HSA Alert: Four Products Found To Contain Potent Medicinal Ingredients Including Steroids And Banned Substance; Four Consumers Had Adverse Effects After Consuming Three Of The Products

The Health Sciences Authority (HSA) is alerting members of the public not to purchase or consume ‘ENRU PLUS+’, ‘HKT HERBA KURUS TRADISI’, ‘PILL HUA LUO CIN TAN 李时珍活络金丹’ and ‘Spinach GINSENG HERB SUGAR’. Four consumers experienced adverse effects after taking three of the products. HSA’s analysis of the products revealed that they contained potent medicinal ingredients, including steroids, sibutramine (a banned weight loss medicine) and tadalafil (an erectile dysfunction medicine).

Please refer to Annex A of the pdf version for photos of the products and Annex B for more information on the medicinal ingredients found in these products.

2          ‘ENRU PLUS+’, ‘HKT HERBA KURUS TRADISI’, ‘PILL HUA LUO CIN TAN’ and ‘Spinach GINSENG HERB SUGAR’ were sold on multiple local e-commerce platforms such as Shopee, Lazada, Carousell and Qoo10 by sellers based in Singapore and Malaysia. ‘ENRU PLUS+’ was also marketed on Facebook. HSA has worked with the platform administrators to remove the affected listings and issued warnings to the respective sellers. As these four products were sold in Malaysia or by sellers based in Malaysia, HSA has also alerted its Malaysian counterpart to the detection of these products.

Three consumers experienced adverse effects, including breathlessness, heart palpitations, dizziness and severe insomnia after consuming ‘ENRU PLUS’ and ‘HKT HERBA KURUS TRADISI’

3          A woman experienced breathlessness, heart palpitations (rapid heartbeat) and nausea while another experienced palpitations and dizziness after consuming ‘ENRU PLUS+’. A third woman experienced severe insomnia and heart palpitations after consuming ‘HKT HERBA KURUS TRADISI’. Both products were marketed online as slimming products and labelled to contain natural ingredients. ‘HKT HERBA KURUS TRADISI’ also claimed to be “100% herbal” with “no banned substances”.

4          Contrary to their claims, both ‘ENRU PLUS+’ and ‘HKT HERBA KURUS TRADISI’ contained high levels of sibutramine when tested by HSA. Sibutramine was a prescription only weight loss medicine banned in Singapore since 2010 due to an increased risk of heart attack and stroke. Other serious health consequences reported with its use include heart problems and central nervous system disorders (e.g., psychosis and hallucinations).

Consumer hospitalised after taking ‘PILL HUA LUO CIN TAN’

5          A man in his 50s developed symptoms of Cushing’s syndrome (a serious steroid-induced condition characterised by a ‘moon face’ appearance), including facial puffiness and abnormal blood cortisol levels^[1] and was hospitalised after consuming ‘PILL HUA LUO CIN TAN’ for about a month. He also experienced a relapse of hepatitis, with a sudden increase in liver inflammation. He had purchased the product for his wrist pain from a “traditional Chinese medicine shop” in Malaysia. Tests showed that the product contained potent steroids (dexamethasone and prednisolone) and a painkiller (diclofenac).

6          Long-term unsupervised use of steroids can cause increased blood sugar levels leading to diabetes, Cushing’s syndrome, suppression of the immune system leading to an increased risk of infections and other serious adverse effects. Unsupervised use of diclofenac can lead to serious bleeding of the stomach.

‘Spinach GINSENG HERB SUGAR’ contained very high level of erectile dysfunction medicine

7          Immigration & Checkpoints Authority (ICA) officers had alerted HSA to a parcel found to contain ‘Spinach GINSENG HERB SUGAR’. The product was packaged as a candy and marketed for sexual enhancement in men. The product’s label carried exaggerated claims such as “strengthen heart tissues’ and “repair endocrine system”. HSA tested ‘Spinach GINSENG HERB SUGAR’ to contain tadalafil, a prescription medicine used to treat erectile dysfunction that should only be given under medical supervision. Use of tadalafil without proper medical supervision is dangerous and can increase the risk of serious adverse effects, including heart attack, stroke, headache, migraine, irregular heart rate and priapism (painful and exceedingly long erections). ‘Spinach GINSENG HERB SUGAR’ was tested to contain up to 45 times higher than the usual prescribed daily dose of tadalafil.

Advisory to consumers

8          Consumers are advised to:

• See a doctor as soon as possible if you are taking ‘PILL HUA LUO CIN TAN’ as it contains potent steroids. Do not stop taking the product on your own as sudden stopping of the product without medical supervision may result in the worsening of underlying medical conditions or other serious withdrawal conditions.

• Stop taking ‘ENRU PLUS+’, ‘HKT HERBA KURUS TRADISI’ and ‘Spinach GINSENG HERB SUGAR’ immediately and consult a doctor if you feel unwell or are concerned about your health.

• Be wary of products that claim to be “100% herbal” or “natural”. Contrary to these claims, they can contain potent ingredients that can seriously harm your health.

• Do not buy products from unknown or unverifiable sources, and exercise caution when buying from overseas, online or 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. Different batches of the same product may contain variable amounts of ingredients and/or different types of adulterants. If buying 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 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.

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
12 JULY 2023

Download PDF version here [PDF, 682 KB]

^{[1] Potent steroids may suppress the normal production of cortisol, a natural steroid hormone produced by the body. This can lead to adrenal insufficiency. Adrenal insufficiency can lead to fatigue, generalised weakness, muscle and joint pain, low blood pressure, fits or shock.}