Allergy Medicine in Japan: What Actually Works for Kafunsho

Sorting out allergy medicine in Japan comes down to one distinction: plain versus combo. Fexofenadine (Allegra), loratadine (Claritin), and cetirizine (Zyrtec) without the -D are generally fine to bring, and Tokyo drugstores sell comparable antihistamines over the counter once you're here. The -D versions are not - they add pseudoephedrine, a decongestant Japan permits only at low concentration (embassy sources cite 10 percent or less), and most -D combo formulas exceed that. If OTC antihistamines don't control your hay fever during kafunsho (花粉症), prescription-strength options exist, but only through a clinic and a dispensing pharmacy.

The antihistamine isn't the problem - pseudoephedrine is. Japan permits it only at low concentration, and embassy and customs guidance flags several combo products as risky: Sudafed, Actifed, Vicks inhalers, Tylenol Cold, NyQuil, Advil Cold and Sinus, Lomotil, and the -D versions of Allegra, Claritin, and Zyrtec. That's reported guidance from secondary sources, not one official list, so confirm anything you're unsure about.

Plain fexofenadine, loratadine, and cetirizine are OTC drugs, and Japan's personal import allowance for OTC drugs, quasi-drugs, and vitamins runs up to a 2-month supply without an import certificate - enough for most travelers across a full pollen season. If your allergist has you on something prescription-only, the allowance drops to a 1-month supply. Either way, carry a copy of the prescription and a doctor's letter; customs can ask.

Once you're in Japan, comparable antihistamines are sold over the counter at drugstores (ドラッグストア), sorted under Japan's OTC classification system by how much pharmacist involvement each item requires. A pharmacist or registered seller at the counter can point you toward something for kafunsho symptoms; ask if you're unsure what maps to what you took at home.

Drugstores are retail - OTC, cosmetics, daily goods - separate from dispensing pharmacies (調剤薬局), which fill prescriptions and are staffed by licensed pharmacists (薬剤師). Some larger drugstores have a dispensing counter; many don't. If OTC antihistamines aren't controlling your symptoms, that's a doctor's visit, not a stronger purchase off the shelf - Japan's free-access system means you can go straight to a clinic or allergist without a referral. Use the pharmacy finder to check which nearby locations have verified English support and confirm hours before you go.

Allergy medicine is one piece of the picture if you're new to Japan. For other categories with their own rules, see getting birth control in Japan, emergency contraception in Japan, and ADHD treatment in Japan. For the fuller reference on import rules and the system generally, the health guide and moving to Japan guide go deeper.