It’s the Chinese medicine often compared to paracetamol.
Lianhua Qingwen has long been used in mainland China to treat common colds and flu-like symptoms.
The traditional Chinese medicine is also given to children, albeit in smaller doses.
Since the start of the pandemic, Chinese authorities and scientists have been saying it is even effective at easing symptoms of Covid-19.
It’s prompted some members of Australia’s Chinese community to stock-up on the medication available in China over-the-counter and with a prescription.
“Lianhua Qingwen is very effective for symptoms such as the cold,” said user Amy*, who recently bought boxes of the “anti-pandemic treatment” on a Chinese e-commerce site.
But the capsules are illegal in Australia because they contain Ephedra, used as a precursor for methamphetamine.
In 2020, the Australian Border Force (ABF) seized 1.3 million capsules containing Ephedra and made over 3,000 detections of the substance.
Last year, there were only 262 detections, which equates to just under 150,000 capsules.
Regarding the large drop in the number of detections over the past two years, an ABF spokesperson told SBS Chinese: “It is likely related to the timing of Covid outbreaks in Australia as well as the deterrent effect of large seizures on illegal imports of Ephedra.”
Professor of Pharmacology at Western Sydney University Chun Guang Li said it is possible for extracts of Ephedra alkaloids in Lianhua Qingwen to end up being used to create methamphetamine.
But he said making the stimulant drug out of the medicine would be a time-consuming and costly exercise.
This is because there a low levels of Ephedra in Lianhua Qingwen and it would be difficult to isolate Ephedra alkaloids from the “hundreds” of different compounds that form the medicine.
“It is generally easier [to make methamphetamine] using over-the-counter [Western] cold and cough medicines or nasal decongestant medicines, which contain pure Ephedra alkaloids to manufacture methamphetamine,” said Prof Li.
SBS Chinese spoke to Oda* who sells boxes of the capsules to Chinese customers in Australia.
She said one of her shipments was seized at the border in November.
“I had another 400 boxes recently shipped and delivered safety to Sydney [after that],” she said.
E-commerce traders are charging customers $22 for a box of 24 capsules, six times the retail price of the medication in mainland China.
SBS Chinese also found some Asian supermarkets illegally selling the medication under the counter at $30 a box.
Oda said the huge mark-up was a major reason why she and other traders found places like Australia as an attractive market.
“I figured it doesn’t matter if one of my shipments get seized at the border,” she added.
“I’ll make up for it in the next shipment.”
Australia’s Therapeutic Goods Administration advises consumers to exercise extreme caution when they consider purchasing medicines on the internet.
“Products that are not regulated by the TGA could contain undisclosed harmful ingredients or toxic contaminants that can pose a serious risk to health,” said the TGA spokesperson.
The use of Ephedra in Chinese medicine has a long history and has been associated with treating asthma.
Lianhua Qingwen was developed by Yiling Pharmaceuticals in response to SARS in mainland China 18 years ago.
Ephedra is not an approved Covid-19 treatment [in Australia] and should not be treated as such.
The TGA said Ephedra can pose serious safety risks to patients, including cardiac toxicity, (potentially triggering a sudden heart attacks), irreversible eye damage and severe depletion of blood sugar, which could lead to a coma.
The use of Ephedra as a dietary supplement has been linked to serious adverse effects including high blood pressure, heart attacks, muscle disorders, seizures, strokes, psychosis, irregular heartbeats, loss of consciousness and death, according to the TGA.
Prof Li said there is limited evidence showing Lianhua Qingwen’s efficacy in improving some symptoms of Covid-19.
He said he was aware that people in mainland China were using the medicine “a lot”.
But one thing you need is a doctor’s prescription. Even if you have access to the medicine, you shouldn’t manage it [intake] yourself.
Australia does allow the import of small quantities, up to three months’ supply at the maximum dose recommended by the manufacturer, of some medicines that are not approved in Australia.
Users must be able to show written authority such as a prescription from an Australian registered medical practitioner.
Without an exemption, the illegal commercial import of Ephedra is punishable by up to 25 years in prison or a fine of up to $1.1 million under the Australian Criminal Code.
Individuals can face seven years’ imprisonment and fines of up to $250,000.
Despite the ban, shipments of Lianhua Qingwen are still getting through customs and making their way to the black markets and household medicine cabinets.
Amy told SBS Chinese she entered Australia with the banned medication in her suitcase without declaring it with customs while understanding the potential risks of confiscation and penalty.
“It was mixed in with my other belongings, so customs officials won’t find it so easily,” she said.
Chinese resident, Lily*, told SBS Chinese that Lianhua Qingwen is used by “everybody” in China.
Before migrating to Australia six months ago, Lily was told she couldn’t legally bring it into the country.
Instead, she successfully sent capsules to herself by air. A fortnight later, they arrived at her door in Melbourne.
“I heard how bad Covid was in Australia, so I wanted to take every precaution to take care of myself and my family in Melbourne.”