Govt Warns Against Overusing Antibiotics And Painkillers: No Prescription, No Pills

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A few tablets for a headache. A painkiller before the gym. An antibiotic left over from the last bout of fever. None of it feels like a habit until it is one, and India's drug regulator has now said so in writing.

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In a circular dated September 21, the Central Drugs Standard Control Organisation (CDSCO) asked pharmacists, retailers, hospitals and the public to stop the casual, repeated use of non-steroidal anti-inflammatory drugs (NSAIDs) and antibiotics without a prescription. The advisory, issued under the Drug Controller General of India Dr Rajeev Singh Raghuvanshi, flags two consequences directly: rising chronic kidney disease linked to painkiller overuse, and antimicrobial resistance driven by antibiotic misuse.

Most NSAIDs fall under Schedule H, meaning they legally require a prescription. Most antibiotics fall under the more tightly controlled Schedule H1. Both carry printed warnings that they should not be taken except on medical advice, yet both remain easy to buy over the counter at a neighbourhood pharmacy. The CDSCO has now told pharmacists and retailers not to "encourage or facilitate self-medication with antibiotics or prescription-only NSAIDs," and asked hospitals to strengthen prescription reviews and antimicrobial stewardship.

How An Occasional Tablet Turns Into A Habit

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For most people, the shift from occasional to habitual painkiller use happens so gradually that it goes unnoticed. According to Dr P Vikranth Reddy, Clinical Director and Senior Consultant, Nephrology, CARE Hospitals, Banjara Hills, Hyderabad, this is one of the more overlooked patterns he sees in his practice: patients don't set out to depend on these medicines, but the dependence builds quietly over time.

"It may begin with a few tablets a month for migraines or body aches, then gradually become several doses a week," Dr Reddy said. Some people even start taking painkillers preventively, ahead of a workout or a long flight, treating them less like medicine and more like routine. Others reach for two or three over-the-counter combinations at once, unaware that the active ingredients overlap. "Others combine multiple over-the-counter medicines without noticing that they contain similar ingredients," he added.

Why The Kidneys Bear The Cost

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The kidneys are especially vulnerable to this kind of low-grade, repeated exposure. Dr Reddy explained that kidney function depends on a steady, uninterrupted blood supply, which is what allows the organ to filter waste and keep the body's fluid and electrolyte levels in balance.

"Certain commonly used painkillers, particularly non-steroidal anti-inflammatory drugs (NSAIDs), can interfere with this circulation when used too frequently or under the wrong conditions," he said.

He was careful to draw a line, though, between occasional use and the pattern that actually causes harm. "For most healthy people, taking a painkiller occasionally is unlikely to cause major harm," Dr Reddy noted. "The problem usually begins when 'occasional' slowly turns into habitual use."

The CDSCO's advisory draws the same distinction. It has asked that patients with existing kidney disease, diabetes, hypertension, heart failure or liver disease be flagged before any NSAID is dispensed, given how much more exposed they already are to renal complications.

Disclaimer: The information provided in this article is for general informational and educational purposes only and is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or a qualified healthcare provider with any questions you may have regarding a medical condition.