Over-the-Counter Drugs in Japan

Nothing is worse than getting sick in a far-away land and having to drag yourself off to a doctor. Following our recent medical theme, today's feature we will explain the world of Japanese over the counter (OTC) medications (一般用医薬品 ippan-yo iyakuhin).

Drug Classifications
There are three main classifications of OTC drugs

• Type 1 Drugs (第一類医薬品 dai-ichi-rui iyakuhin）-- These drugs are classified as having side effects that could "interfere with daily life" as well as the potential for serious health risks if used improperly. A pharmacist must be on hand to dispense these drugs and give adiquit advice about side effects and necessary precautions. 

• Type 2 Drugs (第二類医薬品 dai-ni-rui iyakuhin)-- These drugs are classified as having potential side effects that can interfere with daily but not with the severity of Type 1 medication. A pharmacist or a "registered seller" (登録販売者 toroku hanbai-sha) must be on staff to sell these drugs and provide consultation if necessary.

• Type 3 Drugs (第三類医薬品 dai-san-rui iyakuhin)-- These drugs are consider to have non serious side effects and, in most cases, won't impair one's functionality in any major way. A pharmacist or a "registered seller"  must be on staff to sell these drugs and provide consultation if necessary.

In addition to the above mentioned category, there is another classification of drugs known as i-yakubu gaihin (医薬部外品) shitei i-yakubu gaihin (指定医薬部外品). In English, these are ofter refered to as "quasi-drugs" or "supplements." This category includes vitamin drinks, nutritional supplements, cough drops, and all those energy tonics. These can be sold in any establishment including convenience stores and super markets.


Buying Drugs
As we have discussed in the previous article covering prescription drugs, pharmacies are plentiful in Japan and there is a solid chance that your local grocery or home center store has a non-prescription drug section, too.

But you may notice that these sections of the grocery store periodically get fenced off. This happens whenever a registered seller is not on staff since it is not legal to sell Type 2 and Type 3 drugs without a registered staffer on hand. Even 24 hour chains will generally close these sections off after 9 or 10 pm or so, so don't bank on getting pills for those late night headaches.

Unlike many North American and European countries, the sales of drugs over the internet are still strictly regulated. Currently, online drug stores can only sell Type 3 drugs and quasi-drugs. The sale of Type 2 drugs are limited to specially designated outlying islands and remote areas. The sale of Type 1 drugs over the internet is strictly forbidden.

Type 1 drugs usually only are available on request. In other words, you're going to have to ask for it at the counter - bring along enough Japanese to do so.

If you are worried about what's in your drugs, or what they may do, check out our article on side-effects and ingredients.


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• Pharmaceutical sales in Japan have long been a highly regulated affair. Until the recently passed Revised Pharmaceutical Law came into effect, you weren't allowed to sell so much as an aspirin without a pharmacist on hand.
• Price wise, OTC drugs in Japan are generally significantly more expensive than the USA but probably closer to prices found in Europe.
• Japanese OTC drugs are usually weaker than their Western counterparts. So, double check the dosage of something you have taken elsewhere before.

And that is all for drug and health. Keep on checking back regularly for more great information on all kinds of topics and don't forget to peek back at our coverage of Japanese health insurance, doctors, and dentists if you are still lost.

Pharmacies and Prescriptions in Japan

Now that we have covered health insurance, medical specialties, and dentists, it seem only fair that we tell you about the ins and outs of your local Japanese pharmacy establishments.

Types of Pharmacies
There are a few types of pharmacies (yakkyoku 薬局 or kusuriya 薬屋) in Japan. The first are the big commercial chains like Matsuo Kyoshi, similar to US counterparts insofar as they sell a variety of food, beer, cleaning supplies and so on in addition to over the counter drugs. However, not many of these big chains fill prescription drugs (shohoyaku 処方薬). If you are filling a prescription at a chain store, make sure to double check to make sure there is a pharmacist on hand.

Another common sight are small, family-run establishments which are almost always found right across the street from a doctors office. These small pharmacies only fill prescriptions and, for the most part, don't sell extra goodies.


Types of Prescription Drugs
Despite being a major drug market, Japan is legendarily strict when it comes to prescription medication. Legal maximum prescription sizes tend to be significantly smaller than the US, and when you want to renew a prescription you need to see a doctor directly. Furthermore, the dosage strength of Japanese medicine is generally weaker than its Western counterparts. 

Also, keep in mind that drugs have different brand names and possibly even slightly different ingredients compared to your home country. Japan does not strictly recognize US Food and Drug Administration approval or the European equivalent so drug makers must go through an additional cumbersome process in order sell their drugs in Japan. Therefore, your drug of choice may not yet be legal here or only available in a different form/dosage. One popular ADD drug, Adderall has actually been illegalized due to fears of over prescription.  


See our previous post on medication side-effects and ingredients.

Filling a Prescription (shohosen 処方箋)
Since all prescriptions must have doctor's original seal, e-prescriptions are pretty much unheard of since seals cannot be transmitted electronically. However, large hospitals and clinics will sometimes offer to fax a copy of your medication to the pharmacy of your choice so it can be ready for you on arrival.

Using Your Drugs
Don't be surprised if a lot of drugs come in the form of granules in little plastic baggies. Be it a cultural thing or some sort pharmaceutical industry quirk, lots of pain killers come in the form of nomi-gusuri (飲み薬) that must be mixed with water and drunk.

Another odd type of drug that appears a lot is the ugai-gusuri (うがい薬) which are solutions that must be mixed and gargled. Usually these types of medications are for sore throats and cough suppression. Even though they may look like cough syrups, make sure not to drink them.

The pharmacist on duty should explain everything to you when you get your drugs and many shops will print out nice detailed sheets with dosage information and instructions in case you need to get your prescription filled at another facility.

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• Japan has a drug market worth 93.2 billion USD, only trailing the USA's ludicrous 301.3 billion USD (Financial Times, 2010). Therefore, just about every tiny hamlet has a fairly extensive collection of pharmaceutical establishments.

Got all that? Pop back to AccessJ soon since our next topic will be over the counter medication.

Going to the Dentist in Japan

Today: the dentist (歯科 shika).

Despite the fact that the Japanese seems to suffer from a rather high case yaeba (double or indented teeth), cosmetic dentistry is still much less common when compared to Western countries.

However, there are plenty of dental clinics all over the country. In today's guide we will cover all the important differences and points of interest regarding the Japanese dental establishment.


Finding a Dentist and Making an Appointment
In Japan, dentistry is considered part of the basic medical establishment (see our previous article on medical specialties for details) and all the basic rules of Japanese health insurance apply to a dentist office (i.e. paying 30 percent of expenses up front, out-of-pocket expense limits, etc.). However, there is one important difference, which is that dentists almost always require appointments. 

The waiting list for dentists varies greatly depending on the size of the clinic, staffing, time, and general popularity of the dentist. Like regular doctors, dentists generally keep a split schedule with morning and afternoon hours. In this author's experience, wait times for non-emergency peak hours are generally 1 to 3 weeks depending on the dentist.

Dentists are plentiful and, like doctors, are often family establishments passed down through from parent to child. You can use websites like shikaiin.com or haishasan.net to find all the various clinics in your local area as well as their specialties and office hours.

Dental Visits and Follow-Ups
Dental clinics (歯科医院 shika iin or 歯科クリニック shika kurinikku) are generally private practice establishments, however almost every doctor employees a few dental hygienists (歯科衛生士 shika eiseishi) to help with his or her duties. Chances are, unless you are getting a tooth drilled or braces put on, you will mainly be seeing the hygienist. 

One common complaint about Japanese dentists is that they rarely do everything in one sitting. Many dentists offices are quite small and, like doctors, the insurance system encourages seeing as many patients per day as possible. It's quite possible that you will get x-rays one day, come back for brushing and gum checks the next and then get your teeth cleaned over a series of appointments. 

Some people have complained that dentists schedule unnecessary follow ups simply to milk you for insurance money and, while that may be the case, my experience has largely been positive.

Check-ups and Cosmetic Dentistry
After your initial check up, dentist offices will generally send you out yearly post cards to remind you to come in for your annual appointment.



Keep in mind that insurance only covers necessary treatments like cleanings, check ups, treating broken teeth, cavities and so on. Elective treatment (選択医療 sentakuiryo) must be paid totally by the patient and for the most part these procedures are not cost controlled. 

In the case of dentistry, elective treatment includes aesthetic dentistry (審美歯科 shinbi shika) and corrective dentistry (矯正歯科 kyosei shika). This covers tooth whitening, specialized tooth cleaning, braces, customized implants, and high quality fillings. If you get a cavity filled, insurance will only cover the most basic type of filling and cap. Implants are generally considered an extra as well. Unlike other countries, braces are never considered to be a medical necessity, even in the case of extreme tooth deformation.

As it's where the money lies, dentists aren't shy about pushing for braces and extra cleaning. Generally speaking, braces are still considered a luxury in Japan and they are generally significantly more expensive when compared to the US.

A few last things to keep in mind are that if you are looking for more invasive dentistry (surgery, gum work, etc.), make sure you find a clinic that specializes in oral surgery (口腔外科 koku geka). Like a doctor's office, its a good idea to bring a Japanese speaker along to fill out forms and explain your symptoms in detail. Luckily, many younger dentists have a fair comprehension of written English and basic medical terminology so its not impossible to communicate.


And that's a wrap. If you have any personal experiences or advice you want to share, please feel free to add comments. Also, check back to our health insurance, medical specialties and doctors office articles if you have other any burning medical questions.

Going to the Doctor in Japan

As you frequent AccessJ readers may have noticed, we have just covered the various medical specialities in Japan as well as the Japanese health insurance system. Following up on our medical theme, today we will look at the important points of getting fixed up at the local clinic.

Going to the Doctor's Office
While some specialists such as psychiatrists require advanced reservations, for the most part appointments are not needed - all you need do is walk in, present your insurance card and wait for the doctor to see you. For most small clinics, the wait is generally less than an hour but for big hospitals it can be longer. Also, some hospitals require reservations for certain specialists or services depending on the time and day of the week. For a detailed list of medical specialities avaliable in Japan, check out our post here.

Finding a clinic is relatively easy. Chances are there is at least one in your neighborhood. If not, Yahoo Japan, My Clinic, and Doctor.ne.jp all offer nation-wide doctor searches to help locate your nearest health care provider. You can also search by speciality and geographic location.

These sites also show times when the clinic is open. Most doctors divide their day into morning and afternoon blocks. Generally speaking, morning hours end around 11:00 or 12:00 followed by a two hour break wherein evening hours begin (generally until 5:00 or 6:00). Since most doctors still make house calls in Japan, its not unusual for a doctor to be late returning for his evening appointments. Some clinics may offer priority to returning patients or those with reservations. Referrals are generally not necessary except of certain appointment hours at large hospitals (usually late afternoon).

If you are not a Japanese speaker or reader, it is probably a good idea to bring a friend along so you can explain what ails you as well as fill out forms regarding allergies, medication history, etc. 

Dealing With Doctors
In Japan, like many other countries, a doctor is a position of particularly high esteem. Doctors are always addressed as sensei (先生) much like teachers and lawyers to reference their prestigious position. Despite being a lucrative business, many doctors practice well into their 60s and even 70s so except the average age of your practitioner to be on the older side.

Here are some points to keep in mind:

• For older doctors, asking directly for a second opinion is akin to calling him or her a liar. The good news is that this is changing as younger doctors take the reigns and medicals schools make their curriculum more patient-sensitive. More and more big hospitals are posting signs telling their patients not to fear asking for a second opinion.
• Due to the "doctor knows best" school of thought, doctors usually don't ask your opion regarding treatment, instead preferring to go right ahead with whatever treatment they deem necessary. Again, this tends to be more true for older doctors.
• Finally, doctors in Japan sometimes often come off as curt and down right dismissive. Keep in mind, doctors get paid per patient. Therefore, there isn't a lot of chit-chat involved and usually the doctor isn't interested in hearing anything but your immediate symptoms. 

As to the question of quality, Japan is internationally of high-regard medically, and this author's experience has been a largely positive one. If one particular clinic doesn't do it for you, then just take your business to another, more reputable doctor. 


What to Bring
If you are just going for a routine check-up, then all you need is an insurance card/booklet. If you don't have one yet (i.e. you are waiting for it to come in the mail), you can often submit a claim for reimbursement so long as you are current on your premiums and your insurance has officially kicked in. If you find yourself going to the doctor multiple times, most medical providers will check your insurance card once a month to make sure your insurance is current.

If you check into the hospital overnight or longer, most facilities ask that you bring your own towels, slippers, tooth brush, tissues, and other sundries. This may sound strange to many but hospitals love to bill you for anything that you don't bring yourself so if you find yourself hospitalized, it doesn't hurt to ask a friend to bring some goods to you. Also, if you want a nicer room, private quarters, and other goodies, then be prepared to pay a lot more out of pocket.


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• According to the OECD's 2003 health data, the average Japanese person visits a doctor 14.4 times a year, far out pacing the second place USA (8.9 visits per person). Not surprisingly, even a small city will likely have many doctors offices and specialists just waiting to take your insurance money.
• Unlike many other countries, doctors are almost always in private practice, although in bigger cities some doctors have multiple branches or cooperative clinics. For basic treatment, there are two main types of doctor's offices: "clinics" (クリニック kurinikku) and i-in (医院). The two are essentially the same except i-in are almost always private practices, while clinics can have multiple branches. 
• Furthermore, some cities like Tokyo have special "foreigner clinics" geared toward short term business travelers and temporary residents. These clinics don't accept Japanese health insurance and are usually more expensive although they provide English speaking staff.
• One thing that gets particularly confusing is the the exact definition of "hospital" (病院 byoin). In Japan, it is not unusual for a single doctor or a group of doctors to run small, private hospitals with a few beds and over night staff. These small hospitals also double as clinics. However, not all hospitals accept ambulances. Emergency intake is generally limited to big private hospitals, city run hospitals (市立病院 shiritsu byoin), prefectural hospitals (県立病院 kenritsu byoin), national hospitals (国立病院 kokuritsu byoin), and university hospitals (大学病院 daigaku byoin). 
• Almost all large hospitals have an extensive array of out-patient (外来 gairai) doctors that specialize in a variety of non-emergency medicine much like a regular clinic. Most hospitals and many clinics are part of a area-wide doctor practice group (denoted by 会 -kai).
• Clinics and hopitals will often give you a card with a patient number in case you come back. Hang on to this as it will make finding your medical records that much easier.

Well, loyal readers, that about covers our doctor visit guide. For our next post we will look at dentistry in Japan. With any luck you won't need to use any of this info on a regular basis, but in the event that you get ill just remember that AccessJ has your back!

Medical Specialties in Japan

Since we have recently been covering the topic of health insurance, it seems logical to follow up with information about the various types of services you can get for your hard earned insurance money. Today, we will look at the medical specialities in Japan.


Unlike the UK and US, Japan lacks anything like a general practitioner (GP) or family doctor. People simply go to whatever specialist suits them. The most basic type of doctor is internal medicine (内科 naika) which is the closest thing to a GP. Almost every doctor has at least this one qualification and many doctors in private practice have several specialities, although they usually advertise one in particular. The various specialties are listed (for the first time in English) below:

内科 naika Internal Medicine
小児科 shonika Pediatrics
神経内科 shinkeinaika Neurological Internal Medicine
リウマチ科 riumachika Rheumatology
消化器科 shoukika Gastroenterology
臨床検査科 rinshokensaka Laboratory Medicine/Clinical Pathology
耳鼻咽喉科 jibiinkoka Otorhinolaryngology/Ears-Nose-Throat
性病科 seibyoka Sexual Transmitted Disease Specialist
歯科 shika Dentistry
東洋医学科 toyoigakuka Eastern Medicine
乳腺外科 nyusengeka Mammary Surgery
胃腸科 ichoka Gastro-intestinal Medicine
腎臓内科 jinzonaika Nephrology
心療内科 shinryonaika Psychosomatic Medicine
小児外科 shonigeka Pediatric Surgery
放射線科 hoshasenka Radiology
気管食道科 kikanshokudoka Broncho-Esophology
肛門科 komonka Proctology
矯正歯科 kyoseishika Corrective Dentistry
予防医学科 yoboigakuka Preventative Medicine
不妊治療 funinchiryo Infertility Treatment
血液内科 ketsueki naika Haematology
外科 geka Surgery
呼吸器外科 kokyuki geka Chest and Respiratory Surgery
形成外科 keisei geka Plastic and Reconstructive Surgery
麻酔科 masuika Anaesthesiology
アレルギー科 arerugika Allergist
産科 sanka Obstetrics
小児歯科 shoni shika Pediatric Dentistry
審美歯科 shinbi shika Aesthetic Dentistry
呼吸器科 kokyukika Pulmonology
神経科 shinkeika Neurology
整形外科 seikei geka Orthopedic Surgery
心臓血管外科 shinzo kekkan geka Cardiovascular Surgery
美容外科 biyo geka Cosmetic Surgery
内分泌科 naibunbika Endocrinology
皮膚科 hifuka Dematology
婦人科 fujinka Gynecology
歯科口腔外科 shikakoku geka Oral Surgery
インプラント inpuranto Medical Implants
循環器科 junkankika Cardiology
リハビリ科 rihabirika Rehabilitation
胸部外科 kyobu geka Thoracic Surgery
病理科 byorika Pathology
内視鏡科 naishikyoka Endoscopy
泌尿器科 hinyokika Urology
眼科 ganka Ophthmology
スポーツ科 supootsuka Sports Medicine
予防歯科 yobo shika Preventative Dentistry

Note: Obstetrician and Gynecology (婦人産科 fujin sanka) are often practiced by the same doctor much like a Western OBGYN, although in bigger clinics they may be divided into separate sections.

Typically, a doctor's main field of specialization will be in the name of the clinic (i.e. Taka Internal Medicine Clinic) or the specialities of a given practice will be listed after the clinic name. In the case of large hospitals, various out patient specialities will be divided by section, floor, and sometimes even by building.


That about does it. But what good is a list without an explanation of how to handle going to the Japanese doctor? No worries, next week: "Going to the Doctor's Office in Japan"!