The Union Health Ministry implemented a ban on 156 "irrational" FDC medicines, effective immediately. These medicines, including widely used antibiotics, painkillers, and multivitamins, were commonly used to treat fever, cough, and infections. The ban was imposed due to the associated health risks and lack of therapeutic justification for the ingredients in these FDCs.

What are FDC medicines?

FDCs or fixed-dosed combinations, also known as "cocktail drugs," are medications that combine multiple drugs in a single pill. They are designed to treat multiple symptoms or conditions simultaneously. While they offer convenience, they can pose significant risks. These risks include the possibility of overdose, adverse interactions between the drugs, and the development of antibiotic resistance. Additionally, many FDC medicines lack sufficient scientific evidence to support their safety and efficacy.

Expert opinions on FDC medicines

Experts have raised concerns about the use of FDC medicines. They believe that many of these combinations lack sufficient scientific evidence to support their safety and effectiveness. Additionally, the combination of multiple drugs in a single pill can increase the risk of adverse side effects and interactions with other medications.

Experts have also found that FDC medicines may not be as effective as individual drugs in treating certain conditions. It is important to note that safer and more effective alternatives are available for most of the medical conditions that FDC medicines were used to treat. One particular concern is the inclusion of antibiotics in some FDCs. Overuse of antibiotics can contribute to the development of antibiotic resistance, a major public health threat.

The risks of FDC medicines

The use of FDC medicines can lead to adverse effects, including serious ones. Additionally, safer alternatives, tested in clinical trials, are available to treat the same medical conditions. Experts recommend prescribing drugs individually based on a patient's clinical symptoms rather than combining them in FDCs.

The ban on irrational FDC medicines by the Union Health Ministry can be seen as a positive step towards promoting rational drug use and protecting public health. The goal is to eliminate unnecessary and potentially harmful drug combinations. This is a step forward in reducing the risks associated with medication and ensure safer and more effective treatment options for patients.

From weight loss and diabetes to cancers and much more, GLP-1 drugs have delivered blockbuster results and transformed treatment for millions of people worldwide.

Clinical data have consistently shown that GLP-1 receptor agonists containing semaglutide and tirzepatide—including Ozempic, Wegovy and Mounjaro—reduce overall mortality as well as the risk of heart-related deaths.

However, reports from the UK and US have linked these medicines to more than 200 deaths. While a direct causal relationship has not been established and millions of people use these medications safely, high-profile inquests and adverse event databases have highlighted reports of deaths in which these drugs were listed as a suspected contributing factor, including cases associated with severe complications, dosing errors, and the use of counterfeit or compounded products.

UK Reports 82 Deaths Linked to GLP-1 Drugs

Data submitted to the UK's Medicines and Healthcare Products Regulatory Agency (MHRA) show a total of 82 deaths associated with glucagon-like peptide-1 (GLP-1) receptor agonists, the class of drugs used to treat obesity and type 2 diabetes, up to January 31, 2025.

The data includes 22 deaths associated with GLP-1 agonists used for weight loss, while 60 deaths were linked to their use in treating type 2 diabetes. As per the MHRA data:

• 18 deaths were linked to tirzepatide (Mounjaro), including 10 associated with weight loss and eight with type 2 diabetes treatment.
• 29 deaths werelinked to semaglutide products, including Ozempic, Rybelsus and Wegovy. Of these, four were associated with weight loss and 25 with diabetes treatment.
• 35 deaths werelinked to liraglutide products, including Saxenda and Victoza.

"The decision to start, continue, or stop treatments should be made jointly by patients and their doctor, based on full consideration of benefits and risks," said Alison Cave, MHRA Chief Safety Officer.

Northern Ireland Reported Two Deaths in 2026

In 2026, the deaths of two people in Northern Ireland potentially linked to Wegovy and Mounjaro injections were also reported to the MHRA.

The two cases are among more than 500 suspected adverse drug reaction reports submitted from Northern Ireland over the past two years related to GLP-1 medications.

US Reported 162 Deaths

In the US, Ozempic and Wegovy have been linked to 162 deaths since 2018, according to reports in the FDA's FAERS (FDA Adverse Event Reporting System) database.

While none of the deaths have been proven to be directly caused by semaglutide injections, the reports indicate the drugs were listed as a factor in the fatalities.

Growing Use of GLP-1 Drugs

Driven by the rising prevalence of obesity and type 2 diabetes, the use of GLP-1 medications such as Ozempic, Wegovy, Mounjaro and Zepbound has increased dramatically in recent years. The global GLP-1 drug market is estimated to reach $200 billion by 2030.

Although each medication has distinct FDA-approved uses, they share four common mechanisms of action:

• Stimulate insulin release.
• Reduce blood sugar.
• Slow digestion.
• Reduce hunger.

FDA Warning on Unapproved GLP-1 Drugs

In June 2026, the FDA raised concerns about patients and healthcare professionals seeking unapproved versions of GLP-1 receptor agonists, including semaglutide and tirzepatide, for weight loss.

The agency warned that unapproved products do not undergo FDA review for safety, effectiveness or quality before being marketed.

The FDA recommends that:

• Compounded drugs should only be used when a patient's medical needs cannot be met by an FDA-approved drug.
• Patients should obtain a prescription from their doctor and fill it at a state-licensed pharmacy.
• Patients should use the FDA's BeSafeRx campaign resources to safely purchase prescription medicines online.
• Patients should consult their doctor if they have questions about their medications.
• Patients should contact the compounder or telehealth platform where they purchased the drug if they have questions about instructions for use or label information.

What Are The Red Flags

The FDA advises consumers to watch for warning signs, including companies that:

• Claim a compounded drug is the same as an FDA-approved product.
• Offer medicines at deep discounts or prices that seem too good to be true.
• Send medicines that look different from previous prescriptions, arrive in damaged packaging or lack instructions for use.
• Do not require screening and a prescription from a licensed doctor.
• Do not have a licensed doctor available to answer questions after the medication is received.
• Have spelling errors on labels or provide incorrect pharmacy addresses.
• List a pharmacy name on the label that appears to be fraudulent.

Even as the ongoing Chandipura virus outbreak in Gujarat and Rajasthan has reportedly claimed 22 lives, most of them children, the Centre has launched a comprehensive 'One Health' investigation that combines human, animal and vector surveillance to better understand how the virus spreads and how future outbreaks can be contained.

The Union Ministry of Health and Family Welfare has deployed a National Joint Outbreak Response Team (NJORT) comprising experts from the National Centre for Disease Control (NCDC), the Indian Council of Medical Research (ICMR) and the Department of Animal Husbandry and Dairying (DAHD). The team will support the two states in outbreak investigations, strengthen surveillance and recommend evidence-based public health measures.

What Will the Multidisciplinary Probe Do?

The investigation aims to improve understanding of the Chandipura virus by studying:

• How the virus spreads
• The full clinical spectrum of the disease
• Its epidemiology
• Potential treatment approaches
• Measures to strengthen outbreak response

The exercise brings together experts in epidemiology, virology, entomology, veterinary sciences and laboratory diagnostics to study infections ranging from mild fever to Acute Encephalitis Syndrome (AES).

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Surveillance Intensified in Affected Areas

As part of the investigation, authorities have stepped up surveillance among patients presenting with:

• Acute Febrile Illness (AFI)
• Acute Encephalitis Syndrome (AES)

Researchers are also conducting community-based serosurveys to estimate asymptomatic infections and understand the true extent of virus transmission. At the same time, laboratories are working to strengthen diagnostic tests and develop improved animal models to better understand the disease.

Scientists Probe the Virus Transmission Cycle

While sandflies are the established vectors of Chandipura virus, the scientists are also investigating whether other arthropods—including mosquitoes, ticks and mites—could play a role in transmission, the Ministry said.

Large numbers of vector samples collected from affected areas are currently undergoing laboratory analysis. However, officials have stressed that it is too early to identify the vector responsible for the current outbreak until scientific investigations are complete.

Livestock Also Under Investigation

Animal surveillance has been expanded to determine whether domestic animals could act as reservoirs for the virus.

Blood samples collected include:

• cattle
• buffaloes
• goats
• Milk samples

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Around 70 animal blood samples have been collected so far and are being tested for Chandipura virus and other relevant pathogens. Authorities have clarified that no conclusions can be drawn until laboratory investigations are completed. The scientists' team is also examining whether the virus has undergone genetic changes.

While scientists investigate how the virus spreads and whether it has evolved, HealthandMe spoke to infectious disease experts who stressed that parents should focus on recognising symptoms early, as there is no specific antiviral treatment or vaccine for Chandipura virus.

No Need to Panic

Dr. Subramanian Swaminathan, Senior Consultant, Infectious Diseases, Gleneagles Chennai, says the recent cases are a reminder to remain vigilant—not alarmed.

"The virus can cause severe illness, particularly in children under 15 years, but prompt recognition and early hospital care can make a difference," he said.

He added that not every fever during the monsoon is Chandipura virus, but children with warning signs in affected areas should be evaluated without delay.

Symptoms Parents Should Never Ignore

The doctor advised seeking immediate medical attention if a child develops:

• Sudden high fever
• Persistent vomiting or diarrhoea
• Excessive sleepiness or unusual drowsiness
• Confusion or altered behaviour
• Seizures
• Rapid deterioration in consciousness

Dr. Divya Shetty, Infectious Diseases Specialist at Apollo Hospitals, Seshadripuram, added that the illness can progress rapidly.

"Within 24–48 hours, children may develop neurological symptoms such as lethargy, irritability or altered consciousness. In severe cases, deterioration to coma can occur within 48–72 hours."

Why Cases Rise During the Monsoon

According to Dr. Shetty, Chandipura virus is endemic and cyclical in Gujarat, with cases typically increasing during the monsoon.

• Sandflies are the primary vectors.
• They breed in humid conditions during the rainy season.
• Researchers are also investigating whether Aedes aegypti mosquitoes may play a role in transmission.

Can Chandipura Virus Spread From Person to Person?

"There is no documented human-to-human transmission. Chandipura virus is a vector-borne infection," Dr. Shetty told HealthandMe.

How To Prevent

The experts stressed that there is no approved antiviral treatment or vaccine for Chandipura virus. Treatment focuses on supportive care, including:

• Maintaining hydration
• Controlling fever
• Monitoring for brain involvement

To reduce the risk of infection, they recommended:

• Using mosquito nets and insect repellents
• Keeping surroundings clean
• Filling cracks and crevices in mud walls where sandflies breed
• Seeking immediate medical care if warning symptoms develop.

The International Agency for Research on Cancer (IARC), the World Health Organization's (WHO) cancer research agency, has classified three widely used medicines—hydrochlorothiazide, voriconazole, and tacrolimus—as Group 1 carcinogens, meaning they are "carcinogenic to humans."

All three medicines are included on the WHO Model List of Essential Medicines and are prescribed to millions of people worldwide for treating hypertension, serious fungal infections, and preventing organ transplant rejection.

A Group 1 classification means there is sufficient scientific evidence that an agent can cause cancer in humans under certain circumstances. However, it does not indicate how likely a person is to develop cancer while taking the medicine as prescribed. The actual risk depends on factors such as the dose, duration of use, individual health, and other risk factors.

Which Medicines Have Been Classified as Carcinogenic?

Hydrochlorothiazide: It is a thiazide diuretic commonly prescribed to treat essential hypertension. Although newer blood pressure medications are increasingly used, it remains a widely prescribed treatment because of the global burden of hypertension.

Voriconazole: It is a broad-spectrum triazole antifungal medicine used to treat invasive aspergillosis and other serious fungal infections, particularly among transplant recipients and other immunocompromised patients.

Tacrolimus: It is an immunosuppressive medicine used to reduce the risk of organ rejection in adult and pediatric transplant recipients and to prevent graft-versus-host disease following stem cell transplantation. Topical tacrolimus is also used as a second-line treatment for atopic dermatitis and vitiligo when topical corticosteroids are unsuitable.

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Why Did IARC Classify Them as Carcinogenic?

"The IARC Monographs Working Group reviewed evidence from epidemiological studies, cancer bioassays in experimental animals, and mechanistic studies to assess the carcinogenic hazard to humans of exposure to these agents and concluded that hydrochlorothiazide, tacrolimus, and voriconazole are all carcinogenic to humans (Group 1)," the IARC said.

• Hydrochlorothiazide has been linked to squamous cell skin cancer and lip cancer because it increases the skin's sensitivity to sunlight.
• Voriconazole is associated with squamous cell carcinoma of the skin through the phototoxic effects of one of its metabolites.
• Tacrolimus has been linked to non-Hodgkin lymphoma and post-transplant lymphoproliferative disorders, largely due to its immune-suppressing effects.

What Does This Mean for Patients?

Dr. Shyam Aggarwal, Chairman, Medical Oncology, Sir Ganga Ram Hospital, told HealthandMe that the classification identifies a cancer hazard, not the level of cancer risk associated with normal therapeutic use.

"The IARC underlines that this Group 1 listing identifies a cancer hazard—the potential of an agent to cause malignancy rather than measuring how great the actual risk is when the medicines are taken at normal therapeutic doses. All three remain listed as essential medicines by WHO, reflecting their critical role in treating serious illness," he said.

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Dr. Aggarwal stressed that patients should not stop taking these medicines without consulting their doctor.

"Abruptly stopping any of these agents can result in dangerous rises in blood pressure, uncontrolled infection, or transplant failure. The recommended course is to speak with the treating physician, adopt rigorous sun-protection habits if taking hydrochlorothiazide or voriconazole, and maintain regular surveillance for those receiving tacrolimus after transplantation," he added.

No Need to Panic

Dr. Tushar Tayal, Associate Director – Internal Medicine, CK Birla Hospital, Gurugram, told HealthandMe the reclassification should not be a cause for alarm.

According to him, the concern relates to long-term cumulative exposure rather than a single dose. Stopping treatment abruptly could pose a much greater immediate risk, including uncontrolled hypertension, severe infection, or transplant rejection.

What Should Patients Do?

• Do not stop or change your medication on your own.
• Consult your treating physician before making any changes to your treatment.
• Discuss whether regular skin examinations or an alternative treatment plan may be appropriate based on your individual risk.
• Use sun protection if you are taking hydrochlorothiazide or voriconazole, as advised by your doctor.
• Attend regular follow-up appointments, especially if you are taking tacrolimus after an organ transplant.