NEW DELHI: A nasal spray used to relieve a blocked nose can eventually make congestion worse. An epilepsy medicine may also warrant attention to changes in a patient’s gum health. These are among the safety concerns flagged by the Indian Pharmacopoeia Commission (IPC) in its latest alerts on three commonly used medicines.
The alerts cover levetiracetam, prescribed for epilepsy, and two nasal decongestants, xylometazoline hydrochloride and oxymetazoline hydrochloride. While the medicines serve different purposes, the reported reactions point to a common concern: patients may overlook side effects, particularly when medicines are taken over long periods or used repeatedly for quick relief.
For people with epilepsy, levetiracetam is often part of long-term seizure management. The IPC has identified gingival hypertrophy, or abnormal enlargement of gum tissue, as a suspected adverse drug reaction associated with the medicine.
The concern is that changes in gum tissue may go unnoticed unless patients undergo regular oral examinations. Swelling or enlargement can make oral hygiene difficult and may lead to further dental complications. The alert therefore calls for doctors and pharmacists to pay attention to oral health while reviewing patients on long-term treatment.
This does not mean patients should discontinue levetiracetam. Stopping anti-seizure medication without medical supervision can put seizure control at risk. Instead, patients should report unusual gum changes and seek medical or dental advice.
The other concern involves two nasal decongestants that many people turn to during colds, allergies and episodes of nasal blockage.
Xylometazoline and oxymetazoline work by constricting blood vessels in the nasal lining, reducing swelling and providing temporary relief. But repeated use beyond the recommended period can have the opposite effect. Once the medicine wears off, congestion may return, sometimes more intensely.
This can lead to a cycle of repeated use. A person may believe the cold or allergy is worsening and reach for the spray again, without realising that prolonged use could itself be contributing to the blocked nose.
The condition, known as rhinitis medicamentosa or rebound congestion, can make it increasingly difficult to stop using the spray. The IPC has advised healthcare professionals to counsel patients against using these products for more than five consecutive days and to assess those reporting persistent nasal blockage.
A drug prescribed to control seizures may require attention to oral health, while a product bought over the counter for temporary relief may worsen symptoms if used for too long.
The IPC’s alerts are based on suspected adverse drug reaction signals and do not amount to a ban or a conclusion that every patient using these medicines will develop complications. Such signals need continued monitoring and assessment.
The commission has urged healthcare professionals and consumers to report suspected adverse reactions through the Pharmacovigilance Programme of India portal, its mobile application or toll-free helpline.
These reports help authorities assess emerging safety concerns and determine whether changes to medicine labels or package inserts are necessary.
For patients, the message is to use medicines appropriately, follow the prescribed duration and report unusual symptoms rather than ignoring them or changing treatment on their own.
