HSA Alert: Three Products Found With Potent Medicinal Ingredients, Including Steroids; Two Consumers Experienced Adverse Effects

The Health Sciences Authority (HSA) is alerting members of the public not to purchase or use three adulterated health products, namely “纯天然草药 Natural Herbs”, “辣木草药丸” (“La Mu Cao Capsules”), and “Special Skin Treatment”. HSA’s tests revealed that these products contained potent medicinal ingredients, including steroids. 

 Please refer to Annex A of the pdf version for photos of the products.

 Use of “纯天然草药 Natural Herbs” led to steroid-induced adverse effects

 2        A woman in her 50s developed Cushing’s syndrome (a serious steroid-induced condition characterised by a round or ‘moon face’ appearance) after taking “纯天然草药 Natural Herbs” for two months for general wellbeing. The product was labelled to be “SGS approved” and ”suitable” to treat a wide range of conditions including knee pain, itchy skin, internal injury and stroke. It also claimed to have “no steroid and mercury added”. Contrary to the claim, HSA’s analysis found the tablets to contain a potent steroid, dexamethasone. The woman had purchased the tablets through a relative.

 “辣木草药丸” (“La Mu Cao Capsules”) led to eye discomfort

 3        A man in his 70s took “辣木草药丸” (“La Mu Cao Capsules”) after observing the product’s quick effect in relieving his wife’s leg pain. However, a day after consuming the capsules, he started to develop discomfort in his eyes. The capsules contained dark brown powder and were packed in an unlabelled transparent bag. They came with a leaflet printed in Chinese stating the product as “辣木草药丸” (“La Mu Cao Capsules”) and which claimed that the capsules contained herbal ingredients including Moringa seeds (“辣木籽”), cordyceps (“冬虫夏草”) and panax ginseng (“高丽参”). However, HSA’s analysis found that the capsules contained several potent medicinal ingredients, including prednisolone (steroid), amoxicillin (antibiotic), diclofenac (anti-inflammatory painkiller), and paracetamol (painkiller). The man had purchased the capsules locally through a friend.

 4        While the man only suffered eye discomfort, the consequences of taking these potent ingredients in the capsules could have been worse. In 2019, a woman in her 50s had taken similar looking capsules that were bought from a peddler at a local market[1]. She developed Cushing’s syndrome, a serious adverse effect. Although it cannot be determined if the product was the same as “辣木草药丸” (“La Mu Cao Capsules”), HSA had tested those capsules sold by the peddler to contain similar potent medicinal ingredients. Illegal manufacturers may repackage or re-label adulterated products and hence, it is important for consumers to be wary of dubious products with exaggerated claims or unexpected quick effects.

 Skincare cream marketed for babies and pregnant women found to contain potent steroid

 5        HSA was alerted by a member of the public to “Special Skin Treatment” sold on the now inactive touchskin.com.sg website after noticing significant improvement in her children’s eczema within 5 days of using the product. The cream was promoted to relieve skin conditions such as eczema. It claimed to contain natural ingredients, is safe for use in babies, young children, pregnant women, and anyone with sensitive skin, and not contain steroids. However, HSA tested it to contain clobetasol propionate, a potent steroid. Creams containing such potent steroids for treatment of skin conditions should only be prescribed by doctors for use under medical supervision. HSA has not detected the sale of ‘Special Skin Treatment’ on local e-commerce platforms. Investigation is ongoing.

 Harmful effects from unsupervised use of potent medicinal ingredients

 6        Clobetasol propionate, 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 could lead to diabetes, Cushing’s syndrome and other serious adverse effects.

7        Unsupervised use of diclofenac (painkiller) can lead to damage and bleeding of the stomach while inappropriate use of amoxicillin (antibiotic) without medical supervision can lead to antibiotics being less effective in treating infections (antibiotic resistance). Refer to Annex B of the pdf version for more information on the potent ingredients.

 Advisory to consumers

 8        Consumers are advised to:

• See a doctor as soon as possible if you are taking “纯天然草药 Natural Herbs” or “辣木草药丸” (“La Mu Cao Capsules”) or using “Special Skin Treatment”. Sudden stopping of products containing steroids may worsen underlying medical conditions or result in other serious withdrawal symptoms such as fatigue, confusion and low blood pressure.

• Be wary of products that promise miraculous effects or make exaggerated claims of recovery from chronic medical conditions or have “no side effects”. Such products may contain potent ingredients that may harm your health.

• Exercise caution when buying products from unknown or unfamiliar sources, even from well-meaning friends or relatives, as you cannot be certain where and how these products were made and whether they have been adulterated with harmful ingredients. Adulterated products are often manufactured under poor conditions with no quality control, and different batches of the same product may contain variable amounts of ingredients and/or different types of adulterants.

• When buying health products online, only buy from reputable pharmacies or retailers’ websites or those with an established retail presence in Singapore.
  

 Advisory to sellers and suppliers

 9        All sellers and suppliers must stop selling these products immediately. HSA will not hesitate to take stern enforcement actions against anyone who sells and supplies products found to be adulterated with banned substances, potent ingredients or toxic heavy metals beyond the allowable limits. Sellers and suppliers are liable to prosecution and if convicted, may be imprisoned for up to 3 years and/or fined up to $100,000.

 10       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
3 MAY 2024

Download PDF version here [PDF, 369 KB]

[1]https://www.hsa.gov.sg/announcements/press-release/hsa-alert-three-products-found-with-undeclared-potent-medicinal-ingredients-one-led-to-serious-adverse-reaction-in-consumer