Medicine guide
Bofutsushosan in Japan: Approved Uses, Limits and Safety
This guide to Bofutsushosan in Japan covers product-specific Kampo use, suitability and side effects. It separates medicine-specific information from the product and prescription checks needed for an individual consultation.
This page explains how Bofutsushosan works, its directions, limitations and safety. For prices and individual prescriptions, see SWIFT’s relevant care information.
Bofutsushosan is a Kampo medicine used for conditions including obesity in people with abundant abdominal subcutaneous fat who tend to be constipated. It is not a weight-loss medicine for every constitution, and Kampo medicines can also cause serious side effects. Follow the dose for the specific product.
Medical reviewer: Masashi Morita, MD
Bofutsushosan is a Kampo medicine used for conditions including obesity in people with abundant abdominal subcutaneous fat who tend to be constipated. It is not a weight-loss medicine for every constitution, and Kampo medicines can also cause serious side effects. Follow the dose for the specific product.
- Ingredient/class
- Bofutsushosan extract
- Eligible patients/indications
- The approved indications for Tsumura’s medical-use formulation include obesity, edema, constipation and symptoms associated with hypertension in people with abundant abdominal subcutaneous fat who tend to be constipated. It may not suit people prone to diarrhea, with a weak digestive system or with reduced physical strength.
- Assessing effects
- Bowel habits, abdominal symptoms and weight trends are assessed during consultation. Weight loss does not necessarily occur after a fixed number of days. Rather than continuing indefinitely, review with a doctor whether the indication and symptoms remain appropriate.
- Clinic care
- Service information supported by public sources is identified in the article. Final prescribing decisions are made during consultation.
What the medicine is
This formula combines several crude drugs. The pharmacology section of the prescribing information includes animal-study findings, but these do not guarantee fat burning in humans. Suitability is assessed in view of bowel habits and constitution.
Eligible patients and approved indications
The approved indications for Tsumura’s medical-use formulation include obesity, edema, constipation and symptoms associated with hypertension in people with abundant abdominal subcutaneous fat who tend to be constipated. It may not suit people prone to diarrhea, with a weak digestive system or with reduced physical strength.
Source: Medicine-specific primary documentation. The product used by the clinic is not assumed to be identical to the formulation in this documentation.
Treatment limitations and when diagnosis is needed
Weight loss without changing diet or activity cannot be promised. A temporary weight decrease after a bowel movement differs from a change in body fat. Do not continue long term without sufficient change or combine additional laxatives.
Formulations and basic directions
For Tsumura’s medical-use formulation, adults usually take a total of 7.5 g daily in 2–3 divided doses before or between meals. Extract amounts and doses differ by product. SWIFT’s manufacturer and sachet amount are unconfirmed; do not treat these numbers as clinic prescribing instructions. Check the explanation for your actual prescription.
Source: Medicine-specific primary documentation. The product used by the clinic is not assumed to be identical to the formulation in this documentation.
Do not take two doses together after a missed dose. Check the directions for your actual product and the doctor’s or pharmacist’s instructions, including when to skip a dose if the next dose is due soon.
Timing of response and decisions about continuation
Bowel habits, abdominal symptoms and weight trends are assessed during consultation. Weight loss does not necessarily occur after a fixed number of days. Rather than continuing indefinitely, review with a doctor whether the indication and symptoms remain appropriate.
Side effects and symptoms to watch for
Side effects include diarrhea, abdominal pain, nausea, palpitations and insomnia. Listed serious reactions include interstitial pneumonia, pseudoaldosteronism, myopathy, liver injury and mesenteric phlebosclerosis.
Source: Medicine-specific primary documentation. The product used by the clinic is not assumed to be identical to the formulation in this documentation.
When to stop and seek medical attention
Stop taking it and seek advice promptly for fever, cough, breathing difficulty, severe weakness or leg cramps, edema or jaundice. Also seek medical assessment for recurrent abdominal pain, diarrhea or constipation, or abdominal distension during long-term use.
Restrictions and interactions
Disclose heart or kidney disease, hypertension, hyperthyroidism, difficulty urinating and a tendency to diarrhea. Watch for duplication with other medicines containing licorice or glycyrrhizin, Kampo remedies containing ephedra, and ephedrine medicines.
Source: Medicine-specific primary documentation. The product used by the clinic is not assumed to be identical to the formulation in this documentation.
Because the formula contains licorice, blood pressure and blood potassium levels require attention. Low potassium can lead to muscle weakness, and blood tests may be performed during treatment. Tell the doctor or pharmacist about all Kampo remedies, OTC medicines and supplements you use so they can check for overlapping licorice or glycyrrhizin, ephedra or ephedrine, rhubarb and other ingredients.
Pregnancy, breastfeeding and patient precautions
The prescribing information for Tsumura’s medical-use granules advises that administration should preferably be avoided during pregnancy or possible pregnancy. Rhubarb and anhydrous sodium sulfate in the formula may increase the risk of miscarriage or preterm birth; tell the doctor before use. During breastfeeding, continuation or discontinuation of breastfeeding should be considered in light of the benefits of treatment and breast milk. Rhubarb-derived constituents can pass into breast milk and cause diarrhea in the infant; consult the doctor.
Additional care
Record diet, exercise and bowel habits, and do not continue taking enough to cause diarrhea. Do not add an over-the-counter Kampo remedy of the same name. Show the packaging, not just the medicine name, at the consultation.
Storage and quality checks
Store in a cool location away from moisture and direct sunlight. Color variations can occur in crude-drug products, but do not decide yourself to use a medicine that is damp or smells unusual.
Differences from other medicines and treatments
Rybelsus and Mounjaro belong to other medicine classes. Even when all are described as weight-loss medicines, approved indications, side effects and administration differ. OTC and medical-use Bofutsushosan may also differ in extract amounts and directions.
Bofutsushosan is available as medical-use formulations and over-the-counter products in Japan. For example, Tsumura’s medical-use granules are classified as a medicine other than a prescription-only medicine, while its OTC product is a Class 2 OTC medicine. The shared name does not make their extract amounts, directions or precautions interchangeable. For medicine supplied through a clinic, follow the instructions for the actual product and those of the doctor or pharmacist.
Discussing consultation and prescribing with SWIFT
SWIFT’s official medical weight-management page lists Bofutsushosan, 90 sachets for 1 month, at JPY 4,800 including tax. Confirm the manufacturer, amount per sachet and individual administration frequency during consultation.
Frequently asked questions
For Bofutsushosan, do Kampo medicines have no side effects?
Side effects occur. Breathing difficulty, edema or reduced muscle strength require medical assessment.
For Bofutsushosan, can I use it with an over-the-counter product?
Do not combine medicines with the same name or similar crude drugs. A pharmacist or doctor checks ingredient duplication.
For Bofutsushosan, can I use it if I am not constipated?
Eligibility depends on constitution and symptoms. Do not select it based only on weight; confirm suitability during consultation.
Medical supervision
Dr Masashi Morita (Board-certified specialist and supervising physician, Japanese Urological Association / Board-certified specialist, Japan Endocrine Society / Doctor of Medical Science).