Mounjaro® (tirzepatide)
Mounjaro® is a GLP-1/GIP receptor agonist given once a week. Along with suppressing rises in blood glucose, it suppresses appetite and also helps with weight loss.
How It Works
- It acts on the center in the brain that controls appetite, suppressing appetite.
- By suppressing the movement of the stomach, it helps you feel full more easily.
- It promotes insulin secretion only when blood glucose rises, stabilizing blood glucose levels.
How to Use & Dosage
Frequency
It is a subcutaneous injection given once a week. Inject it on the same day of the week every week.
Injection Sites
Inject it into the abdomen, thigh, upper arm or similar areas.
Dosage
Treatment starts at 2.5mg. You will first use this dose for 1 month (4 weeks).
If the effect is insufficient and you can use it comfortably without side effects, the dose can be increased in 2.5mg steps at intervals of at least 4 weeks, up to a maximum of 15mg.
If You Miss a Dose
If there are 72 hours or more until your next dose, inject it as soon as you notice. If there are less than 72 hours, skip that dose and resume on your next scheduled day.
How to Inject
- Take the pen out of the refrigerator before use.
- Wash your hands before use so that they are clean.
- Areas with plenty of subcutaneous fat, such as the abdomen or thighs, are good injection sites.
Shift the injection site slightly each time. Please be careful, as injecting into the same spot every time may cause the skin to harden or change color.
- Disinfect the injection site with the enclosed disinfectant swab.
- Take the pen out of its package and remove the gray cap by pulling it straight off.
- While keeping the clear base pressed firmly against your skin, unlock the pen by turning the green marker in the unlock direction until it stops.
- Press the injection button (purple) in until it “clicks”, and keep holding it down for a few seconds.
The first “click” means the injection has started, and a second “click” sounds when the medicine has finished being injected. If you cannot confirm this by sound, the injection is complete when you can see the gray plunger in the pen’s window.
Injection Video
Please watch it at the link below. (From the official website of Eli Lilly Japan K.K.)
For patients using Mounjaro® Subcutaneous Injection Ateos® (in Japanese) ↗
Storage & Handling
Always Store in the Refrigerator
To prevent the protein from denaturing, always store it in the refrigerator (2–8°C).
If a refrigerator cannot be used, it can be stored at room temperature for up to 21 days, away from direct sunlight and high temperatures.
Do not freeze it. If the medicine has been frozen, do not use it; dispose of it.
Disposal
Mounjaro® has a safety design in which the needle is retracted into the pen after use. Without touching the retracted needle, put the pen in a hard container with a secure lid (such as a milk carton or an empty medicine container), then put it in a garbage bag and dispose of it as burnable waste.
If you live near our clinic, we can also collect used pens at our clinic, so please feel free to ask us.
For details, please also see the link below.
Are you disposing of it correctly? Home medical care waste (in Japanese) ↗
Contraindications: Who Cannot Be Prescribed
If any of the following items apply to you, you cannot receive medical diet treatment using Mounjaro® (contraindication). Be sure to check for yourself that none of these items apply to you.
If it becomes clear during the consultation that an item applies to you, we will not be able to prescribe the medicine, but the consultation fee will still be charged. Please make sure to check thoroughly in advance.
1. History of Pancreatic Disease
- People who have had pancreatitis or another serious disease of the pancreas in the past.
2. Severe Digestive Disorders
- People with a severe gastrointestinal disorder (such as a gastric ulcer or inflammatory bowel disease).
- People who have had gastrectomy (stomach removal surgery).
3. Thyroid Disease
- People with a history of thyroid disease who are currently receiving oral medication for it.
4. Certain Conditions with a High Risk of Hypoglycemia
- People with a history of pituitary disease.
- People with a history of adrenal insufficiency.
5. Diabetes
- People who are currently diagnosed with diabetes.
(If you have been diagnosed with diabetes, please consult your attending physician about being prescribed Mounjaro®.)
6. Pregnancy & Breastfeeding
- People who are currently pregnant or breastfeeding.
- People planning to become pregnant within 2 months of starting treatment.
- People within 3 months after giving birth.
7. Nutritional Status & Body Build
- People with a BMI of 19 or below.
- People who are undernourished or underweight (too thin).
8. Age Restrictions
- People under 20 years of age.
- People aged 60 or over.
(For people aged 60 or over, physiological functions may have declined, and the risk of hypoglycemia is considered high when people without diabetes use Mounjaro®; for this reason, we decline to prescribe it.)
Side Effects
1. Gastrointestinal Symptoms
Gastrointestinal symptoms such as nausea, vomiting and diarrhea may occur. Caution is needed, as these side effects are especially likely when you first start using Mounjaro® or when the dose is increased. Constipation may also occur.
• Course and what to do:
In most cases, the symptoms improve on their own. However, if the symptoms continue for a long time, or are severe enough to interfere with daily life, stop using this medicine and consult our clinic.
To help prevent these symptoms, avoid high-fat meals such as fried foods, and once you feel full, do not force yourself to eat any more.
2. Hypoglycemia
Blood glucose may fall too low, which can bring on symptoms of hypoglycemia.
• Typical symptoms:
These include headache, fatigue, drowsiness, dizziness, unsteadiness, weakness in the arms and legs, palpitations, cold sweats and tremor (involuntary shaking of the hands and feet).
• What to do in an emergency:
If these symptoms appear, take sugar immediately (glucose, table sugar, juice, etc.). Great care is needed, because if hypoglycemia is left untreated, there is a risk of serious consequences such as loss of consciousness.
Amount needed: 10g of glucose, or a drink containing glucose (about 200mL of juice or a soft drink), or 20g of sugar (sugar cubes)
• Prevention:
- Try to eat three meals a day as usual.
- Avoid extreme carbohydrate restriction, as it increases the risk of hypoglycemic attacks.
- Excessive exercise and excessive drinking of alcohol can also trigger hypoglycemic attacks, so please avoid them.
3. Injection Site Pain
Because this medicine is given by subcutaneous injection, local reactions such as redness, swelling and pain may occur at the injection site. If these reactions keep recurring, stop using it.
4. Serious Digestive Disorders
• Acute pancreatitis:
Inflammation of the pancreas often causes severe, stabbing pain from the pit of the stomach (above the navel) through to the back, accompanied by strong nausea.
• Cholecystitis, cholangitis and gallstones:
These typically cause severe pain in the upper right abdomen (from the right side of the abdomen to the pit of the stomach).
• What to do:
If you suspect any of these conditions, stop using this medicine immediately and seek medical care promptly.
5. Allergic Reactions
• Anaphylaxis and angioedema:
These are severe allergic reactions in which symptoms such as difficulty breathing, a drop in blood pressure, redness all over the body, swelling (edema), itching and a feeling of tightness in the throat progress rapidly. (They occur extremely rarely.)
• What to do:
If you suspect an allergic reaction, stop using this medicine immediately and seek medical care promptly.
* If you have any concerns or questions while using this medicine, please contact our clinic.
In Japan, Mounjaro® is approved as a treatment for type 2 diabetes. The indication for obesity disease has been approved separately for Zepbound® (tirzepatide), which contains the same active ingredient. In our clinic’s diet treatment, it is used for the purpose of weight loss, so in the unlikely event that a serious side effect occurs, you will not be covered by Japan’s Relief System for Sufferers from Adverse Drug Reactions.
Frequently Asked Questions
Up to what dose (mg) of Mounjaro® can be prescribed?
We carry doses from 2.5mg to 15mg. We ask that first-time users always start at 2.5mg. If you are already using 5mg or another dose, we will prescribe an appropriate dose as needed if the doctor judges it to be medically appropriate based on the consultation.
To ensure your safety, please report your current use, any side effects, how long you have been using it and other details as accurately as possible when filling out the medical questionnaire and during the consultation.
How soon does Mounjaro® start to work?
Weight loss is often seen within 1–3 months of starting to use it. Even while using Mounjaro®, if the amount you eat does not change, you may not get the results you expect. Combining it with moderate exercise is also effective.
Extreme dietary restriction not only increases the risk of hypoglycemia, but can also lead to malnutrition resulting in osteoporosis, hair loss, lethargy, amenorrhea (loss of menstrual periods) and other problems, so you must never do it.
Are the medicines genuine products?
Yes, they are genuine products. We handle genuine products supplied by major pharmaceutical wholesalers in Japan.
Is the Mounjaro® injection painful?
Mounjaro® Ateos® uses an extra-fine needle, so it is less painful than ordinary injections. Holding the pen upright and pressing it firmly against the skin when injecting can reduce the pain.
You may feel pain if the medicine is cold, so let Mounjaro® come to room temperature before injecting it.
What should I do if an injection goes wrong?
If an injection goes wrong partway through, do not inject an additional pen, as this would be an overdose and make side effects more likely.
Should I stop using it when I have a health checkup?
Blood glucose may be measured lower than usual in blood tests and similar tests.
If you are scheduled for a gastroscopy (stomach camera), food may remain in the stomach at the time of the examination and affect the results, so we recommend suspending the injections 1 week before the examination.
(The package insert does not specify a period for suspending the medicine, but because it suppresses gastrointestinal motility, it is considered advisable to suspend it before the examination.)
* If you have any other concerns or questions, please contact our clinic.
Rybelsus® (oral semaglutide)
Rybelsus® is a GLP-1 receptor agonist taken by mouth. Along with improving blood glucose, it has an appetite-suppressing effect.
How It Works
- It acts on the center in the brain that controls appetite, suppressing appetite.
- By suppressing the movement of the stomach, it helps you feel full more easily.
- When blood glucose rises, it promotes insulin secretion from the pancreas, lowering blood glucose.
- It suppresses the secretion of a hormone called glucagon, reducing the release of glucose from the liver.
How to Use & Dosage
How to Take It
Take 1 tablet once a day, every day, in the morning after you wake up, on an empty stomach.
Take it with half a glass of water (120mL or less).
Do not eat or drink anything for 30 minutes after taking it.
Dosage
Treatment starts at 3mg. You will first use this dose for 1 month (4 weeks).
If the effect is insufficient and you can use it comfortably without side effects, the dose can be increased to 7mg after an interval of at least 4 weeks, and up to a maximum of 14mg.
Storage & Handling
The tablets absorb moisture very easily and are unstable in light, so do not take them out of the blister sheet; store them at room temperature (1–30°C).
Please be careful: if you cut the blister sheet, the medicine may be exposed to air and deteriorate.
Contraindications: Who Cannot Be Prescribed
If any of the following items apply to you, you cannot receive medical diet treatment using Rybelsus® (contraindication). Be sure to check for yourself that none of these items apply to you.
If it becomes clear during the consultation that an item applies to you, we will not be able to prescribe the medicine, but the consultation fee will still be charged. Please make sure to check thoroughly in advance.
1. History of Pancreatic Disease
- People who have had pancreatitis or another serious disease of the pancreas in the past.
2. Severe Digestive Disorders
- People with a severe gastrointestinal disorder (such as a gastric ulcer or inflammatory bowel disease).
- People who have had gastrectomy (stomach removal surgery).
3. Thyroid Disease
- People with a history of thyroid disease who are currently receiving oral medication for it.
4. Certain Conditions with a High Risk of Hypoglycemia
- People with a history of pituitary disease.
- People with a history of adrenal insufficiency.
5. Diabetes
- People who are currently diagnosed with diabetes.
(If you have been diagnosed with diabetes, this will affect your treatment, so please consult your attending physician about being prescribed Rybelsus®.)
6. Pregnancy & Breastfeeding
- People who are currently pregnant or breastfeeding.
- People planning to become pregnant within 2 months of starting treatment.
- People within 3 months after giving birth.
7. Nutritional Status & Body Build
- People with a BMI of 19 or below.
- People who are undernourished or underweight (too thin).
8. Age Restrictions
- People under 20 years of age.
- People aged 60 or over.
(For people aged 60 or over, physiological functions may have declined, and the risk of hypoglycemia is considered high when people without diabetes use Rybelsus®; for this reason, we decline to prescribe it.)
Side Effects
1. Gastrointestinal Symptoms
Gastrointestinal symptoms such as nausea, vomiting and diarrhea may occur. Caution is needed, as these side effects are especially likely when you first start using Rybelsus® or when the dose is increased. Constipation may also occur.
• Course and what to do:
In most cases, the symptoms improve on their own. However, if the symptoms continue for a long time, or are severe enough to interfere with daily life, stop using this medicine and consult our clinic.
To help prevent these symptoms, avoid high-fat meals such as fried foods, and once you feel full, do not force yourself to eat any more.
2. Hypoglycemia
Blood glucose may fall too low, which can bring on symptoms of hypoglycemia.
• Typical symptoms:
These include headache, fatigue, drowsiness, dizziness, unsteadiness, weakness in the arms and legs, palpitations, cold sweats and tremor (involuntary shaking of the hands and feet).
• What to do in an emergency:
If these symptoms appear, take sugar immediately (glucose, table sugar, juice, etc.). Great care is needed, because if hypoglycemia is left untreated, there is a risk of serious consequences such as loss of consciousness.
Amount needed: 10g of glucose, or a drink containing glucose (about 200mL of juice or a soft drink), or 20g of sugar (sugar cubes)
• Prevention:
- Try to eat three meals a day as usual.
- Avoid extreme carbohydrate restriction, as it increases the risk of hypoglycemic attacks.
- Excessive exercise and excessive drinking of alcohol can also trigger hypoglycemic attacks, so please avoid them.
3. Serious Digestive Disorders
• Acute pancreatitis:
Inflammation of the pancreas often causes severe, stabbing pain from the pit of the stomach (above the navel) through to the back, accompanied by strong nausea.
• Cholecystitis, cholangitis and gallstones:
These typically cause severe pain in the upper right abdomen (from the right side of the abdomen to the pit of the stomach).
• What to do:
If you suspect any of these conditions, stop using this medicine immediately and seek medical care promptly.
* If you have any concerns or questions while using this medicine, please contact our clinic.
In Japan, Rybelsus® is approved as a treatment for type 2 diabetes. In our clinic’s diet treatment, it is used for the purpose of weight loss, so in the unlikely event that a serious side effect occurs, you will not be covered by Japan’s Relief System for Sufferers from Adverse Drug Reactions.
Frequently Asked Questions
How soon does Rybelsus® start to work?
Weight loss is often seen within 1–3 months of starting to take it. Even while taking Rybelsus®, if the amount you eat does not change, you may not get the results you expect. Combining it with moderate exercise is also effective.
Extreme dietary restriction not only increases the risk of hypoglycemia, but can also lead to malnutrition resulting in osteoporosis, hair loss, lethargy, amenorrhea (loss of menstrual periods) and other problems, so you must never do it.
Are the medicines genuine products?
Yes, they are genuine products. We handle genuine products supplied by major pharmaceutical wholesalers in Japan.
Up to what dose (mg) of Rybelsus® can be prescribed?
We carry 3mg, 7mg and 14mg. We ask that first-time users always start at 3mg. If you are already using Rybelsus®, we will prescribe an appropriate dose as needed if the doctor judges it to be medically appropriate based on the consultation.
To ensure your safety, please report your current use, any side effects, how long you have been using it and other details as accurately as possible when filling out the medical questionnaire and during the consultation.
What should I do if I forget to take Rybelsus® in the morning?
Do not take it that day; take it the next morning instead. If you take it after a meal, the medicine will not be sufficiently absorbed from the stomach, and you will not get the intended effect.
Should I stop using it when I have a health checkup?
Blood glucose may be measured lower than usual in blood tests and similar tests.
If you are scheduled for a gastroscopy (stomach camera), food may remain in the stomach at the time of the examination and affect the results, so we recommend suspending the medicine from 1 week to 3 days before the examination.
(The package insert does not specify a period for suspending the medicine, but because it suppresses gastrointestinal motility, it is considered advisable to suspend it before the examination.)
* If you have any other concerns or questions, please contact our clinic.
Canaglu® (canagliflozin)
Canaglu® is an SGLT2 inhibitor, a medicine that lowers blood glucose by excreting excess glucose in the urine. Weight loss and lower blood pressure can also be expected.
How It Works
It blocks excess glucose that the kidneys would otherwise return to the body (blocking its reabsorption in the renal tubules), and excretes the excess glucose in the urine.
Unlike Rybelsus® and Mounjaro®, it lowers blood glucose without relying on insulin or similar hormones.
How to Use & Dosage
How to Take It
Take 1 tablet once a day, every day, before or after breakfast.
Dosage
Canaglu® comes in a single dose of 100mg. The dose cannot be increased.
Contraindications: Who Cannot Be Prescribed
If any of the following items apply to you, you cannot receive medical diet treatment using Canaglu® (contraindication). Be sure to check for yourself that none of these items apply to you.
If it becomes clear during the consultation that an item applies to you, we will not be able to prescribe the medicine, but the consultation fee will still be charged. Please make sure to check thoroughly in advance.
1. Diabetes
- People who are currently diagnosed with diabetes.
(If you have been diagnosed with diabetes, this will affect your treatment, so please consult your attending physician about being prescribed Canaglu®.)
2. People Receiving Treatment with Diuretics
- Chronic renal failure, heart failure, liver cirrhosis, etc.
(Using Canaglu® together with this treatment would affect the treatment, so we decline to prescribe it.)
3. People Who Have Been Told They Have Renal Failure
(Using Canaglu® together with this treatment would affect the treatment, so we decline to prescribe it.)
4. Certain Conditions with a High Risk of Hypoglycemia
- People with a history of pituitary disease.
- People with a history of adrenal insufficiency.
5. Pregnancy & Breastfeeding
- People who are currently pregnant or breastfeeding.
- People planning to become pregnant within 2 months of starting treatment.
- People within 3 months after giving birth.
6. Nutritional Status & Body Build
- People with a BMI of 19 or below.
- People who are undernourished or underweight (too thin).
7. Age Restrictions
- People under 20 years of age.
- People aged 60 or over.
(For people aged 60 or over, physiological functions may have declined, and the risk of hypoglycemia is considered high when people without diabetes use Canaglu®; for this reason, we decline to prescribe it.)
Side Effects
1. Hypoglycemia
Blood glucose may fall too low, which can bring on symptoms of hypoglycemia.
• Typical symptoms:
These include headache, fatigue, drowsiness, dizziness, unsteadiness, weakness in the arms and legs, palpitations, cold sweats and tremor (involuntary shaking of the hands and feet).
• What to do in an emergency:
If these symptoms appear, take sugar immediately (glucose, table sugar, juice, etc.). Great care is needed, because if hypoglycemia is left untreated, there is a risk of serious consequences such as loss of consciousness.
Amount needed: 10g of glucose, or a drink containing glucose (about 200mL of juice or a soft drink), or 20g of sugar (sugar cubes)
• Prevention:
- Try to eat three meals a day as usual.
- Avoid extreme carbohydrate restriction, as it increases the risk of hypoglycemic attacks.
- Excessive exercise and excessive drinking of alcohol can also trigger hypoglycemic attacks, so please avoid them.
2. Urinary Tract Infections
The risk of infections such as cystitis, pyelonephritis, skin infections of the external genitalia and perineum, and genital infections (candidiasis) increases. This is because glucose excreted in the urine makes it easier for bacteria, fungi and other microorganisms to grow.
• What to do:
If you have symptoms that suggest an infection, such as abnormalities of the urinary tract or genitals, or a fever, stop taking it immediately and seek medical care.
• Prevention:
Drink an appropriate amount of fluids and keep the genital area clean to help prevent urinary tract and genital infections.
3. Dehydration and Thrombosis Associated with Dehydration
Because of its diuretic effect, you may pass large amounts of urine and urinate frequently. The decrease in body fluid volume can lead to dehydration, so drink fluids appropriately. Also, when you are feeling unwell, have a fever or the like, the risk of dehydration is higher than usual, so please refrain from taking it. In addition, if you are taking the contraceptive pill, please be careful, as the risk of thrombosis increases with dehydration.
* If you have any concerns or questions while using this medicine, please contact our clinic.
In Japan, Canaglu® is approved as a treatment for type 2 diabetes and chronic kidney disease. In our clinic’s diet treatment, it is used for the purpose of weight loss, so in the unlikely event that a serious side effect occurs, you will not be covered by Japan’s Relief System for Sufferers from Adverse Drug Reactions.
Frequently Asked Questions
Are the medicines genuine products?
Yes, they are genuine products. We handle genuine products supplied by major pharmaceutical wholesalers in Japan.
What should I do if I forget to take Canaglu® in the morning?
You can also take it at a time other than the morning.
Should I stop using it when I have a health checkup?
Blood glucose may be measured lower than usual in blood tests and similar tests.
If you are scheduled for a urine test, Canaglu® will cause glucose to be detected in your urine, so please stop taking it at least 1 week before the test.
* If you have any other concerns or questions, please contact our clinic.
Bofutsushosan (Kampo herbal medicine)
A Kampo (traditional Japanese herbal) medicine used for people who tend to be overweight and have constipation. It is said to work by removing excess heat and fluid.
How It Works
Bofutsushosan is a Kampo medicine that is thought to expel “heat (hot flushes)”, “fluid” and “waste products” that have built up in the body, and to restore the body’s balance. It is mainly used for people who tend to be constipated and for people whose constitution makes them prone to gaining fat in the lower abdomen.
In Kampo medicine, one of the causes of symptoms such as obesity, swelling and constipation is thought to be poor flow (circulation) in the body, which causes excess heat and fluid to stagnate. Bofutsushosan combines multiple herbal ingredients (crude drugs) to produce the following effects.
① Removes excess heat and reduces inflammation
Herbal ingredients such as ephedra herb, gypsum and scutellaria root cool the heat trapped inside the body. This improves skin inflammation, hot flushes and similar symptoms.
② Regulates bowel movements and expels waste products
Ingredients such as rhubarb (daio) and sodium sulfate (bosho) increase the movement of the intestines and improve bowel movements. As constipation improves, waste products are expelled and the body feels lighter.
③ Expels excess fluid from the body
Herbal ingredients such as Japanese angelica root, peony root, cnidium rhizome and mentha herb (mint) regulate the body’s flow and help relieve swelling. Balancing the fluids in the body also improves metabolism.
④ Supports fat metabolism
Multiple herbal ingredients improve circulation throughout the body, creating a state in which fat burns more easily. It is sometimes used especially to improve a constitution that is prone to gaining fat around the abdomen.
The characteristic of Bofutsushosan is that these effects work together to expel excess substances from inside the body and regulate metabolism.
How to Use & Dosage
How to Take It
Take 1 packet 3 times a day, before each meal, every day.
Because side effects such as diarrhea may occur, start with 1 packet a day and gradually increase to a maximum of 3 packets a day.
Side Effects
1. Diarrhea, Nausea & Abdominal Pain
Due to the action of the herbal ingredients rhubarb and sodium sulfate, gastrointestinal movement becomes more active, which may cause diarrhea, nausea and abdominal pain.
If these symptoms appear, they often improve by reducing the amount or the number of doses.
2. Palpitations, Sweating & Insomnia
As a result of the sympathetic nervous system–stimulating action of the herbal ingredient ephedra herb, symptoms such as palpitations, sweating, mental excitement and insomnia may occur.
If such symptoms appear, stop taking it.
3. Hypokalemia
Due to the action of the herbal ingredient glycyrrhiza (licorice), the excretion of potassium, a type of mineral, from the body increases, which may cause hypokalemia (low blood potassium). Symptoms include weakness in the arms and legs, leg cramps and numbness in the hands and feet. If such symptoms appear, stop taking it immediately and seek medical care.
4. Hypertension
Due to the action of the herbal ingredient glycyrrhiza (licorice), blood pressure may rise in some people. If hypertension is suspected, stop taking it.
The following side effects occur extremely rarely, but they are important, so we would like you to be aware of these symptoms.
Liver Dysfunction
Changes in liver test values have been reported in rare cases, depending on long-term use or individual constitution.
If you have any of the following symptoms, see a doctor promptly.
- Severe fatigue, continued loss of appetite, yellowing of the skin or the whites of the eyes, dark-colored urine
Interstitial Pneumonia (Very Rare)
As with Kampo medicines in general, inflammation of the lungs may occur in extremely rare cases.
If the following symptoms appear, stop taking it immediately and seek medical care.
- Shortness of breath, difficulty breathing, a persistent cough, fever
This side effect is very rare and is not something that happens to most people.
* If you have any concerns or questions while using this medicine, please contact our clinic.
Frequently Asked Questions
When is the best time to take it?
It is recommended to take it before meals or between meals (2–3 hours after a meal). People with a weak stomach may take it after meals instead.
How long does it take to work?
It depends on your constitution, but bowel movements may change relatively quickly.
Improvements in constitution, such as how you gain fat, are evaluated over several weeks to several months.
My diarrhea won’t stop. What should I do?
Please stop taking it for now.
The ingredients that stimulate the intestines may be acting too strongly. Your dose needs to be adjusted, so please consult us.
What should I do if I forget to take a dose?
It is fine to take it when you remember, but avoid taking two doses in a row within a short time.
Will it cause drowsiness or make me feel unwell at work?
Increased intestinal movement may cause temporary fatigue.
If you feel very unwell, stop taking it.
Boiogito (Kampo herbal medicine)
Boiogito is a Kampo (traditional Japanese herbal) medicine that removes excess fluid that tends to build up in the body (swelling) and improves your physical condition while replenishing your strength.
It is used especially for people who sweat easily and tire easily, and for people whose constitution makes them prone to swelling in the lower body.
How It Works
Whereas Bofutsushosan, another Kampo medicine, is suited to “heat, fat and constipation”, Boiogito is used for constitutions centered on “reduced fluid metabolism”, “swelling” and “sluggishness”.
In Kampo medicine, one of the causes of symptoms such as obesity, swelling and constipation is thought to be poor flow (circulation) in the body, which causes excess heat and fluid to stagnate. Boiogito combines multiple herbal ingredients (crude drugs) to produce the following effects.
① Expels excess fluid that has built up in the body
Herbal ingredients such as sinomenium stem and atractylodes lancea rhizome (sojutsu) balance the fluids in the body and make it easier to expel excess fluid as sweat and urine. This reduces swelling in the hands, feet and lower body.
② Replenishes strength and makes you less prone to fatigue
Astragalus root (ogi) works to support the body from within and helps relieve tiredness and sluggishness. It is a Kampo medicine that is easy to use even for people who do not have much physical strength.
③ Regulates sweating and stabilizes your physical condition
In people whose constitution makes them sweat easily, more strength and fluid than necessary may be lost. Boiogito prevents the body from being worn down by regulating sweating.
The characteristic of Boiogito is that these effects work together to expel excess substances from inside the body and regulate metabolism.
How to Use & Dosage
How to Take It
Take 1 packet 3 times a day, before each meal, every day.
Because side effects such as stomach discomfort may occur, start with 1–2 packets a day and gradually increase to a maximum of 3 packets a day.
Side Effects
1. Stomach Discomfort & Loss of Appetite
In the early stages of taking it, you may feel heaviness in the stomach, an unsettled stomach, mild nausea or similar symptoms. If these symptoms appear, they often improve by reducing the amount or the number of doses.
2. Allergic Symptoms (Rare)
If symptoms such as a rash, redness or itching appear, stop using it.
3. Hypokalemia
Due to the action of the herbal ingredient glycyrrhiza (licorice), the excretion of potassium, a type of mineral, from the body increases, which may cause hypokalemia (low blood potassium). Symptoms include weakness in the arms and legs, leg cramps and numbness in the hands and feet. If such symptoms appear, stop taking it immediately and seek medical care.
The following side effects occur extremely rarely, but they are important, so we would like you to be aware of these symptoms.
Liver Dysfunction
Changes in liver test values have been reported in rare cases, depending on long-term use or individual constitution.
If you have any of the following symptoms, see a doctor promptly.
- Severe fatigue, continued loss of appetite, yellowing of the skin or the whites of the eyes, dark-colored urine
Interstitial Pneumonia (Very Rare)
As with Kampo medicines in general, inflammation of the lungs may occur in extremely rare cases.
If the following symptoms appear, stop taking it immediately and seek medical care.
- Shortness of breath, difficulty breathing, a persistent cough, fever
This side effect is very rare and is not something that happens to most people.
* If you have any concerns or questions while using this medicine, please contact our clinic.
Frequently Asked Questions
When is the best time to take it?
It is recommended to take it before meals or between meals (2–3 hours after a meal). People with a weak stomach may take it after meals instead.
How long does it take to work?
It depends on your constitution, but swelling may change relatively quickly.
Improvements in constitution are evaluated over several weeks to several months.
What should I do if I forget to take a dose?
It is fine to take it when you remember, but avoid taking two doses in a row within a short time.
Is it safe to take it for a long time?
In many cases, it can be continued as long as your physical condition is being monitored.
We recommend regular check-ups with a doctor.
* If you have any other concerns or questions, please contact our clinic.