HSA updates on products found overseas that contain potent ingredients (November 2020)

The Health Sciences Authority (HSA) would like to update the public on products that have been found and reported by overseas regulators in November 2020 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)
Africa Rhino Platinum 75K	Yohimbe	Health Canada
AleZaR Argan Oil	Octamethylcyclo-tetrasiloxane (D4)	EU RAPEX (Finland)
Alien Power Platinum 11000	Tadalafil (PDE-5 inhibitor)	Health Canada
Alien 2 Power Platinum 11000	Tadalafil (PDE-5 inhibitor)	Health Canada
Amsterdam	Isobutyl nitrite (Alkyl nitrites)	Health Canada
Bigger Longer More Time More Sperms (sic)	Sildenafil (PDE-5 inhibitor)	United States Food and Drug Administration
Bio Claire Crème Corporelle Eclaircissante Skin Lightening Cream	Mercury	EU RAPEX (Sweden)
Black Mamba 2 Premium	Sildenafil (PDE-5 inhibitor)	Health Canada
Black Mamba 7K	Yohimbe	Health Canada
Black Mamba Extreme 15000	Yohimbe	Health Canada
Black Opal Even True Tone Correct Fade Cream	Hydroquinone	EU RAPEX  (The Netherlands)
Black Panther	Yohimbe	Health Canada
Black Panther #1	Yohimbe	Health Canada
Black Panther 350K	Yohimbe	Health Canada
Black Panther Platinum 30K	Yohimbe	Health Canada
Blue Boy	Alkyl nitrites	Health Canada
Body Shape Weight Loss System	Sibutramine and Fluoxetine (SSRIs)	United States Food and Drug Administration
Boss-Rhino Gold	Sildenafil (PDE-5 inhibitor)	Health Canada
Botaya Herb Nourishing Skin Care Set	Mercury	Thailand Food and Drug Administration
Bravo for Him	Sildenafil, Tadalafil, Desmethylcarbo-denafil and Dithiodesmethyl-carbodenafil (PDE-5 inhibitors)	Health Canada
Carotone - LIGHT AND NATURAL Crème éclaircissante 3 en 1	Clobetasol propionate (Corticosteroids)	EU RAPEX (France)
Cocoderm Lightening Body Cream	Hydroquinone	EU RAPEX (France)
Crypt Tonight	Isobutyl nitrite (Alkyl nitrites)	Health Canada
DMC Lase Peroxide Sensy	Hydrogen Peroxide	EU RAPEX (Finland)
Double Scorpio Emerald	Isobutyl nitrite (Alkyl nitrites)	Health Canada
English Royale	Isobutyl nitrite (Alkyl nitrites)	Health Canada
FX 3000	Sildenafil (PDE-5 inhibitor)	Health Canada
Ginseng Red 2000	Sildenafil (PDE-5 inhibitor)	Health Canada
Gold Rush Original	Isobutyl nitrite (Alkyl nitrites)	Health Canada
Grain German Shepherd tablets	Sildenafil (PDE-5 inhibitor) and Paracetamol	Australia Therapeutic Goods Administration
Hard Rock 3800	Yohimbe	Health Canada
Herb Gold all natural all in one cream	Mercury	Thailand Food and Drug Administration
Herb Viagra Male Sexual Stimulant	Sildenafil (PDE-5 inhibitor)	United States Food and Drug Administration
Horny Goat Weed	Yohimbe	Health Canada
Jungle Juice Gold Label	Alkyl nitrite	Health Canada
Jungle Juice Platinum	Alkyl nitrite	Health Canada
Kangaroo Ultra 3000	Flibanserin	Health Canada
KiMiSo Dark Chocolate	Sibutramine	Hong Kong Department of Health
Kopi Strong Man Plus	Dexamethasone (Corticosteroids)	Malaysia Ministry of Health
Lana Crème clarifiante super white bio	Hydroquinone	EU RAPEX (France)
L'Abidjanaise Crème éclaircissante carotte	Clobetasol propionate (Corticosteroids)	EU RAPEX (France)
Livtone	Sibutramine and Fluoxetine (SSRIs)	United States Food and Drug Administration
Lucky Lady	Tadalafil (PDE-5 inhibitor)	Health Canada
Magnum XXL 9800	Sildenafil (PDE-5 inhibitor)	United States Food and Drug Administration
Magnum XXL 50K	Sildenafil (PDE-5 inhibitor)	United States Food and Drug Administration
Mamba Is Hero	Sildenafil, Dimethyl-carbodenafil (PDE-5 inhibitors) and Dapoxetine (SSRIs)	Health Canada
Master Zone 1500	Sildenafil and Tadalafil (PDE-5 inhibitors)	Health Canada
Maximum Power Bang All Night Long	Sildenafil (PDE-5 inhibitor)	Health Canada
MV7 Days 3500	Sildenafil and Tadalafil (PDE-5 inhibitors)	Health Canada
MYO-HGH workout supplement	MK-677 (SARMs)	Health Canada
MYO-RAD workout supplement	RAD 140 Testolone (SARMs)	Health Canada
MYO-STA workout supplement	MK-2866 (SARMs)	Health Canada
MYO-TKO Total Knock-Out workout supplement	MK-2866 (SARMs)	Health Canada
New Face Whitening Cream	Mercury	EU RAPEX (Sweden)
Optimal Wet Wipes Chamomile	Methylchloro-isothiazolinone (MCI) and Methyl-isothiazolinone (MI)	EU RAPEX (Cyprus)
Piment doux plus Crème de visage éclaircissante	Hydroquinone	EU RAPEX (France)
Platinum Amsterdam	Alkyl nitrite	Health Canada
Poseidon Platinum 3500	Sildenafil (PDE-5 inhibitor)	Health Canada
Powerplay Formula Leather Eagle	Isobutyl nitrite (Alkyl nitrites)	Health Canada
Premium Pro Power 3500	Sildenafil (PDE-5 inhibitor) and Yohimbe	Health Canada
Prestige – Rejuvenating Plus Toner	Hydroquinone and Tretinoin	Brunei Darussalem, Ministry of Health
Rhino Super Long Lasting 200K	Tadalafil (PDE-5 inhibitor)	Health Canada
Rhino XL 75K	Yohimbe	Health Canada
Rhino 7 Platinum 3000	Desmethyl-carbodenafil (PDE-5 inhibitor) and Dapoxetine (SSRIs)	Health Canada
Rhino 7 Platinum 5000	Sildenafil (PDE-5 inhibitor) and Yohimbe	Health Canada
Rhino 8 Platinum 80000	Sildenafil (PDE-5 inhibitor)	United States Food and Drug Administration
Rhino 12 Titanium 200K	Sildenafil (PDE-5 inhibitor)	Health Canada
Rhino 25 Platinum 25000	Yohimbe	Health Canada
Rhino 69 Platinum 35000	Tadalafil (PDE-5 inhibitor)	Health Canada
Rhino 69 Platinum 75000	Sildenafil (PDE-5 inhibitor)	United States Food and Drug Administration
Rhino 69 Power 500K	Sildenafil (PDE-5 inhibitor)	United States Food and Drug Administration
Rhino 96 Platinum 77000	Sildenafil (PDE-5 inhibitor)	United States Food and Drug Administration
Rhino 99 Extreme 90000	Sildenafil (PDE-5 inhibitor)	United States Food and Drug Administration
Rhinozen 69 Platinum 25000	Sildenafil (PDE-5 inhibitor)	United States Food and Drug Administration
Rise 2.0 Liquid Cialis 30ml bottle(s)	Tadalafil (PDE-5 inhibitor)	Australia Therapeutic Goods Administration
Rising Phoenix	Yohimbe	Health Canada
Rochefort	Isobutyl nitrite (Alkyl nitrites)	Health Canada
Rush Hour 72	Sildenafil, Tadalafil, Desmethyl-carbodenafil and Dithiodesmethyl-carbodenafil (PDE-5 inhibitors)	Health Canada
Rush	Isobutyl nitrite (Alkyl nitrites)	Health Canada
Rush Original	Isobutyl nitrite (Alkyl nitrites)	Health Canada
Sandal Whitening Beauty Cream	Mercury	EU RAPEX (Germany)
Shark 5K	Yohimbe	Health Canada
Spanish Fly 22,000	Tadalafil (PDE-5 inhibitor)	Health Canada
Stiff Rox	Sildenafil and Tadalafil (PDE-5 inhibitors)	Health Canada
Stree Overlord	Sildenafil (PDE-5 inhibitor) and Ciprofloxacin	United States Food and Drug Administration
Super Mamba-Triple Maximum	Yohimbe	Health Canada
Super RUSH Original	Isobutyl nitrite (Alkyl nitrites)	Health Canada
Super RUSH Original-Black Label	Isobutyl nitrite (Alkyl nitrites)	Health Canada
S.W.A.G Sex with a grudge	Sildenafil (PDE-5 inhibitor)	Health Canada
Titanium 4000	Sildenafil and Tadalafil (PDE-5 inhibitors)	Health Canada
Triple Green	Yohimbe	Health Canada
Triple MiracleZEN Gold	Sildenafil, Tadalafil (PDE-5 inhibitors) and Dapoxetine (SSRIs)	Health Canada
Triple MiracleZEN Plus	Sildenafil, Tadalafil (PDE-5 inhibitors), Dapoxetine (SSRIs) and Yohimbe	Health Canada
Trojan-X 300K	Yohimbe	Health Canada
Ultimate 3500	Sildenafil and Tadalafil (PDE-5 inhibitors)	Health Canada
U.S.A. Viagra	Sildenafil (PDE-5 inhibitor)	United States Food and Drug Administration
Unlabelled Slimming Products	Hydrochlorothiazide, Propranolol and Fluoxetine (SSRIs)	Hong Kong Department of Health
Vigorous Man	Sildenafil (PDE-5 inhibitor)	United States Food and Drug Administration
VIP Go Rhino Gold 69K	Yohimbe	Health Canada
Vita-X Revitalizing Capsules Extra Strength (sleeve package)	Sildenafil (PDE-5 inhibitor)	Health Canada
Vita-X Revitalizing Capsules Extra Strength (blister package)	Sildenafil (PDE-5 inhibitor)	Health Canada
V8 Super Energy	Sildenafil (PDE-5 inhibitor)	United States Food and Drug Administration
White Panther Extreme 50K	Yohimbe	Health Canada
White Panther Triple Maximum	Yohimbe	Health Canada
XOXO Hard Rock	Sildenafil (PDE-5 inhibitor)	Health Canada
XPanther 9X	Yohimbe	Health Canada
XXLant 3000	Yohimbe	Health Canada
7K	Yohimbe	Health Canada
777	Yohimbe	Health Canada

 

Annex B

The possible side effects of the potent ingredients

 

Alkyl nitrites

"Poppers" is a slang term for products that contain alkyl nitrites. Despite being labelled for various uses such as leather cleaners, room odourizers or liquid incense, these products are inhaled or ingested by consumers for recreational purposes. Alkyl nitrites, such as amyl nitrite, butyl nitrite and isobutyl nitrite, are prescription medicines and should be used only under medical supervision. Products containing alkyl nitrites may pose serious risks, including death, depending on the amount used, how frequently they are used and how long they are used for, as well as the person's health and the other medications they may be taking. Since it is difficult to control how much is inhaled, people can accidentally overdose. Swallowing these products can lead to serious medical complications and may be fatal.

 

Ciprofloxacin

Ciprofloxacin is an antibiotic used to treat bacterial infections. It is a prescription medicine and should be used under medical supervision. Common side effects include nausea, vomiting, diarrhoea and rash. Severe side effects include an increased risk of tendon rupture, hallucinations and nerve damage.

 

Corticosteroids

Clobetasol propionate and dexamethasone 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.

 

Flibanserin

Flibanserin was originally developed as an antidepressant. Side effects include dizziness, nausea, sense of tiredness, sleepiness and difficulty in falling asleep.

 

Hydrochlorothiazide

Hydrochlorothiazide 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, vomiting, diarrhoea, low blood pressure, electrolyte imbalance and dehydration.

 

Hydrogen Peroxide

Hydrogen peroxide is commonly used in teeth whitening products and mouth rinses. At high concentrations, however, it causes skin irritation and is harmful if swallowed. It should not be used to treat deep wounds, animal bites or serious burns. Side effects associated with its use include redness, stinging or irritation at the application site. Serious allergic reactions are rare but may be life-threatening.

 

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.

 

 

Methylchloroisothiazolinone (MCI) and Methylisothiazolinone (MI)

Methylchloroisothiazolinone (MCI) and Methylisothiazolinone (MI) are used as preservatives in water-based cosmetics and personal care products, as well as in industrial products such as paints and adhesives. They can cause chemical burns and have been associated with skin allergic reactions, such as allergic contact dermatitis.

 

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.

 

Octamethylcyclotetrasiloxane (D4)

Octamethylcyclotetrasiloxane, also called D4, has been used in cosmetics, personal care and commercial cleaning products such as polishes and waxes. It is a chemical classified as a ‘substance of very high concern’ by health authorities due to its persistent, bio-accumulative and toxic nature. It is suspected of damaging fertility.

 

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 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.

 

Propranolol

Propranolol is a prescription medicine used to treat high blood pressure and should be used under medical supervision. Common side effects include diarrhoea, nausea, weakness and tiredness. The inappropriate use of propranolol without medical supervision may lead to serious side effects such as vomiting, breathing difficulty, muscle cramps or weakness and changes in blood sugar.

 

Selective Androgen Receptor Modulators (SARMs)

Selective Androgen Receptor Modulators (SARMs) are chemicals that mimic the effects of the male hormone, testosterone. Some of these chemicals are still undergoing research and no SARMs has been approved for clinical use in humans. Using such chemicals can be dangerous as not all their side effects are known. The possible side effects may be similar to testosterone, such as insomnia, irritability, aggressive behaviour, hypertension, and impotence. Examples include Ibutamoren (MK-677), ostarine (MK 2866), testolone, and RAD-140.

 

Selective Serotonin Reuptake Inhibitors (SSRIs)

Selective Serotonin Reuptake Inhibitors (SSRIs) are a class of medicines typically used to treat conditions like depression and eating disorders, and they should be used under medical supervision. They include dapoxetine and fluoxetine. The use of SSRIs has been associated with side effects including headaches, insomnia, palpitations and dizziness.

 

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.

 

Yohimbe

Yohimbine is a potent medicinal ingredient derived from yohimbe, a bark extract. Side effects associated with yohimbe 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 document:  hsa-foreign-alert_2020_nov

Published: 2 Nov 2021

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