The World Health Organization on Monday issued a medical alert against the use of three cough syrups that were found to have diethylene glycol beyond the permissible limit, which can cause acute kidney and liver failure.

The alert warned against specific batches of the Coldrif Cough Syrup manufactured by Sresan Pharmaceutical in Tamil Nadu, and Gujarat-based Rednex Pharmaceuticals’ Respifresh TR and ReLife from Shape Pharma.

The action came after the deaths of 22 children in Madhya Pradesh in the past month linked to the consumption of Coldrif cough syrup. Deaths related to a generic cough syrup have also been reported from Rajasthan.

Several children, who had been suffering from fever and cold, consumed the Coldrif syrup, resulting in vomiting and difficulty urinating in Madhya Pradesh.

The first death was recorded on September 2.

On October 2, the Tamil Nadu director of drugs control found that the Coldrif samples were not of standard quality. Three days later, Madhya Pradesh also reported that one sample of Coldrif had 48.6% of diethylene glycol in it.

On October 6, the Madhya Pradesh drug controller found that a sample of Relife syrup had 0.616% diethylene glycol. A sample of Respifresh TR syrup was found to have 1.34% diethylene glycol.

The permissible limit of diethylene glycol as an impurity is 0.1%. However, drug officials Scroll spoke to said that the chemical is unsafe even in trace amounts and should ideally be completely absent from an ingestible syrup. Its presence is a serious quality compliance issue, the officials said.

“On 8 October, the Central Drugs Standard Control Organisation of India reported to WHO the presence of diethylene clycol in at least three oral liquid medicines,” stated the World Health Organization on Monday.

It added: “This followed information identified by WHO on 30 September 2025 of localised clusters of acute illness and child fatalities in India.”

The health body said that the Indian authorities had informed it that the contaminated formulations were not exported outside the country and “there is currently no evidence of illegal export”.

Despite this, the WHO said it has asked National Regulatory Authorities “to consider targeted market surveillance, with particular attention to informal and unregulated supply chains where products may circulate undetected”.

This came days after the WHO said that it was concerned about India’s “regulatory gap” in screening syrup medicines. It had said on October 9 that it would investigate the need to issue a Global Medical Products Alert.

On the same day, the Madhya Pradesh Police arrested the owner of Sresan Pharmaceutical Manufacturer, G Ranganathan, in Chennai. On Monday, the firm’s manufacturing licence was revoked.

Two drug inspectors from Tamil Nadu have been suspended for failing to conduct quality checks on the drugs manufactured by Sresan Pharmaceutical Manufacturer in the past two years.

Following the deaths, the formulation was banned in Tamil Nadu, Madhya Pradesh, Kerala, Karnataka, Punjab, Himachal Pradesh, Uttar Pradesh, Puducherry, West Bengal and Delhi.

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