HSA Alert: Three Health Products Detected with Potent Undeclared Ingredients; One of Which Led to Hospitalisation of a Consumer

The Health Sciences Authority (HSA) is alerting members of the public not to consume the following three health products:

(a)  ‘Pil Raja Urat Asli’

(b)  ‘XXS xtraxtrasmall’

(c)  ‘Best Nutrition Products Diabotica 500mg Capsules’

An elderly male who consumed ‘Pil Raja Urat Asli’ was hospitalised due to the development of Cushing’s syndrome.

2    HSA has tested the products and found that they contain the following undeclared potent western medicinal ingredients, including a steroid and a banned substance for weight loss:

Name of product

Undeclared potent ingredients

‘Pil Raja Urat Asli’


‘XXS xtraxtrasmall’


‘Best Nutrition Products Diabotica 500mg Capsules’

Mycophenolic acid

The products were detected through HSA’s post-market product quality surveillance and adverse event monitoring programme. ‘Pil Raja, Urat Asli’ was sold by street peddlers in Geylang and Chinatown, ‘XXS xtraxtrasmall’ was sold online, and ‘Best Nutrition Products Diabotica 500mg Capsules’ was sold at local retail outlets. HSA has initiated the recall of the affected products from the retail outlets, and has directed the administrators of online platforms to remove web listings of the affected products. Please refer to Annex A for photos of the products.

Adverse event reported to HSA

3    A man in his 70s had purchased ‘Pil Raja Urat Asli’ from street peddlers in Geylang and Chinatown, and had been taking it to relieve his knee pain. He was recently hospitalised due to the development of Cushing’s syndrome, which is characterised by a ‘moon’ face, thin limbs, thinning of the skin and easy bruising. This was caused by the long-term consumption of steroids such as dexamethasone that was fraudulently added into the product.  

Potent ingredients found in these products

4    Dexamethasone is a steroid and is usually prescribed for inflammatory conditions and should only be used under strict medical supervision. Long-term unsupervised use of oral steroids can cause increased blood glucose levels (which may lead to diabetes), as well as high blood pressure, cataracts, muscular and bone disorders, an increased risk of infections, and Cushing’s syndrome.

5    Sibutramine was a prescription-only-medicine for weight loss but has been withdrawn in Singapore since 2010 because of an increased risk of heart attacks and strokes. In recent years, HSA has detected several slimming products adulterated with sibutramine. These have caused serious adverse effects in consumers, including palpitations, hallucinations or hearing voices.

6    Mycophenolic acid is used to suppress immunity in auto-immune diseases and prevent rejection in organ transplantation. Gastrointestinal side effects such as abdominal pain, constipation, diarrhoea and infections have been reported with the use of mycophenolic acid.

Advisory to consumers

7    Consumers are advised on the following:

  • Stop taking ‘XXS xtraxtrasmall’ and ‘Best Nutrition Products Diabotica 500mg Capsules’ immediately and consult a doctor if you feel unwell or are concerned about your health.  
  • As ‘Pil Raja Urat Asli’ contains a potent steroid, consumers who have taken this product 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, especially when the product has been taken for more than a few weeks.
  • Be wary of health products that promise or deliver quick and miraculous effects, or carry exaggerated claims such as “unexpectedly good result from the first day” as claimed in ‘XXS xtraxtrasmall’.
  • Avoid purchasing health products from street peddlers, and exercise caution when buying such products online. You cannot be certain where and how these products were made. They could potentially be counterfeits or adulterated with undeclared potent or banned ingredients which can seriously harm your health.

8    HSA has produced a short video on the risks associated with buying health products online. This video can be viewed at https://youtu.be/dmjl_bSqJgA.

Advisory to sellers and suppliers

9    All sellers and suppliers must stop selling these products immediately.

  • These are illegal products which contain medicinal or prohibited 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.

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.

30 NOV 2018

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