Health Guide

Japan’s medication and customs rules are strict, they change without notice, and whether a specific medicine is allowed depends on its exact active ingredient, formulation, and quantity — not its brand name. Before you travel, relocate, or make any decision about a medication, verify it yourself against the official sources:

• MHLW — bringing medicines into Japan for personal use ↗
• Narcotics Control Department (NCD) — controlled substances
• Japan Customs ↗
• Your own embassy’s medication guidance for Japan

The rest of this guide explains each of these and what to do about them.

Japan separates prescribing from dispensing — a system called iyaku bungyō 医薬分業. Your doctor or hospital diagnoses you and writes a prescription; a licensed pharmacist at a separate pharmacy fills it. The clinic checks the diagnosis; the pharmacist independently checks for drug interactions, duplicate ingredients, and allergies. Hospitals and clinics generally do not dispense medicine on-site.

A 処方箋 is your paper prescription — the document that authorizes a pharmacy to dispense your medicine. You receive it after your consultation (Japan is also rolling out 電子処方箋, electronic prescriptions) and carry it to the pharmacy of your choice.

A standard prescription is valid for 4 days, including the day it’s issued. This is a national health-insurance rule, and the count is calendar days — weekends and public holidays are included. Miss the window and you must return to the doctor for a re-issue (usually another consultation and fee). A doctor can write a longer validity period on the form in special cases, such as upcoming travel — the pharmacy honors whatever is printed.

Traditionally each prescription is single-use — there’s no built-in “3 refills” as in the US. Since April 2022, Japan has offered refill prescriptions リフィル処方箋 for patients with stable chronic conditions, at the doctor’s discretion. One refill prescription can be reused up to 3 times. Narcotics, psychotropics, newly approved drugs, and medicated patches are excluded.

Japanese OTC drugs are labeled by risk class under the Pharmaceutical and Medical Devices Act, which determines who can sell them and whether they’re available online:

One recent change worth knowing: emergency contraception is now available OTC — see section 6.

According to Japan’s Narcotics Control Department, amphetamine and methamphetamine are controlled as “Stimulants” under the Stimulants Control Act and cannot be imported into Japan, even for medical treatment. In the NCD’s own words, amphetamine “cannot be imported into Japan, even for treatment purposes.” This includes:

• Adderall (amphetamine salts) and Dexedrine — common ADHD medications abroad, banned here.
• Heroin, cocaine, MDMA/ecstasy, opium.
• Cannabis / marijuana, including CBD products containing any THC. Japan does not recognize foreign or state-level legalization.
• Psilocybin.

Several over-the-counter products sold freely abroad contain ingredients restricted in Japan — chiefly pseudoephedrine and codeine. Per embassy and customs guidance (not a primary MHLW list, so confirm), flagged products include the “-D” decongestant formulations (Allegra-D, Claritin-D, Zyrtec-D — the pseudoephedrine versions), Sudafed, Actifed, Vicks inhalers, Tylenol Cold, NyQuil, Advil Cold & Sinus, and Lomotil. Pseudoephedrine is permitted only at low concentration (embassy sources cite 10% or less).

Note that the base antihistamine — fexofenadine (Allegra), loratadine (Claritin), cetirizine (Zyrtec) without the “-D” — is generally fine. The problem is the added decongestant, which is why checking the active ingredient, not the brand, matters so much.

The Yunyu Kakunin-sho 輸入確認書 — formerly and still commonly called the Yakkan Shoumei 薬監証明 — is an import certificate issued by MHLW. You apply for it before you travel and present it to the customs officer on arrival. It’s what lets you bring in more than the standard personal allowance, or certain restricted categories.

Exact allowances and category definitions are on the MHLW personal-import page.

Narcotics and “Stimulants’ Raw Materials” are handled by the Narcotics Control Department (NCD) on a different and stricter process — not the ordinary certificate desk. This covers drugs such as morphine, fentanyl, oxycodone, codeine, tapentadol (narcotics) and lisdexamfetamine / Vyvanse (a stimulant raw material). Key differences, per the NCD application guidance:

• Advance NCD permission is required regardless of quantity — there is no exemption threshold.
• Import by mail or via another person is prohibited — the patient must carry it personally.
• You’ll need a medical certificate issued within the last 3 months stating the specific medical reason (a generic “for personal use” is not accepted), a drug list with doses, the doctor’s signature, and packaging photos.
• Apply at least 14 days before travel to the NCD office covering your arrival airport.

(Note: tramadol is not classified as a narcotic in Japan.)

For many psychotropics, no doctor’s certificate or permit is needed at or below a set total amount (non-injectable forms). From the NCD’s official List of Psychotropics:

Some medications common elsewhere are not approved in Japan, are restricted, or are formulated differently, so an equivalent may not be a like-for-like swap. If you rely on a specific drug, plan the switch with a local doctor before you run out. Bring your medication list using generic (INN) names, not brand names, so a Japanese doctor can identify what’s available. A few examples that trip people up:

• ADHD stimulants: Adderall/amphetamine is banned (section 3). Available in Japan instead: methylphenidate (Concerta) — dispensed only through a government registration system for prescribers, pharmacies, and patients; atomoxetine (Strattera) and guanfacine (Intuniv), both non-stimulants; and lisdexamfetamine (Vyvanse), approved but tightly restricted and treated as a stimulant raw material for import.
• Antidepressants: Japan markets fewer antidepressants than many Western countries. SSRIs available include fluvoxamine, paroxetine, sertraline, and escitalopram; some (e.g. citalopram, fluoxetine) are not marketed here. Your specific molecule may not exist.
• Birth control: oral contraceptives are legal but not covered by insurance for contraception (self-pay). Emergency contraception is now OTC: since 2 February 2026, levonorgestrel EC (brand NorLevo, and a second product Lesoeru 72) is sold without a prescription at thousands of pharmacies, though it must be taken on-site in front of a trained pharmacist.
• EpiPen: available in Japan by prescription (often via allergy specialists or international clinics). A needle-free option, neffy (epinephrine nasal spray), was approved in September 2025. To bring an EpiPen from abroad, treat it as an injectable under the import rules and carry a prescription + doctor’s letter.

A fuller drug-availability guide — a direct crosswalk from common foreign medications to their Japanese equivalents — is in development and will be linked here when ready.

Japan has universal coverage. Residents not on an employer plan enroll in National Health Insurance 国民健康保険 at their city or ward office — generally within 14 days of moving or losing other coverage. What you pay for prescriptions (the patient co-payment):

At the pharmacy, present your insurance card (from 2026, this is transitioning to the My Number health card) and pay only your share of the government-regulated drug price. Choosing a brand-name drug when a generic exists can cost more out of pocket. The High-Cost Medical Expense benefit 高額療養費 caps your monthly out-of-pocket costs. OTC medicines bought without a prescription are not covered.

There’s no comprehensive official directory of English-speaking pharmacies, and language support is genuinely limited — which is exactly why we built the finder. It shows language support only where we’ve verified it, so what you see is what you actually get at the counter.