Central drugs authority finds over 100 cough syrups sold in India fail quality tests: What doctors suggest to safely tackle flu symptoms this monsoon

Recent findings from the Central Drugs Standard Control Organisation (CDSCO) have raised alarming concerns about the quality of cough syrups available in India. 

The regulatory body’s report, presented to the Ministry of Health and Family Welfare, reveals that samples from over 100 pharmaceutical units failed to meet quality standards. 

Out of 7,087 batches tested, 353 were classified as ‘not of standard quality’ (NSQ), with nine batches containing potentially harmful substances like diethylene glycol (DEG) and ethylene glycol (EG), according to a report by The Hindu. 

The report adds that these toxins have been linked to tragic incidents of child fatalities in countries such as Gambia, Uzbekistan, and Cameroon.

As the monsoon season approaches, bringing with it an increased risk of flu-like symptoms, this report highlights the urgent need for caution when using over-the-counter medications. With the safety of commonly available cough syrups now in question, it becomes crucial for the public to understand safer ways to manage flu symptoms.

Health risks and contamination of diethylene glycol and ethylene glycol in cough syrups

Dr Rakesh Gupta, senior consultant, Internal Medicine, Indraprastha Apollo Hospitals says, “Diethylene glycol (DEG) and ethylene glycol (EG) are highly toxic substances that can contaminate cough syrups during manufacturing, posing serious health risks to consumers. Ingestion of DEG or EG can cause severe kidney damage, respiratory failure, and even death.”

Contamination can occur due to the use of adulterated glycerin or propylene glycol, inadequate quality control measures, poor manufacturing practices, or intentional adulteration, he states. 

Symptoms of DEG or EG poisoning include vomiting, diarrhea, abdominal pain, central nervous system depression, and in severe cases, seizures, coma, and death. “It is essential to ensure that cough syrups are manufactured with strict quality control measures, including regular testing of raw materials, to prevent contamination.”

To prevent contamination and ensure the safety and quality of medicinal products, pharmaceutical companies and regulatory bodies must take a multi-faceted approach. (Source: Freepik)

Key indicators for high-quality cough syrup labels and packaging

Dr Ankit Kumar Sinha, consultant pulmonologist, Yashoda Super-speciality Hospital Kaushambi, reveals, “It’s very difficult to say that because in India, the Drugs Controller General of India (DCGI) is not very stringent. So many companies produce drugs without regulatory authority. No one is there to check them.”

Dr Gupta recommends that when purchasing cough syrup, “consumers should scrutinise the label and packaging to ensure they are buying a high-quality, safe product. Key indicators include the manufacturer’s name and address, batch number and expiration date, active ingredients and concentrations, clear instructions for use, warning labels (e.g., for children, pregnant women), tamper-evident packaging, and regulatory approvals (e.g., FDA, WHO).”

Additionally, consumers should check for any signs of tampering, such as broken seals or torn packaging. 

Safe alternatives to over-the-counter cough syrups

For managing flu symptoms, Dr Gupta suggests, there are several safe and effective alternatives to over-the-counter cough syrups. “These include saline nasal sprays or drops, honey-based cough syrups (for adults and children over 1 year), warm liquids like tea or broth, steam inhalation with eucalyptus oil, antiviral medications (prescription-only), and homeopathic remedies like zinc lozenges or elderberry syrup.” 

Some of these alternatives, such as honey and steam inhalation, have additional benefits like soothing the throat and promoting mucus clearance.

Measures to prevent contamination and ensure medicinal product safety

According to Dr Gupta, “To prevent contamination and ensure the safety and quality of medicinal products, pharmaceutical companies and regulatory bodies must take a multi-faceted approach. 

“This includes implementing robust quality control measures, conducting regular inspections and audits, using authenticated raw materials, training personnel on good manufacturing practices, establishing traceability systems, enforcing strict regulations and penalties for non-compliance, and collaborating internationally to share best practices and safety information.” 

Additionally, companies should invest in advanced technologies, such as analytical testing and supply chain monitoring, to detect and prevent contamination.

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