HSA Alerts Public to Three Illegal Products Purchased from Overseas which Contain Undeclared Potent Western Medicinal Ingredients

The Health Sciences Authority (HSA) is alerting members of the public to three illegal health products purchased from overseas, used for the treatment of pain, that were detected to contain undeclared potent western medicinal ingredients. The three products are:

Product	Undeclared Western Medicinal Ingredients	Source of purchase
‘JOINT-SOFT’	Piroxicam and Dexamethasone	Overseas purchase through a friend
‘KEBIGUTAIJIAONANG 克痹骨泰胶囊’	Hydrochlorothiazide, Piroxicam and Prednisone	Overseas purchase through a family member
‘Pil Raja Urat Asli’	Piroxicam and Indomethacin	Overseas retail shop

Please refer to Annex A for pictures of the products.

2      Three adverse reaction reports were received by HSA involving patients in their 50s-60s^[1]. One patient in his 60s, who had consumed ‘JOINT-SOFT’ for joint pain, experienced bleeding that led to his hospitalisation. Another patient in her 50s experienced weight gain and worsening of her diabetic condition after she consumed ‘KEBIGUTAIJIAONANG’ for joint pain. A third patient in her 60s gained over 8 kg after consuming ‘Pil Raja Urat Asli’ for relief of pain and for general well-being.   

3       The products were bought overseas and are not known to be available locally. Such illegal health products from illegitimate or unknown sources are generally produced under poor manufacturing conditions with no quality control and the contents can vary significantly from batch to batch.

Undeclared western medicinal ingredients found in the illegal products

4       HSA’s laboratory findings revealed the presence of potent steroids, dexamethasone and prednisone, in ‘JOINT-SOFT’ and ‘KEBIGUTAIJIAONANG’ respectively. These steroids are usually prescribed for inflammatory conditions and should only be used under strict medical supervision. Long term unsupervised use of oral steroids can cause increased blood glucose levels leading to diabetes, high blood pressure, cataracts, muscular and bone disorders, an increased risk of infections, and Cushing’s syndrome (which is characterised by a round face or ‘moon face’ and upper body obesity with thin limbs).

5       Other than steroids, two potent painkillers, piroxicam and indomethacin, were detected in the products. These medicinal ingredients can potentially cause serious gastric bleeding, as well as cardiovascular events such as heart attack and stroke when used for a prolonged period. They should be used with close medical supervision, especially in patients with underlying heart conditions. Please refer to Annex B for more information on the potential adverse reactions that can be caused by these undeclared medicinal ingredients found in the products.

HSA advisory

6       Members of the public who are consuming these products are advised to:

(i) Consult a doctor as soon as possible before stopping the products. Sudden discontinuation of steroids without proper medical supervision can cause serious withdrawal symptoms such as weakness, fatigue, confusion and low blood pressure, especially when these products have been taken for more than a few weeks. Undeclared western medicinal ingredients may cause possible adverse reactions as well as drug interactions with consumers’ own medications which can seriously harm health. 

(ii) Be wary of complementary health products (e.g. traditional medicines, health supplements) which claim to provide unexpected rapid relief of pain symptoms associated with chronic conditions such as gout, arthritis and rheumatism. Complementary health products comprising natural ingredients are generally less potent than western medicines. Their effects are often not immediate and may only be seen after prolonged consumption. Consumers should exercise discretion in their purchase of these complementary health products, and obtain them from reliable and reputable sources locally.

(iii) Seek appropriate medical treatment for acute and chronic medical symptoms and conditions (such as arthritis and rheumatism) and do not self-medicate.

7      HSA will take strong enforcement actions against those who engage in the sale and supply of health products containing undeclared potent medicinal ingredients. Anyone found to contravene the Poisons Act faces a penalty of up to $10,000 and/or imprisonment for a period of up to two years.

8      Members of the public who have any information on the sale and supply of these three illegal products or other illegal products may contact HSA's Enforcement Branch at Tel: 6866-3485 during office hours (Monday to Friday) or email: hsa_is@hsa.gov.sg. Additionally, members of the public are encouraged to visit www.healthdangers.sg to learn more about the dangers of buying illegal health products from dubious sources.

^{[1] Individuals may respond differently to the undeclared western medicinal ingredients and it is possible to experience adverse reactions other than those reported to HSA.}

HEALTH SCIENCES AUTHORITY
SINGAPORE
31 JULY 2014

Download pdf version here331 KB Published: 31 Jul 2014

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