This is what happens to the body when you have paracetamol on an empty stomach for fever

People tend to pop paracetamol thinking it’s completely harmless because it’s available over-the-counter -- but the body remembers.

Should you have paracetamol on empty stomach? (Source: Freepik)

4 min readNew DelhiSep 10, 2025 05:30 PM IST First published on: Sep 10, 2025 at 05:30 PM IST

We, Indians, are a little too reliant on paracetamol for solving the smallest of issues. It’s easily available at a chemist’s store, and inexpensive as well. However, too much paracetamol can come with its share of risks.

Dr Kapil Adwani, PharmD, Clinical Pharmacist, Kokilaben Dhirubhai Ambani Hospital, shared that people tend to pop paracetamol thinking it’s completely harmless because it is available over-the-counter — but the body remembers. Regular intake can silently damage the liver, strain the kidneys, and even mess with your blood pressure.

Often, we try to self-medicate and take pills to fix our problems. But doing so can cause long-term damage to our bodies. Indianexpress.com spoke to the health expert and found out what happens if you take paracetamol on an empty stomach during a fever:

“Paracetamol on an empty stomach for fever is typically regarded as safe and may result in quicker symptom relief, as its absorption into the bloodstream is expedited in the absence of food. Although paracetamol is mainly processed by the liver, consuming it on an empty stomach does not heighten the risk of liver strain when taken at recommended doses, nor does it induce the gastrointestinal irritation that is often associated with NSAIDs such as ibuprofen,” he explained.

According to Dr Adwani, numerous medical professionals and health organizations, including the NHS in the UK, advocate for the consumption of paracetamol on an empty stomach, highlighting its mild effect on the stomach lining and the advantage of faster alleviation of pain and fever in acute situations.

Nevertheless, he warned that individuals who are susceptible to nausea might opt to take it with food for added comfort.

Paracetamol is mainly processed by the liver (Source: Freepik)

What if you go overboard?

“Paracetamol is one of the most widely used medications in the world. The adult upper limit is four grams per day (roughly eight 500-mg tablets). But that’s a daily maximum, not a suggestion for daily use. Unfortunately, many take it multiple times a week without giving it much thought,” he shared, adding that as per a 2019 study, long-term use, even within recommended limits, can increase liver enzyme levels, indicating liver stress. Liver damage is a serious risk for people who drink alcohol, have pre-existing liver conditions, or are underweight.

A 2022 study revealed that two weeks of paracetamol at 4g/day raised blood pressure in those with existing hypertension, according to Dr Adwani. He quoted an older 2015 study that also linked regular use (two–four g/day) to stomach upset, and doses over three grams with a higher risk of gastric bleeding.

While paracetamol seems universally safe, He mentioned that certain groups need to tread with caution:

People with liver disease or those who consume alcohol frequently: even normal doses can be risky.
Underweight individuals (<50 kg): standard doses may be excessive.
People with kidney conditions: more prone to cumulative damage.
Pregnant women: prolonged use has been associated with potential risks to the baby’s heart development.
Patients on blood thinners (like warfarin): long-term use may raise bleeding risk.

“It is crucial to avoid key pitfalls, such as surpassing the daily maximum dosage of 4 grams for adults, as this can result in liver toxicity,” he said, adding that you should connect with your doctor or pharmacist for more guidance.

Taking paracetamol during pregnancy might increase the offspring’s chances of developing neurodevelopmental disorders, including autism and attention-deficit hyperactivity disorder, according to a study. Learn more about the pitfalls and precautions to take here.

DISCLAIMER: This article is based on information from the public domain and/or the experts we spoke to. Always consult your health practitioner before starting any routine.