SINGAPORE - The Health Sciences Authority (HSA) has warned the public to avoid buying or consuming three health products.

It said on Monday (Feb 10) that two of these products, Tian Ma Tu Chung Seven Leave Ginseng and Perliere Mimi Pearl Cream, have caused consumers to develop adverse reactions, while the third product, Impactra, contained dangerously high levels of a potent medicine used to treat erectile dysfunction.

Tian Ma Tu Chung Seven Leave Ginseng was sold in medical halls in Malaysia, Perliere Mimi Pearl Cream was sold on Perliere's website and other e-commerce platforms, and Impactra was sold on Gold Tree's website and other e-commerce platforms.

A man in his 50s developed abnormal blood cortisol levels after long-term consumption of Tian Ma Tu Chung Seven Leave Ginseng, bought in Malaysia.

Tests by HSA detected two medicinal ingredients, chlorpheniramine, an antihistamine, and dexamethasone, a potent steroid.

Dexamethasone can be obtained only through a doctor's prescription, while chlorpheniramine should be obtained from a doctor or pharmacist. Long-term unsupervised use of steroids like dexamethasone can cause increased blood glucose levels, which may lead to diabetes, Cushing's syndrome (characterised by a round or "moon" face appearance and upper body obesity with thin limbs), and other serious adverse effects.

In 2011, HSA alerted the public to Tian Ma Tu Chung Seven Leave Ginseng, which had caused an elderly woman to develop Cushing's syndrome, high blood pressure, hallucination and memory loss. She had obtained the product from a relative who bought it in Malaysia.

Meanwhile, a woman in her 30s developed redness, extreme itchiness and a burning sensation after she stopped using Perliere Mimi Pearl Cream. She had bought the product online and used it for more than two years.

Tests by HSA detected four medicinal ingredients: trimethoprim and sulfamethoxazole, which are antibiotics; ketoconazole, an anti-fungal medicine; and clobetasol propionate, a potent steroid.

These ingredients can pose serious health risks if used without medical supervision. The woman's skin specialist confirmed that she had developed steroid withdrawal symptoms.

Additionally, HSA found high levels of male erectile dysfunction medicines in Impactra. It was found to contain sildenafil, tadalafil and chloropretadalafil, which are prescription medicines used to treat male erectile dysfunction.

Tadalafil was present in high levels of up to 10 times the maximum daily dose, potentially causing serious adverse effects such as low blood pressure, stroke, heart attack, and painful and sustained erections, which can lead to permanent erectile dysfunction if left untreated.

Impactra was sold by Gold Tree and marketed for "male sexual enhancement", with claims such as the ability to boost libido and cause an increase in testosterone level.

The product also falsely claimed that "its all-natural formula ensures no inclusion of harmful synthetic chemicals", when it actually contained three prescription medicines.

HSA has directed the companies selling Perliere Mimi Pearl Cream and Impactra to stop selling the products and is also working with local e-commerce website administrators to take down affected postings.

The agency also advised consumers as follows:

- As Tian Ma Tu Chung Seven Leave Ginseng and Perliere Mimi Pearl Cream contain a potent steroid, consumers who have taken these products should see a doctor as soon as possible. Discontinuation of steroids without proper medical supervision can cause serious withdrawal symptoms such as fatigue, confusion and low blood pressure;

- Consumers should stop taking Impactra immediately and consult a doctor if they are feeling unwell or concerned about their health;

- Be wary of health products that promise or produce quick and miraculous effects, or carry exaggerated claims;

- Avoid buying health products from unfamiliar sources and be cautious when buying such products online. No one can be certain what these products contain, and where and how they were made.

Those selling or supplying the products must stop immediately as it is illegal to sell complementary health products containing potent medicinal ingredients or banned substances.

Anyone convicted of doing so can be jailed up to three years and/or fined up to $100,000.