Painkillers and antibiotics can harm kidneys when misused: Drug regulator issues fresh advisory - The Indian Express

In a move to curb the indiscriminate use of painkillers and antibiotics, the country’s apex drug regulator has issued an advisory asking the public, healthcare professionals, pharmacists, retailers and hospitals to ensure their rational and supervised use lest overuse results in a higher risk of kidney disease.

The advisory comes amid concerns over the health risks associated with inappropriate and prolonged use of these medicines, including the risk of chronic kidney disease. Most non-steroidal anti-inflammatory drugs (NSAIDs), commonly used as painkillers, are covered under Schedule H of the Drugs Rules and cannot be sold without a prescription from a registered medical practitioner. Most antibiotics are listed under Schedule H1 and must carry a warning stating: “It is dangerous to take this preparation except in accordance with the medical advice. Not to be sold by retail without the prescription of a Registered Medical Practitioner.”

The regulator said these medicines should be used “only when clinically indicated, in the appropriate dose and for the appropriate duration, and under the supervision of a Registered Medical Practitioner.”

The advisory asks people not to use painkillers or antibiotics indiscriminately, repeatedly or for prolonged periods. Antibiotics should not be self-medicated or used for conditions where they are not clinically required, such as viral infections. Patients have also been advised not to share prescribed or leftover antibiotics with others. People with existing kidney problems, or those at risk of kidney disease, should inform their healthcare professionals before taking NSAIDs.The regulator has advised people to seek medical attention if pain, fever or other symptoms persist or recur rather than repeatedly taking painkillers or antibiotics on their own.

Healthcare professionals have been advised to prescribe NSAIDs and antibiotics only when clinically indicated, taking into account the patient’s age, medical condition, co-morbidities, risk factors and other medicines.For NSAIDs, doctors have been asked to use the lowest effective dose for the shortest appropriate duration, particularly in patients at increased risk of kidney impairment.

The advisory also calls for caution while prescribing NSAIDs to patients with kidney impairment, dehydration or heart disease. For antibiotics, doctors should consider the likely causative organism, site and severity of infection and, where appropriate, microbiological investigations and local antimicrobial susceptibility patterns.“Unnecessary combination therapy, inappropriate antibiotic selection, incorrect dosing and unnecessarily prolonged duration of antibiotic treatment should be avoided,” it states.

Pharmacists, retailers and distributors have been directed to comply with the rules governing the sale of Schedule H and H1 medicines. Such medicines should not be sold without a prescription except where specifically permitted under the rules.

“Pharmacists and retailers shall not encourage or facilitate self-medication with antibiotics or prescription-only NSAIDS,” the advisory states.

Hospitals and other healthcare institutions have been asked to strengthen systems for rational prescribing and monitoring of NSAID and antibiotic use.The advisory also recommends prescription reviews and patient counselling wherever appropriate. State drug regulatory authorities have been asked to create awareness among doctors, pharmacists, retailers and the public about the risks associated with indiscriminate use of NSAIDs and antibiotics.

Anonna Dutt is a Principal Correspondent who writes primarily on health at the Indian Express. She reports on myriad topics ranging from the growing burden of non-communicable diseases such as diabetes and hypertension to the problems with pervasive infectious conditions. She reported on the government’s management of the Covid-19 pandemic and closely followed the vaccination programme. Her stories have resulted in the city government investing in high-end tests for the poor and acknowledging errors in their official reports. Dutt also takes a keen interest in the country’s space programme and has written on key missions like Chandrayaan 2 and 3, Aditya L1, and Gaganyaan. She was among the first batch of eleven media fellows with RBM Partnership to End Malaria. She was also selected to participate in the short-term programme on early childhood reporting at Columbia University’s Dart Centre. Dutt has a Bachelor’s Degree from the Symbiosis Institute of Media and Communication, Pune and a PG Diploma from the Asian College of Journalism, Chennai. She started her reporting career with the Hindustan Times. When not at work, she tries to appease the Duolingo owl with her French skills and sometimes takes to the dance floor. ... Read More