Painkillers for every ache? CDSCO warns of kidney risks, antibiotic misuse

The Central Drugs Standard Control Organisation (CDSCO) has issued a fresh advisory warning of potential kidney complications from the misuse of painkillers and antibiotics. Non-steroidal anti-inflammatory drugs (NSAIDs), commonly used as over-the-counter pain relievers, should not be taken repeatedly or for extended periods without medical advice. The regulator has also cautioned against self-medicating with antibiotics, particularly for those with existing kidney issues or other risk factors for renal impairment.

Experts warn that unregulated and prolonged use of painkillers can accelerate kidney function decline, especially in chronic kidney disease patients. They stress that all prescription medicines should be taken under a qualified physician's supervision, with prescribed doses and durations strictly adhered to. Alternative medicine use should also be approached with caution, as some substances may be harmful to the kidneys.

Dr. Dinesh Khullar of Max Super Speciality Hospital stressed that misuse of NSAIDs can lead to serious kidney injury, particularly in vulnerable individuals. Self-medication should be avoided, and only medically prescribed medications should be used. The CDSCO's warning comes amid a significant burden of chronic kidney disease in India, with a 2025 estimate of 13.24% prevalence, although figures vary widely across regions.

The advisory advises doctors to prescribe the lowest effective dose of NSAIDs for the shortest duration, with extra caution for at-risk patients. It also urges judicious antibiotic use, avoiding unnecessary combinations and incorrect dosing. The National Centre for Disease Control's 2024 surveillance across 66 tertiary-care institutions found excessive consumption of "watch" antibiotics and inadequate use of recommended "access" antibiotics.

It also highlighted inconsistent implementation of antimicrobial stewardship programs. Pharmacists and retailers are asked to enforce prescription rules, while hospitals and state regulators are urged to strengthen oversight and awareness of these risks, including kidney complications and antimicrobial resistance.