The World Health Organization
(WHO) has issued a global medical product alert identifying three adulterated syrups manufactured in India, including the infamous Coldrif cough syrup, and urged health authorities worldwide to report immediately if any of these products are detected in circulation.
The alert follows the deaths of several children in Madhya Pradesh linked to the consumption of contaminated cough syrup found to contain the toxic industrial solvent diethylene glycol (DEG). The affected medicines—Coldrif, Respifresh TR and ReLife—are manufactured by Sresan Pharmaceutical in Tamil Nadu, Rednex Pharmaceuticals Pvt Ltd in Gujarat and Shape Pharma Pvt Ltd, also based in Gujarat.
According to WHO and India's central drugs standard control organisation (CDSCO), tests revealed DEG contamination in all three syrups. Coldrif contained 48.6% weight by volume (w/v) of DEG, Respifresh TR 1.34%, and ReLife 0.61%, far above the permissible limit of 0.1%.
WHO described the finding as 'extremely concerning', warning that the contaminated syrups could cause severe and potentially life-threatening illnesses. DEG ingestion can lead to vomiting, abdominal pain, kidney failure and death.
The Coldrif syrup manufactured in Tamil Nadu sparked outrage after reports confirmed that several children who died in Madhya Pradesh had consumed the product. Following this revelation, Sresan Pharmaceutical’s manufacturing licence was revoked and its owner, G Ranganathan, was arrested. The Tamil Nadu government also ordered a statewide inspection of pharmaceutical facilities to identify quality control lapses and prevent similar incidents.
WHO’s medical product alert released on 13 October 2025 says the contaminated products were first reported to WHO by CDSCO on 8 October 2025, following localised clusters of acute illness and child fatalities in India. “The affected products are oral liquid medicines containing active ingredients commonly used to relieve symptoms of the common cold, flu, or cough,” WHO says.
The agency confirmed that DEG contamination had been identified in at least three syrups, reportedly consumed by the affected children.
CDSCO has confirmed that production at the implicated manufacturing sites has been halted and product authorisations suspended. Recalls of the contaminated syrups have already begun.
“The CDSCO has confirmed that none of the contaminated medicines have been exported from India and there is currently no evidence of illegal export,” WHO says. “Nevertheless, national regulatory authorities are encouraged to undertake targeted market surveillance, particularly in informal and unregulated supply chains where products may circulate undetected.”
In the wake of the tragedy, the Union health ministry has issued an advisory to all states and Union Territories (UTs) in India, urging extreme caution in prescribing cough syrups to children. The advisory specifically states that such syrups should not be prescribed or dispensed to children below two years of age and are generally not recommended for those under five. Officials say the incident underscores the urgent need for stricter regulatory oversight and quality testing to prevent substandard medicines from reaching consumers.
The latest alert has revived painful memories of similar DEG poisoning incidents in Gambia in 2022 and Uzbekistan in 2023, where contaminated syrups manufactured in India were linked to the deaths of dozens of children. The new revelation has renewed concerns over the effectiveness of domestic drug regulation, particularly among smaller manufacturers.
WHO has urged governments worldwide to increase vigilance over cough and cold syrups in circulation, verify the authenticity and quality of oral liquid medicines originating from the named companies, and report any detection of these products to the organisation immediately. “The products identified in this alert are considered substandard as they fail to meet their quality standards and specifications,” WHO says, adding that it continues to collaborate closely with Indian authorities to trace the source of contamination and mitigate public health risks.
According to CDSCO data shared with WHO, the contaminated products were manufactured earlier this year. Coldrif was produced in May 2025 with an expiry date of April 2027, Respifresh TR in January 2025 with an expiry of December 2026, and ReLife in January 2025 expiring in December 2026. WHO says that while no exports have been detected so far, the potential risk to public health remains high due to unregulated distribution chains.
