The Health Sciences Authority (HSA) warns against using “骨節靈 (Gu Jie Ling),” revealing its inclusion of a potent steroid, dexamethasone, causing Cushing’s syndrome and containing cetirizine. Refer to Annex A for images.
A woman in her 60s exhibited Cushingoid symptoms and low blood pressure after hospitalization for unrelated medical conditions. Investigations showed low blood cortisol levels and weight gain a month before admission, leading to a Cushing’s syndrome diagnosis. She disclosed using “骨節靈 (Gu Jie Ling)” for foot pain, recommended by her husband’s friend from a “traditional medicine shop” in Johor Bahru, Malaysia.
Despite being labeled a “traditional medicine” with claims of safety and herbal ingredients, HSA’s analysis found dexamethasone and cetirizine. The product displayed a potentially invalid Malaysian registration number, raising legality concerns. HSA informed its Malaysian counterpart.
Possible harmful effects of the potent medicinal ingredients
Dexamethasone, a potent steroid prescribed for inflammatory conditions, must be used strictly under medical supervision. Prolonged, unsupervised steroid use may lead to elevated blood sugar, high blood pressure, cataracts, muscular and bone disorders, increased infection risk, and Cushing’s syndrome. Abrupt discontinuation without proper medical supervision can result in severe withdrawal symptoms like fatigue, confusion, and low blood pressure. Cetirizine, an antihistamine for allergic reactions, should also be used under medical supervision. Adverse effects include drowsiness, fatigue, headache, and dry mouth.
Consumer Advisory:
- Seek immediate medical attention if you are using “骨節靈 (Gu Jie Ling)” due to its potent steroid content. Refrain from discontinuing the product independently, as doing so without medical supervision could exacerbate underlying medical issues or lead to severe withdrawal symptoms.
- Exercise caution with products making exaggerated claims like “no side effects,” as they may contain potent ingredients that pose serious health risks.
- Avoid purchasing products from unknown or unverified sources, especially from overseas or well-meaning friends or relatives, as the origin and manufacturing conditions may be uncertain, potentially containing harmful elements. Adulterated products lack quality control and may falsely claim registration in a specific country. Opt for reputable pharmacies, retailers’ websites, or those with an established presence in Singapore.
- For assistance in managing chronic medical conditions like joint pain, always consult with your doctor or pharmacist.
Seller and Supplier Advisory:
All sellers and suppliers must stop selling these products immediately. HSA will not hesitate to take stern enforcement actions against anyone who sells and supplies products found to be adulterated with banned and prohibited substances or potent ingredients. Sellers and suppliers are liable to prosecution and if convicted, may be imprisoned for up to 2 years and/or fined up to $10,000.
Members of the public who have any information on the sale and supply of these 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.
HSA: Health Sciences Authority
Link to the HSA announcement: https://www.hsa.gov.sg/announcements/press-release/alert-gu-jie-ling
HSA Press Release (Annex A): https://www.hsa.gov.sg/docs/default-source/default-document-library/pr_gu-jie-ling-1feb2024ce818666ed554c96a096506445d05f19.pdf
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