Pediatric Cough Syrup Deaths in India:
In September 2025, several children in Madhya Pradesh and Rajasthan, reportedly died after they were administered a generic cough syrup that was suspected to be poisoned. The news has led to bans in different states, investigations, as well as a fresh review of the drug manufacturing standards with a special focus on pediatric drug formulations.
Pediatric Cough Syrup Deaths in India: Reported Events and Timeline
Madhya Pradesh (Chhindwara district, Sept 7–22, 2025): At least nine kids got acute kidney failure to death after they were given a cough syrup (or medicines including a cough syrup) at local clinics and health centres.
Most of the kids were initially treated for mild fever or cold; however, within a few days, they started to exhibit oliguria/anuria (decreased or no urine output) and renal injury.
Three of the kids that worsened were taken to Nagpur (Maharashtra) for advanced treatment comprising dialysis and ventilator support.
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A postmortem biopsy pointed out toxin-mediated injury to kidneys, no toxins to the brain or infections were found.
Rajasthan: Two kids also died after the administration of the same (or similar) syrup at government health centres. A senior doctor, in a public performance, took the syrup but then he fainted.
The state government removed its Drug Controller for allegedly meddling with drug standards instead of helping.
Rajasthan prohibited 22 batches of the suspicious syrup and, as a safety measure, stopped all cough syrups that contained dextromethorphan.
Samples collected from Sikar, Jhunjhunu, and Bharatpur were being tested.
Tamil Nadu (October 2025): The state prohibited “Coldrif” cough syrup (made in Kancheepuram) following links of child deaths in MP and Rajasthan. The factory was urged to stop production pending the lab test results.
Central / National Response: The Union Government appointed a multi-agency team consisting of NCDC, NIV, CDSCO, ICMR, AIIMS-Nagpur, and state health authorities to cover the affected areas.
According to initial checks of syrup samples from MP, no contamination with Diethylene Glycol (DEG) or Ethylene Glycol (EG) was detected.
But the very next test by the Tamil Nadu FDA confirmed that Coldrif syrup (batch SR-13) was found to have 48.6% DEG which is way over the limit allowed.
Therefore, Madhya Pradesh has placed a ban on all products of the manufacturer (Sresan Pharmaceuticals), ordered the stocks to be seized, and stopped the distribution of Coldrif in the state.
An advisory was circulated at the national level that recommended against the use of cough and cold medicine in children less than 2 years of age, stressed on the use of non-pharmacologic management first (hydration, rest, etc.) and called for the purchase of drugs only from GMP-certified manufacturers.
Currently, multiple samples are still under examination and the entire cause-effect relationship has not been publicly acknowledged yet.
Guidance for Consumers / Parents: How to Identify Safe Cough Syrups for Children?
Though it is important to remember that medical advice should be tailored to each individual’s needs, here are some practical tips for using pediatric cough medicines more safely:
1. Always consult a paediatrician: Do not self-medicate your young children, especially those under 2 years of age.
2. When possible, choose oral over syrup: Solid forms (lozenges, tablets) or non-drug methods might be safer for certain age groups.
3. Know all the product facts through the label:
- Company name, batch number, production and expiration dates
- “For paediatric use / suitable for children” and age indications
- Regulatory approval / license number (e.g. Central / State drug authority)
- Warning statements and usage instructions
4. Don’t use products that are not made under the GMP standard:
- Medicines bought from a reputable pharmacy or through a government health program are safer.
- Stay away from suspect sources, street vendors, or unlabelled syrups.
5. Examine the bottle or the syrup for physical signs of anomalies:
- Unnatural color, sediment, cloudiness, separation, unpleasant smell, pH changes
- Tamper-evident caps or seals that have been opened
6. Switch To Ayurvedic Line of Treatment:
As someone who’s studying to be a Ayurvedic doctor, I would sincerely suggest to switch to Ayurvedic formulations rather than cough syrups. Especially for infants and toddlers, it is highly advisable to avoid using cough syrups on regular basis.
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7. Use minimum effective dose and shortest duration:
- As per doctor’s prescription and do not prolong the use unnecessarily
- Keep a close eye on side effects, especially when urine output is reduced, lethargy occurs or there is vomiting
8. When available, use non-pharmacologic measures instead:
- The child should be adequately hydrated, get humidified air, use saline nasal drops and have an elevated head position
- Initially, only introduce medication if symptoms worsen or are severe
9. Pick manufacturers with a good and well-supervised history:
- Brands or businesses that have been known to adhere to the rules, have undergone audits, and are responsive to recalls
- In India, you can also check whether the manufacturer is GMP certified and listed in regulatory databases
10. Preserve and report suspicious bottles:
If a child becomes unusually ill after being given a syrup, then the medicine bottle should be preserved, batch/expiry noted and local health authorities informed
