A Need for Pharmacovigilance in OTC Steroid Misuse: Real-World Insights

Published on: September 2025Indian Journal of Pharmacy Practice, 2026; 19(1):137-138. Letter to the Editor| doi: 10.5530/ijopp.20260450Authors and affiliation (s): Jayasri Karthikesan* Department of Pharmacy Practice, E.G.S. Pillay College of Pharmacy, Nagapattinam, Tamil Nadu and MoU with Government Medical College and Hospital, Orathur, Nagapattinam, Tamil Nadu, INDIA. ABSTRACT Over-the-Counter (OTC) corticosteroid misuse remains a pressing yet underreported issue in rural India. This letter presents a case of a 70-year-old male who developed iatrogenic Cushing’s syndrome complicated by urosepsis and septic shock after prolonged self-medication with dexamethasone. The case underscores the urgent need for enhanced pharmacovigilance systems at the community level, stricter enforcement of Schedule H regulations, and the active involvement of pharmacists in identifying and preventing such adverse drug reactions. Strengthening public awareness and pharmacist-led interventions are vital to curb the inappropriate use of potent corticosteroids. Keywords: Over-the-counter drugs, Corticosteroids, Pharmacovigilance, Schedule H violations, Rural healthcare.