Buying weight-loss jabs online? SAHPRA's signs yours could be fake

South Africa's medicines regulator says illegal weight-loss injections are being sold through websites, gyms and even hair salons, and it has logged about 600 complaints about fake or illegitimate medicines so far this financial year, Bhekisisa reported via Daily Maverick.

"We are worried that the scourge is getting out of control," Daphne Fafudi, head of regulatory compliance at the South African Health Products Regulatory Authority (SAHPRA), told a panel in Sandton on 14 October (Daily Maverick).

How can you tell if a weight-loss injection is fake?

SAHPRA's public warning on peptide products and regulators at the Sandton panel point to the same red flags:

• Where you bought it. Products sold on social media, by online vendors, at gyms or by informal suppliers are likely counterfeit or substandard, SAHPRA says.
• Powder instead of a pen. Registered GLP-1 medicines come ready to use, in pre-filled pens or vials. Powder forms are not registered (SAHPRA).
• A price that's too good. Unusually low prices often point to counterfeit or illegally made products (SAHPRA).
• The packaging. Blank or unusual boxes, no printed expiry date, no package insert, or broken or dented packaging are common signs, the panel heard (Daily Maverick).
• No prescription asked for. Semaglutide medicines should only come with a prescription from a licensed doctor and from a licensed pharmacy (SAHPRA).

If you buy online, SAHPRA says South African online pharmacies are linked to physical pharmacies, so check that the website belongs to a licensed one (SAHPRA).

What can go wrong with an illegal jab?

SAHPRA warns that medicines bought outside the legal supply chain may contain dangerous doses, a different drug such as insulin instead of semaglutide, harmful inactive ingredients, or germs that make them unsafe to inject (SAHPRA).

Some products sold in the "semaglutide" name use salt forms such as semaglutide sodium or semaglutide acetate. These are not the ingredient in the registered medicine, haven't been assessed for safety, and are illegal in compounded medicines (SAHPRA).

Which products are being sold illegally?

SAHPRA lists BPC-157, TB-500, Melanotan II, CJC-1295, Ipamorelin, PT-141, AOD-9604, Selank and Semax among peptides being marketed unlawfully (SAHPRA). Any product meant to treat, prevent or change how the body works must be registered before it can be sold here, under the Medicines and Related Substances Act.

Retatrutide, an experimental weight-loss injection still in trials, isn't licensed for sale anywhere in the world but is being sold openly in South Africa, Stavros Nicolaou of the Pharmaceutical Task Group told the panel (Daily Maverick).

Aren't pharmacies allowed to make their own versions?

Only within narrow limits. Compounding is meant for an individual patient with a valid prescription, not large-scale production, advertising or distribution (SAHPRA).

In May, SAHPRA and the South African Pharmacy Council inspected a Pretoria compounding pharmacy, seized all its semaglutide and tirzepatide injectables and ordered a recall. SAHPRA said it found illegally imported ingredients, no testing for identity or purity, and a high risk of contamination, and that it had reports of adverse events including hospitalisations linked to these products (SAHPRA). The Gauteng High Court later ordered the pharmacy to stop producing semaglutide medicines, according to Bhekisisa.

Revised guidelines for compounding pharmacies are only expected in February or March 2027, the Pharmacy Council's CEO, Vincent Tlala, told the panel (Daily Maverick).

Is there a cheaper legal option?

South Africa's first generic semaglutide medicine went on sale in August, Bhekisisa reported. SAHPRA advises speaking to a healthcare professional about weight management or diabetes treatment rather than buying from unverified sellers (SAHPRA).

How do you report a suspicious product or side effect?

• SAHPRA's 24-hour hotline: 0800 204 307 (SAHPRA)
• Side effects: email [email protected] or use the Med Safety app (SAHPRA)