HSA Alerts Public to Three Adulterated Products Purchased Overseas Which Led to Four Patients Being Hospitalised

The Health Sciences Authority (HSA) is alerting members of the public not to purchase or consume three health products bought in Malaysia that were tested to contain several undeclared western medicinal ingredients, including a potent steroid and several prescription only medicines¹. Four patients were hospitalised for serious conditions, including liver injury and metabolic disorder, after consuming them. The three adulterated products are:

No.	Name of product	Undeclared potent ingredients found
1	‘Snake Powder Capsules’ (‘蛇毒血清丸’)	Dexamethasone Chloramphenicol Chlorpheniramine Ibuprofen Tetracycline
2	‘JC Gold’ (‘金丹’)	Dexamethasone Dexchlorpheniramine Frusemide
3	‘Tu Cho Pan Chi Pian’ (‘四川商標杜仲巴吉片’)	Dexamethasone Chlorpheniramine Frusemide

Please see Annex A of the pdf version for pictures of the products.

In 2005, HSA had warned consumers against purchasing or consuming ‘Snake Powder Capsule’ as it was found to be adulterated with undeclared ingredients².

2    Two family members were hospitalised for about a week, after consuming ‘Snake Powder Capsules’ for three weeks. The daughter, in her 30s, developed drug-induced hepatitis or inflammation of the liver, and the father, in his 50s, had liver injury.

3    A patient in her 60s was hospitalised for about a week after consuming ‘JC Gold’ for about four months. She developed Cushing’s syndrome, a metabolic disorder characterised by round face or ‘moon face’, upper body obesity with thin limbs, and high blood glucose. The presence of dexamethasone (a potent steroid) in the product is likely to have contributed to her medical condition.

4    Another male patient in his 70s was hospitalised for Cushing’s syndrome for over a week after taking ‘Tu Cho Pan Chi Pian’ for a few years to help with lower limb weakness. Similar to ‘JC Gold’, ‘Tu Cho Pan Chi Pian’ was found to contain dexamethasone, which could have caused Cushing’s syndrome in the patient.

5    ‘Snake Powder Capsules’ purportedly contain natural ingredients, including a protein found in various snake species’ venom, and was touted to treat a variety of illnesses, such as pneumonia, hepatitis, shingles, kidney disease, skin problems, joint pain and rheumatism. ‘JC Gold’ is marketed for joint pains and labelled to contain various natural herbs. ‘Tu Cho Pan Chi Pian’ is labelled to treat rheumatic joint pain, backache and numbness of the limbs. All three products were purchased overseas, either by the patients themselves or through their friends or relatives.

6    Dexamethasone is a potent steroid that is usually prescribed for inflammatory conditions, and should only be used under strict medical supervision. It was one of the undeclared ingredients found in all three products. Long-term unsupervised use of such an oral steroid can cause Cushing’s syndrome, increased blood glucose levels leading to diabetes, high blood pressure, cataracts, muscular and bone disorders, and an increased risk of infections. Please refer to Annex B of the pdf version for more information on the potential adverse effects of the other undeclared medicinal ingredients found in these products.

Consumer advisory

7    Members of the public who have purchased or are consuming these products are advised to:

• Consult a doctor as soon as possible. Do not stop the use of any of the three products immediately as sudden discontinuation of steroids without proper medical supervision can cause serious withdrawal symptoms such as weakness, fatigue, confusion and low blood pressure, especially if they have been consumed for more than a few weeks.
• Consult your doctor or pharmacist if you need help for the management of your acute and chronic medical symptoms and conditions (e.g. joint pain or eczema). Be wary of any health products that produce unexpected quick recovery of medical conditions, especially when purchasing them from sources 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 undeclared ingredients which can harm your health.

Additionally, members of the public are encouraged to visit www.healthdangers.sg to learn more about the dangers of buying illegal health products from dubious sources. Do not gamble with your health.

8    Although ‘Snake Powder Capsules’, ‘JC Gold’ and ‘Tu Cho Pan Chi Pian' were purchased overseas, it does not rule out the possibility of these products being sold or supplied in Singapore. Sellers should stop the sales and distribution of ‘Snake Powder Capsules’, ‘JC Gold’ and ‘Tu Cho Pan Chi Pian’ immediately. Sellers should be cautious when sourcing for health products to sell and are reminded of their responsibility in ensuring the safety of the products and adherence to local legislations prior to introducing them to the market. HSA takes a serious view against those engaged in the sale and supply of illegal health products and will take strong enforcement action against such persons.

9    Anyone convicted of selling illegal health products may be liable for prosecution under the Health Products Act, Poisons Act and/or Medicines Act. Offenders will face a penalty fine of up to $100,000 and/or imprisonment for a period of up to three years under the Health Products Act; a penalty fine of up to $10,000 and/or imprisonment for a period of up to two years under the Poisons Act and a penalty fine of up to $5,000 and/or imprisonment for a period of up to two years under the Medicines Act.

10    Members of the public who have any information on the sale and supply of ‘Snake Powder Capsules’, ‘JC Gold’, ‘Tu Cho Pan Chi Pian’ or other 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.

HEALTH SCIENCES AUTHORITY
SINGAPORE
1 SEPTEMBER 2016

_{¹ Prescription Only Medicines can only be supplied by a doctor or by a pharmacist according to a prescription by a doctor.}

_{² Please refer to the press release issued in 2005: http://www.hsa.gov.sg/content/dam/HSA/News_and_Events/Press_Releases/2005/PressRelease-HSACautionsAgainstSelfMedicationWithMedicinesObtainedFromDubiousSources-17Jun05.pdf}

Download pdf version here418 KB Published: 1 Sep 2016

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