Following the deaths of at least three children in the state allegedly from consuming cough syrups, the Rajasthan government Friday banned the distribution of cough syrups containing Dextromethorphan. Additionally, the government has banned the distribution of all 19 types of medicines supplied by Kaysons Pharma - the company which is at the centre of the controversy - until further orders. In a crackdown, the department has also suspended Drug Controller II, Rajaram Sharma “for influencing the process of determining standards based on the salt content in various medicines”. Officials said that Chief Minister Bhajan Lal Sharma had directed a thorough investigation into the issue and ensured effective action. The government is also learnt to have initiated the process of requiring necessary information to be printed on medicines that may be harmful to children and pregnant women. Additionally, the purchase and supply of medicines used to treat diseases like COPD will also be regulated. Under normal circumstances, alternative medicines will be used to treat coughs, Health Department officials said. Rajasthan Medical Services Corporation Limited (RMSCL) Managing Director Pukhraj Sen said that since 2012, 10,119 samples have been taken from Kaysons Pharma, Jaipur, which supplies the drug Dextromethorphan. Of these, 42 samples have been found to be substandard. As a precaution, the department has suspended the supply of all 19 types of drugs supplied by this company until further orders while also banning Dextromethorphan from all suppliers. The Rajasthan government also distanced itself from the deaths of children linked to the cough syrup, saying that it did not prescribe this medicine to them, even as another family in Bharatpur claimed that a child had died due to the said cough syrup. Medical and Health Department Minister, Gajendra Singh Khimsar said Friday: “These medicines were not via a prescription or recommendation of government hospitals. If any parent anywhere gives an ‘unprescribed’ medicine and it leads to an incident, then there is no role of the department. It is outside the purview of our department. We have tested our medicines, they have no problem. But I will anyway investigate this more”. However, the victims’ families insist that that medicine was prescribed at the government hospital. Jyoti, the mother of one of the children, told The Indian Express, “My son had a cough and cold and the doctor at the government clinic prescribed us this syrup. I gave this to my older children as well who vomited after some time. But Samrat’s condition worsened. When we got to Jaipur, doctors claimed that my son’s lungs were not working. I told the doctors that their condition worsened due to the syrup but they didn’t believe me.” As the row escalated, another family from Bharatpur’s Weir claimed that their two-year-old was given the cough syrup by doctors at the government hospital in Weir, which worsened his condition, leading to his death in Jaipur on September 27. The cough syrup is also linked to some other cases of hospitalised children in the state. The generic cough syrup, manufactured by Kaysons Pharma, is supplied through various outlets under the Chief Minister’s free medicine scheme. The government, however, denied that the cough syrup had to do with the deaths. Citing its report, the government said that cough medicine Dextromethorphan was not prescribed to both the children who died earlier. “According to protocol, this medication is not prescribed to children. A case of prescribing this cough medicine to a child at the Hathideh PHC in Sikar's Ajitgarh block had come to light, leading to the suspension of physician Dr Palak and pharmacist Pappu Soni,” Dr Ravi Prakash Sharma, the state's director of public health, said. The deaths have become a political flashpoint, with Congress state president Govind Singh Dotasra accusing the state government of having “no shame or sensitivity” left. “The lap of a mother has been emptied, her heart has been snatched away, yet the BJP government is holding that mother responsible for her child's death. It is shameful. The only crime of that mother is that she gave her child the medicine obtained from the government hospital on the doctor's advice,” he said. He said, “The lives of three innocents were lost, kidneys of many children have been permanently damaged, and the BJP's insensitive government is still engaged in making excuses. Kaysons Pharma company, which was banned on charges of making fake medicines, is the same one whose medicine was being supplied. Despite the ban, the poisonous medicine continued to be distributed in Rajasthan's government hospitals under the 'Chief Minister Free Medicine Scheme.'” Meanwhile, the Union Ministry of Health and Family Welfare has also recommended cautious use of cough syrups, saying they were not recommended for children below 5 years of age and that most acute cough illnesses in children “are self-limiting and often resolve without pharmacological intervention”. On Thursday, the Rajasthan government had also issued fresh guidelines for prescribing the cough syrup, advising physicians to avoid using dextromethorphan-containing syrups for cough in paediatric patients, and not to give it to children under 4 years of age, while also issuing instructions for Pharmacists, ASHA/ANM/CHO and the common citizens regarding the usage of the drug.
