Advisory warns against prolonged painkiller use and antibiotic self-medication; pharmacies told to follow prescription rules
How often do you take a painkiller for a headache, body ache or fever without consulting a doctor? Nagaland’s Drugs Control Administration has issued a fresh health safety advisory cautioning the public against indiscriminate and prolonged use of painkillers and antibiotics, citing associated health risks including chronic kidney disease.
The advisory, issued under the Directorate of Health and Family Welfare in pursuance of the Central Drugs Standard Control Organisation (CDSCO) directive, calls for the safe and rational use of medicines and greater compliance with prescription requirements. The CDSCO issued its national circular on September 21, specifically warning about the indiscriminate use of non-steroidal anti-inflammatory drugs (NSAIDs), antibiotics and the associated risk of chronic kidney disease.
The State advisory cautions people against taking NSAIDs, painkillers and antibiotics “indiscriminately, repeatedly or for prolonged periods” without medical advice.
It also specifically warns against self-medication with antibiotics or using them for conditions where they are not clinically indicated, including most uncomplicated viral infections.
People have been advised to take antibiotics only as prescribed by healthcare professionals, not to share them with others and not to use leftover medicines. Those with existing kidney disease or other risk factors for renal impairment have been advised to inform their healthcare providers before taking NSAIDs.
The advisory further urges people to seek medical attention when pain, fever or other symptoms persist or return, rather than repeatedly treating them on their own with painkillers or antibiotics.
For healthcare professionals, the Drugs Control Administration has advised that NSAIDs and antibiotics should be prescribed only when clinically indicated, taking into account the patient’s age, medical conditions, other medicines and relevant risk factors.
In the case of NSAIDs, doctors have been advised to consider the lowest effective dose for the shortest appropriate duration, particularly for patients at increased risk of kidney problems.
The advisory also calls for more judicious antibiotic prescribing in line with antimicrobial stewardship. Doctors have been asked to consider the likely cause, site and severity of infection and, where appropriate, relevant laboratory investigations and local antibiotic-susceptibility patterns.
Unnecessary combinations of antibiotics, inappropriate drug selection, incorrect dosing and unnecessarily prolonged treatment have been discouraged.
The warning extends beyond patients and doctors to pharmacies and drug distributors.
Pharmacists, retailers and distributors have been directed to comply with statutory requirements governing the sale and distribution of Schedule H, H1 and other prescription medicines. Under the Drugs Rules, 1945, Schedule H and H1 medicines are not to be sold at retail except in accordance with the applicable provisions. The CDSCO circular similarly states that most NSAIDs fall under Schedule H and most antibiotics under Schedule H1, requiring prescription and appropriate medical supervision.
Pharmacies and retailers have also been advised not to encourage or facilitate self-medication with antibiotics or prescription-only NSAIDs and to follow the warnings and conditions of sale prescribed on medicine labels.
Hospitals and healthcare institutions have been asked to strengthen systems for rational prescribing and monitoring of NSAIDs and antibiotics, including prescription review, antimicrobial stewardship and patient counselling.
The advisory comes days after pharmacists and drug experts in Nagaland raised concerns over self-medication and misuse of antibiotics and painkillers during a World Pharmacists Day program in Kohima.
