Cold medicine in Japan: what's on the drugstore shelf, and what to check before you take it
By Natsuko Shibata, pharmacist licensed in Japan · Updated 2026-10-07
The short version
- Most Japanese cold medicines are all-in-one combinations (総合感冒薬, sogo kanboyaku): a pain and fever reliever, a cough suppressant, an antihistamine, a decongestant and caffeine in one tablet.
- That means the main risk isn't picking the "wrong" box. It's taking a second medicine on top of it, such as the Tylenol or Advil you brought from home.
- Almost all of them cause drowsiness, and the label tells you not to drive.
- You don't need to read Japanese to choose well. Tell the pharmacist or registered seller your main symptom and what else you take. That is what they're there for.
- Everything below is as of October 2026. Formulas and packaging change; the box and its leaflet are always the final word.
Why the shelf looks different from home
In the US or Europe you can often buy single-ingredient products and combine them yourself. In Japan the default is the combination product. A typical box contains five to nine active ingredients:
- A pain and fever reliever: acetaminophen, ibuprofen, or both
- A cough suppressant: often dihydrocodeine, a codeine-type ingredient
- An antihistamine: usually an older, sedating one such as chlorpheniramine or clemastine
- A decongestant/bronchodilator: dl-methylephedrine
- An expectorant, caffeine, and a vitamin or two
Japan does not sell high-dose pseudoephedrine tablets like original Sudafed. If you were planning to bring your own, read Can I bring Sudafed to Japan? first.
Reading the risk class on the box
Every over-the-counter medicine carries one of these marks:
| On the box | What it means in the shop |
|---|---|
| 第1類医薬品 (Class 1) | Kept behind the counter. Sold only by a pharmacist, who must explain it. |
| 指定第2類医薬品 (Designated Class 2; the "2" is printed inside a circle or box) | Sold by a pharmacist or registered seller, shelved near the counter. Most combination cold medicines are here. |
| 第2類医薬品 (Class 2) | Open shelf. Most Kampo cold formulas and single-ingredient acetaminophen. |
| 第3類医薬品 (Class 3) | Open shelf. Throat powders, lozenges, vitamins. |
If a shop has no pharmacist on duty at that hour, the Class 1 shelf is closed. Cold medicines are still available.
Common brands, by the symptom on the box
These are the names you will see most often. I am describing what the manufacturers label them for, not ranking them. Each line also comes in "Premium", "DX" or "EX" versions with different formulas, so check the ingredient panel of the exact box in your hand.
Pabron Gold A (パブロンゴールドA) — general
Taisho's household all-rounder, in tablets or fine granules. Acetaminophen-based, with dihydrocodeine, dl-methylephedrine, chlorpheniramine, guaifenesin and caffeine. Not for children under 12.
Lulu Attack (ルルアタック) — by letter
Daiichi Sankyo Healthcare's ibuprofen-based line. All are for age 15 and over.
- EX: labeled for colds with sore throat. Ibuprofen plus tranexamic acid.
- NX: labeled for colds with runny or blocked nose.
- CX: labeled for colds with cough and phlegm.
Even the "throat" version is still a full combination product: it also contains a cough suppressant and a sedating antihistamine.
Benza Block (ベンザブロック) — by color
Alinamin Pharmaceutical color-codes the range, which helps if you can't read the box:
- Yellow (S): colds that start in the nose
- Silver (L): colds that start in the throat
- Blue (IP): colds that start with fever and chills
- Green (T): colds that start with a cough (newer Premium DX line)
Yellow is acetaminophen-based. Silver and blue contain ibuprofen; some blue versions contain ibuprofen and acetaminophen together. All are for age 15 and over.
Single-symptom options
- Tylenol A (タイレノールA): acetaminophen only, 300 mg per tablet, age 15 and over. No antihistamine, so no drowsiness from that source.
- Ryukakusan Direct (龍角散ダイレクト): a Class 3 herbal throat powder in stick packs, taken without water. Labeled for cough, phlegm and throat discomfort, from age 3 with a reduced amount.
Four things to check before you take anything
1. Don't double up
A combination cold medicine already contains a pain and fever reliever. Adding Tylenol, Advil, DayQuil, NyQuil or a second Japanese product on top means two doses of the same kind of ingredient. Too much acetaminophen harms the liver; stacked ibuprofen-type medicines are hard on the stomach and kidneys.
The leaflets say this directly: while taking the product, do not take other cold medicines, pain and fever relievers, cough medicines, or antihistamine-containing medicines (including allergy and motion-sickness tablets).
2. Expect drowsiness, and don't drive
The antihistamines used are the older, sedating kind. The standard label warning is not to drive or operate machinery after taking the medicine. If you have a rental car booked, plan around this.
Avoid alcohol while taking them. Most leaflets say so.
3. Age limits are strict
Since 2019, Japan has not allowed codeine-type cough suppressants (codeine, dihydrocodeine) for children under 12, and many adult boxes set the minimum at 15. Don't split an adult tablet for a child. Children's cold products exist and are labeled by age; ask at the counter with the child's age ready.
4. Some people should ask first
Ask the pharmacist, or a doctor, before buying if you are pregnant or breastfeeding, or if you have asthma, high blood pressure, heart disease, a thyroid condition, glaucoma, or difficulty urinating. The same applies if you take prescription medicines every day. Several of these are listed on the leaflets as "consult before use", and some products exclude late pregnancy outright.
A note on taking boxes home. Codeine-type and ephedrine-type ingredients are controlled differently from country to country. Check your own country's rules before you pack extra boxes as souvenirs; I can't confirm them for you from here.
Kampo cold formulas
Kampo formulas sold in drugstores are approved medicines, not supplements. They carry the same class marks and leaflets. Most are Class 2, in single-dose granule packs from makers such as Tsumura, Kracie and Kotaro. They are usually taken before or between meals with water or warm water.
How they are traditionally matched to a cold, and what the labels say:
- Kakkonto (葛根湯): the early stage of a cold, when you feel chilled and stiff across the neck and shoulders and are not yet sweating. Labeled for people of moderate or stronger constitution.
- Ginkyosan (銀翹散): a cold with sore throat, thirst, cough or headache.
- Bakumondoto (麦門冬湯): a dry cough with phlegm that is hard to bring up, or a dry throat. Often chosen for the cough that lingers after the cold.
Two cautions. "Herbal" does not mean "free to combine": kakkonto contains ephedra herb (mao) and licorice, so taking it together with a combination cold medicine stacks ephedrine-type ingredients, and people with high blood pressure, heart or thyroid conditions are told to consult first. And these formulas are matched to a pattern of symptoms, so the right one changes as the cold changes.
For when Kampo is not the right tool at all, see When not to use Kampo.
At the counter
You can show these on your phone. More are on the scripts page.
| English | Japanese |
|---|---|
| I have a sore throat / fever / cough / runny nose. | のどが痛いです／熱があります／せきが出ます／鼻水が出ます。 |
| I am already taking this medicine. Can I take a cold medicine with it? | この薬を飲んでいます。かぜ薬を一緒に飲めますか？ |
| Is there one that doesn't cause drowsiness? | 眠くならない薬はありますか？ |
| It's for a child. They are ___ years old. | 子ども用です。___歳です。 |
On the back of the box: 1回2錠 means 2 tablets per dose, 1日3回 means 3 times a day, 食後 after meals, 食前 before meals, 食間 between meals (about two hours after eating, not during the meal).
When to skip the drugstore
Over-the-counter cold medicine is for ordinary colds. See a doctor instead if:
- you have a sudden high fever with body aches (influenza and COVID-19 treatments are prescription-only, and work best started early)
- you are short of breath, wheezing, or have chest pain
- you can't swallow liquids
- you have taken a cold medicine as directed for several days without improvement (most leaflets set a limit of about five days)
- a rash, swelling or breathing difficulty appears after a dose: stop taking it
Antibiotics are prescription-only in Japan. No drugstore can sell them to you.
For an ordinary illness, go to a local internal medicine clinic (内科, naika), not a large hospital. Large hospitals charge an extra fee of ¥7,000 or more for a first visit without a referral letter. The Japan National Tourism Organization keeps a searchable list of medical institutions and runs a 24-hour visitor hotline in English, Chinese and Korean: 050-3816-2787. In an emergency, call 119 for an ambulance.
Official sources
- PMDA: search for over-the-counter medicine leaflets (Japanese) — the package inserts for every product named above
- Alinamin Pharmaceutical: Benza Block product information in English
- Ministry of Health, Labour and Welfare: restriction of codeine-type ingredients in children under 12 (2019)
- Japan National Tourism Organization: guide for when you are feeling ill
Not sure what you can take with your own medicines?
If you already take prescription medicines and want to know what is safe to add from a Japanese drugstore, you can ask in English and get a written answer from a pharmacist licensed in Japan.
I am a pharmacist. I cannot diagnose you or tell you to stop a medicine your doctor has prescribed.