DGHS advises judicious use of cough syrups for children following reports of deaths
Cough syrups have come under the scanner again, following reports of 11 children dying in Madhya Pradesh and Rajasthan.
The Directorate General of Health Services (DGHS) has advised States and Union Territories to ensure “judicious prescribing and dispensing of cough syrups for children”. Most acute cough illnesses in children are self-limiting and often resolve without pharmacological intervention, the advisory said.
“Cough and cold medications should not be prescribed or dispensed to children under two years. These are generally not recommended for ages below 5 years, and above that, any use should follow careful clinical evaluation with close supervision and strict adherence to appropriate dosing, the shortest effective duration and avoiding multiple drugs combinations,” the DGHS said.
Further, it called on health facilities and clinical establishments to purchase products manufactured under good manufacturing practices (GMP) and formulated with pharmaceutical grade excipients.
The advisory comes even as the Union Health Ministry (MoH), citing joint investigations, said the cough syrup samples collected from MP did not have contaminants that were being linked to the possible deaths.
Possible deaths
Just years ago, India-made cough syrups were linked to possible deaths of children in Gambia and Uzbekistan – following which the Centre tightened the quality checks on cough syrups exported from the country.
The MoH said, a joint team with representatives from National Centre for Disease Control (NCDC), National Institute of Virology (NIV), Central Drugs Standard Control Organisation (CDSCO), among others, visited the site and samples were collected in co-ordination with the State authorities, including samples of various cough syrups.
“As per the test results, none of the samples contained diethylene glycol (DEG) or ethylene glycol (EG), contaminants that are known to cause serious kidney injury. The Madhya Pradesh State Food and Drug Administration (SFDA) also tested three samples and confirmed absence of DEG/EG,” the MoH said. Further, it added, “blood/CSF samples have been tested by NIV Pune for common pathogens. One case has been found positive for leptospirosis”.
Paediatric use
On the deaths of two children in Rajasthan reportedly from contaminated cough syrup consumption, “it has been clarified that the product in question does not contain propylene glycol, which can be potential source of contaminants, DEG/EG. Additionally, the product under reference is a dextromethorphan-based formulation, which is not recommended for paediatric use,” the note said.
Samples of water, entomological vectors and respiratory specimens are also being investigated by National Environmental Engineering Research Institute (NEERI), NIV Pune, and other laboratories, the Ministry said, adding that a multi-disciplinary team was investigating causes behind the death.
Meanwhile, reports indicated that the two cough syrups being investigated by regulatory authorities were brands Coldrif and Nesto DS. In fact, Tamil Nadu is said to have banned Coldrif and its facility was investigated, according to reports.
Published on October 3, 2025