3 Consumers, Including a 12-Year-Old, Experienced Serious Adverse Effects After Taking Products with Banned or Potent Medicinal Ingredients

The Health Sciences Authority (HSA) warns members of the public against purchasing or consuming three products that have been sold at various locations including online platforms. The three products are: “C-Nine Dietary Supplement Product”, “血压高中风青草药草 (Xue Ya Gao Zhong Feng Qing Cao Yao Cao)” and “B-LIAN-S HERBAL CREAM 百莲霜草本修复乳膏 (Bai Lian Shuang Cao Ben Xiu Fu Ru Gao)”.

2       These products were marketed as supplements or herbal products, which should not contain any medicinal ingredients. However, after receiving adverse event reports from doctors and feedback from the public, HSA tested the products and found that they contained potent medicinal ingredients such as steroids, an antifungal medicine, and the banned substance, sibutramine. These ingredients may be harmful if taken without medical supervision. Three consumers developed serious adverse effects after using the products, including heart palpitations, Cushing’s syndrome and skin striae (stretch marks). Those who have used these products are advised to see a doctor. As these are illegal products, there are no authorised distributors, and they were mainly sold locally via online platforms. HSA has worked with the online platforms to remove listings of the products. Investigations are ongoing and errant sellers will be dealt with accordingly.

3        Please refer to Annex A for photos of the products, and Annex B for information on the possible adverse effects of the banned or potent ingredients found in the products.

Product Marketed for Slimming Purpose Caused Heart Palpitations, Nausea and Other Discomforts in Consumer

4        A woman experienced heart palpitations, nausea, a constant feeling of thirst and a lack of appetite after consuming “C-Nine Dietary Supplement Product”. “C-Nine Dietary Supplement Product” was marketed as a “Dietary Supplement” and was labelled to contain chia powder and chilli pepper powder. However, HSA’s analysis revealed that “C-Nine Dietary Supplement Product” also contained the banned substance, sibutramine, and an undeclared laxative, sennosides.

5        HSA found sale listings of “C-Nine Dietary Supplement Product” on Shopee, Lazada, Carousell, Facebook, and TikTok, and has asked the platform administrators to remove the affected listings.

Two Consumers Including a Child Developed Serious Adverse Effects After Taking Two Different “Herbal” Products Laced with Steroids

6        A woman in her 60s took “血压高中风青草药草 (Xue Ya Gao Zhong Feng Qing Cao Yao Cao)” regularly for 10 days for her knee pain, back pain, and to improve her blood circulation. She had obtained the product from a market in Bentong, Malaysia. She experienced signs of Cushing’s syndrome, with its characteristics of a rounded “moon face” appearance and abnormal fat accumulation on her upper back. She also developed lethargy upon stopping the product. A family friend, who is a pharmacist, suspected that the product was adulterated and reported the case to HSA. The woman has since recovered after she sought treatment at an Accident and Emergency department and stopped using the product.

7        The product “血压高中风青草药草 (Xue Ya Gao Zhong Feng Qing Cao Yao Cao)” was marketed as a herbal remedy and claimed to remove blood vessel blockages, relieve back pain and limb stiffness, and help with multiple chronic conditions such as hypertension, stroke, and diabetes. HSA’s analysis revealed that it contained dexamethasone, a potent steroid which is a prescription medicine and should only be used under strict medical supervision. The product’s packaging also appeared similar to another product that was adulterated with the same steroid, which HSA had alerted the public to in 2016.¹ From HSA's investigations, there are no known local suppliers of this product.

8        In the case of “B-LIAN-S HERBAL CREAM 百莲霜草本修复乳膏 (Bai Lian Shuang Cao Ben Xiu Fu Ru Gao)”, a 12-year-old boy had applied it regularly for two months for his eczema. He rapidly gained 6kg over this period and developed stretch marks on his legs (refer to photos in Annex C). The child's mother came across the product on Facebook and placed an order with the vendor who was based in Malaysia through Facebook Messenger.

9        “B-LIAN-S HERBAL CREAM 百莲霜草本修复乳膏 (Bai Lian Shuang Cao Ben Xiu Fu Ru Gao)” was marketed as a “Natural Extract Formula” with “zero steroids” to manage psoriasis, eczema, red and itchy skin. However, when HSA tested the product, it was found to contain a potent steroid (clobetasol), and an antifungal agent (miconazole).

10        HSA’s investigations found that the overseas vendor’s social media account was linked to a local Shopee store. HSA has since worked with the platform administrator to disable the online store, while the relevant Malaysian authorities have also been alerted to the Facebook account.

Advisory to Consumers

11       Stop taking “C-Nine Dietary Supplement Product” immediately and consult a doctor if you feel unwell or are concerned about your health.

12       See a doctor immediately if you are using “血压高中风青草药草 (Xue Ya Gao Zhong Feng Qing Cao Yao Cao)” or “B-LIAN-S HERBAL CREAM 百莲霜草本修复乳膏 (Bai Lian Shuang Cao Ben Xiu Fu Ru Gao)”. Do not stop using these products suddenly on your own as they contain potent steroids. Sudden discontinuation of steroids (including topical steroids which can be absorbed) may cause severe withdrawal symptoms such as fatigue, weakness and low blood pressure, especially when it has been used for more than a few weeks. Children and infants are more susceptible to the effects of steroids and may be at a higher risk of steroid-associated adverse effects.

13       Consumers are advised to be ALERT when purchasing health products:

• AVOID Dubious Products: Steer clear of products from unknown or unverified sources, especially online - they may contain harmful ingredients. Exercise caution if the products appear similar to adulterated products previously detected by HSA, as they may also run the risk of adulteration.

• LOOK for Reputable Sellers: Only purchase from trusted pharmacies or reputable retailers with an established presence in Singapore.

• EXAMINE Claims: Be cautious and wary of products that claim to deliver quick and miraculous results or carry exaggerated claims. These may be tactics employed by unscrupulous manufacturers to deceive consumers into believing that their products are effective and safe. Such products may contain potent ingredients that could seriously harm your health.

• REPORT Suspicious Products: Help protect others by reporting dangerous or dubious products to HSA.

• TRUST Medical Advice: Consult a healthcare professional if you need help managing your chronic medical conditions instead of risking your health with use of unfamiliar products.

Advisory to Sellers and Suppliers

14       All sellers and suppliers must stop selling “C-Nine Dietary Supplement Product”, “血压高中风青草药草 (Xue Ya Gao Zhong Feng Qing Cao Yao Cao)”, and “B-LIAN-S HERBAL CREAM 百莲霜草本修复乳膏 (Bai Lian Shuang Cao Ben Xiu Fu Ru Gao)” immediately. HSA will not hesitate to take stern enforcement actions against anyone who sells and supplies products found to be adulterated with banned or potent ingredients. Sellers and suppliers are liable to prosecution and if convicted, may be imprisoned for up to 2 years and/or fined up to $10,000.

15       Members of the public who have any information on the sale and supply of these illegal products may contact HSA at Tel: 6866 3485 during office hours (Monday to Friday) or email: hsa_is@hsa.gov.sg.

HEALTH SCIENCES AUTHORITY
SINGAPORE
23 JULY 2026

¹https://www.hsa.gov.sg/announcements/hsa-alerts-public-to-three-health-products-found-to-contain-undeclared-western-medicinal-ingredients/

ANNEX A

Photos of “C-Nine Dietary Supplement Product” tested by HSA

Photo credits: Contributed by consumer.

Photos of “血压高中风青草药草 (Xue Ya Gao Zhong Feng Qing Cao Yao Cao)” tested by HSA

All photos are to be credited to the Health Sciences Authority, Singapore.

Photos of “B-LIAN-S HERBAL CREAM 百莲霜草本修复乳膏 (Bai Lian Shuang Cao Ben Xiu Fu Ru Gao)” tested by HSA

All photos are to be credited to the Health Sciences Authority, Singapore.

ANNEX B

POSSIBLE ADVERSE EFFECTS OF BANNED OR POTENT MEDICINAL INGREDIENTS FOUND IN THE PRODUCTS

Dexamethasone, Clobetasol

Dexamethasone and clobetasol 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 sugar levels (which may lead to diabetes), high blood pressure, cataracts, muscular and bone disorders (such as osteoporosis), an increased risk of infections and Cushing’s syndrome (characterised by a round face or ‘moon face’ appearance and upper body obesity with thin limbs).

Discontinuation of steroids without proper medical supervision can lead to steroid withdrawal effects and adrenal insufficiency, a serious condition where the body does not produce adequate amounts of steroid hormones after stopping long-term steroid use. This may cause fatigue, generalised weakness, muscle and joint pain, low blood pressure, fits or shock.

Miconazole

Miconazole is used to treat fungal infections. Possible adverse effects associated with the inappropriate use of creams containing miconazole may include skin irritation, itching, skin rash and burning sensation of the skin.

Sennosides

Sennosides is a laxative that is used for the relief of constipation. Adverse effects associated with its use include cramping, diarrhoea and loss of essential minerals. Prolonged use may cause chronic constipation, fluid and electrolyte abnormalities, bloating and abdominal pain.

Sibutramine

Sibutramine, previously a prescription-only 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.

ANNEX C

Photo of stretch marks caused by use of “B-LIAN-S HERBAL CREAM 百莲霜草本修复乳膏 (Bai Lian Shuang Cao Ben Xiu Fu Ru Gao)”

Photo credits: Contributed by patient.