HSA Alert: Three Products Found To Contain Potent Medicinal Ingredients, Including Steroids And High Levels Of Banned Substance Sibutramine; Two Consumers Developed Adverse Effects

The Health Sciences Authority (HSA) is alerting members of the public not to purchase or consume ‘LORENXO DELICIOUS PURE CHOCOLATE SUPPLEMENT’, ‘DND Rx9’ and ‘MOFA COFFEE’. HSA’s analysis of the products revealed that they contained potent medicinal ingredients, including tadalafil (an erectile dysfunction medicine), steroids, and sibutramine (a banned weight loss medicine). Two consumers experienced adverse effects after taking the products.

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 the product.

2        HSA detected that ‘LORENXO DELICIOUS PURE CHOCOLATE SUPPLEMENT’ and ‘MOFA COFFEE’ were also sold on multiple local e-commerce and social media platforms, including Carousell, Qoo10, Shopee and Facebook. HSA has worked with the platform administrators to remove the affected listings. Investigations are ongoing. HSA has also alerted its Malaysian counterpart to the two products ‘DND Rx9’ and ‘MOFA COFFEE’ that were purchased or sourced from Malaysia.

Use of ‘LORENXO DELICIOUS PURE CHOCOLATE SUPPLEMENT’ led to severe headaches in consumer

3        ‘LORENXO DELICIOUS PURE CHOCOLATE SUPPLEMENT’ was marketed online as a dietary supplement and was falsely labelled to contain only natural ingredients. A man in his 30s experienced severe headaches after taking the product which he purchased from a local e-commerce platform. His doctor diagnosed the headaches to be an adverse effect associated with a potent medicinal ingredient in the product. It was subsequently tested by HSA to be 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 attacks, stroke, headaches, migraines, irregular heart rate and priapism (painful and exceedingly long erections).

Consumer suffered steroid-induced adverse effect with ‘DND Rx9’

4        A man in his 30s developed Cushing’s syndrome (a serious steroid-induced condition characterised by a round face or ‘moon face’ appearance) after taking ‘DND Rx9’ for several months for gout. He had obtained the product by courier from Malaysia via the seller’s website. Based on his symptoms and abnormal blood results, his doctor suspected that the product could be adulterated with steroids. HSA tested ‘DND Rx9’ to contain the potent steroids, dexamethasone and prednisolone, and a painkiller, diclofenac. Long-term unsupervised use of such steroids can also cause increased blood sugar levels, which could lead to diabetes and other serious adverse effects. Unsupervised use of diclofenac can lead to damage and bleeding of the stomach.

‘MOFA COFFEE’ tested to contain high levels of banned weight loss medicine

5        Immigration & Checkpoints Authority (ICA) officers at Changi Airfreight Centre had noticed anomalies in the scanned images of two parcels from Malaysia. After further checks, they uncovered consignments declared as ‘MOFA COFFEE’ and referred the parcels to HSA for further investigation. ‘MOFA COFFEE’ was labelled to aid appetite suppression and to contain natural ingredients such as coffee extract, white kidney bean extract and garcinia cambogia. However, HSA tested ‘MOFA COFFEE’ to contain high levels of sibutramine, which may cause serious adverse effects when consumed.  

6        Sibutramine was a prescription-only weight loss medicine that has been banned in Singapore since 2010 due to an increased risk of heart attack and stroke. Other serious health consequences include heart problems and central nervous system disorders (e.g., psychosis and hallucinations). In 2019, a consumer experienced an extremely fast heart rate and became unconscious after taking a product adulterated with sibutramine. She was resuscitated and suffered debilitating consequences requiring the implantation of a defibrillator (a medical device) to help her heart to function.

Advisory to consumers

7        Consumers are advised to:

• See a doctor as soon as possible if you or other family members are taking ‘DND Rx9’ as it contains potent steroids. Long-term steroid use can suppress the body’s production of steroids. Sudden stopping of the product without medical supervision may result in worsening of underlying medical conditions or other serious withdrawal conditions such as adrenal insufficiency^[1].

• Stop taking ‘LORENXO DELICIOUS PURE CHOCOLATE SUPPLEMENT’ and ‘‘MOFA COFFEE’ immediately and consult a doctor if you feel unwell or are concerned about your health.

• Exercise caution when buying products from unknown or unfamiliar sources online as you cannot be certain where and how these products were made and whether they have been adulterated with harmful ingredients. Only buy from reputable pharmacies or retailers’ websites or those with an established retail presence in Singapore. 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.

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

• Always consult your doctor or pharmacist if you need to manage your chronic medical conditions.

Advisory to sellers and suppliers

8        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.

9        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
16 MAY 2023

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^{[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.}