HYDERABAD: Months after the Food Safety and Standards Authority of India (FSSAI) barred certain firms from using the “ORS” prefix or suffix in product names, a Hyderabad-based paediatrician has received a legal notice from pharmaceutical firms accusing her of making “false and defamatory” remarks about their products on social media. The notice, issued to Dr Sivaranjani Santosh and dated March 16, 2026, asks her to remove her posts and reels within seven days and refrain from commenting on the companies’ products in the future. Dr Sivaranjani has been raising concerns about ORSL for nearly eight years, stating that it was often sold alongside Oral Rehydration Salts (ORS) despite not matching the formulation recommended by the World Health Organization. She argued that ORSL had higher sugar and lower electrolyte content, while its name closely resembled “ORS”, which could confuse parents and caregivers.
“Spreading unscientific myths”
In the notice, the firms alleged that the doctor made “false, misleading and defamatory” statements, particularly about the presence of sucralose in a product marketed as ERZL. According to the notice, Dr Sivaranjani claimed that sucralose could worsen gut inflammation, disrupt the microbiome, and increase the risk of diabetes and cardiovascular disease, and that it should not be consumed by children under two years of age. The companies maintained that sucralose is an approved sweetener under Indian and international regulatory frameworks, including those of the FSSAI and the Indian Pharmacopoeia. The notice also cited a February 2026 review by the European Food Safety Authority reaffirming the safety of sucralose. It further alleged that the paediatrician was “spreading unscientific myths” and “running a malicious campaign” against the product. The companies also strongly disputed Dr Santosh’s claim that ORSL products were still being sold or that ERZL was being presented as a substitute for Oral Rehydration Solution (ORS). In the notice, the firms described such allegations as “baseless and malicious”. “The new brand name ERZL does not contain the term ‘ORS’, and it is beyond reasonable comprehension how it can be confused with WHO ORS,” the notice stated. The firms further said that the earlier ORSL branding had already been revised in compliance with regulatory directions and that the new product name and packaging were clearly distinct from ORS. They added that older stock was being withdrawn or relabelled in line with the advisory and maintained that there was no attempt to mislead consumers. According to the companies, any suggestion that the product was being passed off as ORS or marketed in violation of regulatory orders was incorrect and damaging to their reputation.
‘Market ERZL as a drink, but not as a health drink’
Dr Sivaranjani, however, said presenting ERZL as a replacement for ORSL could violate the advisory and mislead consumers. She alleged that firms rebranded ORSL as ERZL by placing new stickers over existing packs. “In my post, I clearly explained that this is essentially the same ORSL product that has been relabelled legally,” she said, adding that her comments were part of her professional duty as a practising paediatrician to raise public health concerns. Referring to the October 2025 FSSAI order, she said her criticism was about the earlier branding being misleading, not about the product being unsafe or adulterated. Speaking to TOI, she said the product, currently marketed as having “87% less sugar”, contains sucralose, and that her intention was to inform the public about this. “However, their advertisements say ERZL is the new ORSL, which is against the government order. The order clearly states that such claims cannot be made. In my social media posts, I included images showing ORSL with an arrow pointing to ERZL to explain how the product was repositioned. Moreover, the company also circulated video advertisements highlighting sucralose and promoting the product as a replacement,” she added. According to the paediatrician, companies can market ERZL as a drink, but not as a health drink. “If people believe it is a health drink, they may think it is safe to consume daily, especially for children. However, sweeteners such as sucralose should not be consumed regularly without awareness of potential long-term concerns.” She stressed that, as a paediatrician, it is her responsibility to inform parents not to mistake such drinks for health products and to avoid giving them to children every day.
FSSAI regulation
In October 2025, the Food Safety and Standards Authority of India directed that no product could use the term “ORS” in its name or label unless it complied with the formulation standards set by the World Health Organization (WHO). The advisory asked companies to revise branding and packaging to prevent consumer confusion. Following the regulatory action, the company discontinued the ORSL branding and launched ERZL around November 2025. It claimed that ERZL is not a therapeutic ORS product but a reformulated electrolyte beverage containing “87% less sugar” than its predecessor.
