India’s drug regulator has called for greater caution over the use of non-steroidal anti-inflammatory drugs (NSAIDs), a class of medicines commonly used to relieve pain and inflammation, and antibiotics. The warning focuses on the potential complications associated with taking these medicines indiscriminately, repeatedly or for prolonged periods without medical advice.
The CDSCO circular, dated 21 September 2026, says these medicines should be used when clinically indicated, in the appropriate dose and for the appropriate duration, under the supervision of a registered medical practitioner.
Editorial Insight
Key Highlights
Important points readers should notice.
Issue/Event: India’s drug regulator has highlighted the potential risks associated with indiscriminate use of certain painkillers and antibiotics.
Location: The advisory applies across India and addresses the public and the healthcare sector.
Authority/Organisation: The Central Drugs Standard Control Organisation (CDSCO), under the Government of India’s health-regulatory framework, issued the circular.
Action Taken: The regulator called for clinically appropriate use, proper doses and duration, medical supervision, prescription compliance and greater public awareness.
Impact: Responsible medicine use can help reduce avoidable adverse effects, support kidney health and limit unnecessary antibiotic use that contributes to antimicrobial resistance.
The advisory is relevant to patients as well as doctors, pharmacists, medicine retailers, distributors, hospitals and other healthcare institutions. It calls for responsible prescribing, proper dispensing practices and stronger public awareness.
Why can some painkillers affect the kidneys?
The kidneys help filter waste products from the blood and maintain the body's fluid and electrolyte balance. Certain medicines can affect kidney function, particularly when taken inappropriately or by people who already have medical conditions that increase their risk.
Editorial Analysis
Why This Matters
The advisory matters because pain relief and antibiotics are often viewed as routine solutions to everyday illnesses. Yet a medicine that is suitable for one person or condition may not be appropriate for another. For people with kidney disease or other risk factors, a healthcare professional may need to consider kidney function, other medicines and the potential benefits and risks before recommending treatment. Responsible antibiotic use is equally important. Using antibiotics for illnesses that do not require them offers no benefit against the underlying viral infection and can create unnecessary risks. The broader public-health lesson is that access to medicines must be accompanied by accurate information, appropriate prescribing and responsible dispensing. Patients should feel comfortable asking questions about a medicine rather than relying on informal advice or previous prescriptions.
Some NSAIDs can reduce blood flow to the kidneys. This may contribute to acute kidney injury in susceptible individuals, while repeated or prolonged inappropriate use can worsen existing kidney problems.
The level of risk depends on several factors, including the medicine, dose, duration of use, hydration status, kidney function, age and other medicines a person takes. Not everyone who uses a painkiller will develop kidney damage, and prescribed treatment should not be stopped simply because of this warning.
People with existing kidney disease, dehydration or other relevant health conditions should discuss the suitability of these medicines with their healthcare professional before using them.
Why antibiotics should not be self-prescribed
Antibiotics are used to treat bacterial infections. They are not effective against viruses that cause illnesses such as the common cold and most uncomplicated viral infections.
Taking antibiotics unnecessarily or using an unsuitable antibiotic can expose patients to avoidable side effects and contribute to antimicrobial resistance. This occurs when microorganisms develop the ability to survive medicines that previously controlled them.
Some antibiotics can also affect kidney function or require dose adjustments for people with impaired kidney function. The risks vary by medicine and patient; antibiotics are not all the same and should not be treated as a single risk category.
Patients should not use leftover antibiotics, take another person's prescription or change a prescribed course without speaking to their healthcare professional. If side effects occur or treatment is difficult to tolerate, they should seek medical advice.
Prescription rules and the role of pharmacies
The CDSCO circular reiterates that medicines covered by applicable prescription-only categories must be supplied in accordance with the relevant provisions of the Drugs Rules, 1945. Many NSAIDs fall under Schedule H, while many antibiotics fall under Schedule H1, which has specific prescription and record-keeping requirements.
The regulator has called on healthcare professionals to prescribe medicines judiciously and on pharmacists and retailers to avoid encouraging or facilitating inappropriate self-medication. Hospitals and healthcare institutions are also encouraged to strengthen prescription review, monitoring and patient counselling.
The circular further asks state and Union Territory drug-control authorities to increase awareness among the public and healthcare stakeholders and support compliance with applicable rules.
What should the public do?
People can take several sensible steps to reduce avoidable medicine-related risks:
- Tell a doctor about existing kidney disease, diabetes, high blood pressure, dehydration or other relevant medical conditions before starting a medicine.
- Share a complete list of prescription medicines, over-the-counter products and supplements with the healthcare professional.
- Avoid taking multiple products containing the same active pain-relieving ingredient.
- Do not use antibiotics left over from a previous illness or prescribed to someone else.
- Ask a qualified healthcare professional if pain persists, symptoms worsen or a medicine causes concerning side effects.
- Follow the prescribed dose and duration rather than increasing doses or extending treatment independently.
Kidney problems may not always produce obvious early symptoms. A healthcare professional may recommend tests such as blood creatinine/eGFR or urine testing when clinically appropriate, particularly for people with relevant risk factors.
The advisory should not create fear of necessary medicines. Its central message is to use the right medicine for the right reason, in the appropriate way, with suitable professional guidance.
