In southern India, pharmacies are caught between two types of products: the WHO-approved therapeutic ORS sachets and sugary electrolyte drinks misleadingly branded as “ORS” or “ORSL”. Despite new regulatory directives, the latter remain widely available, sparking concern among paediatricians and health regulators.
Glimpse:
Pharmacies in states such as Tamil Nadu and Telangana are still selling tetra-pack “electrolyte” drinks labelled with “ORS/ORSL” despite the Food Safety and Standards Authority of India (FSSAI) directive that only WHO-formulated ORS sachets may carry that label. These sugary substitutes often more expensive do not meet therapeutic standards for dehydration management and may worsen outcomes when used during diarrhoea.
Across southern India, including Tamil Nadu and Telangana, there’s rising alarm in the medical community over how pharmacies are stocking and dispensing rehydration-related drinks. Many stores continue to sell colourful, fruit-flavoured “electrolyte drinks” marketed as or alongside ORS or ORSL, despite the fact that these drinks do not adhere to the World Health Organization recommended formula for Oral Rehydration Solution (ORS). These standards include specific concentrations of sodium, glucose, potassium and citrate with a total osmolarity of 245 mOsm/L.
In recent months, FSSAI issued a strong directive (14 October 2025) prohibiting the use of the term “ORS” on any food product name unless it strictly follows the WHO-recommended formula. The order bans the prefix, suffix or trademark use of “ORS” on food/drinks not meeting the standard. However, despite this policy, ground-level surveys show that pharmacies in places like Hyderabad and Tiruchy continue to offer tetra-pack brands with names like “ORSL Rehydrate” or “Electro+ ORS” to customers who ask for “ORS”. Many children with diarrhoea and dehydration have received these drinks instead of the correct therapeutic sachets.
The problem is multi-fold. First, pharmacies may prefer stocking these ready-to-drink tetra packs because they offer higher margins and better shelf appeal. Second, customers often confuse these products with genuine ORS and may not verify labels or formulas. Third, some of these drinks carry disclaimers (“Not an ORS formula…”) in very small print, but the main “ORS” branding remains dominant. Doctors warn that high sugar content in these drinks can actually aggravate diarrhoea or dehydration rather than treat it.
Regulators and child-health specialists are now calling on pharmacies to clearly distinguish between true ORS sachets (usually regulated as drugs, lower margin, minimal flavouring) and electrolyte/energy drinks (regulated as foods) that are not appropriate substitutes. They stress that for children with diarrhoea, only WHO-formulated ORS sachets should be used, and public awareness must improve.
“Most of the so-called ORS in Indian pharmacies are fake sweet drinks masquerading as lifesaving solutions. Pharmacies must stock only true ORS, not fruit-flavoured impostors.”
By
HB Team

