HSA updates on products found overseas that contain potent ingredients (December 2022)

The Health Sciences Authority (HSA) would like to update the public on products that have been found and reported by overseas regulators in December 2022 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)
Airee Beauty Care – Night Cream	Mercury	Ministry of Health, Brunei Darussalam,
Brilliant Skin Essentials Brilliant Rejuv Set	Hydroquinone and Tretinoin	Health Canada
Brilliant Skin Essentials Brilliant Rejuv Topical Cream	Hydroquinone and Tretinoin	Health Canada
Brilliant Skin Essentials Brilliant Rejuv Topical Solution	Hydroquinone and Tretinoin	Health Canada
KAMAGRA Oral Jelly	Sildenafil	Hong Kong Department of Health
Super P-FORCE Oral Jelly	Sildenafil and Dapoxetine	Hong Kong Department of Health
Miao Xuan Wang Cao Ben Ru Gao	Clobetasol propionate, ketoconazole and miconazole	Hong Kong Department of Health
Zang Yao Xuan Du Wang	Clobetasol propionate, ketoconazole and miconazole	Hong Kong Department of Health
百芙通九毒王藏药乳膏	Miconazole	Hong Kong Department of Health
草本专家止痒王抑菌乳膏	Clobetasol propionate, ketoconazole and miconazole	Hong Kong Department of Health

 

Annex B

The possible side effects of the potent ingredients

 

Corticosteroids 

Clobetasol propionate is a potent steroid that is 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.

 

Dapoxetine

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

 

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.

 

Ketoconazole

Ketoconazole is a medicine used to treat fungal infections. Side effects from creams containing ketoconazole include burning, stinging, redness and itching of the skin.

 

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.

 

Miconazole

Miconazole is a medicine used to treat fungal infections. Side effects from inappropriate use of creams containing miconazole include burning, stinging, swelling, irritation, redness and flaking of the skin.

 

Phosphodiesterase Type 5 (PDE-5) inhibitors

This class of medicine includes Desmethylcarbodenafil, Dithiodesmethylcarbodenafil, 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.

 

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_2022_Dec412 KB

Published: 3 Jan 2023

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