Substandard Drugs Pose Serious Health Risks in Telangana
In a concerning development for public health, at least 17 drugs flagged as not of standard quality (NSQ) by the Central Drugs Standard Control Organisation (CDSCO) have been found circulating in Telangana. This revelation comes from a recent list of 167 drugs identified as substandard, highlighting significant gaps in pharmaceutical safety measures across the state.
Repeated Violations Raise Alarm Bells
More alarmingly, five of these drugs continued to be sold in the market despite being repeatedly marked as substandard during monthly quality checks conducted between July and December 2025. This persistent circulation of compromised medications underscores systemic failures in drug regulation and enforcement mechanisms.
The flagged list includes widely used medications that form the backbone of daily treatment for common ailments. These encompass painkillers, antacids, antibiotics, anti-inflammatory drugs, and anti-parasitic medicines—essential therapeutic agents that millions rely on for routine healthcare needs.
Specific Drugs Failing Quality Parameters
Samples of several critical medications failed to meet established quality standards or were found to be misbranded, raising serious safety concerns. Among the compromised drugs are:
- Paracetamol-aceclofenac combinations (pain and fever management)
- Pantoprazole (acid reflux treatment)
- Rabeprazole (gastric acid control)
- Amoxycillin with potassium clavulanate (antibiotic therapy)
- Albendazole (anti-parasitic treatment)
Health experts have issued stern warnings about the potential consequences of prolonged use of such substandard medicines. Dr. G Srinivas, assistant professor of clinical pharmacology at Nizam's Institute of Medical Sciences (NIMS), emphasized that "these are routine medicines for pain, fever and gastric problems. Any compromise in quality can seriously harm patients."
Systemic Regulatory Challenges
B Shivshankar Gupta, member of the Telangana Chemists & Druggists Association (TSCDA), pointed to manufacturing non-compliance as a primary cause of quality failures. "Many drugs fail quality checks because manufacturers do not fully comply with CDSCO regulations," Gupta stated, emphasizing the need for stricter enforcement by drug authorities.
Gupta further highlighted the broader implications: "NSQ drugs weaken the healthcare system, worsen patient outcomes and fuel antibiotic resistance. Strong surveillance is crucial to protect public trust." He also raised concerns about duplicate medicines entering the market through look-alike products offered at higher discounts, which often reach consumers before regulatory intervention.
Parallels with Recent Tragedies
Experts have drawn disturbing parallels with recent child deaths linked to contaminated cough syrups in Madhya Pradesh and Rajasthan, underscoring the urgent need for rigorous drug testing protocols. The situation is further complicated by retail-level lapses, where pharmacies frequently sell medicines without valid prescriptions, increasing risks of misuse and medical errors.
A senior professor from AIIMS Bibinagar identified systemic regulatory gaps as a fundamental problem. "Pharma companies must follow good manufacturing and laboratory practices, but enforcement is the responsibility of regulators," the professor noted, pointing to jurisdictional overlaps between CDSCO (under the health ministry) and drug pricing authorities that create enforcement loopholes.
Resource Constraints in Monitoring
The Telangana Drug Control Administration (DCA) faces significant operational challenges, operating with just 65–70 inspectors to monitor nearly 50,000 manufacturing and retail units across the state. This severe manpower shortage hampers effective surveillance and timely intervention.
A senior DCA official confirmed that show-cause notices have been issued for all five repeatedly flagged drugs, particularly those manufactured within Telangana. "Prosecutions were launched wherever samples failed. For drugs made outside the state, the respective state DCAs and CDSCO were alerted," the official stated, adding that responses from pharmaceutical companies are still awaited.
The official further assured that "all affected batches were recalled, and inspectors conducted field checks at pharmacies and health centres to ensure the drugs were removed from circulation."
Common Drugs with Serious Health Risks
The five repeatedly flagged NSQ drugs in Telangana present specific dangers:
- Aceclofenac–Paracetamol: Substandard quality can trigger liver damage, stomach bleeding, and delayed pain relief
- Pantoprazole: Poor-quality batches may cause uncontrolled acidity, ulcers, and persistent gastric symptoms
- Rabeprazole: Ineffective formulation can worsen acid reflux and long-term digestive complications
- Amoxycillin–Clavulanate: Substandard doses risk severe diarrhoea and contribute to antibiotic resistance
- Albendazole: Poor efficacy can lead to persistent parasitic infections and repeated treatment failures
This situation demands immediate attention from regulatory authorities, healthcare providers, and consumers alike to ensure that only quality-assured medications reach patients, protecting public health from preventable harm.
