Private care and unapproved medicines.
What private care means here, and for medicines that aren’t approved in Japan or are used off-label: approval status, how we get them, approved alternatives, information from other countries, and the relief system.
1Private care
This service is private care (jiyū shinryō): public health insurance doesn’t apply, and you pay the full cost of treatment. A doctor sees you, decides whether treatment is suitable, and prescribes. The doctor may decide not to prescribe.
- Approved in Japan, used as approved: sildenafil, tadalafil and vardenafil (ED medicines), and finasteride and 5% topical minoxidil (AGA medicines), are each approved in Japan for their indications.
Costs (tax included) are shown on each treatment and medicine page.
2ED and PE: avanafil, dapoxetine and the combination pills
Approval status
Avanafil, dapoxetine, and the combination pills that contain them (sildenafil + dapoxetine, tadalafil + dapoxetine) are not approved in Japan.
How we get them
Under the doctor’s judgement, we use medicine obtained through import procedures.
Approved medicines in Japan
PDE5 inhibitors of the same kind (sildenafil, tadalafil, vardenafil) are approved in Japan for ED. No medicine with the same active ingredient as avanafil or dapoxetine is approved in Japan.
Safety and information from other countries
Avanafil is approved by the US FDA and the European EMA. Dapoxetine is approved in some countries, including in Europe, but not by the US FDA. The combination pills are not approved by the US FDA or the European EMA. See each medicine’s product information for details.
- Main side effects of ED medicines (PDE5 inhibitors): headache, flushing, indigestion, a blocked nose, dizziness. Never with nitrates.
- Main side effects of dapoxetine: nausea, dizziness, headache, diarrhoea, trouble sleeping, tiredness.
Relief System for Sufferers from Adverse Drug Reactions
Because they’re not approved in Japan, if serious harm to your health happens, Japan’s Relief System for Sufferers from Adverse Drug Reactions doesn’t cover it.
3Medical weight loss: Mounjaro, Rybelsus, Victoza and Wegovy
Approval status
Mounjaro (tirzepatide), Rybelsus (semaglutide) and Victoza (liraglutide) are approved in Japan to treat type 2 diabetes. Prescribing them for obesity or medical weight loss is not approved in Japan (off-label use). Wegovy (semaglutide) is approved in Japan to treat obesity disease.
How we get them
The doctors at the clinic that gives our consults buy them through medicine wholesalers in Japan.
Approved medicines in Japan
Medicines with the same active ingredient approved in Japan (for obesity disease): semaglutide as Wegovy, and tirzepatide as Zepbound. A liraglutide medicine for obesity is not approved in Japan.
Safety and information from other countries
GLP-1 and GIP/GLP-1 receptor agonists are approved by the US FDA, the European EMA and others. See each medicine’s product information for details.
- Main side effects: nausea, vomiting, diarrhoea, constipation, stomach pain, headache.
- Serious: a risk of pancreatitis. Not for anyone with a history of medullary thyroid cancer.
Relief System for Sufferers from Adverse Drug Reactions
Off-label use isn’t covered by Japan’s Relief System for Sufferers from Adverse Drug Reactions. For other medicines too, if a serious side effect happens, the relief system may not cover it.