Bought a weight-loss jab online? SAHPRA's signs it could be fake

If you bought a weight-loss injection from a gym, an Instagram page or a WhatsApp seller, there is a good chance it is illegal. The South African Health Products Regulatory Authority (SAHPRA) says GLP-1 products sold through social media, online vendors, gyms or informal suppliers are "likely counterfeit or substandard" (SAHPRA).

The regulator has logged about 600 complaints this financial year about fake and illegitimate medicines moving through informal channels, including online portals, gyms and even hairdressers, its head of regulatory compliance Daphne Fafudi told a Sandton panel on 14 October (Bhekisisa).

"People do die, and it doesn't even come to our attention," Fafudi said (Bhekisisa).

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

SAHPRA and the regulators at the Sandton meeting flagged these warning signs (SAHPRA, Bhekisisa):

• It comes as a powder. Registered GLP-1 medicines are supplied ready to use, in pre-filled pens or vials. Powder forms are not registered.
• The price is far below pharmacy prices. SAHPRA says unusually cheap products often point to counterfeit or illegally made stock.
• It's sold without a prescription or outside a licensed pharmacy.
• The packaging looks wrong. Blank or unusual boxes, no printed expiry date, no package insert, or broken and dented packaging.
• It claims SAHPRA approval in an advert. SAHPRA found sellers using its logo and the names of big pharmacy chains to sell GLP-1 products shipped from China by post, not from local warehouses as advertised (SAHPRA).
• It's an oral GLP-1 "solution". SAHPRA says it has not approved any oral GLP-1 solution (SAHPRA).

"If you cannot trust the source, do not trust the medicine," Fafudi said (Bhekisisa).

What does SAHPRA say you should do instead?

Use GLP-1 medicines only in original packaging, from licensed manufacturers, prescribed by a registered healthcare professional and dispensed by a licensed pharmacist (SAHPRA). You can check whether a product is registered on SAHPRA's registered health products database.

SAHPRA chief executive Boitumelo Semete-Makokotlela told Bhekisisa that part of the answer is giving people cheaper registered options, including generics (Bhekisisa). South Africa's first generic semaglutide went on sale in August (Bhekisisa).

Are compounded weight-loss jabs legal in South Africa?

Only within tight limits. Compounding is meant for an individual patient with a valid prescription, and cannot be used for large-scale manufacture, advertising or distribution of unregistered medicines, SAHPRA says (SAHPRA). SAHPRA also does not check the safety or efficacy of compounded medicines, and compounding with salt forms of semaglutide, such as semaglutide sodium or acetate, is illegal (SAHPRA).

In May, SAHPRA and the South African Pharmacy Council inspected iDexis (Pty) Ltd, trading as Sentra Pharmacy, in Silverton, Pretoria. SAHPRA said it found illegally imported semaglutide and tirzepatide ingredients, no testing for potency or purity and inadequate sterile conditions, and seized all GLP-1 and GIP injectables on site. It also said it had noted reports of adverse events, including hospitalisations, linked to such products (SAHPRA). In June the Gauteng High Court ordered the pharmacy to stop producing semaglutide medicines (Bhekisisa).

What about retatrutide and other peptides?

Retatrutide is still being tested in studies and is not licensed anywhere in the world, yet it is being sold openly in South Africa, Pharmaceutical Task Group chair Stavros Nicolaou told the panel (Bhekisisa).

SAHPRA lists BPC-157, TB-500, Melanotan II, CJC-1295, Ipamorelin, PT-141, AOD-9604, Selank and Semax among peptides being marketed illegally, often for weight loss, muscle growth or anti-ageing. It warns of risks including infections from injecting, hormone disruption, possible tumour stimulation and contaminated products (SAHPRA).

When will the rules get tighter?

Revised guidelines for compounding pharmacies, led by SAHPRA with input from the Pharmacy Council, are only expected around February or March 2027, Pharmacy Council CEO Vincent Tlala said (Bhekisisa).

How do you report a fake jab or a side effect?

• Suspicious sellers or fake approval claims: SAHPRA's 24-hour whistleblower hotline on 0800 204 307 (SAHPRA).
• Side effects: email [email protected] (SAHPRA).

If you have already used a product and feel unwell, see a doctor or pharmacist and take the packaging with you.