NEW DELHI: Taking painkillers repeatedly for everyday aches or antibiotics without proper medical advice could put people at risk of kidney complications and other adverse effects, prompting the Central Drugs Standard Control Organisation (CDSCO) to issue a fresh advisory on their rational use.The drug regulator has asked people not to take non-steroidal anti-inflammatory drugs (NSAIDs), commonly used as painkillers, repeatedly or for prolonged periods without medical advice. It has also cautioned against self-medication with antibiotics and advised people with existing kidney disease or other risk factors for renal impairment to inform their doctor before taking NSAIDs.Prof Sandeep Mahajan, nephrologist at AIIMS, said that unregulated and prolonged use of painkillers can accelerate the decline in kidney function, particularly in people with chronic kidney disease. “All prescription medicines should be taken under the supervision of a qualified physician, with the prescribed dose and duration strictly followed. Medicines from alternative systems should also be used with caution, as some may contain substances that can be toxic to the kidneys.”“Misuse of non-steroidal anti-inflammatory drugs can cause serious kidney injury, particularly in people with pre-existing kidney disease. Even short-term use can be risky in vulnerable individuals,” said Dr Dinesh Khullar, Group Chairman, Nephrology & Renal Transplant Medicine, Max Super Speciality Hospital, Saket. “People should therefore avoid unnecessary self-medication and take these medicines only on medical advice.”The warning comes against the backdrop of a substantial chronic kidney disease burden in India. A 2025 systematic review of community-based studies estimated pooled chronic kidney disease prevalence at 13.24%, although estimates varied widely across regions and studies.The CDSCO circular, issued on Monday, says NSAIDs and antibiotics are prescription medicines under the Drugs and Cosmetics Rules and should be used only when clinically indicated, at the appropriate dose and duration and under medical supervision.The regulator has advised doctors to use the lowest effective dose of NSAIDs for the shortest appropriate duration, with extra caution in patients at risk of kidney injury. It has also urged judicious antibiotic use, avoiding unnecessary combinations, incorrect dosing and prolonged treatment.The National Centre for Disease Control’s 2024 surveillance across 66 tertiary-care institutions found excessive consumption of “Watch” antibiotics, which have a higher resistance potential, along with inadequate use of “Access” antibiotics recommended as first-line treatment. The report also flagged inconsistent implementation of antimicrobial stewardship programmes.
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Self-medication remains common in India, with analgesics, antipyretics and antibiotics among the frequently self-medicated drugs. Pharmacists and retailers have been asked to enforce prescription rules, while hospitals and state regulators have been told to strengthen oversight and awareness of the risks, including kidney complications and antimicrobial resistance.
