Responsible Med Use: Things To Know About Dolo Before Popping It Like Candy

In India, Dolo 650 has become near-ubiquitous in medicine cabinets, pharmacy strips and WhatsApp memes. A banner pill that promises fast relief of fever and pain, it earned such popularity during the COVID-19 pandemic that some doctors warned people were treating it like "candy". However, this convenience comes with responsibility. Paracetamol (acetaminophen), the active ingredient in Dolo 650, is safe when used correctly, but misuse, overuse or incorrect dosing can lead to serious health consequences, including liver failure.

With guidelines tightening and newer evidence emerging on long-term risks, it's time for every Indian adult to pause before popping Dolo or paracetamol at the first sign of a headache. Here's how Dolo 650 works, when it's appropriate, how much is safe, and what hidden dangers you should be aware of so you can use it wisely, not reflexively.

What is Dolo 650 and how does it work?

Dolo 650 is a brand-name tablet containing 650 mg of paracetamol (acetaminophen), manufactured by Micro Labs in India. Paracetamol is widely used as a fever-reducer (antipyretic) and pain-reliever (analgesic). Unlike non-steroidal anti-inflammatory drugs (NSAIDs), it has minimal anti-inflammatory effect, but it acts centrally in the brain to block release of prostaglandins that trigger pain and reduce the hypothalamic set-point to control fever.

Why it became so common in India

During the COVID-19 waves and vaccination drives, Dolo 650 played a starring role as it was widely recommended for post-vaccination fever and body aches. India sold more than 350 crore tablets of Dolo 650 in recent years. Its OTC availability, low cost and trusted brand status propelled usage, but also the risk of casual, unsupervised consumption.

What the safe dosage and official guidelines are

Standard guidance in India and internationally for paracetamol is:

One tablet every 4 to 6 hours as needed, up to maximum 4000 mg (i.e., around six tablets of 650 mg) per day for adults. But in India, some sources now recommend a maximum of 600 mg per day (i.e., four tablets of 650 mg) as safer under local conditions.

Crucially, you must always check if you are also taking other medicines that contain paracetamol because combining them can push you into overdose territory.

Hidden risks of paracetamol and why it's not "just a pill"

While paracetamol is widely considered safe when used properly, there are notable risks:

• Liver toxicity: The liver metabolises paracetamol; overdose leads to accumulation of a toxic metabolite (NAPQI) that can destroy liver cells and cause acute liver failure. India has recorded such cases.
• Chronic use harms: A review found long-term paracetamol use associated with increased risk of gastrointestinal bleeding, small rises in blood pressure (4 mmHg), and kidney damage. 
• Masking serious illness: Regular use to suppress fever or pain may delay diagnosis of underlying infections or inflammatory conditions. As one Indian doctor put it, "It's not a candy."

Important cautions: When you should be especially careful

If you have any or all of the following conditions, you should be very cautious about paracetamol use.

• Alcohol and liver disease: Combining paracetamol with alcohol or in the presence of liver disease multiplies risk of damage.
• Kidney disease or malnutrition: Both conditions reduce metabolism of drugs and increase vulnerability.
• Other medications: If you're on blood-thinners (e.g., warfarin), or anti-epileptics, or taking multiple analgesic preparations, you need medical supervision.

When to use paracetamol, and when not to

• Use paracetamol 650 for short-term relief of fever, headache, body aches, post-immunisation discomfort or mild pain. Do not consume more than 3 a day without a doctor's guidance.
• However, if symptoms persist for more than 3 days, or you have high fever, unexplained pain, jaundice (yellow skin/eyes), dark urine, or you are using it regularly, stop self-medicating and consult a doctor.

Dolo or paracetamol 650 is a reliable, effective medication for fever and pain relief, but like any medicine, it demands respect. In India, the culture of popping it "just in case" or for trivial discomfort has created a false sense of ease. While safe when used correctly, it is not a candy, nor a substitute for professional diagnosis. Know the dose limits, don't stack multiple paracetamol-containing products, avoid alcohol if you are using it, and if you're using it frequently or for long periods you need a doctor's check-up. By treating it with caution, you harness its benefits without falling into unnecessary risk. Your liver, kidneys, and your health, deserve nothing less.

Disclaimer: This content including advice provides generic information only. It is in no way a substitute for a qualified medical opinion. Always consult a specialist or your own doctor for more information. NDTV does not claim responsibility for this information.