HSA updates on products found overseas that contain potent ingredients (June 2023)

The Health Sciences Authority (HSA) would like to update the public on products that have been found and reported by overseas regulators in June 2023 to contain potent ingredients which are not allowed in these products and may cause side effects. This information is provided to increase awareness on safety issues of such products found overseas, which may impact the local population. Please refer to Annex A and Annex B for the list of products and the possible side effects of the potent ingredients. Please refer to the pdf document for images of the products.

HSA’s Advisory

2          Members of the public are advised to:

• Consult a doctor if you have consumed any of the products and are feeling unwell.
• Avoid buying any of the products when abroad.
• Exercise caution when purchasing health products online or from sources (either local or overseas) 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 potent ingredients which can harm your health. If buying health products online, we encourage you to buy them from websites with an established retail presence in Singapore.
• Be wary of products that promise quick and miraculous results or carry exaggerated claims like “100% safe”, “no side effects” or “scientifically proven”. Consumers should also be cautious of products that produce unexpected quick recovery of medical conditions.
• Consult your doctor or pharmacist if you need help for the management of your acute and chronic medical symptoms and conditions (e.g. diabetes, hypertension, eczema).

3          Additionally, members of the public are encouraged to visit https://www.hsa.gov.sg/consumer-safety/ to learn more about the dangers of buying health products from dubious sources.

4          Members of the public who come across the sale and supply of these products in Singapore may contact HSA's Enforcement Branch at Tel: 6866 3485 during office hours (Monday to Friday) or email: hsa_is@hsa.gov.sg.

Annex A

List of Products

Note: There may be different versions or variants of the products listed below. You are advised to consult your doctor or pharmacist if you are unsure of any health product you intend to use, or if you need help for your acute and chronic medical symptoms and conditions

Name of product	Potent ingredient(s)	Source (Regulatory Agency)
AIFUBAO Whitening Red Ginseng Whitening And Anti - Freckle Trial Pack (Day Cream)	Corticosteroid	Myanmar Food and Drug Administration
AIFUBAO Whitening Red Ginseng Whitening And Anti - Freckle Trial Pack (Night Cream)	Mercury	Myanmar Food and Drug Administration
AK Forte	Dexamethasone (Corticosteroid), Diclofenac and Methocarbamol	United States Food and Drug Administration
Artri Ajo King	Diclofenac	United States Food and Drug Administration
Alessia – Whitening Night Cream	Mercury	Myanmar Food and Drug Administration
All Nite Long	L-dopa	Health Canada
Australia tablets	Sildenafil (PDE-5 inhibitor)	Australia Therapeutics Goods Administration
Big Penis USA tablets	Sildenafil (PDE-5 inhibitor)	Australia Therapeutics Goods Administration
Black Panther	Yohimbe	Health Canada
Caiyilin(bird’s Nest) Herb Whitening Night Cream	Mercury	Myanmar Food and Drug Administration
ExtenZe	Yohimbe	Health Canada
Ginseng Red 2000	Sildenafil (PDE-5 inhibitor)	Health Canada
Germany Niubian tablets	Sildenafil (PDE-5 inhibitor)	Australia Therapeutics Goods Administration
Horny Goat Weed	L-dopa	Health Canada
Hunchibeauty – Lipstick & Lipgloss (2 in 1)(No.17)	Rhodamine B	Myanmar Food and Drug Administration
Jamu Herba Kampong Ramuan Asli Turun Temurun	Sibutramine	Brunei Darussalam/ Ministry of Health
LALCUME Excellent Day Cream LD – 402	Mercury	Myanmar Food and Drug Administration
LALCUME Excellent Night Cream LN - 403	Mercury	Myanmar Food and Drug Administration
MAGBLUE Habbatus Sauda 100% Asli	Sibutramine	Brunei Darussalam/ Ministry of Health
Magnum XXL 250K	Tadalafil (PDE-5 inhibitor)	Health Canada
Magnum XXL 750K (Red Label)	Tadalafil (PDE-5 inhibitor)	Health Canada
Magnum XXL 750K (Gold Label)	Tadalafil (PDE-5 inhibitor)	Health Canada
Magnum XXL HIS&HER 250K	Sildenafil, Tadalafil (PDE-5 inhibitors) and Yohimbine	Health Canada
Multani Kaminividravana Rasa (Kamini) tablets	Mercury	Australia Therapeutics Goods Administration
Pink Pussycat	Hydroxythiohomosildenafil (PDE-5 inhibitor)	Health Canada
Poseidon Platinum 3500	Tadalafil (PDE-5 inhibitor)	Health Canada
Rhino 69 Extreme 35000	Tadalafil (PDE-5 inhibitor)	Health Canada
Rhino 7 Platinum 5000	Sildenafil (PDE-5 inhibitor) and Yohimbe	Health Canada
Spanish Fly 20,000	Tadalafil (PDE-5 inhibitor)	Health Canada
Spanish Fly 22,000	Tadalafil (PDE-5 inhibitor)	Health Canada
Triple Green	Yohimbe	Health Canada
USA Black Gold tablets	Sildenafil (PDE-5 inhibitor)	Australia Therapeutics Goods Administration
Vialis 2 Oral Jelly	Tadalafil (PDE-5 inhibitor)	Health Canada
White Panther	Yohimbe	Health Canada
7K Max Power	Yohimbe	Health Canada

 

Annex B

The possible side effects of the potent ingredients

Corticosteroids

Betamethasone 17-valerate, Clobetasol propionate and Dexamethasone are potent steroids that are usually prescribed for inflammatory conditions and should only be used under strict medical supervision. Long-term unsupervised use of steroids (including topical use where the steroid can be absorbed into the body) can cause increased blood glucose levels (which may lead to diabetes), high blood pressure, cataracts, muscular and bone disorders, an increased risk of infections and Cushing’s syndrome (a round face or ‘moon face’ appearance and upper body obesity with thin limbs). 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.

 

Diclofenac

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

 

Levodopa (L-Dopa)

Levodopa or L-Dopa is a prescription medicine used in the treatment of Parkinson’s Disease and should be used under medical supervision. Levodopa may potentially interact with medicines used to treat high blood pressure. Side effects of levodopa may include low blood pressure, irregular heart rate and breathing abnormalities.

 

Mercury

Mercury is a toxic substance and is prohibited for use as an ingredient in cosmetic products. Regular application of creams containing mercury could lead to rash, skin discolouration and blotching. Chronic exposure to very high levels of mercury in cosmetic products may also cause toxic effects to the kidneys, digestive and nervous system, as it can be absorbed through the skin. This could lead to organ damage.

 

Methocarbamol

Methocarbamol is a medicine used to treat acute, painful musculoskeletal spasms. Common side effects include headaches, sleepiness and dizziness. Serious side effects may include anaphylaxis, liver problems, confusion and seizures.

 

Phosphodiesterase Type 5 (PDE-5) inhibitors

This class of medicine includes carbodenafil, sildenafil, tadalafil, vardenafil and their derivatives. These medicines can cause serious side effects such as strokes, heart attacks, decreased or loss of vision and hearing and priapism (painful and exceedingly long erections). If priapism is not treated immediately, it may lead to permanent impotence. PDE-5 inhibitors are also not suitable for patients with medical conditions such as certain heart-related problems or who are on heart medications such as nitrates. Deaths of patients found to be using sildenafil while on nitrates have been reported overseas.

 

Rhodamine B

Rhodamine B is a dye used for printing and dyeing of textiles, paper, paints and leathers. It is prohibited to be used in health products, including cosmetic products, as it may be carcinogenic. It can cause side effects, such as irritation, when in contact with the skin and eyes. Cases of permanent injury to the eye and chemical conjunctivitis due to exposure to the dye have been documented. When ingested, it may cause gastrointestinal irritation with nausea, vomiting and diarrhoea.

 

Sibutramine

Sibutramine, previously a prescription weight loss medicine used in the treatment of obesity, has been disallowed for sale in Singapore since 2010 due to increased risk of heart attacks and strokes. The use of sibutramine has been associated with serious side effects, including high blood pressure, irregular heartbeats, hallucinations and mood swings.

 

Yohimbe/Yohimbine

Yohimbine is a potent medicinal ingredient derived from yohimbe, a bark extract. Side effects associated with yohimbe or yohimbine include insomnia, anxiety, palpitations (sensation of heart pounding, racing or skipped beats), sweating and blurred vision. Overdosage can cause low blood pressure, rapid heartbeats, seizures, paralysis and coma. Deaths from overdose have also been reported.

Download PDF: HSA Foreign Alert_2023_June1088 KB

Published: 3 Jul 2023

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