Buying cold, fever and pain medicine in Japan: drugstores, labels and limits

Drugstore (ドラッグストア): chains such as Matsumoto Kiyoshi, Welcia, Sundrug and Tsuruha. Big range, longer hours, and often a prescription counter (調剤) at the back. A pharmacist (薬剤師) is not always on duty; a registered seller usually is.

Pharmacy (薬局): mainly dispenses prescriptions, often next to a clinic. Always has a pharmacist during opening hours, so it's the better choice for Class 1 products and for questions, but the OTC range is small.

Convenience store: most sell only quasi-drugs (医薬部外品) such as some stomach and vitamin products, plus oral rehydration drinks and cooling sheets. Some branches also sell Class 2 and 3 medicines while a registered seller is working, but no official figure shows how many (not stated officially as of 11 October 2026), so don't count on it.

The risk class is printed on every outer box.

要指導医薬品 (guidance-required): Pharmacist only. What happens at the till: Pharmacist checks your symptoms and history; one pack per person. Examples: Newly switched products.

第1類医薬品 (Class 1): Pharmacist only. What happens at the till: Written explanation before sale; often kept behind the counter. Examples: Loxonin S (loxoprofen).

指定第2類医薬品 (designated Class 2): Pharmacist or registered seller. What happens at the till: Signs or staff prompt you to read the leaflet. Examples: EVE A (ibuprofen).

第2類医薬品 (Class 2): Pharmacist or registered seller. What happens at the till: Staff should try to explain; ask if unsure. Examples: Allegra FX (fexofenadine), Tylenol A (acetaminophen).

第3類医薬品 (Class 3): Pharmacist or registered seller. What happens at the till: Explanation only if you ask. Examples: Some vitamins and digestives.

The products above are examples to help you recognise labels, not recommendations. Brand names differ from home, so match the active ingredient (有効成分) on the box.

Pain, fever: Acetaminophen (アセトアミノフェン). Example product and dose on the box: Tylenol A: 300 mg, 1 tablet per dose, up to 3 times a day, at least 4 hours apart. Same drug as paracetamol; not for under-15s.

Pain, fever: Ibuprofen (イブプロフェン). Example product and dose on the box: EVE A: 150 mg per 2-tablet dose, up to 3 times a day, at least 4 hours apart. Also contains allylisopropylacetylurea (a sedative) and caffeine; not for under-15s; no driving after a dose.

Pain: Loxoprofen (ロキソプロフェン). Example product and dose on the box: Loxonin S: 60 mg, 1 tablet per dose, up to twice a day (a third dose is allowed if symptoms return), at least 4 hours apart. Class 1; not for under-15s.

Hay fever: Fexofenadine (フェキソフェナジン). Example product and dose on the box: Allegra FX: 60 mg, 1 tablet twice daily. Not for under-15s.

Hay fever: Loratadine (ロラタジン). Example product and dose on the box: Claritin EX: 10 mg, 1 tablet once a day after a meal. Class 2; not for under-15s.

Two things catch visitors out. First, Japanese OTC ibuprofen doses (150 mg per dose in EVE A) are lower than many UK and EU packs. Don't double up to match your usual dose; follow the Japanese box or ask the pharmacist. Second, many pain and cold products combine several ingredients, including sedatives and caffeine. Take one product at a time so you don't take the same ingredient twice, and don't drink alcohol with products that contain a sedative or antihistamine. Ibuprofen and loxoprofen are not suitable for everyone, and nor is acetaminophen: if you are pregnant, have had a stomach ulcer or have kidney problems, ask the pharmacist before taking any painkiller. If a painkiller or cold remedy has ever set off asthma, do not take any of the three; the leaflets for EVE A, Loxonin S and Tylenol A all say so.

Japan's revised Pharmaceuticals and Medical Devices Act created a category of abuse-prevention medicines (指定濫用防止医薬品). As of 13 February 2026, it covers oral products containing:

ephedrine, methylephedrine and pseudoephedrine (decongestants)

codeine and dihydrocodeine (cough suppressants)

dextromethorphan (cough suppressant)

diphenhydramine (antihistamine, also in sleep aids)

bromovalerylurea (sedative)

External-use products are excluded, and the ministry counts creams, patches, lozenges, nasal sprays and eye drops as external. Products whose main active ingredient is a herbal (crude-drug) one are also outside the category. Most "all-in-one" cold remedies (総合かぜ薬) contain at least one of these.

What it means for you:

A small pack is one that holds up to 7 days' doses for cold remedies, painkillers and fever reducers, and oral rhinitis (nasal allergy) medicines (5 days for other products). An adult can buy one after staff check age, other medicines and purchases elsewhere.

A large pack, or more than one pack, can only be bought face to face (or by live video), after staff check why you need it and whether you've bought it elsewhere.

People under 18 can't buy large packs or multiple packs, and staff check name and age.

These products are shelved out of reach or within sight of staff.

None of this stops a visitor buying a normal cold remedy. It does mean you will be asked a few questions, so have your symptoms ready in Japanese. Whether you can take these products home is a separate question: see what you can bring home from Japan.

You wake up in Osaka on day 4 with a sore throat, a temperature of 37.8°C and a blocked nose. Your partner has hay fever. It's 21:00 by the time you reach a drugstore.

Fever and sore throat: Acetaminophen (paracetamol) product, Tylenol A, 20 tablets. Class: Class 2. Price (tax incl.): ¥1,408. Days covered: 20 doses of 1 tablet; the leaflet says to stop and ask if no better after 5 or 6 doses.

Partner's hay fever: Allegra FX, 28 tablets. Class: Class 2. Price (tax incl.): ¥2,074. Days covered: 14 days.

Blocked nose: Menthol chest rub (Vicks VapoRub, 50 g) instead of a pseudoephedrine product. Class: Designated quasi-drug. Price (tax incl.): ¥1,320.

Fluids: Oral rehydration drink (OS-1), 500 ml × 2. Class: Food. Price (tax incl.): ¥428 (¥214 each). Days covered: 1 day.

Totals: ¥3,482 for the two medicines, ¥4,802 with the chest rub, and ¥5,230 including two oral rehydration drinks (Create SD online for Tylenol A and OS-1, Matsumoto Kiyoshi online for the others, checked 11 October 2026; store prices vary). Allegra FX works out at about ¥148 a day.

Why acetaminophen? It is the single ingredient the table above suggests for a sore throat and mild fever, and it has no sedative or caffeine. Why not EVE A (ibuprofen, ¥921 for 60 tablets)? It also contains a sedative and caffeine you don't need. Why not Loxonin S (¥767 for 12 tablets)? At 21:00 the pharmacist has often gone home, and Class 1 products can't be sold without one. Why not an all-in-one cold remedy? It would bring decongestants and cough suppressants you don't need. If the fever is no better after 5 or 6 doses (the limit on the Tylenol A leaflet, two days at three doses a day), or you feel worse at any point, stop self-treating and see a clinic.

Show, don't explain. Point to your symptom on the phrase card below and to the ingredient on the box.

AMDA International Medical Information Center: 0120-339-266 (or 03-6233-9266), Monday to Friday 10:00–16:00, closed on public holidays and 29 December–3 January. It can tell you where to find English-speaking clinics.

Tokyo "Himawari" medical information service: 03-5285-8181, 09:00–20:00 daily, English available. For finding clinics in Tokyo.

JNTO Japan Visitor Hotline: 050-3816-2787, 24 hours, English.

Phone translation apps work well at the counter; pharmacists are used to them.

I have a cold: 風邪をひきました. Reading: kaze o hikimashita.

I have a fever: 熱があります. Reading: netsu ga arimasu.

Sore throat: のどが痛いです. Reading: nodo ga itai desu.

Headache: 頭が痛いです. Reading: atama ga itai desu.

Diarrhoea: 下痢です. Reading: geri desu.

Hay fever: 花粉症です. Reading: kafunshō desu.

Something that doesn't make me drowsy: 眠くならない薬はありますか. Reading: nemuku naranai kusuri wa arimasu ka.

I'm taking this medicine: この薬を飲んでいます. Reading: kono kusuri o nonde imasu.

I'm pregnant: 妊娠しています. Reading: ninshin shite imasu.

Japanese medicine leaflets tell you when to stop and seek advice: the EVE A and Tylenol A leaflets say after 5 or 6 doses without improvement, the Loxonin S leaflet after 1 or 2. Get medical help rather than buying more if:

a fever is no better after the number of doses the leaflet allows, or is very high;

you have difficulty breathing, chest pain, a sudden or severe headache, a stiff neck, or confusion;

your face, lips or tongue swell, or a rash comes with breathing trouble after taking a medicine (call 119);

you can't keep fluids down, or there is blood in your stool or vomit;

a baby has a fever, or a child is getting worse (adult products are not for under-15s; ask a pharmacist before using a children's product);

you need antibiotics, an inhaler or anything prescription-only (no OTC route exists).

For "should I call an ambulance?" questions, Tokyo, Osaka and Kyoto all run #7119, mainly in Japanese. If it's an emergency, call 119. Both are explained in emergency numbers and visitor help. Check what your travel insurance covers before a clinic visit; most clinics want payment on the day.

1. Screenshot the phrase card above and the ingredient table, so you can show a pharmacist exactly what you need without searching while ill.

2. Save the drugstore nearest your hotel in Google Maps and note its closing time.

3. If you take a regular medicine, photograph its box or label so a pharmacist can read the active ingredient.

Who can sell Class 1: Pharmacist only, with written explanation.

Who can sell Class 2 and 3: Pharmacist or registered seller.

Abuse-prevention medicine rules start: 1 May 2026.

Designated ingredients: 8 (ephedrine, codeine, dihydrocodeine, diphenhydramine, dextromethorphan, pseudoephedrine, bromovalerylurea, methylephedrine), oral products (list as of 13 February 2026).

Small-pack limit: 7 days' doses (cold remedies, painkillers and fever reducers, oral rhinitis medicines); 5 days (others).

Under-18 rule: No large packs or multiple packs.

Claritin EX: Class 2; loratadine 10 mg; adults 15+, 1 tablet once a day after a meal.

#7119 coverage: 42 areas, including all of Tokyo, Osaka and Kyoto prefectures.

AMDA International Medical Information Center: 0120-339-266 (or 03-6233-9266), Mon–Fri 10:00–16:00, closed public holidays and 29 Dec–3 Jan.

Sources for this section: Sakai City, OTC medicine risk categories · Kagawa Prefecture, abuse-prevention medicine system · MHLW notice 医薬発1226第16号 (26 December 2025), sale of abuse-prevention medicines · Pharmaceuticals and Medical Devices Agency (PMDA), Claritin EX OTC record · Fire and Disaster Management Agency, #7119 implementation areas (checked 11 October 2026) · AMDA International Medical Information Center, telephone consultation

The rules in this guide come from the official pages below. Japan, Booked. does not book or submit requests on your behalf.

• Sakai City, OTC medicine risk categories
• Kagawa Prefecture, abuse-prevention medicine system
• MHLW notice 医薬発1226第16号 (26 December 2025), sale of abuse-prevention medicines
• Matsumoto Kiyoshi online, Loxonin S 12 tablets
• Matsumoto Kiyoshi online, Allegra FX 28 tablets
• Matsumoto Kiyoshi online, EVE A 60 tablets
• AMDA International Medical Information Center, telephone consultation
• Fire and Disaster Management Agency, #7119 implementation areas (checked 11 October 2026)
• Pharmaceuticals and Medical Devices Agency (PMDA), Claritin EX OTC record
• Matsumoto Kiyoshi online, Vicks VapoRub 50 g
• Create SD online, OS-1 500 ml
• Create SD online, Tylenol A 20 tablets (price and leaflet text)
• SSP, EVE A product page
• Daiichi Sankyo Healthcare, Loxonin S product page
• Johnson & Johnson, Tylenol A package leaflet (PDF)
• MHLW, scope of abuse-prevention medicines (external-use and crude-drug exclusions)
• e-Gov, Pharmaceuticals and Medical Devices Act, Article 36-9