Artri Ajo Rey in Panama: Hidden Steroid and Minsa Alert

What Minsa warned about Artri Ajo Rey and Artri Ajo King in Panama

On July 23, 2026 the Ministerio de Salud (Minsa), through the Dirección Nacional de Farmacia y Drogas (DNFD), issued a health alert in Panama over the falsification and illegal sale of Artri Ajo Rey and Artri Ajo King, products promoted for joint pain¹². Neither has sanitary registration in Panama, so their quality, safety and efficacy have not been evaluated or authorized for sale¹².

The alert followed a notice from the U.S. Food and Drug Administration (FDA)¹². According to the press, the products are sold mainly through websites and possibly some retail stores¹. Minsa asked people not to buy medicines on social media, websites or the street, and to report any distribution or sales point at 501-0306¹². It also asked physicians, pharmacists and other professionals to report any event that could endanger patients¹.

What the FDA found: undeclared dexamethasone, diclofenac and methocarbamol

According to FDA laboratory analysis, Artri Ajo Rey "contains dexamethasone, diclofenac and methocarbamol not listed on the product label"³. For Artri Ajo King, the January 2022 notice reported diclofenac not listed on the label³. In April 2022 the FDA also warned about Artri King: its analysis confirmed undeclared diclofenac and dexamethasone, and the agency had received adverse event reports, including liver toxicity and death⁴.

A note on rigor: the liver toxicity and death reports the FDA cites relate to the Artri King line in 2022 and, in the sources consulted, are not attributed to a specific product in the Panamanian alert or to cases in Panama⁴. La Estrella does not detail FDA findings for Artri Ajo King². One reading caution: La Prensa's headline speaks of stopping use "immediately," but the body of the article advises consulting a professional before stopping¹.

Hidden dexamethasone: iatrogenic Cushing and adrenal insufficiency

The FDA describes dexamethasone as able to weaken defenses against infection, raise blood sugar, cause muscle injury and psychiatric problems, and suppress the adrenal glands; diclofenac can raise heart attack and stroke risk and cause gastrointestinal bleeding, ulceration or perforation; methocarbamol can cause sedation, dizziness and low blood pressure³.

The clinical literature on the Artri King line agrees, though it consists mostly of case reports and series, not controlled studies. Two women developed exogenous Cushing syndrome, one with very low morning cortisol and ACTH⁶; another report describes iatrogenic Cushing from prolonged use⁷; a three-patient series in Los Angeles documented hypothalamic-pituitary-adrenal axis disruption, with elevated serum dexamethasone in two patients⁸. In a cohort of 13 joint-replacement patients using Artri King or similar products, nine had low cortisol (< 6.7 mcg/dL) and needed a perioperative corticosteroid strategy⁹. A systematic review of 16 patients found 75% diagnosed with Cushing syndrome; the serious effects were Cushing syndrome, adrenal insufficiency and worsening hyperglycemia¹⁰.

New cases keep appearing: an 82-year-old man with purpura and thin skin¹², and a man in his 40s whose symptoms began weeks after stopping the supplement, with secondary adrenal insufficiency treated with hydrocortisone¹³. That sequence, symptoms after stopping the product, is why it should not be stopped without medical guidance.

What to do in the clinic: ask about supplements and do not stop abruptly

• Ask. In a California primary care clinic study, 14 patients were taking supplements flagged by the FDA; all 12 interviewed reported relief and none knew about the hidden ingredients. Reasons: word of mouth, inadequate relief from prescribed treatment, and the belief that "natural" means safe¹¹.
• Suspect. Cushing or adrenal insufficiency without a prescribed glucocorticoid, new hyperglycemia, striae, easy bruising or fragility fractures in a patient with chronic arthralgia justify asking about these products⁶⁹¹⁰¹².
• Do not stop abruptly. The FDA advises consulting a health care professional right away to stop safely; only a professional can assess the risk of adrenal suppression and corticosteroid withdrawal³⁴.
• Report. Minsa asks professionals to report events that endanger patients¹; for the national mechanism, see pharmacovigilance in Panama with VigiMedic.

Adulterated supplements: a known problem

This is not isolated. An analysis of FDA warnings from 2007 to 2016 identified 776 adulterated supplements and 146 companies, with unapproved pharmaceutical ingredients found even after earlier warnings; about 39% of recent samples (2014-2016) were identified through online sampling⁵. The FDA itself says hidden drugs are a growing problem in "all natural" products and that it cannot test every product³. For Panamanian context, see also Minsa's alerts against counterfeit medicines and the fake Minsa inspectors.