HSA updates on products found overseas that contain potent ingredients (November 2022)

The Health Sciences Authority (HSA) would like to update the public on products that have been found and reported by overseas regulators in November 2022 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)
Alpiflor Tea	Sibutramine	Swissmedic
Alpiflor Tea / Time to detox	Sibutramine & Sildenafil (PDE-5 inhibitors)	Swissmedic
Artri Ajo King	Diclofenac	United States Food and Drug Administration
Artri King	Dexamethasone (Corticosteroids) and Diclofenac	United States Food and Drug Administration
Artri King Reforzado con Ortiga y Omega 3	Dexamethasone (Corticosteroids) and Diclofenac	United States Food and Drug Administration
Black Ant	Sildenafil (PDE-5 inhibitors)	Swissmedic
Boners Libido Performa	Nortadalafil (PDE-5 inhibitors)	Swissmedic
Cherry detox tea	Fluoxetine & Phenolphthalein	Swissmedic
Epimedyumlu Macum (Paste)	Sildenafil (PDE-5 inhibitors)	Swissmedic
Esillaa	Sibutramine and Sildenafil (PDE-5 inhibitors)	Swissmedic
Esillaa Elma-Apple	Lidocaine and Sildenafil (PDE-5 inhibitors)	Swissmedic
Esillaa Live Beautiful	Sibutramine	Swissmedic
Esillaa Elma-Mango	Lidocaine and Sildenafil (PDE-5 inhibitors)	Swissmedic
Festal chocolate bar	Sildenafil (PDE-5 inhibitors)	Swissmedic
Goree Day and Night Beauty Cream Oil Free	Mercury (Toxic Heavy Metals)	Hong Kong Department of Health
Goree Beauty Cream with Lycopene, Avocado & Aloe vera	Mercury (Toxic Heavy Metals)	Hong Kong Department of Health
Happy Night Energy Chocolate	Sildenafil (PDE-5 inhibitors)	Swissmedic
Hilti gold (Paste)	Sildenafil (PDE-5 inhibitors)	Swissmedic
Hilti gold (capsules)	Sildenafil (PDE-5 inhibitors)	Swissmedic
HAVYCO-Vy&Tea	Sibutramine	Swissmedic
Imperia Elita Vitaccino	Sibutramine	Swissmedic
JACK’D Sexual Enhancement Liquid	Sildenafil (PDE-5 inhibitors)	United States Food and Drug Administration
Li Da	Fluoxetine	Swissmedic
Libido Forte	Nortadalafil (PDE-5 inhibitors)	Swissmedic
Liquid XXX plus	Hydroxythiohomosildenafil (PDE-5 inhibitors)	Swissmedic
Maxman	Sildenafil (PDE-5 inhibitors)	Swissmedic
Miel du Soudan Aphrodisiaque	Sildenafil (PDE-5 inhibitors)	Swissmedic
NewQueen	Sibutramine	Swissmedic
Ortiga Mas Ajo Rey	Diclofenac	United States Food and Drug Administration
Ortiga Mas Ajo Rey Extra Forte	Dexamethasone (Corticosteroids), Diclofenac and Methocarbamol	United States Food and Drug Administration
Protecvital plus	N-phenyl propoxyphenyl carbodenafil (PDE-5 inhibitors)	Swissmedic
Pussykilla	Sildenafil & Tadalafil (PDE-5 inhibitors)	Swissmedic
Sangter Natural Male Energy Supplement	Sildenafil (PDE-5 inhibitors)	The United States Food and Drug Administration
Teff Tohumlu Cay Mixed Herbal Tea	Phenolphthalein, Sennoside and Sibutramine	Swissmedic
VIP Golden Royal Honey	Tadalafil (PDE-5 inhibitors)	Swissmedic
X7 Plus	Phenolphthalein and Sibutramine	Swissmedic
接骨七厘丸	Toxic Heavy Metals	China National Medical Products Administration
金银花	Toxic Heavy Metals	China National Medical Products Administration
草本護膚膏	Triamcinolone (Corticosteroids)	Hong Kong Department of Health

 

 

Annex B

The possible side effects of the potent ingredients

Corticosteroids

Dexamethasone and triamcinolone 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.

 

Fluoxetine

Fluoxetine is a prescription medicine used to treat conditions including depression and eating disorders, and it should be used under medical supervision. The use of fluoxetine has been associated with side effects including headaches, insomnia, palpitations and dizziness.

 

Lidocaine

Lidocaine or lignocaine is a medicine used to decrease or eliminate the feeling of pain. The inappropriate use of products with high concentrations of lidocaine can cause low blood pressure and dizziness.

 

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.

 

Phenolphthalein

Phenolphthalein may cause kidney disorders and has been found in animal studies to be associated with cancer. It may also cause breathing difficulties, rashes and abdominal cramps.

 

Phosphodiesterase Type 5 (PDE-5) inhibitors

This class of medicine includes hydroxythiohomo sildenafil, nortadalafil, N-phenyl propoxyphenyl carbodenafil, sildenafil and tadalafil. 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.

 

Sennosides

Sennosides are laxatives which can cause diarrhoea, stomach discomfort and abdominal cramps. Long-term consumption may be unsafe and cause serious side effects like electrolyte imbalance from decreased potassium levels in the body.

 

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.

 

Toxic Heavy Metals

Consumption of excessive amounts of toxic heavy metals such as arsenic, lead and mercury pose serious health risks and may increase the chance of poisoning. Possible symptoms of arsenic poisoning include vomiting, abdominal pain, diarrhoea, heart-related problems, breathing difficulties and numbness of the limbs. Exposure to high levels of lead may cause anaemia, weakness, and kidney and brain damage. High levels of mercury may cause kidney injury (e.g. protein in urine and oedema) and affect the nervous system (e.g. numbness, tingling, dizziness, forgetfulness, headaches and depression).

 

Download PDF:HSA Foreign Alert_2022_Nov_Final 2Dec20221131 KB

Published: 2 Dec 2022

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