US doctor warns against using DOLO-650, says it is not a 'candy': Liver, kidney-related side effects to know

Dolo-650. A name that rings louder than most medicines in Indian households. Whether it's a mild fever, a headache, even a bodyache or fatigue, this tiny white pill has been the nation’s go-to remedy. But there lies a story of overuse, misuse, and ignored warnings: One that doctors now believe needs urgent attention.

When a doctor's tweet sparked a debateIt took just one tweet to shine a spotlight on India’s pill-popping culture. US-based gastroenterologist Dr Palaniappan Manickam, also known as Dr Pal, tweeted, “Indians take Dolo-650 like it’s Cadbury Gems.” It was funny, yes—but also deeply true.

Indians take Dolo 650 like it's cadbury gems

— Palaniappan Manickam (@drpal_manickam) April 14, 2025

The tweet went viral, and with it came thousands of confessions: people admitting to taking Dolo-650 not just for fever, but for tiredness, stress, or “just in case.” What began as a humorous comment quickly turned into a serious conversation.

Manufactured by Micro Labs Limited, Dolo-650 contains 650 mg of paracetamol—higher than the commonly known 500 mg dose. It became a household name during the COVID-19 pandemic, when people were advised to take paracetamol to manage vaccine side effects or mild symptoms.

According to healthcare research firm IQVIA, Dolo-650 sales skyrocketed during the second wave of COVID-19. Its popularity even sparked social media memes, with people calling it “India’s favourite snack.”

But what many don’t realise is that frequent, unsupervised use of paracetamol can have serious consequences, especially on the liver.

What the doctors are saying: Not a candy, not harmless


Dr Pal, despite his humorous approach, gave a stark warning: That it’s not a candy. Frequent use can mask symptoms and delay proper diagnosis.


According to a review, paracetamol overdose remains a leading cause of acute liver failure globally. The liver’s job is to break down toxins—including medications. But too much paracetamol overwhelms it, leading to toxicity, inflammation, and in severe cases, liver failure.


In 2022, a Public Interest Litigation (PIL) filed in the Supreme Court by the Federation of Medical and Sales Representatives Association of India accused the makers of Dolo-650 of distributing freebies worth ₹1,000 crore to doctors to promote the pill.

Even Justice D.Y. Chandrachud commented, “I was also asked to have the same when I had COVID. This is a serious issue.”

Self-medicating with painkillers can blur the lines between minor and serious symptoms. It might offer temporary relief but hides what’s actually happening inside the body. Fever, for example, is a sign of infection. Suppressing it without treating the root cause can delay treatment—and worsen outcomes.