HSA Alert: A Consumer Was Hospitalised in ICU and Another Developed Serious Adverse Reactions After Taking Health Products Bought Overseas

The Health Sciences Authority (HSA) is alerting members of the public not to purchase or consume ‘WAN LING REN SEM CHIN KUO PILL’ (‘金龍牌萬靈人参筋骨丸’) and ‘CHONG CAO DAN’ (‘人参樹商標虫草活絡丹’). The products, which were purchased in Malaysia, were tested to contain undeclared western medicinal ingredients, including a potent steroid. One consumer was admitted to ICU after experiencing severe breathing difficulty following the long-term consumption of ‘WAN LING REN SEM CHIN KUO PILL’. Another consumer developed Cushing’s syndrome after taking ‘CHONG CAO DAN’. These products have not been detected locally so far. However, there may still be a possibility for them to be purchased over the Internet or imported from overseas sources.

2    HSA had tested the products and found that both products contain dexamethasone, a potent steroid. In addition, ‘CHONG CAO DAN’ also contains frusemide (a diuretic which helps to remove excess fluid from the body) and chlorpheniramine (an anti-allergy medicine).

Illegal health products

Undeclared western medicinal ingredients






Dexamethasone, Chlorpheniramine,and Frusemide

Please refer to Annex A and Annex B of the pdf version for pictures of the products, and for more information about the western medicinal ingredients found in the products.

Adverse events reported

3    A woman in her 70s had been consuming ‘WAN LING REN SEM CHIN KUO PILL’ daily for 4 to 5 years, to relieve her rheumatism and pain. She suffered from adrenal insufficiency (a serious condition where the body does not produce adequate amounts of steroid hormones, resulting in generalised weakness, muscle and joint pain, low blood pressure, fits or shock) and was admitted to the ICU due to severe difficulty in breathing.

4    Another woman in her 60s had been taking ‘CHONG CAO DAN’ weekly for the past 2 to 3 years for blood circulation, and to relieve muscle aches and pain.  Her aches and pain returned if she did not take the product. She experienced two episodes of fainting this year and developed Cushing’s syndrome, with symptoms such as round or ‘moon’ face and thinning of the skin. Her high blood pressure also worsened due to long-term steroid consumption. She is currently under outpatient care for the management of these conditions.

5    ‘WAN LING REN SEM CHIN KUO PILL’ and ‘CHONG CAO DAN’ were promoted as traditional Chinese medicine, carrying claims that they contain herbal ingredients to help with a number of conditions such as  pain, numbness of the limbs and blood circulation. However, the undeclared potent western medicinal ingredients in the products can pose serious health risks to consumers, especially when taken over a prolonged period without medical supervision. 

Advisory to consumers

6    Consumers are advised:

  • As the products contain a potent steroid, consumers who have taken these products should see a doctor as soon as possible. Discontinuation of steroids without proper medical supervision can cause serious withdrawal symptoms such as fatigue, confusion and low blood pressure.
  • Be wary of health products that promise or produce quick and miraculous results for chronic conditions. Such products may contain hidden prescription medicines which should only be taken under medical supervision, or potent or banned ingredients that may harm you.
  • Be cautious when purchasing health products from unfamiliar sources, even if they are recommended by friends or relatives. No one can be certain what these products contain, and where and how they were made.
  • Consult your doctor or pharmacist to manage your acute and chronic medical symptoms and conditions (such as joint pain, arthritis and rheumatism).

Advisory to sellers and suppliers

7    Sellers and suppliers are warned that:

  • The supply of ‘WAN LING REN SEM CHIN KUO PILL’ and ‘CHONG CAO DAN’ must be stopped immediately. It is illegal to sell and supply complementary health products (e.g., traditional medicines, health supplements) containing potent western medicines or banned substances.
  • Anyone who supplies illegal health products is liable to prosecution and if convicted, may be imprisoned for up to 3 years and/or fined up to $100,000.

8    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.


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