SRINAGAR: The Central Drugs Standard Control Organisation (CDSCO) has cautioned against indiscriminate, repeated or prolonged use of painkillers and antibiotics, warning of associated risks including chronic kidney disease and renal impairment.
In a circular, the drug regulator advised healthcare professionals, pharmacists, retailers, hospitals and State drug control authorities to ensure that these medicines are used only when clinically indicated and at appropriate doses and for appropriate durations.
The CDSCO said non-steroidal anti-inflammatory drugs (NSAIDs) and antibiotics are regulated under the Drugs and Cosmetics Act, 1940 and the Drugs Rules, 1945, and are required to be sold and distributed on the prescription of a registered medical practitioner.
Most NSAIDs are covered under Schedule H, while most antibiotics fall under Schedule H1. Both schedules carry prescription-related requirements and warnings against use without medical advice.
The regulator advised the public against self-medication with antibiotics, particularly for conditions where they are not clinically indicated, including most uncomplicated viral infections.
Patients prescribed antibiotics have been advised to follow the treatment strictly as directed by healthcare professionals and not share the medicines with others or use leftover doses from previous treatments.
People with pre-existing kidney disease or other risk factors for renal impairment have been advised to inform their healthcare professionals before taking NSAIDs.
The CDSCO also asked people to seek medical advice if pain, fever or other symptoms persist or recur, instead of repeatedly using painkillers or antibiotics without medical supervision.
For medical professionals, the regulator recommended assessing factors including a patient’s age, comorbidities, other medicines and risk factors before prescribing the drugs.
It advised doctors to consider the lowest effective dose for the shortest appropriate duration when prescribing NSAIDs, particularly for patients at higher risk of renal impairment.
On antibiotics, the CDSCO urged doctors to follow antimicrobial stewardship principles and avoid unnecessary combination therapy, inappropriate drug selection, incorrect dosing and unnecessarily prolonged treatment.
Pharmacists and retailers have been directed to comply strictly with statutory requirements governing Schedule H and H1 medicines and not facilitate self-medication.
The regulator also asked hospitals and healthcare institutions to strengthen systems for rational prescribing, prescription review, antimicrobial stewardship and patient counselling.
State and Union Territory drug control authorities have been asked to conduct awareness activities on the risks associated with inappropriate use of these medicines and the applicable regulatory requirements.
