HSA updates on products found overseas that contain potent ingredients (December 2021)

The Health Sciences Authority (HSA) would like to update the public on products that have been found and reported by overseas regulators in December 2021 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)
Avaphinal	Sildenafil (PDE-5 inhibitor)	United States Food and Drug Administration
Away Tablet	Paracetamol	Indonesian Food and Drug Authority
Banana Boat Dry Balance Very High Protection Clear Sunscreen Spray SPF 50+	Benzene	Australia Therapeutic Goods Administration
Banana Boat Simply Protect Kids Very High Protection Sunscreen Lotion Spray SPF 50+	Benzene	Australia Therapeutic Goods Administration
Banana Boat Ultra Very High Protection Clear Sunscreen Spray SPF 50+	Benzene	Australia Therapeutic Goods Administration
Beaute’ White Perfect White & Firm	Mercury	Thailand Food and Drug Administration
Big Penis	Sildenafil (PDE-5 inhibitor)	Indonesian Food and Drug Authority
Black Gorilla	Sildenafil (PDE-5 inhibitor)	Indonesian Food and Drug Authority
Black Panther	Sildenafil (PDE-5 inhibitor)	Indonesian Food and Drug Authority
Bintang Dua Mustika Dewa	Paracetamol	Indonesian Food and Drug Authority
Brahma Male Enhancement	Sildenafil (PDE-5 inhibitor)	United States Food and Drug Administration
Buaya Jantan	Sildenafil (PDE-5 inhibitor)	Indonesian Food and Drug Authority
Chinese Zhigenduan	Acetosal	Indonesian Food and Drug Authority
Gan Mao Tong Tablet	Diclofenac	Indonesian Food and Drug Authority
Ginseng Kianpi Pil	Cyproheptadine	Indonesian Food and Drug Authority
Go On Red	Tadalafil (PDE-5 inhibitor)	United States Food and Drug Administration
Hard AF!	Acetaminophen and Sildenafil (PDE-5 inhibitor)	United States Food and Drug Administration
Helmi’s Honey VIP	Tadalafil (PDE-5 inhibitor)	United States Food and Drug Administration
Irish White Day Cream	Mercury	Thailand Food and Drug Administration
Irish White Night Cream	Mercury and Retinoic acid	Thailand Food and Drug Administration
Jaguar Power	Sildenafil (PDE-5 inhibitor)	United States Food and Drug Administration
Jaguar 30000	Sildenafil and Tadalafil (PDE-5 inhibitors)	Health Canada
Jamu Tradisional Kumbang Mas	Paracetamol	Indonesian Food and Drug Authority
JEED JEES Lip Tint Velvet No. 06	CI 15585 (Pigment Red)	Thailand Food and Drug Administration
JEED JEES Lip Tint Velvet No. 07	CI 15585 (Pigment Red)	Thailand Food and Drug Administration
Kangaroo Intense Alpha 3000	Sildenafil (PDE-5 inhibitor)	United States Food and Drug Administration
KALLA Cubic Gold Lipstick No. 5 Nude	CI 15585 (Pigment Red)	Thailand Food and Drug Administration
KIM Whitening Pearl and Snowlotus Cream	Betamethasone, Clobetasol (Corticosteroids) and Mercury	Thailand Food and Drug Administration
KIM Whitening Turmeric and Snowlotus Cream	Betamethasone, Clobetasol (Corticosteroids) and Mercury	Thailand Food and Drug Administration
Kuat Lelaki Genotan	Sildenafil (PDE-5 inhibitor)	Indonesian Food and Drug Authority
Lianhua Qingwen Jiaonang	Ephedrine and Pseudoephedrine	Indonesian Food and Drug Authority
Lucky Lady	Tadalafil (PDE-5 inhibitor)	Health Canada
MALISSA Kiss Melted Matte Lip Color #07 Red Moon	CI 15585 (Pigment Red)	Thailand Food and Drug Administration
Magnum XXL 9800	Sildenafil (PDE-5 inhibitor)	United States Food and Drug Administration
ODD Bodha	Furosemide	Indonesian Food and Drug Authority
ODD Booster	Sibutramine	Indonesian Food and Drug Authority
One Night Love	Sildenafil (PDE-5 inhibitor)	Indonesian Food and Drug Authority
Pink Pussycat	Sildenafil (PDE-5 inhibitor)	United States Food and Drug Administration
RD Pelangsing Herbal Original  (kemasan botol bulat)	Sibutramine	Indonesian Food and Drug Authority
RD Pelangsing Herbal Original (kemasan botol segi empat)	Sibutramine	Indonesian Food and Drug Authority
Poseidon Platinum 3500	Sildenafil (PDE-5 inhibitor)	Health Canada
Rempah Alam Papua Buah Merah	Paracetamol	Indonesian Food and Drug Authority
Rhino 7 Platinum 5000	Sildenafil (PDE-5 inhibitor) and Yohimbe	Health Canada
Rick's Hemp Oil Full Spectrum Hemp Supplement 500 mg	Cannabidiol (CBD), Cannabi-chromene (CBC) and Delta-9-tetrahydro- cannabinol (THC) (Cannabinoids)	Australia Therapeutic Goods Administration
Sari Kulit Manggis Asam Urat	Paracetamol	Indonesian Food and Drug Authority
Sinatren	Dexamethasone, Prednisone (Corticosteroids) and Paracetamol	Indonesian Food and Drug Authority
Super Panther 7K	Yohimbe	Health Canada
Tawon Liar kapsul	Tramadol	Indonesian Food and Drug Authority
Tabib Guna Gemuk Sehat Sempurna	Cyproheptadine	Indonesian Food and Drug Authority
Urat Seribu	Sildenafil (PDE-5 inhibitor)	Indonesian Food and Drug Authority
Ji Zhi Tang Jiang	Ephedrine and Pseudo- ephedrine	Indonesian Food and Drug Authority

 

Annex B

The possible side effects of the potent ingredients

Acetaminophen / Paracetamol

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

 

Acetosal / Aspirin

Acetosal or aspirin is a nonsteroidal anti-inflammatory drug (NSAID). NSAIDs are anti-inflammatory medications used to relieve pain and reduce inflammation.  Their prolonged use may potentially cause serious gastric bleeding, nausea and high blood pressure.

 

Benzene

Benzene is a carcinogen that is not allowed in the composition of cosmetic products. Inhalation of benzene can cause central nervous system (CNS) effects, including drowsiness, dizziness, headache, vertigo, tremor and coma. Long-term exposure to excessive levels of benzene in the air can cause leukaemia, in particular - acute myeloid leukaemia and acute nonlymphocytic leukaemia. Exposure to benzene may also lead progressively to aplastic anaemia and multiple myloma.

 

Cannabinoids (Cannabidiol CBD, Cannabichromene CBC and Tetrahydrocannabinol THC)

Cannabinoids are the active chemical extracts of the Cannabis plant. Cannabis and cannabinoids are classified as illicit drugs in Singapore due to their addictive and harmful nature. Side effects from the use of cannabinoids include sedation, tiredness, diarrhoea, or decreased appetite. Use of cannabinoids can also cause anaemia and affect liver function. Tetrahydrocannabinol (THC) is the most psychoactive chemical compound in cannabis associated with negative effects on brain development, causing impaired learning and poor memory. THC is also linked to the development of major psychiatric illnesses.

 

Corticosteroids (Betamethasone, Clobetasol, Dexamethasone and Prednisolone)

Betamethasone, clobetasol, 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.

 

Cyproheptadine

Cyproheptadine is an antihistamine used to relieve allergy symptoms. Side effects associated with its use include weight gain, diarrhoea, nausea, and vomiting.

 

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.

 

Ephedrine / Pseudoephedrine

Ephedrine or pseudoephedrine is used in the treatment of low blood pressure. The inappropriate use of ephedrine may lead to side effects such as nausea, high blood pressure, irregular heart rate, vomiting and dizziness.

 

Furosemide / Frusemide

Furosemide or 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.

 

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

 

Phosphodiesterase Type 5 (PDE-5) inhibitors

This class of medicine includes sildenafil and tadalafil. 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.

 

Pigment Red (CI 15585)

Pigment red is a synthetic colouring agent widely used in printing inks and letter press. It has been associated with contact dermatitis following cosmetic use. Although there is inadequate evidence of carcinogenicity in humans, limited evidence of toxicity, tumours and splenomegaly occurred in experimental animals after long term intake.

 

Retinoic acid

Retinoic acid 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 retinoic acid could lead to side effects such as redness and peeling of skin.

 

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.

 

Tramadol

Tramadol is a prescription medicine used to treat pain and should be used under medical supervision. The inappropriate use of tramadol may lead to side effects including insomnia, dizziness, constipation, nausea, vomiting, drowsiness and potentially, addiction.

 

Yohimbe / Yohimbine

Yohimbine is a potent medicinal ingredient derived from yohimbe, a bark extract. Side effects associated with yohimbe or yohimbine include insomnia, anxiety, palpitations (sensation of heart pounding, racing or skipped beats), sweating and blurred vision. Overdosage can cause low blood pressure, rapid heartbeats, seizures, paralysis and coma. Deaths from overdose have also been reported.

 

Download pdf document: HSA Foreign Alert_2021_December1132 KB

Published: 4 Feb 2022

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