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India Bans High-Dose Oral Nimesulide, Proposes Tighter Rules on Cough Syrups

The Health Ministry invoked Section 26A after expert review, citing liver-toxicity risks with safer alternatives available.

Overview

  • An extraordinary gazette notification issued on Dec 29 prohibits with immediate effect all oral immediate-release nimesulide formulations above 100 mg after consultation with the Drugs Technical Advisory Board.
  • The restriction applies only to high-dose oral products, with lower-strength formulations continuing to be available as patients are advised to consult doctors before changing therapy.
  • The action followed recommendations from the Indian Council of Medical Research and regulatory expert panels highlighting hepatotoxicity concerns in adults.
  • Drugmakers have been told to stop producing affected strengths and recall impacted batches, with analysts expecting limited impact on large firms but pressure on smaller manufacturers reliant on these products.
  • In a separate draft rule, the ministry proposed deleting the word “syrup” from Schedule K to tighten OTC oversight, inviting 30 days of public comment following safety alerts and reported child deaths linked to contaminated cough syrups.