The Drugs Control Administration under the Directorate of Health and Family Welfare, Government of Nagaland, has issued a Health Safety Advisory cautioning against the indiscriminate use of painkillers, particularly Non-Steroidal Anti-Inflammatory Drugs (NSAIDs), antibiotics and associated risk of chronic kidney disease.
The advisory, issued in pursuance of the directive and advisory of the Drugs Controller General (India), Central Drugs Control Organization, Government of India, is aimed at promoting the safe and rational use of medicines and preventing avoidable risks to public health.
For the general public, the advisory states that NSAIDs, painkillers and antibiotics should not be taken indiscriminately, repeatedly or for prolonged periods without medical advice. Antibiotics should not be used for self-medication or for conditions where antibiotic treatment is not clinically indicated, including most uncomplicated viral infections.
The public has also been advised to take antibiotics prescribed by healthcare professionals strictly as directed and not to share them with others or use leftover medicines. Individuals with pre-existing kidney disease or other risk factors for renal impairment have been particularly advised to inform their healthcare professionals before using NSAIDs.
The advisory further urges individuals to seek medical advice when pain, fever or other symptoms persist or recur, instead of repeatedly using painkillers or antibiotics on their own.
For healthcare professionals, NSAIDs and antibiotics should be prescribed only when clinically indicated, after considering the patient’s clinical condition, age, co-morbidities, concomitant medicines and relevant risk factors. In the case of NSAIDs, the lowest effective dose for the shortest appropriate duration should be considered, particularly for patients at increased risk of renal impairment.
Healthcare professionals have also been advised to take appropriate precautions when prescribing NSAIDs to patients with renal impairment, dehydration, cardiovascular disease or other conditions that may increase the associated risks.
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With regard to antibiotics, the advisory calls for judicious prescribing in accordance with applicable antimicrobial stewardship principles. Healthcare professionals have been advised to consider the likely causative organism, site and severity of infection and, wherever appropriate, relevant microbial investigations and local susceptibility patterns. Unnecessary combination therapy, inappropriate antibiotic selection, incorrect dosing and unnecessarily prolonged antibiotic treatment should be avoided.
The advisory also places responsibilities on pharmacists, retailers and distributors. They have been directed to strictly comply with the statutory requirements relating to the sale and distribution of Schedule H, H1 and other prescription drugs. Schedule H/H1 medicines are not to be sold at retail except in accordance with the applicable provisions of the Drugs Rules, 1945.
Pharmacists and retailers have further been advised not to encourage or facilitate self-medication with antibiotics or prescription-only NSAIDs and to duly observe the prescribed warnings and conditions of sale appearing on the labels of such medicines.
Hospitals and healthcare institutions have been advised to strengthen systems for rational prescribing and monitoring of NSAIDs and antibiotics and to promote antimicrobial stewardship, prescription review and appropriate patient counselling.
