The short answer
Not known. We found no study that tested giloy (guduchi, Tinospora cordifolia) with paracetamol. The concern is that each carries its own liver warning. The US liver injury database LiverTox calls giloy a well-established cause of liver injury, and the paracetamol label tells people with liver disease to ask a doctor before use.
In a study from 13 Indian centres, 43 people developed liver injury linked to giloy, and four of them died. Whether giloy and paracetamol together add to liver harm has not been measured. If you take paracetamol regularly or have liver disease, tell your doctor before you start giloy.
Paracetamol is sold in India as Dolo 650, among many other brands.
At a glance
| What was seen | How it may work | Direction | Evidence |
|---|---|---|---|
| Two separate liver warnings[4][3] | Each can harm the liver; combined effect not measured | Possible added strain on the liver; not shown | Theoretical by mechanism |
| Liver injury linked to giloy in 43 people across 13 Indian centres[1] | Immune-mediated injury suspected | Hepatitis, sometimes severe | Observational |
| Autoimmune-like hepatitis after giloy in six people[2] | May trigger or unmask autoimmune liver disease | Hepatitis | Case report |
No listing is not a clearance. A missing interaction here never means a combination is safe.
The evidence, study by study
Study across 13 Indian centres, 2022 Observational
Doctors looked back at 43 people who developed liver injury after taking giloy between April 2020 and July 2021, during the COVID-19 pandemic. Symptoms began a median of 46 days after starting it, and giloy was judged the probable cause in 67.4%. Four people died and two needed a liver transplant. People on medicines already known to harm the liver were left out, so the study does not tell us about giloy taken with paracetamol.[1]
Case series, 2021 Case report
Six people developed liver injury after taking giloy as an immune booster during the 2020 pandemic, for a median of 90 days. Four were women, the median age was 55, and the median peak bilirubin, the pigment behind jaundice, was 17.5 mg/dL. Liver biopsies looked like autoimmune hepatitis. Six cases cannot show how often this happens.[2]
What your doctor may watch for
- Liver tests (enzymes and bilirubin), and any yellowing of the eyes or skin (jaundice).[3]
- Every product you take that contains paracetamol, so your doctor knows your total amount.[4]
What to tell your prescribing doctor
You can read this out, or show them this page:
“I take paracetamol (brand, how much and how often), and I am taking, or planning to take, giloy (juice, tablets, powder or kadha, and how much). Giloy can cause liver injury on its own, and paracetamol carries a liver warning. Should my liver tests be checked?”
Withheld until review
Questions people ask
Related
Tulsi and paracetamol
No study has tested tulsi with paracetamol in people. A rat study used tulsi before a toxic paracetamol dose, which says little about everyday use.
InteractionGiloy with metformin or insulin
Not tested in people. In rats, two weeks of giloy extract raised metformin levels. Giloy also carries its own risk of liver injury.
InteractionGiloy with immunosuppressants and steroids
Not tested together. Giloy has been linked to autoimmune-like liver injury, which matters for people whose immune system is being treated.
InteractionGiloy and blood pressure medicines
No study has tested giloy with blood pressure medicines. Giloy has its own, separate risk of liver injury, documented in Indian patients.
Sources
- Kulkarni AV, Hanchanale P, Prakash V, Kalal C, Sharma M, Kumar K, Bishnu S, Kulkarni AV, Anand L, Patwa AK, Kumbar S, Kainth S, Philips CA; Liver Research Club India. Tinospora cordifolia (giloy)-induced liver injury during the COVID-19 pandemic: multicenter nationwide study from India. Hepatol Commun. 2022;6:1289-1300. PMID 35037744.
- Nagral A, Adhyaru K, Rudra OS, Gharat A, Bhandare S. Herbal immune booster-induced liver injury in the COVID-19 pandemic: a case series. J Clin Exp Hepatol. 2021;11:732-738. PMID 34230786.
- LiverTox: Clinical and Research Information on Drug-Induced Liver Injury. Tinospora. Updated 27 June 2025.
- Tylenol Extra Strength (acetaminophen) tablets, US drug facts label (DailyMed).
Awaiting review by The Good Vaidya Medical Board. Prepared from the sources below and checked against each one.
Published 4 November 2026 · Last updated 4 November 2026
Taking giloy with other medicines? A vaidya can check your full list.
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