Four southern states ban cough and cold syrups for children under two, step up surveillance

Karnataka, Telangana, Kerala and Andhra Pradesh have launched strict surveillance, inspections, and public awareness campaigns, with Kerala forming an expert committee to issue child-specific guidelines.

Karnataka, Kerala, Telangana and Andhra Pradesh have banned the prescription and sale of cough and cold medications for children under two, following the deaths of at least 16 children in Madhya Pradesh and Rajasthan after consuming contaminated cough syrup in September.

The syrup, Coldrif, was allegedly adulterated with Diethylene Glycol (DEG), a highly toxic substance. Laboratory reports from Madhya Pradesh and Tamil Nadu confirmed the presence of DEG in alarming concentrations: 46 percent in the Madhya Pradesh report and 48.6 percent in the Tamil Nadu report. The permissible limit for DEG is just 0.1 percent.

The contaminated Coldrif syrup (Batch No SR-13, manufactured in May 2025 with expiry in April 2027) was made by Sresan Pharma in Sunguvarchathiram, Kancheepuram district, Tamil Nadu. It was distributed to Rajasthan, Madhya Pradesh, Puducherry and Odisha. Rajasthan also reported deaths linked to Dextromethorphan Hydrobromide Syrup manufactured by Jaipur-based Kaysons Pharma.

Following these incidents, the Directorate General of Health Services (DGHS) issued a nationwide advisory on 3 October, stating that “cough and cold medications should not be prescribed or dispensed to children under 2 years” and are “generally not recommended for ages below 5 years.”