HSA updates on products found overseas that contain potent ingredients (December 2020)

The Health Sciences Authority (HSA) would like to update the public on products that have been found and reported by overseas regulators in December 2020 to contain potent ingredients which are not allowed in these products and may cause side effects. This information is provided to increase awareness on safety issues of such products found overseas, which may impact the local population. Please refer to Annex A and Annex B for the list of products and the possible side effects of the potent ingredients. Please refer to the pdf document for images of the products.

HSA’s Advisory

2          Members of the public are advised to:

• Consult a doctor if you have consumed any of the products and are feeling unwell.

• Avoid buying any of the products when abroad.

• Exercise caution when purchasing health products online or from sources (either local or overseas) which you may not be familiar with, even if well-meaning friends or relatives have recommended them. You cannot be certain where and how these products were made. They may be illegal, counterfeit or substandard, and may contain potent ingredients which can harm your health. If buying health products online, we encourage you to buy them from websites with an established retail presence in Singapore.

• Be wary of products that promise quick and miraculous results or carry exaggerated claims like “100% safe”, “no side effects” or “scientifically proven”. Consumers should also be cautious of products that produce unexpected quick recovery of medical conditions.

• Consult your doctor or pharmacist if you need help for the management of your acute and chronic medical symptoms and conditions (e.g. diabetes, hypertension, eczema).

3          Additionally, members of the public are encouraged to visit https://www.hsa.gov.sg/consumer-safety/ to learn more about the dangers of buying health products from dubious sources.

4          Members of the public who come across the sale and supply of these products in Singapore may contact HSA's Enforcement Branch at Tel: 6866 3485 during office hours (Monday to Friday) or email: hsa_is@hsa.gov.sg.

Annex A

List of Products

Note: There may be different versions or variants of the products listed below. You are advised to consult your doctor or pharmacist if you are unsure of any health product you intend to use, or if you need help for your acute and chronic medical symptoms and conditions

Annex B

The possible side effects of the potent ingredients

Hydroquinone

Hydroquinone is a potent ingredient used in prescription medicines for the treatment of skin conditions. The ingredient is prohibited in skincare cosmetic products and should only be used under medical supervision, as hydroquinone may cause harmful effects if not used properly. The inappropriate use of hydroquinone could result in changes in skin colour and hypersensitivity reactions such as rashes, redness, tingling and burning of skin.

Methylchloroisothiazolinone (MCI) and Methylisothiazolinone (MI)

Methylchloroisothiazolinone (MCI) and Methylisothiazolinone (MI) are used as preservatives in water-based cosmetics and personal care products, as well as in industrial products such as paints and adhesives. They are prohibited in leave-on cosmetic products as they can cause chemical burns and have been associated with skin allergic reactions, such as allergic contact dermatitis.

Phenolphthalein

Phenolphthalein may cause kidney disorders and has been found in animal studies to be associated with cancer. It may also cause breathing difficulties, rashes and abdominal cramps.

Phosphodiesterase Type 5 (PDE-5) inhibitors

This class of medicine includes sildenafil, tadalafil, and vardenafil. These medicines can cause serious side effects such as strokes, heart attacks, decreased or loss of vision and hearing and priapism (painful and exceedingly long erections). If priapism is not treated immediately, it may lead to permanent impotence. PDE-5 inhibitors are also not suitable for patients with medical conditions such as certain heart-related problems or who are on heart medications such as nitrates. Deaths of patients found to be using Sildenafil (PDE-5 inhibitor) while on nitrates have been reported overseas.

Pigment Orange

Pigment orange is a colouring agent that is synthetically produced. It may contain heavy metal salts which can penetrate the skin and cause allergic reactions and side effects such as skin irritations, nervous system toxicity and reproductive system disruption.

Rhodamine B

Rhodamine B is a dye used for printing and dyeing of textiles, paper, paints and leathers. It is prohibited to be used in health products, including cosmetic products, as it may be carcinogenic. It can cause side effects, such as irritation, when in contact with the skin and eyes. Cases of permanent injury to the eye and chemical conjunctivitis due to exposure to the dye have been documented. When ingested, it may cause gastrointestinal irritation with nausea, vomiting and diarrhea.

Sibutramine and Desmethylsibutramine

Sibutramine, previously a prescription 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. Desmethyl sibutramine is similar to sibutramine and may have similar side effects.

Toxic Heavy Metals

Consumption of excessive amounts of toxic heavy metals such as lead and mercury poses serious health risks and may increase the chance of poisoning. Exposure to high levels of lead may cause anaemia, weakness, and kidney and brain damage. High levels of mercury may cause kidney injury (e.g. protein in urine and oedema) and affect the nervous system (e.g. numbness, tingling, dizziness, forgetfulness, headaches and depression).

Tretinoin

Tretinoin is a potent ingredient used in prescription medicines for the treatment of skin conditions and should be used under medical supervision. The ingredient is prohibited in skincare cosmetic products. Inappropriate use of tretinoin could lead to side effects such as redness and peeling of skin.

Download PDF document: HSA Foreign Alert_2020_December [PDF, 1330 KB]