HSA Alerts Public to Two Illegal Products Containing Potent Undeclared Ingredients, Including the Banned Chemical Sibutramine

The Health Sciences Authority (HSA) is alerting members of the public to two illegal health products available locally and tested to contain potent, undeclared ingredients, including sibutramine, a prescription medicine that was disallowed for sale in Singapore since 2010, due to serious safety concerns. The two products are:

PRODUCT	UNDECLARED INGREDIENTS FOUND
‘Li Da DAIDAIHUA Weight Loss Capsule’	Sibutramine, Benzyl Sibutramine
‘Du Zhong Jin Gu Wan’ ‘杜仲筋骨丸’	Chlorpheniramine, Dexamethasone and Diclofenac

Please refer to Annex A of the pdf for pictures of the products. 

2     ‘Li Da DAIDAIHUA Weight Loss Capsule’, which claimed to be 100% herbal, was sold through the Internet, while ‘Du Zhong Jin Gu Wan’ was purchased by a woman in her 70s for joint pains from an acquaintance. HSA was alerted to these products by the public and a Traditional Chinese Medicine (TCM) practitioner respectively. The TCM practitioner became concerned after his patient reported immediate pain relief from consuming ‘Du Zhong Jin Gu Wan’.

3     Although HSA has not received any adverse reaction reports associated with the two products, there may be unreported cases of consumers who experienced possible adverse effects without realising that they were caused by these products. They may also not have informed their doctors that they had taken these products. As illegal health products are generally produced under poor manufacturing conditions with no quality control and the contents of the products can vary from batch to batch, they can pose serious health hazards. 

Undeclared ingredients found in the illegal products

4     HSA’s laboratory tests found that ‘Li Da DAIDAIHUA Weight Loss Capsule’ contained the potent undeclared ingredients, sibutramine and benzyl sibutramine, while ‘Du Zhong Jin Gu Wan’ contained chlorpheniramine, diclofenac and a potent steroid, dexamethasone. Sibutramine, chlorpheniramine, diclofenac and dexamethasone are potent medicinal ingredients. 

5     In particular, sibutramine has been disallowed for sale in Singapore and many other countries since October 2010 because of safety concerns about cardiovascular-related risks. Sibutramine was formerly a prescription medicine used in the treatment of obesity whereas benzyl sibutramine is an analogue (a chemically-related compound) of sibutramine. The use of sibutramine and benzyl sibutramine may cause serious adverse effects, including high blood pressure, increased heart rate, anxiety, heart attacks and irregular heartbeats.

6     Diclofenac is a potent painkiller and may potentially cause serious gastric bleeding, as well as cardiovascular events such as heart attacks and stroke when used for a prolonged period. It should be used under close medical supervision, especially in patients with underlying heart conditions. 

7     Dexamethasone, a potent steroid, is usually prescribed for inflammatory conditions and should only be used under strict medical supervision. Long term unsupervised use of an oral steroid can cause increased blood glucose levels leading to diabetes, high blood pressure, cataracts, an increased risk of infections, and Cushing’s syndrome (which is characterised by a round face or ‘moon face’ and upper body obesity with thin limbs). 

8     Potent medicinal ingredients that are licensed in Singapore should be used under the supervision of a doctor. Please refer to Annex B of the pdf for more information on the possible adverse reactions that can be caused by these undeclared ingredients found in these two illegal products.

Consumer Advisory

9     Members of the public who are consuming these products are advised on the following: 

PRODUCT	ADVISORY
‘Li Da DAIDAIHUA Weight Loss Capsule’	Stop consuming ‘Li Da DAIDAIHUA Weight Loss Capsule’ immediately as it contains sibutramine, which is disallowed for sale in Singapore for safety reasons. Consumers who have consumed the product should seek medical attention if they are feeling unwell or are concerned about their health.
‘Du Zhong Jin Gu Wan’ ‘杜仲筋骨丸’	Consult a doctor as soon as possible before stopping its use as it contains a potent steroid. Sudden discontinuation of steroid medication without proper medical supervision can cause serious withdrawal symptoms such as weakness, fatigue, confusion and low blood pressure, especially when consumed for more than a few weeks.

• Undeclared potent ingredients may cause possible adverse reactions as well as drug interactions with other medications, which can seriously harm your health. Seek proper medical treatment for acute and chronic medical conditions and do not self-medicate.  
• Be wary of complementary health products (e.g. weight loss or pain relief supplements) making exaggerated claims or promising ‘miraculous cures', and/or which provide rapid weight loss or unexpected fast relief from pain associated with chronic conditions, such as arthritis or rheumatism. Complementary health products comprising natural ingredients are generally less potent than western medicines. Their effects are often not immediate and may only be seen after prolonged consumption. Rapid relief could mean the product is adulterated with potent western medicines.
• Exercise caution when purchasing complementary health products, especially from online sources.  The dangers of online purchasing include lack of information on the sellers’ location, the source of their products and the conditions under which the products were manufactured and stored. Products sold online could also potentially be counterfeit or adulterated.  
• Purchase and obtain complementary health products from reliable and reputable sources locally. 
• Visit www.healthdangers.sg to learn more about the dangers of illegal health products.

10     Members of the public who have any information on the sale of ‘Li Da DAIDAIHUA Weight Loss Capsule’, ‘Du Zhong Jin Gu Wan’ 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
7 NOVEMBER 2014

Download pdf version here431 KB Published: 7 Nov 2014

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