Cough common in monsoon, but no syrup without prescription? We asked people if they'd actually visit a doctor

When the Centre announced that medicinal cough syrups could no longer be sold over the counter without a doctor's prescription, the move was widely welcomed by public health experts. The decision followed a series of tragedies linked to contaminated cough syrups, including the deaths of at least 24 children in Madhya Pradesh last year, while Indian-made cough syrups have also been linked to the deaths of more than 140 children in Africa and Central Asia since 2022.

The objective is clear- discourage self-medication, ensure timely medical consultation and tighten control over medicines that have repeatedly come under scrutiny. But there is one question that the notification doesn't answer.

Will people actually visit a doctor for something as common as a cough?

To find out, we spoke to people from different walks of life, and even tried purchasing a cough syrup ourselves.

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"I'd rather make kadha"

Despite coming from completely different backgrounds, the two people we spoke to had surprisingly similar answers.

A woman in her twenties, who works as a domestic help and is a mother of two, said visiting a doctor for an ordinary cough is rarely her first choice. Instead, she prefers home remedies. If the cough doesn't improve, especially if it's dry, she usually buys cough lozenges rather than consulting a doctor.

"I wouldn't really go to a doctor just for a cough," she said.

A corporate professional in her early thirties echoed a similar sentiment. For her, the first line of treatment is always home.

"Kadha, warm oil massage and salt-water gargles usually work," she said, adding that she too would avoid visiting a doctor unless the symptoms became severe or prolonged.

Their responses point towards a reality doctors have long observed, many Indians see coughs and colds as illnesses that can largely be managed at home.

Can you still buy a cough syrup?

To understand how the new rule is playing out on the ground, we visited a neighbourhood pharmacy to purchase a cough syrup without a prescription. No prescription was asked for.

Instead, the shopkeeper handed over what appeared to be the store's own herbal formulation. Interestingly, the packaging identified it as a "herbal syrup" rather than explicitly calling it a cough syrup.

While this single interaction is far from enough to judge how uniformly the new regulations are being enforced, it does suggest that consumers may still find alternatives without necessarily visiting a doctor.

Why doctors believe the move was necessary

Doctors, however, argue that the regulation addresses a much larger public health concern than simply controlling cough medicines.

Dr. Diksha Goyal, Consultant, Internal Medicine at Marengo Asia Hospitals, Gurugram, says restricting over-the-counter sales is aimed at reducing the culture of self-medication, which often delays the diagnosis of serious illnesses.

"Persistent coughs may be linked to conditions such as tuberculosis, asthma or pneumonia that require prompt diagnosis and early treatment. Self-medication often delays that process," she explains.

She also points out that certain cough syrups, particularly those containing codeine or other habit-forming ingredients, have long been susceptible to misuse, especially among adolescents and young adults.

In children and newborns, inappropriate use can be even more dangerous. "It can cause increased drowsiness, breathing difficulties and even life-threatening events such as seizures in newborns," she says.

According to Dr. Goyal, the government has attempted to offset concerns around accessibility by expanding healthcare through urban health centres, polyclinics, government dispensaries and private clinics. She believes stricter regulation, combined with stronger quality checks, is essential to prevent similar tragedies in the future.

But will people simply switch to something else?

Not necessarily everyone will begin consulting doctors, says Dr. Shilpa Singi, Lead Consultant – Academies and Strategies, Internal Medicine, Aster Whitefield Hospital, Bengaluru.

"This move might push more people towards seeking medical advice, especially if symptoms persist," she says. "However, there's also a chance that some individuals will shift towards alternative over-the-counter products, traditional remedies or pharmacist recommendations instead of consulting a doctor."

That shift, she explains, could simply move the self-medication habit from one category of products to another unless accompanied by public awareness campaigns explaining when a cough requires medical attention.

After all, not every cough needs antibiotics or prescription medicines. Many viral coughs resolve with adequate hydration, rest and supportive care. The challenge lies in recognising when they don't.

Will the economically weaker sections feel the pinch?

Another concern doctors raise is affordability.

For many families, a doctor's consultation involves much more than consultation fees. It also means transport costs, waiting time and, often, losing a day's wages.

"Economically vulnerable groups might feel the effects more sharply," says Dr. Singi. "This highlights the importance of affordable primary healthcare, telemedicine and community-level healthcare support."

Without these measures, she warns, some patients may postpone treatment altogether or continue relying on informal alternatives.

Is regulating syrups alone enough?

Interestingly, both doctors agree that restricting medicinal cough syrups is only one piece of a much larger puzzle. Cough lozenges continue to be available over the counter. So do several herbal formulations and traditional home remedies.

That means the success of the policy will depend not just on restricting one category of medicines, but on strengthening manufacturing standards, improving quality surveillance, tightening supply chains and educating consumers about responsible self-care.

A policy that now faces its biggest test

The government's decision to make medicinal cough syrups prescription-only comes with a clear public health objective- prevent misuse, encourage timely diagnosis and avoid another tragedy linked to adulterated medicines.

Whether it changes public behaviour, however, remains to be seen. For many Indians, the instinctive response to a cough still begins with a steaming cup of kadha, a salt-water gargle or a cough lozenge, not a visit to the doctor.