Online shopping for medical products such as contraceptives, contact lenses, sex drugs and slimming pills is a growing public health concern in Singapore, the Health Sciences Authority (HSA) says.
Illegal sellers are finding customers easily over social networking platforms like Facebook and Instagram as well as through blogs, forums and other websites.
Warning of serious health risks, the HSA and doctors told The Sunday Times about buyers who have developed serious complications, including liver failure and blindness, after taking such products.
From 2011 to June this year, the HSA caught 122 people for illegally selling health products online, said its deputy group director of health products regulation, Associate Professor Chan Cheng Leng.
The HSA started keeping online statistics in 2011, after noting the growing presence of sellers on the Internet.
Prof Chan said that at least one person has died after taking slimming pills bought online. The 24-year-old woman died in 2012 of dinitrophenol poisoning after consuming pills bought through an overseas website. The banned substance is used in herbicides. The woman had been warned not to take such pills after being hospitalised a year before her death, but she persisted.
Doctors have seen patients complaining about experiencing heart palpitations, feeling jittery or having mood swings after taking slimming pills bought online. In serious cases, they had liver failure or kidney damage.
Some people developed mental health problems but recovered after they stopped taking the pills, said Dr Lee Ee Lian, a psychiatrist who specialises in treating eating disorders at Promises Healthcare, a private clinic.
She has a patient in her 20s who started hearing voices after taking slimming pills bought online. She began thinking people were out to kill her and it became so bad that she had to be hospitalised. She recovered after she stopped taking the pills.
Another patient, a housewife in her 40s, almost died of liver failure after a few weeks of taking slimming pills she bought online.
"If you are lucky, the pills don't harm you. If you are not so lucky, there are unpleasant side effects. If you are really unlucky, the drugs are really toxic and can kill you," Dr Lee said. "It's anyone's guess what toxic stuff the pills contain."
Most of the slimming pills that the HSA seized, such as Bio-Lissom Fat Reducing Caps, Botanical Slimming and Reduce Weight Fruta Planta, were found to contain a banned substance called Sibutramine which can raise the risk of heart attack and stroke.
Other drugs sold on the Internet, such as contraceptives and sexual enhancement pills, may be fake or harmful.
Gynaecologists said they have patients who became pregnant despite taking birth control pills bought online. The medicine turned out to be fake or ineffective.
Prof Chan said the online peddlers caught were solo operators ranging from students to those with respectable jobs, including a nurse who hawked contraceptives.
"They are trying to make a quick buck online. Some know that such sales are illegal, while others don't know," said Prof Chan.
Last year, a woman in her 30s was caught selling slimming products via Facebook. She was found with 739 sachets of "Slimming Orange Juice Curvy Pearl Beauty" and 113 sachets of "V12 Fruit Slimming".
Although they were promoted as natural health supplements to help in weight loss, they were found to contain the banned substance Sibutramine, which was not stated on the product labels. She was fined $6,000.
A 19-year-old student received the heftiest punishment so far - a fine of $19,000 - for selling contraceptives, unregistered condoms and pregnancy test kits. These items have to be registered and approved by the HSA for sale, while contraceptives need a doctor's prescription.
Almost 3,000 pills and items with a street value of about $5,700 were seized from her home in 2012. All were bought overseas or online.
Those caught selling illegal health products can be fined up to $10,000 and/or be jailed for up to two years.
To report illegal sales of drugs or medical products, call 6866-3485 or e-mail firstname.lastname@example.org