The monsoon season brings a much-needed respite from the heat, but it also leads to unexpected bouts of cough, cold, and fever as our bodies adjust to the changing weather. While reaching for your trusted cough syrup might be the first step, recent information about these over-the-counter remedies warrants close attention.
According to an official report from the Ministry of Health and Family Welfare, the Central Drugs Standard Control Organisation (CDSO) tested 7,087 batches of cough syrups, out of which 353 were found to be “not of standard quality” (NSQ). These batches contained alarming levels of diethylene glycol (DEG) and ethylene glycol (EG), making them toxic. Other issues identified in these batches included problems with assay, microbial growth, pH, and volume. While some contaminants are not surprising, the presence of DEG and EG is particularly concerning.
Cough syrups are often a staple in households, ready for those unexpected sore throats and colds. However, given the current situation, it is crucial to be extra cautious, even with basic over-the-counter medications.
DEG is an industrial solvent. Despite its texture making it seem suitable for cough syrups, ingesting a compound also used in antifreeze, brake fluid, wallpaper strippers, and fabric and dye manufacturing is alarming. According to the American National Library of Medicine, consuming DEG can lead to metabolic acidosis and renal injury, which can be fatal or result in serious neuropathies and neurological effects.
Similarly, EG is an industrial compound used in antifreeze, hydraulic brake fluids, some stamp pad inks, ballpoint pens, solvents, paints, plastics, films, and cosmetics, as stated by the National Institute for Occupational Safety and Health (NIOSH). Its sweet taste might explain its use in cough syrups, but the Centers for Disease Control and Prevention (CDC) warns that EG consumption can severely impact the central nervous system, heart, and kidneys, potentially leading to death.
Always read labels thoroughly before purchasing.
This is Not the First Cough Syrup Scandal
The CDSCO identified unsecured supply chains and insufficient testing as primary reasons for this issue. However, this isn’t the first time Indian cough syrups have raised concerns. The World Health Organization (WHO) issued five alerts across 2022 and 2023, holding exported Indian cough syrups accountable for approximately 140 child deaths worldwide. Countries significantly affected include Gambia, with 66 deaths, and Uzbekistan, with 18 deaths.
This troubling pattern presents a serious problem for India, a major global pharmaceutical player and leading exporter. For context, India supplies about 40% of the generic drug demand in the US and provides a quarter of all medicines in the UK, according to a Mint report.
Given that India’s pharmaceutical industry is valued at $50 billion, the cough syrup crisis casts a shadow over its reputation.
The Modi government has emphasized the responsibility of manufacturers to ensure product quality, stating that products should only be marketed after achieving “satisfactory results” in ingredient testing. Additionally, samples from intermediate and finished batches are to be retained to improve the testing process.
In the midst of this crisis, the CDSCO received a 44-page presentation from pharmaceutical industry stakeholders suggesting a waiver for testing cough syrups. For products exported to the USA, UK, Canada, EU, Japan, Australia, Singapore, Republic of Korea, and Switzerland, testing requirements might be waived. The report also suggests, “if cough syrup is manufactured in a plant or section approved by the regulatory agencies of the listed countries for any product, such cough syrup may also be allowed to be exported to any country without testing at the prescribed laboratory.”
While checking labels to understand a product’s nutritional content or ingredient list can be tedious, developing this habit is now more crucial than ever. Stay safe!
