3 People Experienced 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 four products found to be sold at various locations including online platforms and from makeshift stalls around Singapore. The four products are: “Ubat Angin Tulang (松筋风湿透骨丸)”, “Tianma Duzhong Shujing Wan (天麻杜仲舒筋丸 [山花商标])”, “IM SO am” and “IM TOX pm”. They have been tested by HSA and found to contain medicinal ingredients that may be harmful if taken without medical supervision, including potent ingredients like steroids, and the banned substance, sibutramine. Three consumers developed serious adverse effects after taking the products, including high blood pressure, severe tremors and insomnia. HSA has worked with the online platforms to remove the listings, and investigations on the sellers are ongoing.

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

Two consumers developed serious adverse effects after taking two different “herbal” products for knee pain

3        A woman in her 60s took “Ubat Angin Tulang (松筋风湿透骨丸)" for a period of up to three months for her knee pain. She had obtained the product from a relative who purchased it from a makeshift stall in Jurong. She rapidly gained 10 kg and developed elevated blood pressure.  Her family member, who is a healthcare professional, suspected that the product was adulterated and reported the case to HSA.

4         “Ubat Angin Tulang” was touted to strengthen muscles and help with pain management. The product’s label stated only herbal ingredients, including ginseng and cordyceps. However, when HSA tested the product, it was found to contain three potent medicinal ingredients, namely dexamethasone (potent steroid), furosemide (diuretic/water pill) and chlorpheniramine (antihistamine). These are strong medicinal substances that can cause serious adverse effects when used without supervision by a doctor. The steroid in the product could have caused the woman’s rapid weight gain and high blood pressure.

5        Further investigations showed that the seller from Malaysia would set up his makeshift stalls in various locations across Singapore. Investigations on the seller are ongoing.

6        In another case, an elderly man in his 80s experienced dizziness and a drop in blood pressure after consuming “Tianma Duzhong Shujing Wan (天麻杜仲舒筋丸 [山花商标])” for his knee pain for about one year. He had obtained the product from his relative who had purchased it from Malaysia.  He was diagnosed with adrenal insufficiency which led his doctor to suspect that the product was adulterated and to report the case to HSA.

7        “Tianma Duzhong Shujing Wan” was labelled as containing only herbs, including ginseng. However, HSA’s analysis detected five potent medicinal ingredients namely, dexamethasone and prednisolone (potent steroids), diclofenac (anti-inflammatory painkiller), furosemide, and chlorpheniramine. From HSA's investigations, there are no known local suppliers of this product.

Products marketed for slimming purposes caused severe shaking, insomnia, and light-headedness in consumer

8       A woman experienced severe tremors, insomnia, light-headedness and almost fainted twice after consuming “IM SO am” and “IM TOX pm”. Both products were marketed to be taken together for slimming purposes and were labelled to contain food and botanical extracts to “promote better body balance”. However, HSA’s analysis revealed that “IM SO am” contained the banned substance, sibutramine, and “IM TOX pm” contained an undeclared laxative (sennosides).

9      HSA found sale listings of “IM SO am” and “IM TOX pm” on Shopee, Lazada and Carousell and has worked with the platform administrators to swiftly remove the affected listings.

Advisory to consumers

10       See a doctor immediately if you are using "Ubat Angin Tulang" or “Tianma Duzhong Shujing Wan”. Do not stop taking it suddenly as it contains steroids and may cause severe withdrawal symptoms such as fatigue, confusion, and low blood pressure, especially when it has been taken for more than a few weeks.

11       Stop taking “IM SO am” and “IM TOX pm” immediately and consult a doctor if you feel unwell or are concerned about your health.

12       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 even if the dubious products are from well-meaning friends or relatives, as you cannot be certain where and how they were made.

• 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 have miraculous results or “no side effects”.

• 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

13      All sellers and suppliers must stop selling these four products 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.

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

HEALTH SCIENCES AUTHORITY
SINGAPORE
18 MARCH 2026

Annex A

Photos of “Ubat Angin Tulang (松筋风湿透骨丸)” tested by HSA

Photos of “Tianma Duzhong Shujing Wan (天麻杜仲舒筋丸 [山花商标])” tested by HSA

Photos of “IM TOX pm” and “IM SO am” 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

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, Prednisolone

Dexamethasone and prednisolone 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 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 (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.

Diclofenac

Diclofenac is a non-steroidal anti-inflammatory drug (NSAID) used to treat pain and inflammation in the body. It can cause gastrointestinal adverse effects such as nausea and vomiting and gastric bleeding. NSAIDs may be associated with cardiovascular events (e.g. heart attack and stroke), especially when used at high doses for long-term treatment and should be used under close medical supervision.

Furosemide

Furosemide is a potent diuretic 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 furosemide can cause the depletion of sodium, chloride, body water and other minerals in the body.

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.