HSA updates on products found overseas that contain potent ingredients (August 2024)

The Health Sciences Authority (HSA) would like to update the public on products that have been found and reported by overseas regulators in August 2024 to contain potent ingredients which are not allowed in these products and may cause side effects. This information is provided to increase awareness on safety issues of such products found overseas, which may impact the local population. Please refer to Annex A and Annex B for the list of products and the possible side effects of the potent ingredients. Please refer to the pdf document for images of the products.

HSA’s Advisory

2          Members of the public are advised to:

• Consult a doctor if you have consumed any of the products and are feeling unwell.
• Avoid buying any of the products when abroad.
• Exercise caution when purchasing health products online or from sources (either local or overseas) which you may not be familiar with, even if well-meaning friends or relatives have recommended them. You cannot be certain where and how these products were made. They may be illegal, counterfeit or substandard, and may contain potent ingredients which can harm your health. If buying health products online, we encourage you to buy them from websites with an established retail presence in Singapore.
• Be wary of products that promise quick and miraculous results or carry exaggerated claims like “100% safe”, “no side effects” or “scientifically proven”. Consumers should also be cautious of products that produce unexpected quick recovery of medical conditions.
• Consult your doctor or pharmacist if you need help for the management of your acute and chronic medical symptoms and conditions (e.g. diabetes, hypertension, eczema).
  

3          Additionally, members of the public are encouraged to visit https://www.hsa.gov.sg/consumer-safety/ to learn more about the dangers of buying health products from dubious sources.

4          Members of the public who come across the sale and supply of these products in Singapore may contact HSA's Enforcement Branch at Tel: 6866 3485 during office hours (Monday to Friday) or email: hsa_is@hsa.gov.sg

 

Annex A

List of Products

Note: There may be different versions or variants of the products listed below. You are advised to consult your doctor or pharmacist if you are unsure of any health product you intend to use, or if you need help for your acute and chronic medical symptoms and conditions 

Name of product	Potent ingredient(s)	Source (Regulatory Agency)
Aniqa Night Cream	Tretinoin	Malaysia National Pharmaceutical Regulatory Agency
Boom Max Capsules	Sildenafil (PDE-5 Inhibitor)	United States Food and Drug Administration
(Labelled in Chinese as) Cordyceps sinensis	Sildenafil (PDE-5 Inhibitor)	Health Canada
(Labelled in Chinese as) Cordyceps + Deer whip	Sildenafil (PDE-5 Inhibitor)	Health Canada
Marvel X ผลิตภัณฑ์เสริมอาหาร มาเวล เอ็กซ์	Sildenafil (PDE-5 Inhibitor)	Thailand Food and Drug Administration
Dolce Detersive Bello	Isobutyl nitrite	Health Canada
Endurance Pro Energy Boost capsules	Sildenafil (PDE-5 Inhibitor)	United States Food and Drug Administration
Goree Beauty Cream	Mercury	Hong Kong Department of Health
GB Herbal Cream Treatment	Betamethasone (Corticosteroid) and Mercury	Malaysia National Pharmaceutical Regulatory Agency
GB Night Cream Treatment	Hydroquinone and Tretinoin	Malaysia National Pharmaceutical Regulatory Agency
Honey Q ผลิตภัณฑ์เสริมอาหาร ตรา ฮันนี่ ดิว	Fluoxetine and Sibutramine	Thailand Food and Drug Administration
Jaguar	Paracetamol	Indonesian Food and Drug Authority
Kapsul Asam Urat TCU	Dexamethasone (Corticosteroid)	Indonesian Food and Drug Authority
Magnum Gold 5000K	Sildenafil (PDE-5 Inhibitor)	Health Canada
Magnum XXL 9800	Levodopa and Prasterone	Health Canada
Obat Kuat & Tahan Lama URAT MADU	Paracetamol	Indonesian Food and Drug Authority
Pithon	Paracetamol	Indonesian Food and Drug Authority
Rhino 69 375K	Sildenafil and Tadalafil (PDE-5 Inhibitors)	Health Canada
Rhino 69 6000K	Sildenafil (PDE-5 Inhibitor)	Health Canada
Rhino 69 Extreme 50000	Tadalafil (PDE-5 Inhibitor)	Health Canada
Rhino 69 Fire 500K	Levodopa and Prasterone	Health Canada
Rhino 7 Platinum 700K	Tadalafil (PDE-5 Inhibitor)	Health Canada
Rhino Rush Trio 15000K	Sildenafil (PDE-5 Inhibitor)	Health Canada
RMSOL GRACIAN	Diclofenac	United States Food and Drug Administration
SILI PHARMA	Diclofenac	United States Food and Drug Administration
Siri L-Bang ศิริ แอล บาง (ผลิตภัณฑ์เสริมอาหาร)	Fluoxetine	Thailand Food and Drug Administration
Tawon Liar Sakti	Paracetamol	Indonesian Food and Drug Authority
UMARY USA Hyaluronic Acid	Dexamethasone (Corticosteroid), Diclofenac and Omeprazole	Health Canada
Z FIT 純中藥減脂丸	Frusemide and Sibutramine	Hong Kong Department of Health
ZEUS PLUS Dietary Supplement Product ซูส พลัส ผลิตภัณฑ์เสริมอาหาร	Sildenafil (PDE-5 Inhibitor)	Thailand Food and Drug Administration
(Labelled in Chinese as) 8 Times 1 Night	Sildenafil (PDE-5 Inhibitor)	Health Canada

 

Annex B

The possible side effects of the potent ingredients

Corticosteroids

Betamethasone 17-Valerate, Clobetasol propionate, Dexamethasone and Prednisolone are potent steroids that are usually prescribed for inflammatory conditions and should only be used under strict medical supervision. Long-term unsupervised use of steroids (including topical use where the steroid can be absorbed into the body) can cause increased blood glucose levels (which may lead to diabetes), high blood pressure, cataracts, muscular and bone disorders, an increased risk of infections and Cushing’s syndrome (a round face or ‘moon face’ appearance and upper body obesity with thin limbs). Discontinuation of steroids without proper medical supervision can cause serious withdrawal symptoms such as fatigue, confusion, and low blood pressure, especially when the product has been taken for more than a few weeks.

 

Diclofenac

Diclofenac is a potent painkiller and may potentially cause cardiovascular events such as heart attacks and strokes, as well as serious gastric bleeding, when used for a prolonged period. It should be used under close medical supervision, especially in patients with underlying heart conditions, stomach bleeding and ulceration.

 

Fluoxetine

Fluoxetine is a prescription medicine used to treat conditions including depression and eating disorders, and it should be used under medical supervision. The use of fluoxetine has been associated with side effects including headaches, insomnia, palpitations and dizziness.

 

Frusemide

Frusemide is a prescription medicine used to eliminate water and salt from the body and should be used under medical supervision. The side effects associated with its use include loss of appetite and low blood pressure. When taken in excess, the ‘water-eliminating’ effect of frusemide can cause the depletion of sodium, chloride, body water and other minerals in the body.

 

Hydroquinone

Hydroquinone is a potent ingredient used in prescription medicines for the treatment of skin conditions. The ingredient is prohibited in skincare cosmetic products and should only be used under medical supervision, as hydroquinone may cause harmful effects if not used properly. The inappropriate use of hydroquinone could result in changes in skin colour and hypersensitivity reactions such as rashes, redness, tingling and burning of skin.

 

Isobutyl nitrite

Isobutyl nitrite is an alkyl nitrite which is often inhaled or ingested by consumers for recreational purposes, despite being labelled for various uses such as leather cleaners, room odourisers or liquid incense. Overdosage or serious medical complications, sometimes resulting in death, can occur when it is used without medical supervision.

 

Levodopa (L-Dopa)

Levodopa or L-Dopa is a prescription medicine used in the treatment of Parkinson’s Disease and should be used under medical supervision. Levodopa may potentially interact with medicines used to treat high blood pressure. Side effects of levodopa may include low blood pressure, irregular heart rate and breathing abnormalities.

 

Mercury

Mercury is a toxic substance and is prohibited for use as an ingredient in cosmetic products. Regular application of creams containing mercury could lead to rash, skin discolouration and blotching. Chronic exposure to very high levels of mercury in cosmetic products may also cause toxic effects to the kidneys, digestive and nervous system, as it can be absorbed through the skin. This could lead to organ damage.

 

Omeprazole

Omeprazole is a medicine used in the treatment of gastrointestinal diseases such as peptic ulcer disease, Zollinger-Ellison syndrome, and gastroesophageal reflux disease. Common side effects include nausea, vomiting, headaches, abdominal pain, and bloating. Long term use without medical supervision may increase your chances of serious side effects such as an increased risk of bone fractures, gut infections, and vitamin B12 deficiency.

 

Paracetamol

Paracetamol or Acetaminophen is used for relieving pain, headache and fever. Products which contain acetaminophen or paracetamol, but do not have this declared on the label, pose a danger to consumers as accidental overdose can result in liver damage.

 

Phosphodiesterase Type 5 (PDE-5) inhibitors

This class of medicine includes avanafil, carbodenafil, sildenafil, tadalafil, vardenafil and their derivatives. These medicines can cause serious side effects such as strokes, heart attacks, decreased or loss of vision and hearing and priapism (painful and exceedingly long erections). If priapism is not treated immediately, it may lead to permanent impotence. PDE-5 inhibitors are also not suitable for patients with medical conditions such as certain heart-related problems or who are on heart medications such as nitrates. Deaths of patients found to be using sildenafil while on nitrates have been reported overseas.

 

Prasterone

Prasterone, also known as Dehydroepiandrosterone (DHEA), is a hormone that could increase the risk of prostate, breast, ovarian and other hormone-sensitive cancers. Side effects may include serious cardiovascular disease, changes in fertility and sperm production, hair loss, voice deepening, insulin resistance, changes in menstrual pattern, liver dysfunction, abdominal pain, and high blood pressure.

 

Sibutramine

Sibutramine, previously a prescription weight loss medicine used in the treatment of obesity, has been disallowed for sale in Singapore since 2010 due to increased risk of heart attacks and strokes. The use of sibutramine has been associated with serious side effects, including high blood pressure, irregular heartbeats, hallucinations, and mood swings.

 

Tretinoin

Tretinoin is a potent ingredient used in prescription medicines for the treatment of skin conditions and should be used under medical supervision. The ingredient is prohibited in skincare cosmetic products. Inappropriate use of tretinoin could lead to side effects such as redness and peeling of skin.

 

Download PDF:  HSA Foreign Alert_2024_August

Published: 17 Sep 2024

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