The short answer
Not known in people. We found no study of tulsi taken with paracetamol in people. The one study we found was in rats given a very large, liver-damaging dose of paracetamol. Rats that had been given tulsi leaf extract for a week beforehand had liver tests closer to normal.
That does not show that tulsi protects the human liver, or that it changes how paracetamol works at normal doses. It is not a treatment for a paracetamol overdose, and it does not allow higher doses. If you take paracetamol often, for example for long-term pain or fever, tell your doctor about tulsi or any other herbal product you use.
Paracetamol is sold in India as Dolo 650, among many other names, and as Tylenol in the US.
At a glance
| What was seen | How it may work | Direction | Evidence |
|---|---|---|---|
| Less liver damage in rats given a toxic paracetamol dose[1] | Liver protection seen in rats; route not established | No information on paracetamol levels or effect in people | Animal |
No listing is not a clearance. A missing interaction here never means a combination is safe.
The evidence, study by study
Rat study, 2011 Animal
Rats were given an alcohol extract of tulsi leaf, silymarin (the comparison drug), or half doses of both, for 10 days. On day 8 they received paracetamol at 2 g per kg of body weight, a dose meant to injure the liver. Liver enzymes and blood proteins stayed closer to normal than in rats given paracetamol alone, and the liver tissue looked less damaged. The abstract does not say how many rats were used, and paracetamol levels were not measured. Animal results like this cannot tell us what happens in people.[1]
What to tell your prescribing doctor
You can read this out, or show them this page:
“I am taking, or planning to take, tulsi (tea, leaves, capsules or extract, and how much) and I also take paracetamol (how much and how often). Is there anything about the combination you would want to check?”
Withheld until review
Questions people ask
Does holy basil interact with any medications?
The Merck Manual lists cautions for holy basil with sedatives, with medicines that affect bleeding and with diabetes medicines, and in pregnancy. It notes that whether these effects happen in humans is not known. Our other tulsi pages look at each of these medicines.[2]
Related
Tulsi and sleeping pills or sedatives
In mice, tulsi leaf extract made a sedative work for longer. No study has tested tulsi with sleeping pills in people.
InteractionTulsi and blood thinners like warfarin
A man on warfarin had a high INR after a herbal kadha that included tulsi. Tulsi's own role is not clear, and it has not been studied alone.
InteractionTulsi and metformin
Holy basil leaves lowered blood sugar in a 1996 trial in type 2 diabetes. With metformin, sugar could fall further. The pair has not been studied.
InteractionGiloy and paracetamol (Dolo, Crocin)
Not tested together. Giloy is a known cause of liver injury, and the paracetamol label warns people with liver disease. The combined effect is unknown.
Sources
- Lahon K, Das S. Hepatoprotective activity of Ocimum sanctum alcoholic leaf extract against paracetamol-induced liver damage in Albino rats. Pharmacognosy Res. 2011;3(1):13-18. PMID 21731390.
- Merck Manual, Consumer Version. Holy Basil. Reviewed July 2025.
Updated 4 November 2026
Taking tulsi with other medicines? A vaidya can check your full list.
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