HSA updates on products found overseas that contain potent ingredients (December 2023)

The Health Sciences Authority (HSA) would like to update the public on products that have been found and reported by overseas regulators in December 2023 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)
Abyra Seaweed Skin Care- Seaweed Cell Renewal Night Cream	Mercury	Malaysia National Pharmaceutical Regulatory Agency
Alien Power Platinum 11000 (green)	Sildenafil (PDE-5 inhibitor)	Health Canada
Alien 2 Power Platinum 11000 (red)	Tadalafil (PDE-5 inhibitor)	Health Canada
Artri King	Diclofenac (NSAID)	United States Food and Drug Administration
BAIWEI Maximum Powerful tablets	Sildenafil (PDE-5 inhibitor)	Australia Therapeutic Goods Administration
Bestie Moisturizer Cream	Mercury	Malaysia National Pharmaceutical Regulatory Agency
Beau Slim	Sibutramine	Indonesia Food and Drug Authority
Beruang Emas	Yohimbine	Indonesia Food and Drug Authority
Bigger Longer More Time More Sperms capsules	Sildenafil (PDE-5 inhibitor)	Australia Therapeutic Goods Administration
Big Guys Male Energy Supplement	Sildenafil (PDE-5 inhibitor)	United States Food and Drug Administration
Black Panther Triple Maximum	Yohimbe	Health Canada
Concentrate orange cream in blue product package labelled as Dr.วุฒิศักดิ์ 3 ครีมทาฝ้า กระ สิว ปรับสภาพผิว"	Mercury	Thailand Food and Drug Administration
Cula Mas Asli	Tadalafil (PDE-5 inhibitor)	Indonesia Food and Drug Authority
Gemuk Sehat-Flu Tulang Asam Urat	Paracetamol	Indonesia Food and Drug Authority
Gemuk Sehat 151	Paracetamol	Indonesia Food and Drug Authority
Genergy	Tadalafil (PDE-5 inhibitor)	United States Food and Drug Administration
Gerbera Beauty - Treatment & Repairing Night Cream	Betamethasone (Corticosteroid), Hydroquinone and Tretinoin	Malaysia National Pharmaceutical Regulatory Agency
Gerbera Beauty - Whitening Night Cream	Betamethasone (Corticosteroid) and Mercury	Malaysia National Pharmaceutical Regulatory Agency
Ginseng 9800 Male Sexual Enhancement XXL	Tadalafil (PDE-5 inhibitor)	Health Canada
Godong ljo	Dexamethasone (Corticosteroid) and Paracetamol	Indonesia Food and Drug Authority
Gold Rhino Extreme 500K	Tadalafil (PDE-5 inhibitor)	Health Canada
Hadalabo Pearl Barley Facial Foam (Skin treatment)	Aminocaproic acid	Health Canada
Hercules X	Sildenafil (PDE-5 inhibitor)	Indonesia Food and Drug Authority
Jakarta Bandung Plus	Yohimbine	Indonesia Food and Drug Authority
Jamu Urat Kuda Formula Plus	Paracetamol and Sildenafil (PDE-5 inhibitor)	Indonesia Food and Drug Authority
Light yellow cream in blue product package labelled as Dr.วุฒิศักดิ์ 2 ครีมป้องกันแสงแดด SPF 60 PA++"	Mercury	Thailand Food and Drug Administration
Light yellow cream in blue product package labelled as Dr.วุฒิศักดิ์ 4 ครีมทาฝ้า กระ สิว ผลัดเซลล์	Betamethasone (Corticosteroid), Hydroquinone, Mercury and Retinoic acid	Thailand Food and Drug Administration
Kuka Flex Forte	Diclofenac (NSAID)	United States Food and Drug Administration
Li Da Daidaihua capsules	Sibutramine	Australia Therapeutic Goods Administration
LIPOVON capsules	Sibutramine	Mexico COFEPRIS
LOVELY WHITE AURA CREAM เลิฟลี่ ไวท์ ออร่า ครีม	Clobetasol (Corticosteroid)	Thailand Food and Drug Administration
Lovely White Aura Body Cream เลิฟลี่ ไวท์ ออร่า บอดี้ ครีม	Mercury	Thailand Food and Drug Administration
Magnum Gold 24K	Tadalafil (PDE-5 inhibitor)	Health Canada
Magnum XXL 9800	Levodopa and Prasterone	Health Canada
MANNERS Energy Boost	Tadalafil (PDE-5 inhibitor)	United States Food and Drug Administration
Mens Maximum Energy Supplement	Sildenafil (PDE-5 inhibitor)	United States Food and Drug Administration
Moya Slimming	Sibutramine	Indonesia Food and Drug Authority
Muntalinu	Dexamethasone (Corticosteroid) and Paracetamol	Indonesia Food and Drug Authority
New Guna Sari Gemuk Sehat	Dexamethasone (Corticosteroid)	Indonesia Food and Drug Authority
Notoginseng Formula Special Gout Granule	Dexamethasone (Corticosteroid) and Diclofenac (NSAID)	United States Food and Drug Administration
Osagi Gajah Kuat	Dexamethasone & Prednisolone (Corticosteroids), Mefenamic acid (NSAID) and Paracetamol	Indonesia Food and Drug Authority
Power Sex	Sildenafil (PDE-5 inhibitor)	Indonesia Food and Drug Authority
Praewa Night Cream แพรวา ครีมสมุนไพรมะขามป้อม VS น้ำมันมะพร้าว	Betamethasone (Corticosteroid) and Mercury	Thailand Food and Drug Administration
Premium Pro Power 3500	Sildenafil (PDE-5 inhibitor) and Yohimbe	Health Canada
Ram It	Sildenafil (PDE-5 inhibitor)	United States Food and Drug Administration
Ramuan Madura Asam Urat, Flu Tulang, Pegal Linu, Sakit Pinggang, Rheumatik, Kolesterol	Paracetamol	Indonesia Food and Drug Authority
Ramuan Urat Naga Super	Paracetamol and Sildenafil (PDE-5 inhibitor)	Indonesia Food and Drug Authority
Redak-Sam	Dexamethasone (Corticosteroid), Diclofenac and Phenylbutazone (NSAIDs)	Indonesia Food and Drug Authority
Reumo Flex	Diclofenac (NSAID)	United States Food and Drug Administration
Rhino 7 Platinum 5000	Sildenafil (PDE-5 inhibitor) and Yohimbe	Health Canada
Rhino 7 Platinum 10,000	Sildenafil (PDE-5 inhibitor)	Health Canada
Rhino 7 Platinum 700k	Tadalafil (PDE-5 inhibitor)	Health Canada
Rhino 25 Platinum 25000	Sildenafil (PDE-5 inhibitor)	Health Canada
Rhino 25 Titanium 500K	Sildenafil and Tadalafil (PDE-5 inhibitors)	Health Canada
Rhino 69 Extreme 600K	Sildenafil (PDE-5 inhibitor)	Health Canada
Rhino 69 Extreme 990K	Sildenafil (PDE-5 inhibitor)	Health Canada
Rhino 69 Gold 777K	Sildenafil (PDE-5 inhibitor)	Health Canada
Rhino 99 Diamond 30000	Tadalafil (PDE-5 inhibitor)	Health Canada
Round 2	Tadalafil (PDE-5 inhibitor)	United States Food and Drug Administration
Sari Binahong	Paracetamol	Indonesia Food and Drug Authority
Sari Buah Naga Kapsul	Paracetamol	Indonesia Food and Drug Authority
Sari Buah Tin	Paracetamol	Indonesia Food and Drug Authority
Schwinnng	Nortadalafil (PDE-5 inhibitor)	United States Food and Drug Administration
Serbuk Guna Sehat Encok GS No.2	Paracetamol	Indonesia Food and Drug Authority
Simple Heart SPECIFIC SLIMMING PRODUCT	Frusemide, N-desmethyl-sibutramine and Sibutramine	Hong Kong Department of Health
Singa Barong	Sildenafil (PDE-5 inhibitor)	Indonesia Food and Drug Authority
Slim Strong	Paracetamol and Sibutramine	Indonesia Food and Drug Authority
Spanish Fly 22,000	Tadalafil (PDE-5 inhibitor)	Health Canada
Stiff Rox	Sildenafil and Tadalafil (PDE-5 inhibitors)	Health Canada
SUNATCHA BRAND TANAKA & MILK RICE CREAM สมุนไพร ทานาคาน้ำนมข้าว	Betamethasone (Corticosteroid) and Mercury	Thailand Food and Drug Administration
Super Sehat Gemuk Sehat 1	Dexamethasone (Corticosteroid)	Indonesia Food and Drug Authority
Sustain	Avanafil and Tadalafil (PDE-5 inhibitors)	United States Food and Drug Administration
T XTRA Strength Test Booster	Tadalafil (PDE-5 inhibitor)	United States Food and Drug Administration
THE ROCK, Male Sexual Performance Enhancement Capsules	Sildenafil (PDE-5 inhibitor)	United States Food and Drug Administration
TO THE MOON	Sildenafil (PDE-5 inhibitor)	United States Food and Drug Administration
Tusuk Jari Asam Urat	Diclofenac (NSAID) and Paracetamol	Indonesia Food and Drug Authority
U-One Slimming Herbal	Sibutramine	Indonesia Food and Drug Authority
Urat Naga	Sildenafil (PDE-5 inhibitor)	Indonesia Food and Drug Authority
WeFun	Sildenafil (PDE-5 inhibitor)	United States Food and Drug Administration
โสมกลูต้า WHITE SMOOTH AURA	Mercury	Thailand Food and Drug Administration
Wild Bull	Nortadalafil (PDE-5 inhibitor)	United States Food and Drug Administration
Ying Da Wang tablets	Sildenafil (PDE-5 inhibitor)	Therapeutic Goods Administration
3800 Hard Rock	Tadalafil (PDE-5 inhibitor)	Health Canada

 

Annex B

The possible side effects of the potent ingredients

Aminocaproic acid

Aminocaproic acid is a medicine used to treat certain bleeding disorders. Inappropriate use of aminocaproic acid without medical supervision may result in allergic and hypersensitivity reactions. Anaphylaxis has been reported with aminocaproic acid therapy. Blood clotting and blood coagulation disorder have also been reported with the use of aminocaproic acid.

 

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.

 

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.

 

Levodopa

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.

 

Nonsteroidal Anti-inflammatory Drugs (NSAIDs)

NSAIDs are anti-inflammatory medications used to relieve pain and reduce inflammation.  Their prolonged use may potentially cause serious gastric bleeding, nausea, high blood pressure and cardiovascular events such as heart attacks and strokes. They should be used under close medical supervision, especially in patients with underlying heart conditions, stomach bleeding and ulceration. Examples include aspirin, diclofenac, ibuprofen, indomethacin, mefenamic acid, meloxicam, phenylbutazone and piroxicam.

 

Paracetamol

Paracetamol, also known as acetaminophen, is used for relieving pain, headache and fever. Products which contain 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 / N-desmethyl 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. N-desmethyl sibutramine is like sibutramine and may have similar side effects.

 

Tretinoin / Retinoic acid

Tretinoin or 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 tretinoin could lead to side effects such as redness and peeling of skin.

 

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: HSA Foreign Alert_2023_Dec3062 KB

Published: 12 Jan 2024

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