HSA updates on products found overseas that contain potent ingredients (May 2024)
The Health Sciences Authority (HSA) would like to update the public on products that have been found and reported by overseas regulators in May 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. 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) |
| Epimedyum Extraktli Macun Plus | Sildenafil
(PDE-5 inhibitor) | Germany Federal Institute for Drugs and Medical Devices |
| FX 35000 | Sildenafil
(PDE-5 inhibitor) | Health Canada |
| Ginseng Red 2000 | Sildenafil
(PDE-5 inhibitor) | Health Canada |
Karisma Golden
Turmeric Cream | Betamethasone and Mercury | Malaysia National Pharmaceutical Regulatory Agency |
| Lucky Lady | Tadalafil
(PDE-5 inhibitor) | Health Canada |
| Magnum 24K Gold | Sildenafil
(PDE-5 inhibitor) | Health Canada |
| Magnum 500K Gold | Tadalafil
(PDE-5 inhibitor) | Health Canada |
| N Glowing EWSB | Mercury | Malaysia National Pharmaceutical Regulatory Agency |
| Pink Pussycat | Hydroxythiohomosildenafil
(PDE-5 inhibitor) | Health Canada |
| Premium Pro Power 3500 | Sildenafil (PDE-5 inhibitor) and Yohimbe | Health Canada |
| Rhino Super Long Lasting Premium 500k | Sildenafil
(PDE-5 inhibitor) | Health Canada |
| Rhino 7 10000K | Sildenafil
(PDE-5 inhibitor) | Health Canada |
| Rhino 7 Platinum 5000 (large packaging) | Sildenafil (PDE-5 inhibitor) and
Yohimbe | Health Canada |
| Rhino 7 Platinum 5000 (small packaging) | Sildenafil
(PDE-5 inhibitor) | Health Canada |
| Rhino 7 Platinum 10,000 | Sildenafil (PDE-5 inhibitor)
and Yohimbe | Health Canada |
| Rhino 7 Platinum 900K | Levodopa and Prasterone | Health Canada |
| Rhino 25 Platinum 25000 | Sildenafil
(PDE-5 inhibitor) | Health Canada |
| Rhino 69 Extreme 35000 | Tadalafil
(PDE-5 inhibitor) | Health Canada |
| Rhino 69 Extreme 600K | Sildenafil
(PDE-5 inhibitor) | Health Canada |
| Rhino 69 Extreme 990K | Sildenafil
(PDE-5 inhibitor) | Health Canada |
| Rhino 69 Platinum 35000 | Tadalafil
(PDE-5 inhibitor) | Health Canada |
| Rhino 69 23000K | Sildenafil
(PDE-5 inhibitor) | Health Canada |
| Rhino 69 Platinum 700K | Sildenafil
(PDE-5 inhibitor) | Health Canada |
| Rhino 69 Shot 8500K (Double Shot) | Sildenafil
(PDE-5 inhibitor) | Health Canada |
| Rhino 70000 | Sildenafil
(PDE-5 inhibitor) | Health Canada |
| Rush Hour 72 | Sildenafil and Tadalafil
(PDE-5 inhibitors) | Health Canada |
| SL Two Intensive | Betamethasone and Hydroquinone | Malaysia National Pharmaceutical Regulatory Agency |
| Slim Fit | Sildenafil
(PDE-5 inhibitor) | Turkish
Medicines and Medical Devices Agency |
| Spanish Fly 20,000 | Tadalafil
(PDE-5 inhibitor) | Health Canada |
| Spanish Fly 22,000 | Tadalafil
(PDE-5 inhibitor) | Health Canada |
| Stiff Rock | Sildenafil and Tadalafil
(PDE-5 inhibitors) | Health Canada |
| UMARY Hyaluronic Acid Dietary Supplement | Diclofenac and Omeprazole | Health Canada |
Annex B
The possible side effects of the potent ingredients
Betamethasone
Betamethasone is a potent steroid. 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).
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.
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.
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 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.
Yohimbe
Yohimbe is a bark extract from which a potent medicinal ingredient, Yohimbine, is derived. 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_2024_May_FINAL
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