Self-medication has become increasingly common in India, with studies showing alarming rates between 50-85% of the population regularly taking over-the-counter (OTC) medications without medical supervision. While convenient, this practice carries significant health risks that many people overlook. Recent research confirms that improper use of common medications like paracetamol, painkillers, and antacids can lead to serious complications including liver damage, kidney disease, and antibiotic resistance.

The Prevalence of Self-Medication in India

Self-medication has reached critical levels in India, with multiple studies confirming its widespread practice. Research shows that more than half of study participants regularly self-medicate, with some studies reporting rates as high as 84.58%[13]. In urban populations specifically, the prevalence reaches 63.5%, highlighting how deeply entrenched this behavior has become across the country[20].

During the COVID-19 pandemic, these numbers likely increased even further as people avoided hospital visits and relied more heavily on “Doctor Google” for medical advice. The combination of easy access to medications, rising healthcare costs, and convenient self-diagnosis tools has created a perfect storm for medication misuse[18].

What makes this situation particularly concerning is that 90% of self-medicating individuals obtain drugs directly from pharmacies without proper prescriptions, with students aged 18-25 representing the majority of such cases[2]. This reflects significant gaps in regulatory enforcement and public health education across the country.

Hidden Risks of Common OTC Medications

While most people view OTC medications as harmless, scientific evidence reveals significant health risks associated with their improper use. Let’s examine the specific dangers associated with commonly self-prescribed medications:

Paracetamol and Liver Damage

Paracetamol (known as acetaminophen in some countries) is one of the most widely used pain relievers and fever reducers worldwide. Found in products like Crocin and Dolo, it’s often considered completely safe. However, research confirms that paracetamol overdose is one of the leading causes of acute liver failure globally[4].

During paracetamol metabolism, a toxic compound called NAPQI is formed in the liver. Normally, a substance called glutathione quickly detoxifies this compound. However, in overdose situations, glutathione stores become depleted, allowing NAPQI to accumulate and cause liver damage[16].

According to research, paracetamol can damage the liver by harming vital structural connections between adjacent cells in the organ. When these cell wall connections (tight junctions) are disrupted, the liver tissue structure is damaged, cells cannot function properly, and may die[4].

Alarmingly, in 2021-2022, there were over 227 deaths recorded in England and Wales due to paracetamol overdose, highlighting the potential severity of misusing this common medication[16].

Painkillers and Kidney Disease

Non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen (found in medications like Combiflam) are commonly used for pain relief. However, regular use of these medications can significantly impact kidney health.

Medical research confirms that NSAID use has been associated with acute kidney injury, progressive loss of glomerular filtration rate in chronic kidney disease (CKD), electrolyte imbalances, and fluid retention[14]. These medications reduce blood flow to the kidneys by inhibiting protective prostaglandins, potentially causing kidney damage.

Healthcare professionals strongly advise that NSAIDs should be avoided entirely by individuals with chronic kidney disease or kidney transplants, as they can further reduce kidney function[15]. For healthy individuals, the risk increases with age, dosage, and frequency of use.

Studies show that the risk of developing kidney problems from NSAIDs appears to be dose-dependent, with significantly higher risk observed in those taking higher quantities for extended periods[6]. This confirms that even occasional but regular use of painkillers for common aches and pains could contribute to serious kidney issues over time.

Antacids and Digestive Complications

Many people reach for antacids like Gelusil or ENO after heavy meals, considering them harmless digestive aids. However, regular use can lead to several complications that may worsen the very symptoms they’re meant to treat.

Common side effects of antacids include constipation, diarrhea, and abdominal pain[9]. More concerning is the phenomenon known as “rebound acidity,” where stomach acid production increases after the antacid wears off, creating a cycle of dependence where symptoms become worse than they were initially.

Additionally, antacids can interfere with the absorption of other medications. According to product warnings: “This medicine can make it harder for your body to absorb other medicines, especially certain antibiotics. Avoid taking any other medicine within 2 hours before or 2 hours after you take aluminum hydroxide, magnesium hydroxide, and simethicone”[9].

Long-term use of certain antacids can also lead to more severe complications including bone pain, muscle weakness, confusion, and changes in mental state[9]. These risks highlight why self-diagnosing digestive issues and treating them with OTC antacids can be problematic.

Antibiotics and Drug Resistance

Perhaps the most concerning form of self-medication involves antibiotics. India tops the list of countries with the highest antibiotic consumption globally, which directly contributes to antimicrobial resistance (AMR)[10].

Antimicrobial resistance represents a global public health crisis that directly caused 1.27 million deaths and contributed to nearly 5 million more deaths in 2019 alone—more than HIV/AIDS or malaria[10]. The primary driver of this crisis is inappropriate use of antibiotics, including self-medication.

Drug resistance develops when antimicrobials are used improperly and irrationally. In India, this problem is compounded by unrestricted drug manufacturing, marketing, and sales, allowing easy access to antibiotics without prescriptions[10].

Research shows alarming resistance rates developing for common infections in India. For example, resistance to commonly used antimicrobials for treating cholera has reached 60-80% for some medications, and up to 80-90% for others[11]. This means that when you actually need antibiotics for a serious infection, they may no longer work effectively.

Why Self-Medication Has Become the Norm

Several factors contribute to the high prevalence of self-medication in India:

Time and cost considerations: Approximately 56.9% of respondents in studies preferred self-medication to save time from traveling to clinics and to save money[2]. In a healthcare system where consultations can be time-consuming and expensive, many choose the quicker alternative of self-prescription.

Easy accessibility: Studies indicate that 90% of respondents obtain drugs directly from pharmacies without prescriptions[2]. Despite regulations requiring prescriptions for many medications, enforcement remains weak, allowing easy access to most drugs.

Previous experience: Around 44.7% of individuals use previous prescriptions to treat similar illnesses[20]. Familiarity with medications and confidence in self-diagnosis reinforces this behavior.

COVID-19 impact: The pandemic significantly increased self-medication practices as people avoided hospitals and clinics for fear of infection. With increased reliance on online information and telemedicine, many began treating symptoms based on internet research rather than professional diagnosis[18].

Lack of awareness: Many people are simply unaware of the risks associated with self-medication and view OTC drugs as harmless solutions for common symptoms without understanding potential complications.

The Silent Health Crisis: Long-Term Consequences

The cumulative impact of widespread self-medication is creating a silent health crisis in India with several concerning outcomes:

Drug quality issues: In 2022-23, government data revealed that 3,053 drugs were found to be substandard and 424 drugs were declared spurious or adulterated[3]. This quality concern compounds the risks of self-medication, as individuals may be using substandard products.

Masking serious conditions: Self-medication often treats symptoms rather than underlying causes, potentially masking serious health conditions that require proper medical attention. This delay in diagnosis can lead to complications and reduced treatment effectiveness[17].

Adverse drug reactions: Without proper medical guidance, individuals may experience unexpected side effects, drug interactions, or allergic reactions. This is especially concerning for elderly patients who may be taking multiple medications[18].

Growing antimicrobial resistance: Perhaps the most significant long-term consequence is the development of drug-resistant infections, which threatens our ability to treat common infectious diseases and could lead to a post-antibiotic era where minor infections become life-threatening[10].

Economic burden: While individuals may choose self-medication to save money in the short term, the long-term economic impact of treating complications, hospitalizations, and managing chronic conditions resulting from improper medication use creates a much larger financial burden both personally and on the healthcare system.

Expert Recommendations for Safe Medication Practices

To address the growing concerns around self-medication, healthcare experts recommend several approaches:

Consult healthcare professionals: Before taking any medication, even OTC drugs, consult with a qualified healthcare provider. This is especially important if you have any existing health conditions or are taking other medications. Schedule a consultation with Dr. Sumaiya for personalized advice tailored to your specific health needs.

Understand proper dosing: Always follow recommended dosages and never exceed them. For paracetamol, adults can usually take one or two 500mg tablets every 4-6 hours, but should never exceed 8 tablets in 24 hours[4].

Be aware of warning signs: Know the potential side effects of medications you’re taking and seek immediate medical attention if you experience unusual symptoms. For paracetamol overdose, early symptoms may be subtle but can progress to liver failure within days[16].

Avoid long-term use without supervision: Regular use of painkillers, antacids, or other OTC medications should be monitored by a healthcare provider. What seems like a harmless habit could be contributing to serious health issues. Connect with Dr. Sumaiya for proper evaluation and monitoring.

Never share medications: Medications prescribed for one person may not be appropriate for another, even with similar symptoms. Avoid sharing prescriptions or recommending specific medications to friends and family.

Properly store and dispose of medications: Keep all medications in their original containers, out of reach of children, and properly dispose of expired medications rather than keeping them “just in case.”

Seek alternative approaches: For minor ailments, consider non-medication approaches first. For headaches, proper hydration, rest, and stress management may help. For digestive issues, dietary modifications often prove more effective than antacids. Consult with Dr. Sumaiya for natural alternatives that might address your concerns without medication risks.

Conclusion: Taking Control of Your Medical Care

Self-medication has become dangerously normalized in India, with most people unaware of the serious risks associated with common OTC medications. The evidence is clear: paracetamol can cause liver failure, painkillers can damage kidneys, antacids can worsen digestive problems, and improper antibiotic use contributes to a global health crisis of drug resistance.

While the convenience of self-medication is understandable, the potential health consequences far outweigh the short-term benefits. Taking control of your health means working with medical professionals rather than substituting their expertise with internet searches or past experiences.

As we’ve seen from the research, education and awareness are crucial factors in reducing harmful self-medication practices. By understanding the risks and making informed decisions, we can protect ourselves and contribute to better public health outcomes.

If you’re concerned about symptoms or have been regularly self-medicating, now is the time to seek professional guidance. Schedule a consultation with Dr. Sumaiya today to receive personalized advice and develop a safer approach to managing your health concerns.

Remember, medications are powerful tools that can heal when used correctly, but can cause serious harm when misused. Choose safety over convenience when it comes to your health.

Citations:
[1] Prevalence and Predictors of Self-Medication Practices in India https://pmc.ncbi.nlm.nih.gov/articles/PMC7579319/
[2] [PDF] Prevalence of Self Medication and Associated Factors among Urban … https://www.jrmds.in/articles/prevalence-of-self-medication-and-associated-factors-among-urban–population-of-thiruvallur-district-in-south-india.pdf
[3] Over 3,000 drugs found substandard, 424 declared spurious or … https://www.cnbctv18.com/india/healthcare/3053-drugs-found-substandard-424-declared-spurious-or-adulterated-in-fy22-23-centre-19451653.htm
[4] Paracetamol overdose is one of the leading causes of liver failure. https://britishlivertrust.org.uk/researchers-shed-new-light-paracetamol-causes-liver-damage/
[5] Prescription Analgesic Use in Older Adults With and Without Chronic … https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2771040
[6] Kidney damage from nonsteroidal anti‐inflammatory drugs—Myth or … https://pmc.ncbi.nlm.nih.gov/articles/PMC8313037/
[7] Pain management in patients with chronic kidney disease and end … https://pmc.ncbi.nlm.nih.gov/articles/PMC7753951/
[8] Can paracetamol cause liver damage? Doctors weigh in https://timesofindia.indiatimes.com/life-style/health-fitness/health-news/can-paracetamol-cause-liver-damage-doctors-weigh-in/articleshow/107914245.cms
[9] Gelusil Side Effects: Common, Severe, Long Term – Drugs.com https://www.drugs.com/sfx/gelusil-side-effects.html
[10] Antibiotic Misuse in India Could Exacerbate Drug Resistance | SPH https://www.bu.edu/sph/news/articles/2022/antibiotic-misuse-in-india-could-exacerbate-drug-resistance/
[11] [PDF] National Treatment Guidelines for Antimicrobial Use in Infectious … http://www.clinicalestablishments.mohfw.gov.in/sites/default/files/standard-treatment-guidelines/86111.pdf
[12] Addressing over-the-counter drug abuse: A call for stricter … https://www.jpbs.in/html-article/23825
[13] Prevalence, Pattern, and Reasons for Self-Medication: A Community … https://pmc.ncbi.nlm.nih.gov/articles/PMC9936784/
[14] [PDF] NSAIDs in CKD: Are They Safe? | Biogenetech https://www.biogenetech.co.th/wp-content/uploads/2021/03/NSAIDs-in-CKD-Are-they-safe.pdf
[15] Pain medication for people with chronic kidney disease https://kidneycareuk.org/kidney-disease-information/treatments/medicines-for-chronic-kidney-disease-ckd/patient-info-pain-medication-for-people-with-chronic-kidney-disease/
[16] Paracetamol Overdose: Symptoms and Treatment – Patient.info https://patient.info/treatment-medication/paracetamol-overdose
[17] [PDF] Consultation Paper on Drug Registry – Ayushman Bharat https://abdm.gov.in:8081/uploads/Drug_Registry_Consultation_Paper_092e75a15e.pdf
[18] The Abuse and Misuse of Over-the-Counter Medicines During … https://pmc.ncbi.nlm.nih.gov/articles/PMC9988622/
[19] Self-medication Practices of the Rural Community People – LWW https://journals.lww.com/ijcm/fulltext/2023/48040/self_medication_practices_of_the_rural_community.22.aspx
[20] Prevalence of Self Medication and Associated Factors Among Urban … https://www.jrmds.in/articles/prevalence-of-self-medication-and-associated-factors-among-urban-population-of-thiruvallur-district-in-south-india-96986.html
[21] Prevalence and patterns of self-medication practices in India https://www.sciencedirect.com/science/article/abs/pii/S0377123724002533
[22] Acidity? Don’t reach out for that antacid just yet – The Indian Express https://indianexpress.com/article/lifestyle/health/acidity-digestive-issues-rootcauses-antacid-experts-9789065/
[23] Survey confirms rampant misuse of over-the-counter antibiotics in … https://www.indiatoday.in/health/story/survey-confirms-rampant-misuse-of-over-the-counter-antibiotics-in-mumbai-2635723-2024-11-19
[24] Self-medication prevalence and associated factors among adult … https://journals.sagepub.com/doi/10.1177/20503121241240507
[25] Self-medication prevalence and associated factors among adult … https://pmc.ncbi.nlm.nih.gov/articles/PMC10964435/
[26] Erykine 40000IU Injection: View Uses, Side Effects, Price and … – 1mg https://www.1mg.com/drugs/erykine-40000iu-injection-304046
[27] Liver injury induced by paracetamol and challenges associated with … https://pmc.ncbi.nlm.nih.gov/articles/PMC7336293/
[28] Pain management in patients with chronic kidney disease and end … https://pmc.ncbi.nlm.nih.gov/articles/PMC7753951/
[29] List of Common Antacids + Uses, Types & Side Effects – Drugs.com https://www.drugs.com/drug-class/antacids.html
[30] Over-the-Counter Sale of Antibiotics in India: A Qualitative Study of … https://pmc.ncbi.nlm.nih.gov/articles/PMC8472180/
[31] Assessment of practice of self-medication among the general public … https://adejournal.com/assessment-of-practice-of-self-medication-among-the-general-public-of-nagpur-city-a-cross-sectional-survey/
[32] 52% Indians self-medicate | Delhi News – Times of India https://timesofindia.indiatimes.com/city/delhi/52-indians-self-medicate/articleshow/46844097.cms
[33] Comparative Risks of Nonsteroidal Anti-Inflammatory Drugs on CKD https://pmc.ncbi.nlm.nih.gov/articles/PMC8216605/
[34] Ibuprofen-associated Renal Impairment in a Large General Internal … https://www.sciencedirect.com/science/article/pii/S0002962915361243
[35] Use of Nonsteroidal Anti-Inflammatory Drugs and Risk of Chronic … https://www.ahajournals.org/doi/10.1161/HYPERTENSIONAHA.114.05105
[36] Gestational Exposure to Nonsteroidal Anti-Inflammatory Drugs and … https://jamanetwork.com/journals/jamapediatrics/fullarticle/2828039
[37] Gelusil Antacid And Anti-Gas Oral: Uses, Side Effects … – WebMD https://www.webmd.com/drugs/2/drug-14836/gelusil-antacid-and-anti-gas-oral/details
[38] Is Ibuprofen Bad for Your Liver and Kidneys? – Nsaids – GoodRx https://www.goodrx.com/classes/nsaids/nsaids-ibuprofen-bad-liver-kidneys
[39] Pain management in patients with chronic kidney disease – PMC https://pmc.ncbi.nlm.nih.gov/articles/PMC4421348/
[40] Paracetamol overdose in kids can lead to liver failure: Study https://timesofindia.indiatimes.com/city/chennai/paracetamol-overdose-in-kids-can-lead-to-liver-failure-study/articleshow/94061395.cms
[41] Gelusil® Heartburn Medication & Gas Relief http://gelusil.com/about-gelusil
[42] Ibuprofen Prescription and Acute Kidney Injury Among Hospitalized … https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2776972
[43] [PDF] Final Report Survey of Pharma Clusters https://www.pharma-dept.gov.in/sites/default/files/Final%20Report-Survey%20of%20Pharma%20Clusters.pdf
[44] Drugs – CDSCO https://cdscoonline.gov.in/CDSCO/Drugs
[45] An educational review on over-the-counter drugs https://www.ijpca.org/html-article/23782
[46] [PDF] Standard Treatment Workflows of India, Vol. 3, 2022 https://www.icmr.gov.in/icmrobject/custom_data/pdf/downloadable-books/STW_Vol_3_2022.pdf
[47] Over the counter drugs and self-medication: A worldwide paranoia … https://www.sciencedirect.com/science/article/pii/S204908012200557X
[48] Factors associated with the use of over-the-counter sleep aids … https://www.sciencedirect.com/science/article/pii/S1319016423001718
[49] Probing the in-depth analysis of Serious Adverse Drug Reactions in … https://www.sciencedirect.com/science/article/pii/S2667276625000204
[50] [PDF] substance use – Ministry of Social Justice and Empowerment https://socialjustice.gov.in/writereaddata/UploadFile/Survey%20Report.pdf
[51] [PDF] Medications for Obesity Management: Effectiveness and Value – ICER https://icer.org/wp-content/uploads/2022/03/ICER_Obesity_Evidence_Report_083122.pdf
[52] [PDF] a study of otc drugs in india and regulations governing them https://ijbpas.com/pdf/2024/April/MS_IJBPAS_2024_7946.pdf
[53] India: Presentation of key findings from UNODC’s World Drug Report … https://www.unodc.org/southasia/frontpage/2024/June/india_-presentation-of-key-findings-from-unodcs-world-drug-report-2024-to-mark-the-international-day-against-drug-abuse-and-illicit-trafficking.html
[54] [PDF] Annual Report 2022-23 – Department of Pharmaceuticals https://pharma-dept.gov.in/sites/default/files/Annual%20Report%202022-23%20Final-3.pdf
[55] [PDF] Global Use of Medicines 2024 – IQVIA https://www.iqvia.com/-/media/iqvia/pdfs/china/viewpoints/iqvia-institute-general-use-of-medicines-2024-for-print.pdf
[56] Prescription Drug Costs | Pros, Cons, Debate, Arguments, Economy … https://www.britannica.com/procon/prescription-drug-costs-debate
[57] Aspirin – Wikipedia https://en.wikipedia.org/wiki/Aspirin
[58] Enzar 40000 Capsule: View Uses, Side Effects, Price and Substitutes https://www.1mg.com/drugs/enzar-40000-capsule-361604
[59] [PDF] Türkiye 2024 Report – Enlargement and Eastern Neighbourhood https://enlargement.ec.europa.eu/document/download/8010c4db-6ef8-4c85-aa06-814408921c89_en?filename=T%C3%BCrkiye+Report+2024.pdf
[60] [PDF] National Treatment Guidelines for Antimicrobial Use in Infectious … http://www.clinicalestablishments.mohfw.gov.in/sites/default/files/standard-treatment-guidelines/86111.pdf
[61] [PDF] Final Report Survey of Pharma Clusters https://pharma-dept.gov.in/sites/default/files/Final%20Report-Survey%20of%20Pharma%20Clusters.pdf
[62] [PDF] Results from the 2020 National Survey on Drug Use and Health https://www.samhsa.gov/data/sites/default/files/reports/rpt35325/NSDUHFFRPDFWHTMLFiles2020/2020NSDUHFFR1PDFW102121.pdf
[63] [PDF] Brief Overview on Over-the-Counter Medicine and their Impact on … https://ijopp.org/files/InJPharPract-15-2-65.pdf
[64] National Centre for Drug Abuse Prevention – NISD https://www.nisd.gov.in/drug_abuse_prevention.html
[65] Clinical Toxicology of Vitamin D in Pediatrics: A Review and Case … https://pmc.ncbi.nlm.nih.gov/articles/PMC10385357/
[66] Drug-related Offences in India: Observations and Insights from the … https://journals.sagepub.com/doi/full/10.1177/02537176241228415
[67] Drug Abuse in India – An Overview | UPSC – BYJU’S https://byjus.com/free-ias-prep/drug-abuse/
[68] Eporise 40000 Injection: View Uses, Side Effects, Price and … – 1mg https://www.1mg.com/drugs/eporise-40000-injection-70768
[69] Call to action: Addressing asthma diagnosis and treatment gaps in … https://pmc.ncbi.nlm.nih.gov/articles/PMC11093140/
[70] [PDF] ANNUAL REPORT 2023 | Narcotics Control Bureau https://narcoticsindia.nic.in/Publication/ncb-annual-report-2023-24.pdf
[71] [PDF] A Meta-Analysis on Misuse of Prescription/OTC Drugs https://archives.ijper.org/sites/default/files/IndJPhaEdRes-57-1s-167.pdf
[72] [PDF] Consultation Paper on Drug Registry – Ayushman Bharat https://abdm.gov.in:8081/uploads/Drug_Registry_Consultation_Paper_092e75a15e.pdf