HSA Alert: Three Products Found with Undeclared Potent Medicinal Ingredients; One Led to Serious Adverse Reaction in Consumer

The Health Sciences Authority (HSA) is alerting members of the public not to purchase or consume these products:

(a) ‘Skinny Lolita'	Sold on multiple e-commerce websites based in Singapore and Malaysia Sold by peddler at Redhill Market
(b) ‘Xtreme Candy’
(c) Unlabelled clear capsules containing dark brown powder (‘unlabelled capsules’)

A woman in her 50s who took the ‘unlabelled capsules’ developed steroid-induced Cushing’s syndrome, a serious medical condition which may cause high blood pressure, decreased immunity, weight gain, and round or “moon” face.

2 HSA has tested the three products and found the following potent medicinal ingredients:

Name of product	Undeclared potent medicinal ingredients
‘Skinny Lolita’	Sibutramine
‘Xtreme Candy’	N-desmethyl tadalafil
‘Unlabelled capsules’	Amoxicillin, Chlorpheniramine, Diclofenac, Dexamethasone, Prednisolone, Sildenafil

Please refer to Annex A for photos of the products and Annex B for more information on the medicinal ingredients found in the products.

‘Unlabelled capsules’ led to Cushing's syndrome

3 The ‘unlabelled capsules’ were sold in packets of 50 capsules by a peddler at Redhill market. The product came with a leaflet printed in Chinese stating that the capsules contained multiple herbal ingredients such as Moringa seeds (“辣木籽”), cordyceps (“冬虫夏草”) and Panax notoginseng flower (“田七花”). The leaflet claimed that the product was “100% Herbal” and could treat numerous medical conditions, including chronic diseases such as cancer, high blood pressure, high cholesterol and diabetes. A woman in her 50s developed Cushing’s syndrome, a serious medical condition, after taking the product for 3 to 4 months for her headache. Her doctor suspected that the product was adulterated with steroids and alerted HSA. Tests found the product to contain steroids (dexamethasone, prednisolone) and other potent medicinal ingredients; namely, amoxicillin (an antibiotic), chlorpheniramine (an antihistamine), diclofenac (a painkiller), and sildenafil (an erectile dysfunction drug).

Potent ingredients, including banned substance, detected in two products sold online

4 HSA was alerted to the online sale of ‘Skinny Lolita’ by a member of the public. It was marketed as a traditional “all natural” slimming remedy that contained only plant and herbal extracts. However, HSA tested it to contain sibutramine, a medicine that has been banned in Singapore since 2010 due to increased risk of heart attacks and strokes. Besides its false claims, ‘Skinny Lolita’ was also promoted as the new packaging of ‘Beautea Slim’, a product similar to ‘Beautea Slim Fat Burner for Weight Loss’ which was previously tested by HSA in 2017 to contain sibutramine.

5 ‘Xtreme Candy’ was seized from a woman in her 40s who had imported them from Malaysia. The product was packaged and marketed as a candy containing ginseng and other plant ingredients. However, it was tested to contain an analogue (chemically-related compound) of tadalafil, a potent prescription-only medicinal ingredient used in the treatment of erectile dysfunction. Inappropriate use of tadalafil or its analogues can cause serious adverse effects, such as stroke, heart attack, low blood pressure and priapism (painful and exceedingly long erections).

6 Both products are being sold on multiple e-commerce websites in Singapore and Malaysia. HSA has directed the respective local website administrators to remove the postings of both products. We have also informed our Malaysian counterpart of the product postings for their follow- up enforcement actions.

Advisory to consumers

7 Consumers are advised to:

• See a doctor immediately if you suspect that you have taken the ‘unlabelled capsules’ as it contains potent steroids. 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 consumed for more than a few weeks.
• Stop taking ‘Skinny Lolita’ and ‘Xtreme Candy’ immediately and see a doctor if you feel unwell or are concerned about your health.
• Avoid purchasing health products from unfamiliar sources such as street peddlers or unknown sellers on e-commerce platforms and websites, even if they are recommended by close friends or relatives. There is no way to ascertain how these products are made and contrary to their claims to be “100% herbal” or “all natural”, they may contain potent ingredients that can be harmful to health.
• Be wary of health products that are unlabelled or carry exaggerated claims, such as the ability to treat chronic conditions and diseases. They could potentially contain undeclared potent ingredients which could be harmful to health. In addition, none of the claims they make can be verified. Even if the claims that the products are “100% herbal” or “all natural” are true, it does not necessarily mean that the product is safe and of good quality.

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 Sellers and suppliers are warned that:

• It is illegal to sell and supply adulterated products which contain undeclared potent medicinal ingredients.
• Anyone who supplies such adulterated 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 adulterated 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
13 AUGUST 2019

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Published: 13 Aug 2019

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