Tragedy Strikes: Cough Syrup Containing Dextromethorphan Linked to Deaths of 11 Children in Rajasthan and Madhya Pradesh

A widely used cough syrup containing Dextromethorphan Hydrobromide has come under intense scrutiny after reports emerged of 11 child deaths—nine in Madhya Pradesh’s Chhindwara district and two in Rajasthan’s Bharatpur and Sikar districts. The incidents have sparked national concern and prompted urgent investigations by health authorities.

What Happened?

In all reported cases, children had consumed a cough syrup formulation that included Dextromethorphan Hydrobromide, a common ingredient used to suppress dry cough. In Bharatpur, two-year-old Teerthraj was taken to a government hospital with cold and cough symptoms on September 23. He was prescribed a cough syrup and given a dose the same day. He soon fell asleep and remained unresponsive for hours. Despite being rushed to multiple hospitals—including one in Jaipur—he passed away three days later.

A similar case was reported in Sikar, where a five-year-old child died after consuming a similar syrup.

Medical Perspective: What Is Dextromethorphan?

Dextromethorphan is a cough suppressant developed in the 1950s. It acts on the brain to block the cough reflex and is considered a non-addictive alternative to codeine. It is commonly used in over-the-counter and prescription syrups for dry cough relief.

However, pediatric experts emphasize that this medication is not safe for children under the age of two, and should only be used in children aged 2–6 under strict medical supervision.

“The drug can cause drowsiness, dizziness, or even respiratory distress if given in the wrong dosage or to children too young,” said Dr. Sunil Sareen, Pediatrician, Apollo Spectra Hospital, Delhi.

Possible Side Effects and Risks

Side effects of Dextromethorphan can range from mild (drowsiness, stomach upset) to severe (allergic reactions, difficulty breathing). Overdosing or improper use—especially in infants—can lead to coma or death, as the drug may suppress brain activity related to breathing.

Doctors warn that pre-existing liver, kidney, or respiratory conditions can increase the risk of complications, and parents should never administer this medication without professional consultation.

Quality Control Under the Scanner

While Dextromethorphan itself is not a new or banned drug, experts suspect that the deaths may be linked to issues of poor manufacturing quality or contamination, rather than the drug compound itself.

Dr. Sushil Sanghi, a senior pediatrician in Jaipur, noted:

“This drug has been used safely for decades. The concern may lie in the quality of raw materials used or possible contamination during production. Overdose is another potential factor.”

The cough syrup in question was manufactured by Qson Pharmaceuticals, a firm previously penalized for regulatory violations. In 2022, the company was banned for two years over breaches in drug safety and manufacturing standards—a ban that raises further concerns about quality compliance.

Government Response and Investigation

Rajasthan’s Health Minister Gajendra Singh Khimsar confirmed that:

• Samples from the suspect syrup batch have been sent to a government lab for testing.
• A recall of potentially contaminated or unsafe batches is underway.
• An independent investigation committee has been set up to identify the cause and ensure accountability.
• The central and state drug regulators are also involved in the probe, and further action is expected based on lab test results.

Key Takeaways:

• Children under 2 years should never be given Dextromethorphan-based syrups.
• Only use such medications under certified medical guidance.
• Pharmaceutical quality and regulatory enforcement must be strengthened to prevent such tragedies.