HSA updates on products found overseas that contain potent ingredients (September 2024)
The Health Sciences Authority (HSA) would like to update the public on products that have been found and reported by overseas regulators in September 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) |
|---|
| 88 Total White Underarm Cream | Betamethasone | Hong Kong Department of Health |
| 3800 Hard Rock | Tadalafil
(PDE-5 Inhibitor) | Health Canada |
| 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 |
| Black Mamba Premium Triple Maximum | Sildenafil and Tadalafil
(PDE-5 Inhibitors) | Health Canada |
| Blue 6K | Sildenafil
(PDE-5 Inhibitor) | Health Canada |
| Bravo For Him | Sildenafil, Desmethyl carbodenafil, Dithiodesmethyl carbodenafil
(PDE-5 Inhibitors) | Health Canada |
| CHU Brand | Sildenafil and Tadalafil
(PDE-5 Inhibitors) | Thailand Food and Drug Administration |
| Ginseng Red 2000 | Sildenafil
(PDE-5 Inhibitor) | Health Canada |
| HEAVENPLUS | Sildenafil
(PDE-5 Inhibitor) | Thailand Food and Drug Administration |
| Lucky Lady | Tadalafil
(PDE-5 Inhibitor) | Health Canada |
| Magnum Gold 24K | Sildenafil
(PDE-5 Inhibitor) | Health Canada |
| Magnum XXL 50K | Tadalafil
(PDE-5 Inhibitor) | Health Canada |
| Magnum XXL 500K | Sildenafil
(PDE-5 Inhibitor) | Health Canada |
| Magnum XXX 24K | Tadalafil
(PDE-5 Inhibitor) | Health Canada |
| Ossos-Sans | Diclofenac and Methocarbamol | United States Food and Drug Administration |
| OZY | Sibutramine | Thailand Food and Drug Administration |
| Pink Pussycat | Hydroxythiohomosildenafil
(PDE-5 inhibitor) | Health Canada |
| Premium Pro Power 3500 | Sildenafil
(PDE-5 Inhibitor) | Health Canada |
| Rhino 7 Platinum 5000 | Sildenafil
(PDE-5 Inhibitor) | Health Canada |
| Rhino 7 Platinum 10,000 | Sildenafil
(PDE-5 Inhibitor) | Health Canada |
| Rhino 69 Platinum 35000 | Tadalafil
(PDE-5 Inhibitor) | Health Canada |
| Rhino 69 Platinum 700K | Sildenafil
(PDE-5 Inhibitor) | Health Canada |
| Rhino 69 Platinum 35000 | Tadalafil
(PDE-5 Inhibitor) | Health Canada |
| Rhino Double Premium 25000 | Tadalafil
(PDE-5 Inhibitor) | Health Canada |
| Rhino Rush 15000K Trio | Sildenafil
(PDE-5 Inhibitor) | Health Canada |
| Rush Hour 72 | Sildenafil and Tadalafil
(PDE-5 Inhibitors) | Health Canada |
| Spanish Fly 20,000 | Tadalafil
(PDE-5 Inhibitor) | Health Canada |
| Spanish Fly 22,000 | Tadalafil
(PDE-5 Inhibitor) | Health Canada |
| Stiff Rox | Sildenafil and Tadalafil
(PDE-5 Inhibitors) | Health Canada |
| Super Rhino Gold 18000 | Sildenafil
(PDE-5 Inhibitor) | Health Canada |
| Titanium 4000 | Sildenafil and Tadalafil
(PDE-5 inhibitors) | Health Canada |
| Vail-Bon Jie Yang Wan | Chlorpheniramine and Dexamethasone | United States Food and Drug Administration |
Annex B
The possible side effects of the potent ingredients
Betamethasone and Dexamethasone
Betamethasone and Dexamethasone are potent steroids that are 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.
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.
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.
Methocarbamol
Methocarbamol is a medicine used to treat acute, painful musculoskeletal spasms. Common side effects include headaches, sleepiness and dizziness. Serious side effects may include anaphylaxis, liver problems, confusion and seizures.
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.
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.
Download PDF: HSA Foreign Alert_2024_September
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