HSA Alert: Four Products Found To Contain Potent Medicinal Ingredients; Four Consumers Had Adverse Effects After Consuming Three Of The Products

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HSA Alert: Four Products Found To Contain Potent Medicinal Ingredients Including Steroids And Banned Substance; Four Consumers Had Adverse Effects After Consuming Three Of The Products

The Health Sciences Authority (HSA) is advising the general public against buying or using the following products: ‘ENRU PLUS+’, ‘HKT HERBA KURUS TRADISI’, ‘PILL HUA LUO CIN TAN 李时珍活络金丹’, and ‘Spinach GINSENG HERB SUGAR’. After consuming three of these products, four consumers reported experiencing negative effects. Upon analyzing the products, HSA discovered the presence of potent medicinal components, including steroids, sibutramine (a prohibited weight loss medication), and tadalafil (a medication for erectile dysfunction).

Please refer to Annex A of the pdf version for photos of the products and Annex B for more information on the medicinal ingredients found in these products.

2          These products [‘ENRU PLUS+’, ‘HKT HERBA KURUS TRADISI’, ‘PILL HUA LUO CIN TAN’, and ‘Spinach GINSENG HERB SUGAR’], were available for purchase on various local e-commerce platforms such as Shopee, Lazada, Carousell, and Qoo10, and were sold by vendors based in Singapore and Malaysia. ‘ENRU PLUS+’ was also promoted on Facebook. HSA has collaborated with platform administrators to remove the affected listings and has issued warnings to the sellers. Since these products were sold either in Malaysia or by Malaysian-based sellers, HSA has also notified its Malaysian counterpart regarding the discovery of these products.

Three consumers experienced adverse effects, including breathlessness, heart palpitations, dizziness and severe insomnia after consuming ‘ENRU PLUS’ and ‘HKT HERBA KURUS TRADISI’

3         One woman experienced breathlessness, rapid heartbeat, and nausea, while another suffered from palpitations and dizziness after consuming ‘ENRU PLUS+’. A third woman encountered severe insomnia and heart palpitations after using ‘HKT HERBA KURUS TRADISI’. Both products were marketed online as slimming aids and were labeled as containing natural ingredients. ‘HKT HERBA KURUS TRADISI’ additionally claimed to be “100% herbal” and free from “banned substances”.

4          One woman experienced breathlessness, rapid heartbeat, and nausea, while another suffered from palpitations and dizziness after consuming ‘ENRU PLUS+’. A third woman encountered severe insomnia and heart palpitations after using ‘HKT HERBA KURUS TRADISI’. Both products were marketed online as slimming aids and were labeled as containing natural ingredients. ‘HKT HERBA KURUS TRADISI’ additionally claimed to be “100% herbal” and free from “banned substances”.

Consumer hospitalised after taking ‘PILL HUA LUO CIN TAN’

5          A man in his 50s was hospitalized after a month of using ‘PILL HUA LUO CIN TAN’. He exhibited symptoms of Cushing’s syndrome, a severe steroid-induced condition characterized by a swollen face (“moon face”), abnormal blood cortisol levels, and a relapse of hepatitis with heightened liver inflammation. He had purchased the product from a “traditional Chinese medicine shop” in Malaysia to alleviate wrist pain. Testing showed that the product contained potent steroids (dexamethasone and prednisolone) and a painkiller (diclofenac).

6         Extended unsupervised steroid use can lead to elevated blood sugar levels resulting in diabetes, Cushing’s syndrome, weakened immune system increasing infection risks, and other serious adverse effects. Improper use of diclofenac can result in severe stomach bleeding.

‘Spinach GINSENG HERB SUGAR’ contained very high level of erectile dysfunction medicine

7          HSA was alerted by Immigration & Checkpoints Authority (ICA) officers to a package containing ‘Spinach GINSENG HERB SUGAR’. Marketed as a candy for male sexual enhancement, the product’s label made exaggerated claims such as “strengthen heart tissues” and “repair endocrine system”. HSA’s analysis confirmed the presence of tadalafil, a prescription medicine used for treating erectile dysfunction, which should only be administered under medical supervision. The use of tadalafil without proper medical oversight can be dangerous and heighten the risk of serious adverse effects, including heart attack, stroke, headaches, irregular heart rate, and priapism (prolonged and painful erections). Testing revealed that ‘Spinach GINSENG HERB SUGAR’ contained up to 45 times more tadalafil than the usual prescribed daily dose.

Advisory to consumers

If you are using ‘PILL HUA LUO CIN TAN’, it is crucial to consult a doctor promptly, as the product contains potent steroids. Refrain from discontinuing the product without medical guidance, as abrupt cessation without supervision might exacerbate existing medical conditions or lead to severe withdrawal symptoms.

If you are experiencing discomfort or have concerns about your health, cease the use of ‘ENRU PLUS+’, ‘HKT HERBA KURUS TRADISI’, and ‘Spinach GINSENG HERB SUGAR’ immediately and seek medical advice.

Exercise caution when encountering products claiming to be “100% herbal” or “natural”. Despite these assertions, they could contain powerful components that pose serious health risks.

Be cautious about purchasing items from unfamiliar or unverified sources, whether online or overseas, and even from well-intentioned acquaintances or family members. The origin and production processes of such products can’t be assured, raising the possibility of contamination with harmful substances. Products tainted in this manner are often created under substandard conditions and lack quality control. Additionally, different batches of the same product may vary in ingredient content or even contain diverse types of adulterants. If making online purchases, opt for reputable pharmacies or established retail websites based in Singapore.

Advisory to sellers and suppliers

It is imperative for all sellers and suppliers to discontinue the sale of these items immediately. HSA will not hesitate to impose stringent regulatory actions against individuals involved in the sale and distribution of products that are discovered to be contaminated with banned substances or potent components. Those engaged in selling or supplying such products can face legal charges, and upon conviction, may be sentenced to a maximum of two years in prison and/or fined up to $10,000.

Individuals from the public who possess any information about the illicit sale and distribution of these prohibited products can get in touch with HSA’s Enforcement Branch by calling 6866-3485 during official hours from Monday to Friday.

HEALTH SCIENCES AUTHORITY
SINGAPORE
12 JULY 2023

^{[1] Potent steroids may suppress the normal production of cortisol, a natural steroid hormone produced by the body. This can lead to adrenal insufficiency. Adrenal insufficiency can lead to fatigue, generalised weakness, muscle and joint pain, low blood pressure, fits or shock.}

Link to the full announcement:
https://www.hsa.gov.sg/announcements/press-release/hsa-alert-four-products-found-to-contain-potent-medicinal-ingredients-including-steroids-and-banned-substance