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

The Health Sciences Authority (HSA) would like to update the public on products that have been found and reported by overseas regulators in January 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

 

Annex B

The possible side effects of the potent ingredients

 

Allopurinol

Allopurinol is a prescription medicine used to treat gout and certain types of kidney stones. Inappropriate use of allopurinol without medical supervision may cause skin rashes, diarrhoea, nausea and drowsiness. Serious skin reactions, reduced blood count and/or liver disorder may occur in rare instances.

 

Caffeine

The inappropriate use of caffeine may lead to insomnia, agitation, restlessness, palpitations and increased heart rate.

 

Chlorpheniramine

Chlorpheniramine is an antihistamine used to relieve allergic reactions such as hives and rhinitis. It should be used under medical supervision by a pharmacist or doctor. Side effects from the use of chlorpheniramine include drowsiness, blurred vision, vomiting, constipation and poor coordination.

 

Clotrimazole

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

 

Corticosteroids

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.

 

Fenofibrate

Fenofibrate is a prescription medicine used to treat abnormal blood lipid levels and should be used under medical supervision. Common side effects include liver problems, shortness of breath, muscle pain or weakness, abdominal pain and nausea. Serious side effects may include gallstones, blood clots and pancreatitis.

 

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.

 

Glibenclamide

Glibenclamide is a prescription medicine used to treat diabetes mellitus and should be used under medical supervision. Inappropriate use of glibenclamide without medical supervision may cause severe low blood glucose which can cause seizures or coma. Other side effects may include nausea, vomiting, diarrhea and cholestatic jaundice.

 

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.

 

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.

 

Metformin

Metformin is a prescription medicine for the treatment of diabetes and should be used under medical supervision. Common side effects include diarrhea, nausea and abdominal pain. An overdose can cause severe hypoglycemia or lactic acidosis, which can be fatal.

 

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 and high blood pressure. Examples include ibuprofen, mefenamic acid, phenylbutazone and piroxicam.

 

Paracetamol

Paracetamol 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 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 (PDE-5 inhibitor) while on nitrates have been reported overseas.

 

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 document: HSA Foreign Alert_2021_January1871 KB

Published: 2 Nov 2021

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