Hyderabad doctor flags open sale of restricted cough syrups for kids, warns of life-threatening risks

Hyderabad-based doctor has warned against open availability of restricted cough-syrups for kids.

Hyderabad-based pediatrician Dr Shivaranjani Santosh, who earlier drew national attention for challenging the sale of sugary drinks marketed as ORS, has once again raised concerns over the easy availability of cough syrups meant to be restricted for young children.

Dr Santosh warned parents against buying so-called cough syrups over the counter for children, especially those below four years of age, without consulting a doctor. She flagged what she described as a dangerous gap in regulation and enforcement, holding drug authorities, pharmacies and caregivers collectively responsible, while stressing that the ultimate victim is the child.

“Who is to blame? The authorities allowing OTC sales, the pharmacist handing it out without a prescription, or the parent?” she asked, adding that medicines restricted for certain age groups should not be freely available in the first place. If a drug falls under Schedule H, she argued, over-the-counter sales should not be permitted at all.

Dr Santosh also sought to bust a common myth, that there is a single medicine that treats “cough”. She explained that cough is a symptom, not a disease, and can be caused by multiple conditions such as congestion, bronchospasm, bronchiolitis, acid reflux, allergies, infections, throat inflammation, stress or even habit cough. Treating it without identifying the cause can be harmful.

She pointed out that cough syrups sold in India often contain combinations of drugs such as decongestants (like phenylephrine), anti-allergy medicines (chlorpheniramine, cetirizine), mucus-loosening agents (ambroxol, guaifenesin), bronchodilators (levosalbutamol, terbutaline) and cough suppressants (dextromethorphan or codeine). Incorrect dosing or overdosing of these can lead to serious side effects including increased heart rate, high blood pressure, arrhythmias, sedation and even respiratory depression.

Suppressing cough, she added, is not always advisable, as coughing can help clear infections. Each medicine has a minimum safe age, and several commonly used combinations, such as phenylephrine with chlorpheniramine, should not be given to children under four years.

Dr Santosh stressed that problems usually arise when parents self-medicate their children without understanding dosage. She urged parents to consult pediatricians, follow prescriptions strictly, avoid repeating old prescriptions and check expiry dates.

She also cautioned against unsafe home remedies like direct steam inhalation, Vicks, eucalyptus oil and similar products in young children, which can trigger seizures or worsen asthma. For blocked noses, she recommended simple saline drops, and advised seeking medical help if cough is severe, persistent or associated with vomiting.

Calling for systemic reform, Dr Santosh urged drug regulators to curb irrational combinations, avoid multiple formulations under the same brand name and involve paediatricians in approvals. “Avoid combinations,” she said bluntly, emphasising that some medicines are safer only when used in specific forms and under medical supervision.