Illegal product-Huo Luo Jing Dan [活絡金丹] adulterated with undeclared medicinal ingredients

In Dec 2009, HSA issued a press statement to warn consumers not to take an adulterated product labelled “Huo Luo Jing Dan [活絡金丹]”. This illegal product was detected through an adverse reaction report submitted by a doctor.

Details of the case report

A 54 year-old Chinese female was hospitalised after she developed difficulty swallowing and was later diagnosed with supraglottic oedema. It was caused by an aggravation of a neck abscess as her infection was not healing well. The doctor also observed that she had Cushingoid features such as “moon face”. This prompted the doctor to report his suspicion on the association between the traditional medicine and the adverse effects experienced by the patient.

The patient was reported to have takenHuo Luo Jing Dan (活絡金丹) for 12 years to relieve arthritic pain.The product was packaged as a Traditional Chinese Medicine (TCM) to improve circulation, to relieve pain, rheumatism and arthritis. Upon analysis of the product sample, three undeclared western medicinal ingredients were detected in the product, namely indomethacin, dexamethasone and prednisolone. The long-term consumption of steroids by the patient could have suppressed her immunity leading to the poor recovery from the infection. The Cushingoid features observed were also signs of long-term steroid consumption.

HSA's advisory

Healthcare professionals are encouraged to ask their patients about the use of complementary medicine while taking their medication history. The information may be useful to the doctor in making a diagnosis of the patient's condition and identifying potential adverse events associated with complementary medicines.