India’s cough syrup crackdown—why and what happens

• The Central government has restricted the use of a common cold drug combination for children under four.

• The combination consists of chlorpheniramine maleate and phenylephrine hydrochloride, which are used to relieve allergy-like conditions.

• The Union Ministry of Health stated that the FDC was likely to involve risk to children below four years of age and safer alternatives are available.

• The ban is welcomed by paediatricians across the country, who argue that the combination of sedative antihistamines and decongestants like phenylephrine is irrational.

• The ban has caused confusion for pharmacists over whether prescriptions can be honored and what can be done with existing stock.

• The Delhi High Court ruled that the restriction would apply prospectively, not retrospectively, and directed pharma companies to issue notices in national newspapers and issue advisories to doctors, chemists, and retailers regarding the ban.

• Concerns have been raised over the communication of the ban to pharmacies, with a lack of formal communication from manufacturers and wholesalers to retailers.

• The most common type of cough in children is associated with viral upper respiratory tract infections that only last for a few days.

• Other causes of a cough could be: asthma, gastro-oesophageal reflux, or post-nasal drip.

• Doctors recommend that parents should be responsible and refrain from buying cough syrups without prescriptions.

• Widely disseminating information about the restriction is also emphasized, with professional bodies using their continuing medical education programme platforms to share updated protocols.