breaking news Who Warns About Maiden Pharma Cough Syrups – How a Poor Quality Ingredient Can Become a Killer


Four Maiden Pharma cough syrups have been linked to acute kidney injury and 66 child deaths in The Gambia. The authorities, including the CDSCO, took action. Also in 2020, nine children died of kidney failure in Jammu and Kashmir due to Digital Vision’s PC Coldbest cough syrup, which contained the same ingredient found in Maiden Pharma products.

WHO has identified four pediatric cough syrups made by Maiden Pharma in India – Promethazine Oral Solution, Kofexmalin Baby Cough Syrup, Makoff Baby Cough Syrup and Magrip N Cold Syrup – as substandard and linked to 66 child deaths in Gambia, West Africa.

The Central Drugs Standard Control Organization (CDSCO) has sprung into action and is investigating the World Health Organization’s warning against the use of the four cough syrups.

But such contaminations have been observed all over the world. In 2020, 17 children were hospitalized with kidney failure in Jammu and Kashmir due to Coldbest PC cough syrup which contained the same ingredient found in Haryana-based Maiden Pharma products. The Coldbest product from Himachal Pradesh-based pharmaceutical company Digital Vision was banned, but by then nine children had lost their lives.

What is the problem

These cough syrups have been linked to acute kidney injury in children in The Gambia, leading to death. The WHO has warned that although the samples tested came from The Gambia, the product may have been transported or distributed, via informal markets, to other countries or regions.

The WHO has recommended that all countries withdraw these products.

According to interim results received by WHO, four of the 23 samples tested contain diethylene or ethylene glycol (DEG). The WHO has stated that DEG is toxic to humans when consumed and can be fatal. Their toxic effects can include abdominal pain, vomiting, diarrhea, inability to urinate, headache, altered mental status, and acute kidney injury.

What is diethylene glycol?

Diethylene glycol is a solvent present in many formulations such as brake fluids, paints and chemical preparations. These solvents can cause kidney failure and can even lead to death if ingested.

DEG is not used to make cough syrups, but contamination mainly occurs if the company making the drugs uses substandard industrial grade propylene glycol for cough syrups where DEG is one impurities.

Therefore, pharmaceutical companies must ensure that they use propylene glycol, which is safe according to pharmaceutical standards.

Industrial propylene glycol contains high levels of DEG and, if substituted in pharmaceuticals, can be toxic. While there may be other contaminating factors, such as a faulty global supply chain, this is probably the most common, especially when it comes to cough syrups.

DEG contamination is not new

DEG contamination is not new, as many cases have been recorded since the late 1930s worldwide. Here are some cases reported in India earlier:

Year Case
1973 Linked to death of 14 children in Chennai
1986 Linked to 21 deaths in Mumbai
1998 Linked to 36 children with kidney failure in Gurugram
2020 17 children hospitalized with kidney failure in Jammu and Kashmir due to Coldbest PC cough syrup

Cough syrups under scanner

This is not the first time that cough syrups have come under scrutiny from the government. Earlier in July, a News 18 report had indicated that the government was reviewing a policy to ban the manufacture and sale of codeine-based cough syrups. This came after several MPs raised concerns that these syrups are being used as narcotics rather than medicine.


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