Prescription and product checks
A doctor assesses the diagnosis, medical history and other medicines before prescribing. The information below does not guarantee eligibility, availability or a prescription. Detailed information for each medication appears in the companion articles.
A doctor assesses the diagnosis, medical history and other medicines before prescribing. The information below does not guarantee eligibility, availability or a prescription. Detailed information for each medication appears in the companion articles.
| Listed product | Quantity / conditions | Listed price (JPY) |
|---|---|---|
| Cinal | 90 tablets / 1 month | 1,400 |
| Juvela | 90 tablets / 1 month | 1,400 |
| Tathion (glutathione) | 1 tablet / minimum 10 tablets | 70 per tablet |
| Hythiol tablets 80 | 90 tablets / 1 month | 2,400 |
| Transamin (tranexamic acid) | 90 tablets / 1 month | 2,400 |
The clinic’s existing Japanese page lists the amounts below. Consultation fees, shipping and the tax treatment of these particular listings are not specified in that page; confirm the complete payable amount before booking. The listed month supply is a package description, not a personal dose instruction.
This product supplies ascorbic acid and calcium pantothenate. Each tablet contains 200 mg vitamin C and 3 mg calcium pantothenate. The name Cinal alone does not establish that its composition matches an over-the-counter product.
Approved indications include supplementation when vitamin requirements increase beyond what diet can provide, and post-inflammatory pigmentation. Do not group melasma, age spots and freckles together as an approved skin-lightening effect.
Source: Medicine-specific primary documentation. The product used by the clinic is not assumed to be identical to the formulation in this documentation.
Medical-use Cinal has approved indications including post-inflammatory pigmentation, but approval does not extend to every type of dark spot or cosmetic goal. If it is used outside the approved indications, discuss the limits of expected benefits, adverse effects and alternatives with a doctor. The care purpose determines whether Japanese health insurance can apply; confirm the conditions and fees during consultation.
Japan’s Relief System for Sufferers from Adverse Drug Reactions covers qualifying serious health harm that occurs despite appropriate use. Off-label use and other circumstances may fall outside coverage. Eligibility is assessed individually in light of the purpose and manner of use and medical and pharmaceutical knowledge; discuss this with the doctor and contact PMDA if needed.
The approved adult directions for the medical-use combination are 1–3 tablets per dose, 1–3 times daily, adjusted for age and symptoms. Check total intake including supplements and other vitamin products; do not increase the dose yourself.
Source: Medicine-specific primary documentation. The product used by the clinic is not assumed to be identical to the formulation in this documentation.
Side effects include stomach discomfort, nausea, vomiting and diarrhea. A vitamin medicine is not safe in unlimited amounts.
Source: Medicine-specific primary documentation. The product used by the clinic is not assumed to be identical to the formulation in this documentation.
It can affect tests such as urine glucose, urine occult blood and fecal occult blood, making actual abnormalities harder to detect. Disclose use before a health check or test. Also check overlapping supplements and medical history.
Source: Medicine-specific primary documentation. The product used by the clinic is not assumed to be identical to the formulation in this documentation.
Vitamin supplementation during pregnancy and breastfeeding is included among approved indications, but this does not permit self-increasing the dose for cosmetic purposes. Discuss the dose and need during pregnancy with a doctor.
As vitamin E, the ingredient participates in processes such as lipid oxidation. Antioxidant activity alone does not clinically guarantee prevention of aging or whole-body skin lightening.
Approved indications are prevention and treatment of vitamin E deficiency, peripheral circulatory disorders and prevention of increased lipid peroxides. Do not present cosmetic use as approved dark-spot treatment in the prescribing information.
Source: Medicine-specific primary documentation. The product used by the clinic is not assumed to be identical to the formulation in this documentation.
Using Juvela Tablets 50 mg for cosmetic goals such as dark spots or skin lightening is off-label in Japan. Distinguish this from approved treatment of deficiency or peripheral circulatory disorders, and discuss limits of expected benefits, adverse effects and alternatives with a doctor. SWIFT’s cosmetic-care information concerns self-pay care.
Japan’s Relief System for Sufferers from Adverse Drug Reactions covers qualifying serious health harm that occurs despite appropriate use. Off-label use and other circumstances may fall outside coverage. Eligibility is assessed individually in light of the purpose and manner of use and medical and pharmaceutical knowledge; discuss this with the doctor and contact PMDA if needed.
Approved adult directions are 50–100 mg per dose, 2–3 times daily, adjusted for symptoms and other factors. Juvela N is a different vitamin E derivative; do not transfer the tablet count. Check total intake including supplements.
Source: Medicine-specific primary documentation. The product used by the clinic is not assumed to be identical to the formulation in this documentation.
Constipation, stomach discomfort, diarrhea and rash may occur. Seek advice for persistent troublesome symptoms.
Source: Medicine-specific primary documentation. The product used by the clinic is not assumed to be identical to the formulation in this documentation.
Disclose medicines and supplements, including anticoagulants and other vitamin E products. Few listed serious interactions do not guarantee that there are no interaction problems.
Source: Medicine-specific primary documentation. The product used by the clinic is not assumed to be identical to the formulation in this documentation.
During pregnancy or breastfeeding, discuss the need for supplementation with a doctor. For breastfeeding, the prescribing information advises considering the benefits of treatment and breast milk.
Glutathione occurs in the body and participates in redox and enzyme reactions. These physiological actions alone cannot guarantee clinical effects such as lighter skin or relief of fatigue.
Approved indications for the oral formulation include drug poisoning, metal poisoning, cyclic vomiting, hyperemesis gravidarum and hypertensive disorders of pregnancy. Cosmetic skin-lightening and anti-aging purposes must be distinguished from these indications.
Source: Medicine-specific primary documentation. The product used by the clinic is not assumed to be identical to the formulation in this documentation.
Japan’s Relief System for Sufferers from Adverse Drug Reactions covers qualifying serious health harm that occurs despite appropriate use. Off-label use and other circumstances may fall outside coverage. Eligibility is assessed individually in light of the purpose and manner of use and medical and pharmaceutical knowledge; discuss this with the doctor and contact PMDA if needed.
Approved adult directions are 50–100 mg per dose, 1–3 times daily, adjusted for age and symptoms. Amounts differ between 50 mg tablets, 100 mg tablets and powder. Do not infer content from the clinic’s per-tablet price; check the prescribed formulation and dose.
Source: Medicine-specific primary documentation. The product used by the clinic is not assumed to be identical to the formulation in this documentation.
Rash and gastrointestinal symptoms have been reported. Check the actual product’s prescribing information and changes after taking it; oral use does not mean there are no side effects.
Source: Medicine-specific primary documentation. The product used by the clinic is not assumed to be identical to the formulation in this documentation.
Disclose supplements, other oral cosmetic medicines and treatment medicines. Indications concerning poisoning or pregnancy do not mean that you can identify the cause and treat yourself.
Source: Medicine-specific primary documentation. The product used by the clinic is not assumed to be identical to the formulation in this documentation.
Pregnancy-related approved indications do not provide a blanket guarantee that cosmetic use is safe. Continuing breastfeeding also requires consideration of benefits of treatment and breast milk; consult a doctor.
L-cysteine has metabolic actions involving SH groups and is used in medical-use formulations for skin disorders and other conditions. Each medical-use Hythiol Tablet 80 contains 80 mg; distinguish it from over-the-counter vitamin combination products.
The Japanese prescribing information lists eczema, toxic eruptions, drug eruptions, urticaria, acne vulgaris, erythema multiforme and leukopenia caused by radiation injury. Dark spots and whole-body skin lightening are not approved indications of this medical-use formulation.
Source: Medicine-specific primary documentation. The product used by the clinic is not assumed to be identical to the formulation in this documentation.
Using medical-use Hythiol for cosmetic goals such as dark spots or skin lightening is off-label in Japan. Distinguish this from its approved skin-disease and other indications and from the indications of OTC combination products. Discuss the limits of expected benefits, adverse effects and alternatives with a doctor. SWIFT’s cosmetic-care information concerns self-pay care.
Japan’s Relief System for Sufferers from Adverse Drug Reactions covers qualifying serious health harm that occurs despite appropriate use. Off-label use and other circumstances may fall outside coverage. Eligibility is assessed individually in light of the purpose and manner of use and medical and pharmaceutical knowledge; discuss this with the doctor and contact PMDA if needed.
Approved adult directions for skin disorders are 80 mg per dose, 2–3 times daily. This means two Tablet 40 tablets or one Tablet 80 tablet. Directions for radiation injury differ; do not transfer high doses to routine cosmetic use.
Source: Medicine-specific primary documentation. The product used by the clinic is not assumed to be identical to the formulation in this documentation.
Listed reactions include nausea, diarrhea, dry mouth and mild abdominal pain. Check frequencies and types of adverse reactions in the actual product’s prescribing information.
Source: Medicine-specific primary documentation. The product used by the clinic is not assumed to be identical to the formulation in this documentation.
Disclose ingredients in other oral cosmetic medicines and supplements to check for duplicated L-cysteine or vitamins. In older people, doses require attention in view of declining physiological function.
Source: Medicine-specific primary documentation. The product used by the clinic is not assumed to be identical to the formulation in this documentation.
This prescribing information alone does not establish safety for cosmetic use during pregnancy or breastfeeding. Discuss the need and dose with a doctor.
Tranexamic acid inhibits plasmin activity and reduces the breakdown of fibrin, which is involved in blood clotting. Transamin is indicated for certain bleeding conditions, symptoms associated with conditions such as eczema, symptoms of tonsillitis and pharyngolaryngitis, and stomatitis. This explanation is not an instruction to self-treat bleeding or a sore throat without establishing the cause. PMDA: Transamin prescribing information, sections 4 and 18
Prescribing Transamin for melasma falls outside its approved indications in Japan. At our clinic, the doctor assesses your skin and medical history before deciding. Not every area of pigmentation that you regard as a “dark spot” is melasma, so treatment should not be chosen by a medicine's name alone.
Clinical studies have examined its use for melasma. A double-blind randomized controlled trial at a single center outside Japan enrolled 44 people with moderate-to-severe melasma; 39 completed the trial. Both groups used sunscreen and took either tranexamic acid or placebo for 3 months. The tranexamic acid group showed a greater improvement in the modified Melasma Area and Severity Index (mMASI). Del Rosario et al.: randomized trial in melasma
However, this was a small study, and most participants were Hispanic women. The findings cannot be assumed to apply to every type of pigmentation or every person, and the study was not large enough to adequately assess rare adverse events. These results do not mean that the treatment is approved for melasma in Japan or that the same effects have been established for the product and dose used at our clinic. They should inform a discussion with a doctor about expectations and risks after a skin assessment and review of your medical history.
Transino EX is an OTC combination medicine containing tranexamic acid that is approved in Japan for melasma, a specific type of pigmentation. However, its combination of ingredients and directions differ from medical-use Transamin. The indications or treatment duration for an OTC product cannot simply be applied to a medical-use single-ingredient medicine. Manufacturer: Transino EX package insert / Product information
Japan’s Relief System for Sufferers from Adverse Drug Reactions covers qualifying serious health harm that occurs despite appropriate use. Off-label use and other circumstances may fall outside coverage. Eligibility is assessed individually in light of the purpose and manner of use and medical and pharmaceutical knowledge; discuss this with the doctor and contact PMDA if needed.
Treatment choices depend on whether uneven facial pigmentation is melasma or another type of dark spot. Even when research on tranexamic acid concerns melasma, the same findings cannot automatically be applied to sun spots, freckles or acne marks.
At your consultation, explain when you first noticed the changes, where they are, how they have developed, and any medicines or procedures you have tried. Photographs or video may not provide enough information, and an in-person examination may be needed. American Academy of Dermatology: melasma diagnosis and treatment
Check the strength of your prescribed product and follow your doctor's instructions. Different products may contain different amounts of the active ingredient even when described as “one tablet.” Also check your own prescription and dispensing label for how often and when to take it.
Do not treat the dose for an approved indication as a standard dose for melasma, or calculate and increase the number of tablets yourself. Transamin prescribing information, section 6
Some studies of oral treatment for melasma have compared changes after 3 months. This is a study assessment point, not a recommendation that everyone take the medicine for the same duration or a promise that it will work within that time.
The same trial also followed participants for another 3 months after the tablets were stopped, during which they used sunscreen alone. The degree of improvement changed after treatment ended; once pigmentation lightens, it does not necessarily stay that way indefinitely. Del Rosario et al.: randomized trial
Review whether to continue with your doctor, considering not only skin changes but also how you feel during treatment and any newly started medicines. If improvement is limited, reassess the diagnosis of melasma and the combination of treatments before increasing the medicine. Even if your skin improves, discuss why treatment should continue and when the next review should take place.
Do not apply the usage period of an OTC melasma medicine directly to medical-use Transamin. Avoid assuming that a medical-use product is “safe for any number of months” or “must always be taken for this exact period”; check the instructions for your own prescription.
Melasma treatment involves protection from sunlight as well as medication. Alongside sunscreen, combine measures such as wearing a hat and seeking shade. Taking tranexamic acid does not replace sunscreen. American Academy of Dermatology: melasma treatment and sun protection
If sunscreen or a topical medicine irritates your skin, consult your doctor instead of forcing yourself to continue using it. Choose care suitable for your skin and review it together with your response to treatment.
Possible side effects include loss of appetite, nausea, vomiting, diarrhea, heartburn, rash, itching and drowsiness. People receiving hemodialysis require particular attention to seizures, a serious adverse effect.
In people with a blood clot or a risk of thrombosis, the medicine may stabilize a clot. Always tell the doctor if you have previously been diagnosed with cerebral thrombosis, myocardial infarction or thrombophlebitis, or if you have been confined to bed for a prolonged period after surgery. Transamin prescribing information, sections 9 and 11
Transamin must not be used together with thrombin because the combination can increase the tendency to form blood clots. Tell the doctor about every medicine you use, including hemostatic medicines; certain other clotting-related medicines also require caution. Kidney impairment may raise blood concentrations, so disclose kidney disease or dialysis before treatment.
During pregnancy, Transamin is used only if the doctor judges that the expected benefit outweighs the risk. During breastfeeding, whether to continue breastfeeding should be considered in light of the benefits of treatment and breast milk. Do not start or continue it for cosmetic purposes without discussing these circumstances with the doctor.
If you suddenly develop difficulty breathing or severe chest pain, or your lips, tongue or throat suddenly swell while taking the medicine, seek emergency care without waiting for a routine online appointment. In Japan, call 119 for an ambulance. These symptoms require urgent assessment for possible blood clots, severe allergy or other causes.
Also seek prompt medical advice if you develop pain, swelling or redness in a limb on one side, or changes in your vision. Tell the clinician the medicine's name and how you have been taking it, and ask what to do about your next dose. NHS: side effects of tranexamic acid and when to seek help
Even if symptoms seem mild, contact the prescriber if a rash, nausea or other symptoms persist. Do not keep taking it while simply putting up with symptoms, or increase the dose yourself.
No. A doctor checks the diagnosis, other medicines and contraindications. A prescription may not be suitable.
Use the listed product fee as a reference and confirm consultation, shipping and other applicable conditions before booking.
Read the medication-specific sections on this page and the companion articles. Medical benefits and adverse effects vary between products.
