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

The Health Sciences Authority (HSA) would like to update the public on products that have been found and reported by overseas regulators in May 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)
Alfia Weight Loss Capsules	Sibutramine	United States Food and Drug Administration
Alien Power Platinum 11000	Tadalafil (PDE-5 inhibitor)	Health Canada
All Nite Long	L-Dopa	Health Canada
Clemira Care Cream	Miconazole	Malaysia Ministry of Health
Collagen Plus Vit E – Day & Night Cream	Mercury	Brunei Darussalam, Ministry of Health
Diamond Girl Lite	Sildenafil (PDE-5 inhibitor)	United States Food and Drug Administration
DYNAMITE SUPER Capsule 58,000 MG	Sildenafil and Tadalafil (PDE-5 inhibitors)	United States Food and Drug Administration
Fast-Act Rheuma Capsule	Prednisone and Piroxicam (NSAIDs)	United States Food and Drug Administration
Front End Lifter	Sildenatil and Tadalafil (PDE-5 inhibitors)	Health Canada
Ginseng Red 2000	Sildenafil (PDE-5 inhibitor)	Health Canada
Hard Steel 300K	Tadalafil (PDE-5 inhibitor)	United States Food and Drug Administration
Honey Girl	Sildenafil (PDE-5 inhibitor)	United States Food and Drug Administration
Jaguar 25000	Tadalafil (PDE-5 inhibitor)	Health Canada
Infinity 10K	Sildenafil and Tadalafil (PDE-5 inhibitors)	United States Food and Drug Administration
Infinity	Sildenafil (PDE-5 Inhibitor)	United States Food and Drug Administration
Insane Labz Psychotic – Cherry Bomb	Rauwolfia & Yohimbine	Health Canada
Insane Labz Psychotic – Fruit Punch	Rauwolfia & Yohimbine	Health Canada
Master Zone 1500	Sildenafil and Tadalafil (PDE-5 inhibitors)	Health Canada
MEGA 7G 700000	Acetaminophen and Sildenafil (PDE-5 inhibitor)	United States Food and Drug Administration
Mega 9K 800000	Sildenafil and Tadalafil (PDE-5 inhibitors)	United States Food and Drug Administration
Meta Forte	Sildenafil and Tadalafil (PDE-5 inhibitors)	United States Food and Drug Administration
Mr. Strong Guy Honey For Him	Sildenafil (PDE-5 inhibitor)	United States Food and Drug Administration
Natural MiracleZEN GOLD 60000	Sildenafil and Tadalafil (PDE-5 inhibitors)	United States Food and Drug Administration
New Fast-Act Rheumatism Capsule	Indomethacin (NSAIDs)	United States Food and Drug Administration
NutriFitt Carnage Advanced High Stim Pre Workout Grape Candy	Rauwolfia and Yohimbine	Health Canada
NutriFitt Symbiote High Stim Pre Workout Dragon Gummy	Rauwolfia and Yohimbine	Health Canada
NutriFitt Symbiote High Stim Pre Workout Maniacal Melon	Rauwolfia and Yohimbine	Health Canada
NutriFitt Symbiote High Stim Pre Workout White Out	Rauwolfia and Yohimbine	Health Canada
NUX Male Enhancement Capsule	Sildenafil and Tadalafil (PDE-5 inhibitors)	United States Food and Drug Administration
Phentamene XT	DMAA	United States Food and Drug Administration
Platinum 69000 Rhino 69	Sildenafil (PDE-5 inhibitor)	United States Food and Drug Administration
Power Plus Desire	Sildenafil (PDE-5 inhibitor)	United States Food and Drug Administration
PremierZEN Gold 7000	Sildenafil and Tadalafil (PDE-5 inhibitors)	United States Food and Drug Administration
Pro Power Knight Plus capsule, 2550mg	Sildenafil and Tadalafil (PDE-5 inhibitors)	United States Food and Drug Administration
Raw Burn	Yohimbine	Health Canada
Rhino 7S Type F3 7000	Acetaminophen and Sildenafil (PDE-5 inhibitor)	United States Food and Drug Administration
Rhino 69 Extreme 500K	Prasterone	Health Canada
Rhino 99 Platinum 200K	Sildenafil (PDE-5 inhibitor)	Health Canada
RISSA SKIN – SKIN MOISTURISER	Tretinoin	Brunei Darussalam, Ministry of Health
Royal Honey VIP	Sildenafil (PDE-5 inhibitor)	Health Canada
Rush Hour Plus	Tadalafil (PDE-5 Inhibitor)	Health Canada
Special Edition Platinum 10K	Tadalafil and Vardenafil (PDE-5 inhibitors)	United States Food and Drug Administration
Stiff Rox	Sildenafil and Tadalafil (PDE-5 inhibitors)	Health Canada
Super Panther 7K	Yohimbe	Health Canada
UABlock	Indomethacin (NSAIDs)	United States Food and Drug Administration
V=GRA GOLD 500mg	Sildenafil (PDE-5 inhibitor)	United States Food and Drug Administration
White Panther	Yohimbe	Health Canada
XXX Zone 40K	Sildenafil and Tadalafil (PDE-5 inhibitors)	United States Food and Drug Administration

 

Annex B

The possible side effects of the potent ingredients

Acetaminophen

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.

 

1,3-dimethylamylamine (DMAA)

1,3-dimethylamylamine or DMAA is a stimulant. The use of DMAA can lead to high blood pressure, shortness of breath, irregular heart rate, tightening in the chest, and heart attacks, as well as seizures.

 

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.

 

Miconazole

Miconazole is a medicine used to treat fungal infections. Side effects from inappropriate use of creams containing miconazole include burning, stinging, swelling, irritation, redness and flaking of the skin.

 

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.

 

Prasterone (also known as Dehydroepiandrosterone (DHEA))

Prasterone or 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.

 

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.

 

Prednisolone

Prednisolone or prednisone 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 (characterised 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.

 

Rauwolfia / Rauwolscine  

Rauwolscine (also known as alpha-yohimbine) is one of the many chemical compounds found in the Rauwolfia plant. The use of Rauwolfia has been associated with low blood pressure, dizziness, tiredness, drowsiness, irregular heartbeat and breathlessness. Depression or worsening depression has been reported with the use of Rauwolfia.

 

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.

 

Tretinoin

Tretinoin is a potent ingredient used in prescription medicines for the treatment of skin conditions and should be used under medical supervision. The ingredient is prohibited in skincare cosmetic products. Inappropriate use of tretinoin could lead to side effects such as redness and peeling of skin.

 

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_May2092 KB

Published: 6 Jun 2023

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