Lessons from Visiting a Japanese Pharmacy

NOVEMBER 10, 2015
Who knew you could take tranexamic acid for cough and cold? That was one of the many interesting things I learned when visiting a Japanese pharmacy.
 
During a recent trip to Tokyo, I had the unfortunate experience of developing a bout of upper respiratory problems. I only brought some rudimental medications with me, so I ended up making a trip down to the nearest pharmacy with my wife, who is also a pharmacist.
 
We usually try to visit pharmacies when we’re out of the country just to check out their layouts and products, especially OTC ones. But in this case, I actually had in mind what products I wanted.
 
We got there around 8:00 pm their time, but the pharmacy was closed. So, no pharmacist.
 
“No problem,” we thought. “We can just look at the shelves.”
 
Then it hit us: the product layout is very different from ours. The products were intermingled, but there were layouts for different conditions, which we only figured out after noticing that the boxes had images with similar characteristics denoting gastrointestinal, pulmonary, pain, etc.
 
However, the biggest issue was the lack of drug names in English. None of the products we came across had them, although we could see milligram denotations of what was inside.
 
While looking for a product for my cough and cold, I quickly realized that none of the numbers were adding up to products that I thought were similar.
 
Exasperated, I finally approached the counter to ask for advice, and I was pleasantly surprised! The service member gave me a piece of paper with images of the body and symptoms for me to point at, after which she grabbed a few products off the shelves for me to look at.
 
I asked for several products such as pseudoephedrine and phenylephrine, but the staff seemed unsure even after speaking with a few individuals who could converse in English. So, in the end, I bought several boxes and took them back to our hotel.
 
My wife began to use Google Translate on our hotel’s WiFi to find out what the products contained while I looked up the drugs on Lexi-Comp and some other apps.
 
Suffice it to say we were really surprised.
 
Some of the ingredients I had never seen in cough and cold products before, including tranexamic acid. Other ingredients included lysozyme, dihydrocodeine phosphate, bromhexine hydrochloride, and ephedra.
 
I ended up taking something with several combinations of the aforementioned products (including a cough suppressant, mucolytic, analgesic, and antihistamine), and I slept very well to say the least. The one thing I noticed is that my throat felt quite well after taking the product and lacked the scratchiness and soreness I relate to after coughing so much.

Overall, my experience taught me that there are quite a number of OTC products used outside of the United States that have quite different indications than I am used to. For my own personal insights, I would like to look into these products more in the future and see what research is available for their uses.

Timothy Aungst, PharmD
Timothy Aungst, PharmD
Timothy Dy Aungst, PharmD, is an associate professor of pharmacy practice at MCPHS University. He graduated from Wilkes University Nesbitt School of Pharmacy and completed a PGY-1 Pharmacy Practice Residency at St. Luke's University Hospital, and then a Clinical Geriatric Fellowship at MCPHS University. He is passionate about the rise of technology in health care and its application to pharmacy. He has published primarily on the role of mobile technology and mHealth, and made multiple national and international presentations on those topics. He blogs at TheDigitalApothecary.com, and you can find him on Twitter @TDAungst.
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