Paracetamol: Uses, Dose, Side Effects and Top Brands in India (2026)

• Updated 9 October 2026
• Reviewed by Sudhanshu Singhal
• 24 min read
• 49 sources

Top brands in India at a glance

The company names, pack details and MRPs in this table are as shown by Tata 1mg, an Indian e-pharmacy, read on 9 October 2026, and the site itself states that MRP may vary by batch — the price printed on the pack you buy is what governs, and prices change over time.

What is paracetamol (acetaminophen)?

Paracetamol is a single, mild pain reliever and fever reducer, and acetaminophen is simply the other international name for the same drug (chemical name N-acetyl-p-aminophenol, ATC code N02BE01). The US FDA-approved label calls it "a non-salicylate antipyretic and non-opioid analgesic agent", and the UK product information for paracetamol 500 mg tablets describes it as "a mild analgesic and antipyretic", recommended for most painful and febrile conditions. The World Health Organization lists it as "Paracetamol (acetaminophen)" on its Essential Medicines List, first added in 1977.

How it works

The exact mechanism "is not fully understood", as the UK product information states. It may act mainly by inhibiting prostaglandin synthesis in the central nervous system and, to a lesser extent, peripherally, while the fever-lowering effect is probably central, acting on the hypothalamic heat-regulating centre.

Paracetamol is absorbed from the gut, with a peak blood level about 30 minutes to 2 hours after a dose. Between 90% and 95% is metabolised in the liver, and its elimination half-life is about 1 to 4 hours.

It has only weak anti-inflammatory properties and is not recommended for anti-inflammatory use. The UK product information says it "has only weak anti-inflammatory properties", and the WHO list notes "Not recommended for anti-inflammatory use due to lack of proven benefit to that effect." Unlike salicylates, the same product information says it "does not cause gastric irritation or bleeding".

Forms and strengths sold in India

India's National List of Essential Medicines (NLEM 2022, item 2.1.5) lists paracetamol as a tablet 500 mg and tablet 650 mg; oral liquids 120 mg/5 mL, 125 mg/5 mL and 250 mg/5 mL (marked as paediatric); injection 150 mg/mL; and suppositories 80 mg and 170 mg, available at primary, secondary and tertiary care levels.

Product pages on Tata 1mg, read on 9 October 2026, show these forms actually on sale: tablets of 500 mg, 650 mg and 1000 mg; oral suspensions of 120 mg/5 ml, 125 mg/5 ml and 250 mg/5 ml in 60 ml bottles; drops of 100 mg/ml in 15 ml; and an intravenous infusion of 1000 mg in 100 ml (that is, 10 mg/ml).

A note on strength confusion: the WHO list observes that "the presence of both 120 mg/5 mL and 125 mg/5 mL oral liquid strengths on the same market would cause confusion in prescribing and dispensing and should be avoided", and a 2014 letter in Indian Pediatrics records several concentrations in India and states that the authors' hospital uses only one strength (125 mg/5 mL) to prevent overdose. Always read the strength printed on the bottle before measuring a dose.

Paracetamol in combination products

Paracetamol is often sold with other ingredients, and the NHS warns that many cold and flu remedies contain paracetamol, so taking one of these with a plain paracetamol tablet can lead to an accidental overdose. In the intravenous form, the US label lists use together with opioid pain medicines for moderate to severe pain in adults and children 2 years and older. The Indian Academy of Pediatrics notes that a paracetamol plus ibuprofen combination "has not been proven to affect the overall outcome" of fever and that combination drugs "have more side effects than individual drugs".

What is it used for?

Labels state that paracetamol is used for mild to moderate pain and for reducing fever, with the exact list varying slightly between products and countries.

• UK 500 mg tablet product information: headache including migraine, toothache, neuralgia, colds and influenza, sore throat, backache, rheumatic pain and dysmenorrhoea.
• UK 120 mg/5 mL suspension product information: "for the treatment of mild to moderate pain, including headache, migraine, neuralgia, toothache, sore throat, period pains, aches and pains" and "for the reduction of fever and to be used as an adjunctive treatment to relieve symptoms of cold and flu".
• NHS (adults): a painkiller for pain and high temperature, used for headaches, cold or flu symptoms such as a high temperature, toothache and sore throat.
• NHS (children): pain such as aches, teething, earache, sore throat, cold or flu pain, and discomfort from a high temperature.
• US over-the-counter 500 mg label: temporarily relieves minor aches and pains due to the common cold, headache, backache, minor pain of arthritis, toothache, muscular aches, and premenstrual and menstrual cramps; and temporarily reduces fever.
• Intravenous form (UK infusion product information): short-term treatment of moderate pain, especially following surgery, and short-term treatment of fever, when the intravenous route is clinically justified by an urgent need or other routes are not possible.

It is not recommended for anti-inflammatory use, and the Indian Academy of Pediatrics explains that "the purpose of fever medicine is not to bring down the temperature to normal level, but to provide symptomatic relief to child by reducing pain and discomfort" — for example a fever of 104 F may come down to 101 F.

Dose as stated in the labels

The dose differs with age, body weight, product strength and country label, so always use the regimen stated in the pack in your hand and follow your doctor's advice. The regimens below are quoted from the labels and guidelines named, for information only — never start, change or repeat a dose on your own.

Adults — UK labels (NHS and product information)

The NHS adult page states, for 500 mg tablets or capsules, 1 or 2 per dose at least 4 hours apart, to a maximum of 8 in 24 hours; for 1 g tablets, one at a time with a maximum of 4 in 24 hours; and for liquids, 10 to 20 ml of a 250 mg/5 ml liquid or 5 to 10 ml of a 500 mg/5 ml liquid per dose, at least 4 hours apart, with a maximum of 4 doses in 24 hours. It adds that if you weigh less than 50 kg you may need a lower dose, and that you should not take it for more than 3 days unless a doctor tells you to.

The UK 500 mg tablet product information states, for adults, the elderly and those over 16 years, two tablets every four hours as required, not more than eight tablets in 24 hours and no more than four doses in any 24 hours, and not for more than 3 days without consulting a doctor. For children 10 to 15 years it states one tablet every four to six hours when necessary, maximum four doses in 24 hours, and it is not recommended below 10 years of age.

Adults — US labels

The US over-the-counter 500 mg label states, for adults and children 12 years and over, 2 caplets every 6 hours while symptoms last, not more than 6 caplets in 24 hours unless directed by a doctor, and not for more than 10 days unless directed by a doctor. The US 650 mg extended-release label states 2 caplets every 8 hours, not more than 6 caplets in 24 hours, swallowed whole, with under-18s told to ask a doctor. The FDA consumer page says total acetaminophen in 24 hours should not exceed 4,000 mg for adults and children 12 years and older, counting all products.

No official Indian package insert for a 650 mg tablet could be verified for this guide, so for the 650 mg strength please follow the leaflet in your own pack and your doctor's instruction.

Children

The Indian Academy of Pediatrics states that the correct paediatric dose is 15 mg per kg of body weight, repeated after 4 to 6 hours if required (never more doses in 24 hours than the product allows; confirm the dose and schedule with a doctor or pharmacist), and that parents should "avoid overdosing if the fever does not normalize". It adds that children's medicines are dosed by body weight, that "different brands may have different formulation and strength of medicine", which should be confirmed with the pharmacist before buying, and that a doctor may use a rectal suppository when a child cannot take the medicine by mouth.

The NHS children's liquid doses, kept as the page states them, are set out below. From 3 months, doses are up to 4 in 24 hours and at least 4 hours apart (babies of 2 to 3 months have the lower limit shown in the table), and the medicine should not be given for more than 3 days without speaking to a doctor or pharmacist.

The UK 120 mg/5 mL suspension product information gives slightly different age bands from the NHS table, which shows why the pack in your hand governs; it also states that the medicine should not be given to babies less than 2 months of age. The FDA adds that an adult product should not be used for a child under 12 years old and that more than one acetaminophen product should not be given at a time.

Intravenous infusion

Intravenous paracetamol is given only by healthcare professionals on a doctor's order, never as self-treatment; the label figures below are for information. The UK infusion product information states that it is given as a 15-minute infusion, with at least 4 hours between doses and no more than 4 doses in 24 hours (6 hours minimum in severe renal insufficiency), and it sets out weight-banded doses from 7.5 mg/kg up to 1 g per dose, each band with its own daily maximum (over 50 kg with no extra liver risk: 1 g per dose, no more than 4 g a day). The US intravenous label states, for adults and adolescents 50 kg and over, 1000 mg every 6 hours or 650 mg every 4 hours, maximum single dose 1000 mg and maximum 4000 mg per day from all routes. Both labels warn that confusing milligrams with millilitres "could result in accidental overdose and death".

Rules every label repeats

• Never exceed the recommended dose, and do not take it with any other paracetamol-containing product (UK product information).
• Check every other medicine — many cold and flu remedies contain paracetamol (NHS), and the US label says do not use with any other drug containing acetaminophen.
• Stop and ask a doctor if pain gets worse or lasts more than 10 days, or fever gets worse or lasts more than 3 days (US label); MedlinePlus adds, for children, pain lasting more than 5 days.

Side effects

The NHS states that paracetamol very rarely causes side effects when taken correctly, but serious reactions are possible and overdose can damage the liver.

Reactions that need urgent medical help

The NHS lists rare serious effects as an allergic reaction (swollen throat or tongue, raised itchy rash, difficulty breathing), liver problems (feeling sick, yellowing of skin or eyes) and blood cell problems (easy bruising, nosebleeds). The FDA states that acetaminophen "is associated with a risk of rare but serious skin reactions", naming Stevens-Johnson syndrome, toxic epidermal necrolysis and acute generalized exanthematous pustulosis, "which can be fatal"; you should stop the medicine at the first sign of a rash and seek help, and should not take acetaminophen again after a serious skin reaction. MedlinePlus lists these warning signs: red, peeling or blistering skin, rash, hives, swelling of the face, throat or lips, trouble breathing or swallowing, yellow skin or eyes, upper belly pain, dark urine and pale stools.

Overdose and the liver

US labels state that severe liver damage may occur above 4,000 mg of acetaminophen in 24 hours (500 mg product) or above 6 caplets in 24 hours (650 mg extended-release product, 3,900 mg), with other acetaminophen products, or with 3 or more alcoholic drinks every day. The UK 500 mg tablet product information states that liver damage is possible in adults who have taken 10 g or more, and that 5 g or more may cause damage in people with risk factors such as long-term enzyme-inducing medicines (carbamazepine, phenytoin, rifampicin or St John's Wort), regularly drinking more alcohol than recommended, or low glutathione levels from starvation or eating disorders. In children, the UK intravenous product information warns that 140 mg/kg in a single administration can cause hepatic cytolysis likely to cause complete, irreversible liver necrosis.

Early overdose symptoms in the first 24 hours include pallor, nausea, vomiting, loss of appetite and abdominal pain, while liver damage "may become apparent 12 to 48 hours after ingestion". Treatment is urgent hospital referral and the antidote N-acetylcysteine, "even in the absence of significant early symptoms", and the US label stresses that "quick medical attention is critical for adults as well as for children even if you do not notice any signs or symptoms".

Who should not take it, and interactions

Paracetamol should not be used by anyone allergic to it, and it needs care in liver or kidney disease, in heavy alcohol use, in people below 50 kg body weight and alongside certain medicines including warfarin.

Who should be careful

• Allergy: the UK product information contraindicates use in people with hypersensitivity to the active substance or its excipients.
• Liver and kidney: the NHS says it may not suit people with a kidney or liver condition; the UK tablet information advises care in severe renal or severe hepatic impairment; the paediatric suspension information contraindicates severe hepatic dysfunction; the US intravenous label contraindicates severe hepatic impairment or severe active liver disease and advises caution in alcoholism, chronic malnutrition, severe dehydration and severe renal impairment.
• Alcohol: US labels carry a liver warning for "3 or more alcoholic drinks every day while using this product". The NHS says you can eat and drink normally, including alcohol, but that it may not be suitable if you depend on alcohol or binge drink — the two sources word this differently.
• Other conditions: the UK infusion information advises caution in G6PD deficiency and a reduced dose with longer intervals in severe renal impairment; the NHS notes that people under 50 kg may need a lower dose.
• Age: the UK 500 mg tablet is not recommended under 10 years, the suspension is not for babies under 2 months, and the US 650 mg product says under-18s should ask a doctor.

Key interactions

A notable interaction is with warfarin: the UK product information states that the anticoagulant effect of warfarin and other coumarins "may be enhanced by prolonged regular daily use of paracetamol with increased risk of bleeding; occasional doses have no significant effect", and the US intravenous label reports raised INR in some patients stabilised on warfarin after chronic oral use of 4000 mg per day. The NHS lists other paracetamol-containing medicines, metoclopramide, domperidone and flucloxacillin among medicines that may not mix well with it.

Further interactions noted in the product information include metoclopramide or domperidone speeding paracetamol absorption, cholestyramine reducing absorption, probenecid roughly halving paracetamol clearance, enzyme-inducing medicines raising the liver-toxic potential, and flucloxacillin being linked to a risk of metabolic acidosis.

Pregnancy and breastfeeding

The NHS states that if you are pregnant, paracetamol "is usually the best painkiller to use" and "does not harm your baby", and that it is usually the best painkiller while breastfeeding. The UK regulator (MHRA), on 22 September 2025, said "There is no evidence that taking paracetamol during pregnancy causes autism in children", recommended it as the first-choice painkiller in pregnancy at the lowest dose for the shortest duration, and noted that untreated pain and fever "can pose risks to the unborn baby".

The UK product information states that a large amount of data on pregnant women indicates neither malformative nor feto/neonatal toxicity, that studies on neurodevelopment in children exposed in the womb "show inconclusive results", and that if it is clinically needed it should be used at the lowest effective dose for the shortest possible time and the lowest possible frequency; it adds that paracetamol is excreted in breast milk "but not in a clinically significant amount". The US FDA, on 22 September 2025, began a process to change acetaminophen labelling, stating that an association has been described in many studies but "a causal relationship has not been established", and noting that acetaminophen is the only over-the-counter drug approved for treating fever in pregnancy. In every case the advice is the same: use the lowest dose for the shortest time, and discuss it with your doctor.

Rules in India

In India, plain paracetamol tablets are named in Schedule K of the Drugs and Cosmetics Rules, 1945 as a household remedy in limited situations, paracetamol is on NLEM 2022, and the NPPA fixes ceiling prices for the listed forms.

In the consolidated Drugs and Cosmetics Rules, 1945 (as amended up to 30 September 2020), paracetamol is named only in Schedule K, item 13(2) "Paracetamol Tablets", exempt from the sale-licence requirement under conditions: sold only in a village with a population of not more than one thousand where there is no licensed dealer; containing nothing from Schedules G, H or X; and sold in original unopened containers of licensed manufacturers. In that text paracetamol is not named in Schedule H, G or X, so plain tablets are not listed as prescription-only there — but combination products and later amendments were not checked, so read your pack and follow your doctor.

NLEM 2022, notified as Schedule I of the Drugs (Prices Control) Order, 2013 by S.O. 5249(E) in the Gazette of India Extraordinary dated 11 November 2022, lists paracetamol at item 2.1.5 (tablet 500 mg and 650 mg; oral liquids 120, 125 and 250 mg/5 mL; injection 150 mg/mL; suppositories 80 mg and 170 mg) at primary, secondary and tertiary levels, and also under 5.2.3 (antimigraine medicines) and 27.4 (medicines for COVID-19 management).

NPPA revises these ceiling prices every year; the 2026 revision is S.O. 1575(E) of 25 March 2026, in force from 1 April 2026. Ceilings exclude taxes, and the official figure for each form is in that Gazette notification and on NPPA's Pharma Sahi Daam service. NPPA's own historical table shows how they move: the 500 mg tablet ceiling was ₹0.94 in 2013 and ₹1.00 in 2014. 650 mg was recognised as a separate scheduled strength in a Department of Pharmaceuticals order of 22 December 2016. No ceiling was found for the 10 mg/mL infusion, which is not named in NLEM 2022.

Top brands in India

Examples of paracetamol brands in India include Dolo, Crocin, Calpol, Pacimol, Dolopar, P-650, Febrex and ParaCIP, sold as tablets, suspensions, drops and infusions — the pack and MRP details are in the table at the top of this page.

Published sales data covers only one segment. IQVIA SSA data reported by Medical Dialogues (published 1 September 2025) puts DOLO-650 (Micro Labs) first within the paracetamol 650 mg segment, with ₹311.7 crore in MAT July 2025 and about a 50% share, and CALPOL next at ₹135.4 crore, in a segment worth ₹624.2 crore. Earlier IQVIA data reported by ThePrint (15 January 2022) recorded Dolo 650 sales of ₹567 crore since March 2020. No named published sales source was found ranking Crocin, Pacimol, P-650, Febrex or ParaCIP, so no rank is stated for them.

The Vibcare range

Vibcare Pharma supplies paracetamol across five strengths and forms — 500 mg and 650 mg tablets, 250 mg suspensions, paracetamol drops and a 1000 mg/100 ml intravenous infusion — from four of its divisions (Evermed, Medanor, Auspin and Prima), covering 15 product variants.

The same range is available to Vibcare's PCD franchise partners, one partner per district, with monopoly rights confirmed in writing.

Vibcare Pharma Pvt Ltd works from its corporate office at Panchkula, Haryana, with commercial operations since 2015 and more than 5,000 partners across 11 divisions. To start a franchise you need a wholesale drug licence and GST registration.

Frequently asked questions

Sources

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