with a medical expert. The paracetamol-based tablet became a household name after Covid-19 struck people across the globe. It is in the news again, thanks to a US-based doctor who pointed out Indians’ dependence on the medicine. His viral social media post has put the spotlight on the medicine and potential side effects of consuming it frequently. Read on to know the side effects of paracetamol.

What does the viral post say?

Earlier this week, Dr Palaniappan Manickam, a US-based Indian-origin gastroenterologist and health educator, took to social media to talk about the widespread use of Dolo-650 in India. In a post on X, he wrote, “Indians take Dolo 650 like it’s Cadbury Gems.”

Over 25,000 people have liked the post, with one saying, “My mom takes it twice a day if she feels even a slight fever (sic).” Most people laughed it off, but there were some who wanted to know about the side effects of taking the medicine frequently.

Check out his post

His remark actually highlights a real concern. “Many people in India self-medicate with Dolo-650 without consulting doctors, often taking it for minor discomforts or as a go-to solution for any illness,” says internal medicine expert Dr Vikram Jeet Singh. He notes that it is a relatively safe medicine, but excessive or careless use can be harmful. “So yes, to a large extent, the statement is accurate in describing the overuse and casual attitude many Indians have towards Dolo-650,” he says.

What is paracetamol or Dolo-650?

It is a painkiller, which is widely used to treat body aches and reduce a high temperature. It is also combined with other painkillers, and is used in cold and flu remedies, according to the UK’s National Health Service. Dolo-650 is a paracetamol-based white-coloured tablet that became popular in India during the Covid-19 pandemic, which started in 2020. Around 350 crore Dolo-650 tablets were sold during the pandemic period, as per research published in Annals Of Medicine And Surgery. “It is a commonly used over-the-counter medicine in India for relieving fever and mild to moderate pain,” says Dr Singh.

What are the uses of paracetamol or Dolo-650?

This medicine is primarily used for:

• Fever reduction: It helps lower temperature of the body during fever caused by infections or other conditions.
• Pain relief: It relieves headaches, muscle aches, joint pain, toothaches and back pain. “It can also be used to get relief from post-surgical pain,” says the expert.
• Viral infections: It is commonly used during viral fevers, such as dengue or Covid-19, to manage the symptoms.

“Paracetamol or Dolo-650 works by inhibiting the production of prostaglandins (hormone-like substances) in the brain that cause fever and pain,” shares Dr Singh.

Dose of paracetamol or Dolo-650

It is an effective medicine, but the dose matters:

• Recommended adult dose: Adults can take 650 mg of paracetamol of Dolo-650 every 4 to 6 hours as needed. “But it should not be more than 4000 mg (i.e. 6 tablets) in 24 hours,” says the expert.
• Children’s dose: It depends on the weight and age of the child. “There are pediatric formulations that should be used,” says the expert.

“This type of medicine should not be taken for more than 3 days for fever or 5 days for pain without a doctor’s advice,” says the expert.

What are its side effects of paracetamol or Dolo-650?

In the case of an overdose, it can lead to side effects like:

1. Liver damage

Dolo-650 is metabolised by the liver then the products are eliminated in the pee. “So, high doses of this medicine over time can damage the liver,” says Dr Singh. This is particularly a common side effect in people who already have a liver condition.

2. Nausea

When you feel uneasy in the stomach and feel like throwing up, it means you are nauseous. It can be due to pregnancy, travelling by plane or other reasons. Having Dolo-650 can also be one of the reasons. It can occur with higher doses or if taken without food. During a study published in the British Journal Of Clinical Pharmacology, paracetamol use was associated with nausea.

3. Low blood platelets

Low platelet level or thrombocytopenia is one of the potential side effects of Dolo-650. “This side effect due to an overdose is rare, but it is possible. It can lead to easy bruising or bleeding,” says the expert.

4. Kidney damage

Popping pills is not good for your health. If you have Dolo-650 for a long time, it can affect your kidneys. “Prolonged overuse can affect kidney function, especially in people with pre-existing kidney disease,” says the expert. It may affect your urine output and make you feel tired.

5. High blood pressure

Hypertension or high blood pressure may be one of the side effects of Dolo-650. During a study, published in The BMJ, participants who consumed paracetamol (4 grams daily) saw an increase in their blood pressure.

Who should avoid paracetamol or Dolo-650?

People who should avoid or use it cautiously include:

• Liver disease patients: The medicine is metabolised by the liver; so even small doses can worsen liver issues.
• Chronic alcoholics: Alcohol plus paracetamol increases liver toxicity risk.
• People allergic to paracetamol: Though rare, allergic reactions can be severe.
• Severe kidney disease patients: It may damage the kidneys.
• Those already taking other paracetamol-containing drugs: In such cases, there is a risk of accidental overdose.

Dolo-650 or paracetamol may seem like a solution for health problems like fever and pain. However, know the dose and make sure not to use it for long. The medicine comes with a set of side effects.