HSA updates on products found overseas that contain potent ingredients (July 2024)
The Health Sciences Authority (HSA) would like to update the public on products that have been found and reported by overseas regulators in July 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.
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) |
|---|
| Ailas Wild Rose Petal Face Cream | Mercury and Tretinoin | Malaysia National Pharmaceutical Regulatory Agency |
| Bang Maximum Power | Sildenafil
(PDE-5 inhibitor) | Health Canada |
| Big Rhino Fiamund 300K | Tadalafil
(PDE-5 inhibitor) | Health Canada |
| Black Bull Extreme | Sildenafil and Tadalafil
(PDE-5 inhibitors) | Health Canada |
| Desha Night Cream (Moisturizer) | Mercury and Tretinoin | Malaysia National Pharmaceutical Regulatory Agency |
| Ginseng Red 2000 | Sildenafil
(PDE-5 inhibitor) | Health Canada |
| Gold Hard Steel Plus | Acetaminophen and Sildenafil
(PDE-5 inhibitor) | United States Food and Drug Administration |
| Grakcu Capsule | Sildenafil and Tadalafil
(PDE-5 inhibitors) | Thailand Food and Drug Administration |
| GreenSlim Weight Management | Sibutramine | Brunei Darussalam
Department of Pharmaceutical Services |
| Hard Steel | Acetaminophen and Sildenafil
(PDE-5 inhibitor) | United States Food and Drug Administration |
| Infla-650 Herbal Dietary Supplement Capsules | Acetaminophen, Diclofenac and Phenylbutazone (NSAIDs) | United States Food and Drug Administration |
| Lumi Luscious Eyelash & Eyebrow Growth Serum | Bimatoprost | Health Canada |
| Magnum Gold 24K | Sildenafil
(PDE-5 inhibitor) | Health Canada |
| Power Men XXX | Sildenafil and Tadalafil
(PDE-5 Inhibitors) | Swissmedic |
| Rhino 7 Platinum 5000 | Sildenafil
(PDE-5 Inhibitor) | Health Canada |
| Robust Extreme capsules | O-propyl Vardenafil
(PDE-5 inhibitor) | Australian Therapeutic Goods Administration |
| RAM IT, Horny Goat Weed | Sildenafil
(PDE-5 inhibitor) | United States Food and Drug Administration
|
| Schwinnng products being sold in packaging labelled as “On Command” | Nortadalafil
(PDE-5 inhibitor) | United States Food and Drug Administration
|
| SleekFit Detox Cayi Limon | Sibutramine | Swissmedic |
| Umary Acido Hialuronica, Suplemento Alimenticio – 30 Capletas de 850mg | Diclofenac (NSAIDs) and Omeprazole | United States Food and Drug Administration |
| To the Moon Capsules, Horny Goat Weed | Sildenafil
(PDE-5 inhibitor) | United States Food and Drug Administration |
| Vail-Bon Jie Yang Wan | Dexamethasone and Chlorpheniramine | United States Food and Drug Administration |
| XS Dissolved Fat | Furosemide and Sibutramine | Hong Kong Department of Health |
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 this declared on the label, pose a danger to consumers as accidental overdose can result in liver damage
Bimatoprost
Bimatoprost is a medicine used to lower the intraocular pressure of the eye in glaucoma. It should be used under medical supervision as it can cause side effects such as blurred vision, eye irritation, darkened eyelid skin, iris colour change, eye inflammation and macular oedema and hyperemia.
Chlorpheniramine
Chlorpheniramine is an antihistamine used to relieve allergic reactions such as hives and rhinitis. It should be used under medical supervision. Side effects from the use of chlorpheniramine include drowsiness, blurred vision, vomiting, constipation and poor coordination.
Dexamethasone
Dexamethasone is a potent steroid that is usually prescribed for inflammatory conditions and should only be used under strict medical supervision. Long term use of an oral steroid without medical supervision can cause high blood pressure, cataracts, an increased risk of infections, and Cushing’s syndrome (characterised by the appearance of round face or ‘moon face’ 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.
Frusemide / Furosemide
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.
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.
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.
Phosphodiesterase Type 5 (PDE-5) inhibitors
This class of medicine includes 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.
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_July
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