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Easy access to weight-loss drugs rings alarm bells among doctors, authorities; regulators step in

New Delhi, Apr 7 (PTI) As prices tumble and generic versions of GLP-1-based weight-loss drugs flood the market, a quiet frenzy is unfolding that has doctors and authorities alarmed. Medicines that are strictly prescription-based are being bought over the counter with their use expanding beyond clinical settings, often with little medical advice. For many people eager to lose weight quickly, the promise of fast results is overshadowing concerns about safety. Important factors -- like correct dosage, possible side effects, and the need for a doctor's supervision -- are being ignored. Instead, stories on social media and word-of-mouth recommendations are driving demand. This is giving rise to a parallel retail network that's ready to capitalise on the urgency among some customers for trying out these drugs without going through the necessary process of consulting specialists. Despite warnings that these drugs shouldn't be used without proper medical consultation, they are openly available without prescription or with custom-made prescriptions provided through online pharmacies. Schedule H drugs are supposed to be sold only against a prescription, but they are not tough to obtain over the counter, a retailer said on the condition of anonymity. "In many cases, pharmacists demand prescriptions for first-time sale of medicines, but don't demand it for a repeat," he said. The GLP-1 based weight-loss drugs carry a wide range of side effects -- from common symptoms like nausea and vomiting to severe complications, including pancreatitis, kidney injury, and bowel obstruction, the Union health ministry has said. In India, they can be prescribed only by endocrinologists, internal medicine specialists and cardiologists. With multiple variants of GLP-1 drugs (glucagon-like peptide-1 receptor agonists) recently introduced in the Indian market, and concerns emerging over their easy availability through pharmacies, online platforms, wholesalers, and wellness clinics, the Central Drugs Standard Control Organisation(CDSCO) has intensified its regulatory surveillance to check their unauthorised sale and promotion. The government has warned of stricter inspections and surveillance against such practices. Senior endocrinologist at Indraprastha Apollo Hospitals, Delhi, Dr Saptarshi Bhattacharya said that Tirzepatide (Mounjaro) and semaglutide (Ozempic) injections, widely used in the United States and Europe over the past decade, were introduced in India only last year. Since their launch, they have been prescribed widely and have demonstrated clear efficacy and safety in reducing body weight and improving blood glucose control. However, their growing popularity has also raised concerns about misuse, particularly when used for weight loss without appropriate medical supervision, he pointed out. One of the concerns with the use of these medicines was their high cost, which limited access to a small segment of patients who could afford the treatment. That barrier is now changing. With the recent expiry of the semaglutide patent, several Indian companies have introduced more affordable versions, expanding access and broadening their use in routine clinical practice, Bhattacharya said. "With wider availability, concerns related to misuse have also emerged. These injections are often viewed as a quick fix for weight gain, but that can be a worry. Their short-term use without sustained lifestyle changes may lead to rebound weight gain after discontinuation," Bhattacharya highlighted. These therapies require careful patient selection, appropriate dose titration, and continuous monitoring to ensure safe and effective use. "Their indiscriminate use can lead to harm," he said. On March 10, 2026, a comprehensive advisory was issued to all manufacturers, explicitly prohibiting surrogate advertisements and any form of indirect promotion that could mislead consumers or encourage off-label usage. In the recent weeks, enforcement activities have been significantly scaled up. The All India Organisation of Chemists and Druggists (AIOCD) has issued a nationwide advisory mandating that GLP-1 receptor agonists and other critical prescription medicines, particularly injectables, must never be dispensed without a valid prescription from a registered medical practitioner. Despite the rigorous standards maintained by licensed brick-and-mortar pharmacies, AIOCD president J S Shinde and general secretary Rajiv Singhal expressed deep alarm over high-risk medications being distributed indiscriminately via unregulated online platforms. These entities frequently bypass clinical safeguards by utilising "ghost doctors" to facilitate prescriptions through superficial tele-consultations lacking physical examination or professional accountability, Singhal said. "This unchecked ecosystem poses an imminent threat to public health," Singhal said, warning that unsupervised use of potent medications leads to severe adverse reactions and long-term complications. Shinde said that the AIOCD has written a letter to DCGI for immediate and stringent regulatory intervention to dismantle these illegal practices, ensuring patient safety is never compromised for commercial convenience. Adherence to the Drugs and Cosmetics Act remains the non-negotiable priority for all members. In recent weeks, 49 businesses were audited and inspected across the country, including online pharmacy warehouses, drug wholesalers, retailers, and weight loss clinics. These inspections spanned multiple regions across India and focused on identifying violations related to unauthorised sale, improper prescription practices, and misleading marketing. Dr Ambrish Mithal, Chairman, Endocrinology and Diabetes, Max HealthCare, said the GLP-1 drugs are medicines, not cosmetic drugs. "When large volumes of the Indian population will be exposed to these drugs, it's very important that they are prescribed by the right doctor, in the right dose, to the right patient, with proper understanding of side effects." These drugs mimic a natural gut hormone that signals the pancreas, gut, and brain, stimulating insulin, slowing stomach emptying, and promoting satiety. They are effective for diabetes and can aid weight loss, but misuse can cause problems, he said. While gastrointestinal side effects are common, the bigger concern is muscle loss, which can account for 20-30 per cent of total weight lost if diet and exercise are neglected. This isn't a direct drug effect but a result of unstructured weight loss without adequate protein intake, strength training, and medical supervision. Proper use requires specialist oversight, individualised diet and exercise plans, and regular monitoring. People with a history of pancreatitis or certain thyroid cancers should avoid these drugs entirely, he added. PTI PLB SKY SKY

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