Under stricter regulations introduced by the Centre, cough syrups and certain other medicinal syrups have been removed from Schedule K drugs and can now only be sold on a valid doctor's prescription.
The move has come amid growing concerns over the misuse of cough syrups and contaminated cough syrups linked to the deaths of children.
According to the Drugs Rules, 1945, Schedule K provides exemptions from certain provisions of the Drugs and Cosmetics Act, 1940, for some classes of drugs. Before this amendment, Schedule K drugs were allowed to be sold in villages with a population of less than 1,000, and there was no requirement of compliance with certain retail sale licensing provisions.
Medical experts in Kolkata have welcomed the decision, saying that cough syrups are sometimes used without understanding the actual cause of the symptom.
Joydeep Ghosh, consultant, Internal Medicine, Fortis Hospital Anandapur, said self-medication has become too common and can sometimes do more harm than good.
"Broadly, cough syrups are of two types, expectorants, which help clear mucus from the airways, and cough suppressants, which are used for dry, non-productive cough. When taken without proper medical advice, these medications can lead to side effects such as palpitations, fluctuations in blood pressure, drowsiness and other adverse reactions," he said.
Doctors also point out that a cough is a symptom and not a disease. A cough can stem from a wide range of conditions
According to Ghosh, the greater concern is that cough syrups may temporarily relieve symptoms while masking the underlying disease.
"Restricting their sale will help ensure that patients receive appropriate treatment based on the type and cause of their cough," he added.
Doctors also point out that a cough is a symptom and not a disease. A cough can stem from a wide range of conditions.
Shalini Bhutta, consultant physician, Neotia Mediplus, said, "A cough is the body's alarm bell, not the disease itself. Silencing that alarm with a cough syrup without understanding the underlying cause is not the right approach."
She pins hope on prescription-based dispensing to encourage responsible medication use.
The Centre, in the statement, has also stated concerns over self-medication and the misuse of some cough suppressants for their sedative effects. The regulation is especially significant for children, who are more susceptible to side effects from cough medicines.
Somenath Gorain, consultant paediatric intensivist and PICU in-charge at Neotia Bhagirathi Woman and Child Care Centre, New Town, said that cough syrups are usually not recommended for children below four years of age.
"Many commonly used cough formulations contain ingredients that can cause side effects such as drowsiness, irritability, tremors, increased heart rate, breathing difficulties, and in some cases, serious or even life-threatening complications, particularly in infants and young children," he said.
While Kolkata doctors support the decision, some parents are concerned about how it will work in practice.
Parents are concerned about having to get a prescription for a simple cough
Maniratna Roy, a corporate communications professional and mother of a five-year-old boy, backs the decision, but feels it could create challenges for families dealing with recurring childhood illnesses.
"When a child is unable to sleep at night or is feeling choked due to a persistent cough, it is only natural for parents to look for quick fixes for fast relief. In such situations, getting a fresh prescription may not always be practical," she said.
Roy, whose son suffers from allergic bronchitis, said, “I am not in favour of using cough syrups at the first sign of a cough. For many working parents, visiting a doctor every single time, retaining old prescriptions, or accessing a paediatrician during weekends, holidays or late at night may not always be easy.”
Parents are also concerned about having to get a prescription for a simple cough.
Since many children do not want to gargle or take steam, their parents depend on medicines. “My daughter is 12, and she gets the flu every season. While we visit the doctor every time, for simple things like a cough without fever, our family doctor prescribes a cough syrup on WhatsApp. So it will be difficult to issue a prescription every time if we want to buy cough syrup,” said Sarnali Roy, a resident of Behala.