Regulator warns against indiscriminate use of painkillers and antibiotics, cites kidney disease risk

The Central Drugs Standard Control Organisation (CDSCO) has cautioned against the indiscriminate, repeated, or prolonged use of painkillers and antibiotics, citing the associated risk of chronic kidney disease and renal impairment.

In a circular dated September 21, 2026, the regulator 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.

The CDSCO said most NSAIDs are included in Schedule H of the Drugs Rules and cannot be sold at retail without a prescription. Most antibiotics are included in Schedule H1 and carry warnings that they should not be taken except in accordance with medical advice and should not be sold without a prescription.

The circular directed stakeholders, including healthcare professionals, pharmacists, retailers, hospitals, and State drug control authorities, to ensure that such medicines are used only when clinically indicated, at the appropriate dose and for the appropriate duration.

‘Don’t self-medicate’

The regulator advised the public not to self-medicate with antibiotics or use them for conditions where they are not clinically indicated, including most uncomplicated viral infections. It also said antibiotics prescribed by a healthcare professional should be taken strictly as advised and should neither be shared nor used from leftover medicines.

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 urged people to seek medical advice if pain, fever, or other symptoms persist or recur instead of repeatedly taking painkillers or antibiotics on their own.

Advise for medical professionals

For healthcare professionals, the regulator recommended considering a patient’s age, comorbidities, other medicines and risk factors before prescribing these drugs. It said the lowest effective dose for the shortest appropriate duration should be considered when prescribing NSAIDs, particularly for those at increased risk of renal impairment.

Doctors have also been advised to follow antimicrobial stewardship principles while prescribing antibiotics and to avoid unnecessary combination therapy, inappropriate drug selection, incorrect dosing, and unnecessarily prolonged treatment.

Pharmacists and retailers have been directed to strictly comply with statutory requirements governing Schedule H and H1 drugs and not facilitate self-medication.

The CDSCO has 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 create awareness about the risks and regulatory requirements.