17 NSQ drugs flagged in T, 5 sold despite repeated alerts

Hyderabad: Of the 167 drugs recently flagged as not of standard quality (NSQ) by the Central Drugs Standard Control Organisation (CDSCO), at least 17 were found to be in circulation in Telangana. More alarming, five of these continued to be sold despite being repeatedly marked substandard during monthly checks between July and Dec 2025.The flagged list includes widely used painkillers, antacids, antibiotics, anti-inflammatory and anti-parasitic medicines — drugs that are part of daily treatment for common ailments.Samples of medicines such as paracetamol-aceclofenac combinations, pantoprazole, rabeprazole, amoxycillin with potassium clavulanate and albendazole failed quality parameters or were misbranded, raising safety concerns.Health experts warned that prolonged use of such medicines can have serious consequences and, in extreme cases, even trigger life-threatening complications like cardiac arrest or stroke."These are routine medicines for pain, fever and gastric problems. Any compromise in quality can seriously harm patients," said Dr G Srinivas, assistant professor of clinical pharmacology at Nizam's Institute of Medical Sciences (NIMS). "Every drug must pass dissolution, disintegration and impurity tests before reaching the market. If manufacturers repeatedly violate norms, their licences should be cancelled."B Shivshankar Gupta, member of the Telangana Chemists & Druggists Association (TSCDA), said many drugs fail quality checks because manufacturers do not fully comply with CDSCO regulations, making strict enforcement by drug authorities essential."NSQ drugs weaken the healthcare system, worsen patient outcomes and fuel antibiotic resistance. Strong surveillance is crucial to protect public trust," Gupta said. He also flagged the issue of duplicate medicines. "Outside players manufacture look-alike products and offer higher discounts. Pharmacies and customers buy them, and by the time inspectors step in, the drugs are already sold."Experts also drew parallels with recent child deaths linked to contaminated cough syrups in Madhya Pradesh and Rajasthan, underlining the urgency of rigorous drug testing. Lapses at the retail level were also highlighted, with pharmacies often selling medicines without valid prescriptions, increasing the risk of misuse and medical errors.A senior professor at AIIMS Bibinagar pointed to systemic regulatory gaps. "Pharma companies must follow good manufacturing and laboratory practices, but enforcement is the responsibility of regulators. The Drugs & Cosmetics Act clearly defines roles, yet enforcement remains weak. CDSCO comes under the health ministry, while drug pricing is handled by another ministry, these overlaps create loopholes," the professor said.The Telangana Drug Control Administration (DCA) is also grappling with manpower shortages, operating with just 65–70 inspectors to monitor nearly 50,000 manufacturing and retail units across the state.A senior DCA official said show-cause notices had been issued for all five repeatedly flagged drugs, especially 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 said, adding that responses from companies are awaited."All affected batches were recalled, and inspectors conducted field checks at pharmacies and health centres to ensure the drugs were removed from circulation," the official added.COMMON DRUGS, SERIOUS RISKS5 NSQ drugs repeatedly flagged in Telangana Aceclofenac–Paracetamol (pain & fever): Substandard quality can trigger liver damage, stomach bleeding and delayed pain reliefPantoprazole (Antacid): Poor-quality batches may cause uncontrolled acidity, ulcers and persistent gastric symptoms Rabeprazole (Antacid): Ineffective formulation can worsen acid reflux and long-term digestive complicationsAmoxycillin–Clavulanate (Antibiotic): Substandard doses risk severe diarrhoea and fuel antibiotic resistanceAlbendazole (Anti-parasitic): Poor efficacy can lead to persistent parasitic infections and repeat treatment failures