Subsequent to the release of national-level guidelines on antibiotic resistance and multi-drug resistance, Indian Medical Association (IMA) is now in the process of framing guidelines on non-steroid anti-inflammatory drugs (NSAID) to discourage its irrational usage amongst the patients.   

The guidelines according to an IMA official is very much required as patients generally ask for drugs like paracetamol, aspirin, brufen and nimesulide for pain relief and fever from the retail pharmacy store and drugs are dispensed either without a prescription or without under doctor's supervision.

According to health experts, irrational usage of NSAID has been so rampant worldwide that paracetamol has been termed as a suicidal agent in western countries. Global regulatory agencies have, therefore, gone to the extent of banning the combination drugs having paracetamol beyond the prescribed limit of 325 mg.   

It is therefore recommended that usage of NSAID for pain relief in condition of fever or pain in the body due to an ailment should be consulted with the physician to avoid complications in liver, heart and kidney. These over-the-counter (OTC) drugs should ideally be taken under the supervision of a registered medical practitioner (RMP) and usage to be promoted against a prescription. Heart patients should take the drugs only under the supervision of a doctor.    

It has also been recommended that aspirin should not be consumed by children as it can lead to liver failure and especially not recommended for those children who are suffering from diseased conditions like flu and chicken pox.

Drug Controller General of India (DCGI) gave approval to nimesulide on 13 January, 1995 with its recommended usage in children above the age of 12 years. Nimesulide is a European drug which has been approved in 54 countries.

The Central government in September 2013 had amended the Drugs and Cosmetics (D&C) Rules to insert Schedule H1 to curb the indiscriminate use of antibiotics and some other vital drugs, by placing 46 antibiotics under this category. Compliance is also required for Schedule H and Schedule X drugs under the drugs and cosmetics act, 1940.