Toxic Cough Syrup, Deadly Fallout: Here's How The Public Health Crisis Unfolded

It started in rural Madhya Pradesh. A few children with ordinary cold symptoms like cough, fever, mild discomfort, were given a locally prescribed cough syrup. Within days, instead of recovering, they developed dark urine, lethargy, and signs of kidney failure. One by one, the tragedy spread. Before long, authorities were linking the deaths to a contaminated medicinal syrup called Coldrif. What makes this scandal especially haunting is that the cough remedy, something parents trusted, became the suspect. As state after state banned the product, lab results trickled in, revealing dangerously high levels of diethylene glycol (DEG), a toxic industrial solvent, within the syrup.

Alarmed health departments launched simultaneous inspections of manufacturers, drug controllers were suspended, regulatory orders poured in, and police filed FIRs. This is not the first time cough syrup contamination has claimed lives globally. But in India, the scale, confusion, and public outcry have made this a crisis of trust as much as of medicine.

How The Crisis Unfolded: Toxic Cough Syrup Tragedy Explained

While the situation is still developing across the nation, here's a deep-dive into how it all started in one state, how the crisis raised red flags across the country, and where we are now.

Late August - Early September: Madhya Pradesh Initial Reports

NDTV reports suggest that in Chhindwara district of Madhya Pradesh, children began falling ill with what looked like acute kidney injury following administration of a cough syrup. Initially, these cases were treated as isolated medical emergencies rather than a systemic issue. Some symptoms mimicked viral infections or encephalopathy. 

First Week Of October: Pattern Emerges, Suspicions Rise

By early October, reports flagged at least six child deaths in a span of 15 days in MP, with doctors and families questioning whether the syrups prescribed were safe. Investigations broadened and clusters of similar symptoms beyond Chhindwara began surfacing, raising the possibility of contaminated syrups being more widely distributed. The Madhya Pradesh government initially maintained that no toxic elements had been confirmed, as reports of contamination were awaited. 

Bans, Sample Analyses, And Central Action

Soon after these critical red flags were raised, MP authorities banned the sale, distribution, and stock of Coldrif and other suspect syrups made by the manufacturer Sresan Pharmaceuticals (Tamil Nadu). In Chhindwara, 433 bottles of Coldrif syrup (batch SR-13, manufactured May 2025) were seized and 222 of them reportedly had already been sold to consumers.

Meanwhile, Tamil Nadu's drug control officials found that in samples sent for analysis, Coldrif contained 48.6% diethylene glycol, a level critically above safe limits. The Centre launched inspections across 19 drug manufacturing units in six states as a precautionary measure. FIRs were registered, regulatory actions initiated, and a crackdown announced in multiple states. 

Cases Rise, Bans On Cough Syrups Spread

Within days, the reported deaths climbed. Madhya Pradesh confirmed 19 child deaths connected to Coldrif, as two more children (aged 3 and 2) reportedly died during treatment in Nagpur. The opposition escalated pressure, calling for strong action, some even demanding symbolic "bulldozer" measures against official residences.

States Rush To Respond

Immediately following these reports, other states started taking action against suspected cough syrups. Punjab banned Coldrif for being "not of standard quality." Jharkhand prohibited Coldrif, Respifresh, and Relife. Karnataka banned prescribing cough syrups for children under two years. Kerala banned dispensing medicines to children under 12 without a prescription and formed a state expert panel.

Pharmaceutical Responses

At the producer's end, two Gujarat-based companies, Rednex Pharmaceuticals and Shape Pharma, were ordered to suspend production after preliminary testing flagged "Not of Standard Quality" syrups. Gujarat's FDCA, in coordination with the Central Drugs Standard Control Organization (CDSCO), banned distribution of suspect batches, intensified inspection of 624 licensed liquid drug manufacturers, and ordered sample testing.

Toxic Cough Syrup Crisis Turns Into A Human Rights Issue

Given that access to safe medicines and treatments is a human right acknowledged universally, and that the key problem here was a clear non-adherence to drug safety measures resulting in so many child deaths, the National Human Rights Commission (NHRC) issued notices to Madhya Pradesh, Rajasthan, and Uttar Pradesh governments, demanding action-taken reports regarding the child deaths and drug safety failures.

Currently, the Gujarat government is actively investigating and has frozen laboratory testing across implicated firms. The Rajasthan drug controller was suspended after 11 child deaths were linked to the same syrup chain and Kaysons Pharma's products were pulled from the market. The health departments in Jaipur issued new treatment protocols warning that cough medicines offer "minimal proven benefit" in children and could be risky; emphasis shifted to non-medicinal therapies (hydration, rest, steam, nasal saline) especially for young children.

Meanwhile, in Madhya Pradesh, the new state drug controller moved decisively: Coldrif and Nextro-DS syrups were banned, remaining stocks ordered off shelves, and a high-level meeting convened.

Photo Credit: Pexels

What Went Wrong: How System Gaps Created An Avoidable Crisis

India is now known as "the world's pharmacy" thanks to the nation's vital role as a "crucial global pharmaceutical value chain member" that provides vaccines, essential medicines and medical supplies around the world. But what is undoubtedly clear due to this tragic, toxic cough syrup crisis, is that India's pharma and healthcare system is riddled with gaps that can and have claimed lives.

1. Lax Quality Control At Manufacturing

Investigations and media reports describe factories with rust, filth, and degraded infrastructure, all places where maintaining high pharmaceutical standards is a challenge. Substitution of safe excipients (like pharma-grade propylene glycol) with cheaper industrial-grade chemicals has historically led to contamination with DEG or ethylene glycol (EG).

2. Delayed Detection

The contamination apparently went undetected until deaths began surfacing. That suggests that batch testing, in-process quality checks, and post-market surveillance were inadequate. This clearly points to gaps in enforcement and auditing of liquid drug manufacturers.

3. Supply Chain And Distribution Gaps

Large numbers of bottles had already reached consumers before seizures, indicating gaps in distribution traceability and recalls.

4. Weak Regulatory Structures Across States

The coordination among states, laboratories, and central agencies remains patchy. Some states were slower to act, while in others, sample testing differed. This indicates that regulatory action was uneven.

5. Lack Of Early Warning

The first cases appeared in a district subset nearly a month ago. If better surveillance systems had flagged unusual kidney failures earlier, action might have been quicker.

6. Public Communication And Panic Risk

Mixed messages initially (some negative test results, reassurance by authorities) likely slowed public awareness and reaction. As bans expanded across Indian states, fear spread rapidly among the public. And yet, the fact remains that when manufactured under proper regulatory guidelines, cough syrup is safe for consumption for everyone above 2 years of age.

The toxic cough syrup scandal unfolding in India is a wake-up call that medicine, when poorly controlled, can become a source of harm rather than healing. What began with a few strange deaths rapidly snowballed into a multi-state public health and regulatory crisis. Bans, arrests, seizures, and investigations are all necessary responses, but far more is demanded in terms structural reform, accountability, vigilance, and trust restoration.

Disclaimer: This content including advice provides generic information only. It is in no way a substitute for a qualified medical opinion. Always consult a specialist or your own doctor for more information. NDTV does not claim responsibility for this information.