Guides · 処方薬・市販薬 · kusuri

The Japanese Medicine Cabinet — What Equals What

General information, not medical advice. This article explains how the Japanese healthcare system works. It cannot account for your individual circumstances — see a doctor for those.

Standing in a Japanese pharmacy looking for something equivalent to what you would buy at home is one of the more disorienting experiences of moving here. The active ingredients are largely the same; the brand names, the doses and the customs around them are not.

This guide maps the common ones. Names in brackets are the generic (active ingredient) names, which are what your doctor and pharmacist will recognise instantly if the brand name fails you.

Painkillers and fever

In Japan Active ingredient Equivalent to
Loxonin / ロキソニン loxoprofen An NSAID in the ibuprofen family; stronger than typical OTC ibuprofen
Karonal / カロナール, Calonal acetaminophen (paracetamol) Tylenol, Panadol
Bufferin / バファリン varies by product Some contain aspirin, some acetaminophen — check the box
EVE / イブ ibuprofen Advil, Nurofen
Boltaren / ボルタレン diclofenac Voltaren

Loxonin is the default painkiller in Japan and is available both on prescription and over the counter. It is an NSAID, so the usual cautions apply: take it with food, avoid it if you have stomach ulcers or significant kidney disease, and do not combine it with other NSAIDs.

Acetaminophen (Karonal) is the first choice in pregnancy and for children, as elsewhere in the world.

One thing that surprises new arrivals: Japanese OTC doses are often lower than the equivalent product at home, and prescription-strength versions of the same drug are common. If a pharmacy product seems weak, that may be exactly what it is.

Colds, coughs and hay fever

There is no direct equivalent to the American all-in-one nighttime cold remedy. Japanese practice leans towards separate medicines for separate symptoms, plus one distinctive category:

Stomach and gut

What you cannot bring into Japan

This is the part that catches people out, and the consequences are serious — including detention at the airport. Japan's narcotics and stimulants laws are strict and are enforced against ordinary travellers carrying ordinary home medicine.

Banned outright, no exceptions: any product containing pseudoephedrine (Sudafed and many combination cold remedies), amphetamine or methamphetamine derivatives (Adderall, Vyvanse), and codeine above certain concentrations. These are prohibited stimulants under Japanese law regardless of your prescription at home. There is no permit that makes Adderall legal here.

Allowed with advance paperwork: narcotic analgesics (oxycodone, morphine) and psychotropics, including methylphenidate (Concerta, Ritalin) — note that methylphenidate is a psychotropic here, not a banned stimulant, which is why it is treated differently from Adderall and Vyvanse. Small personal quantities of some psychotropics pass without paperwork, but anything beyond roughly a one-month supply, and all narcotics, require an import certificate — the Yakkan Shoumei (薬監証明), now formally the Yunyu Kakunin-sho (輸入確認証) — obtained from the relevant regional bureau of health before you travel. Apply at least two to three weeks ahead, not days.

Generally fine in personal quantities: most ordinary prescription drugs (up to about one month's supply) and OTC medicines (up to about a two-month supply). Bring them in original labelled packaging with a copy of your prescription.

If you take a regular medication, check its status before you fly rather than after you land. If you are already living here and take something in the restricted category, your Japanese doctor can usually prescribe a locally approved alternative — but arrange that before your supply runs out, not on the last day.

Why your prescription is so short

New arrivals routinely find themselves handed three days of medicine and told to come back. This is not distrust; it is how Japanese outpatient care is structured. The reasoning, the fee system behind it, and how to get a longer supply once you are stable are covered in Why Your Doctor Gave You Three Days of Medicine.

Practical notes on buying

Pharmacies are divided into 調剤薬局 (dispensing pharmacies, which fill prescriptions and cluster around clinics) and ドラッグストア (drugstores, for OTC products). Some drugstores do both.

Certain OTC medicines are classed as 第1類 (Class 1) and can only be handed over by a licensed pharmacist, which means they sit behind the counter and may be unavailable when no pharmacist is on duty — often in the evening. If a shelf shows an empty box with a card, that is why.

Finally, keep your medicine notebook (お薬手帳). It is the small booklet the pharmacy stamps with every prescription you fill, and it is genuinely useful: it prevents interactions, speeds up any new consultation, and slightly reduces your pharmacy fee. Digital versions exist as apps.

General information only. Any medication decision should involve a doctor or pharmacist who knows your history — and drug regulations change, so verify import rules with Japanese customs or the Ministry of Health before travelling.

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Dr. Masa

Written under a pen name by a physician licensed by Japan's Ministry of Health, Labour and Welfare (厚生労働省), currently in clinical practice in Japan. Writes Japan Health Compass to make Japanese healthcare legible to the people using it.

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