HSA updates on products found overseas that contain potent ingredients (June 2024)

The Health Sciences Authority (HSA) would like to update the public on products that have been found and reported by overseas regulators in June 2024 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

Annex B

The possible side effects of the potent ingredients

 

Acetaminophen / Paracetamol

Acetaminophen or paracetamol is used for relieving pain, headache and fever. Products which contain acetaminophen or paracetamol, but do not have this declared on the label, pose a danger to consumers as accidental overdose can result in liver damage.

 

Betamethasone

Betamethasone is a potent steroid. Long term use of an oral steroid without medical supervision can cause high blood pressure, cataracts, an increased risk of infections, and Cushing’s syndrome (characterized by the appearance of round face or ‘moon face’ and upper body obesity with thin limbs).

 

Chlorpheniramine

Chlorpheniramine is an antihistamine used to relieve allergic reactions such as hives and rhinitis. It should be used under medical supervision. Side effects from the use of chlorpheniramine include drowsiness, blurred vision, vomiting, constipation and poor coordination.

 

Dehydroepiandrosterone (DHEA) – also known as Prasterone

Dehydroepiandrosterone (DHEA) is a hormone that could increase the risk of prostate, breast, ovarian and other hormone-sensitive cancers. Side effects may include serious cardiovascular disease, changes in fertility and sperm production, hair loss, voice deepening, insulin resistance, changes in menstrual pattern, liver dysfunction, abdominal pain, and high blood pressure.

 

Dexamethasone

Dexamethasone is a potent steroid that is usually prescribed for inflammatory conditions and should only be used under strict medical supervision. Long term use of an oral steroid without medical supervision can cause high blood pressure, cataracts, an increased risk of infections, and Cushing’s syndrome (characterized by the appearance of round face or ‘moon face’ 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.

 

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 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.

 

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.

 

Nonsteroidal Anti-inflammatory Drugs (NSAIDs)

NSAIDs are anti-inflammatory medications used to relieve pain and reduce inflammation.  Their prolonged use may potentially cause serious gastric bleeding, nausea, high blood pressure and cardiovascular events such as heart attacks and strokes. They should be used under close medical supervision, especially in patients with underlying heart conditions, stomach bleeding and ulceration. Examples include aspirin, diclofenac, ibuprofen, indomethacin, mefenamic acid, meloxicam, phenylbutazone and piroxicam.

 

Omeprazole

Omeprazole is a medicine used in the treatment of gastrointestinal diseases such as peptic ulcer disease, Zollinger-Ellison syndrome, and gastroesophageal reflux disease. Common side effects include nausea, vomiting, headaches, abdominal pain, and bloating. Long term use without medical supervision may increase your chances of serious side effects such as an increased risk of bone fractures, gut infections, and vitamin B12 deficiency.

 

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.

 

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.

 

Download PDF: HSA Foreign Alert_2024_June

Published: 3 Jul 2024

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