The Medication Record Book (Okusuri Techo)

Okusuri techo is Japan's free medication notebook that pharmacies update at every prescription fill.¹ It keeps your drug history in one portable place so any pharmacist can check for interactions before dispensing something new.¹²

Confirm current details with official sources

Procedures, fees, and requirements can change. Confirm current details at the Ministry of Health, Labour and Welfare (MHLW) site. This article is general information, not medical advice; for your specific case, consult a licensed physician or pharmacist.

Overview

The お薬手帳 (okusuri techō, "medication notebook") is a patient-carried record of prescription history in paper or app form.¹³⁴ A dispensing pharmacy issues it free at the first fill and updates it free after that, with no referral or prior enrollment needed.¹⁵

It works at any licensed dispensing pharmacy in Japan, not only the one that issued it.¹⁵ That portability is the point, because prescribing and dispensing are separated and patients may fill prescriptions at different pharmacies over time.²¹⁶

The system traces back to a 1994 drug interaction accident in which sorivudine combined with 5-fluorouracil caused 18 deaths, which prompted development of the patient-carried handbook now called okusuri techo.² It gained wider recognition after the Great Hanshin-Awaji Earthquake in 1995 and the Great East Japan Earthquake in 2011, when carried records substituted for unreachable facility systems.² Use is now routine: in FY2021, medication guidance using the handbook covered 64.2 percent of external prescriptions in national claims analysis (as of 2021; confirm current figures with MHLW).²

What the Booklet Records

Each fill adds one entry with the drug name, dose, date, and dispensing pharmacy.¹³ The pharmacist makes the entry at the counter, usually as a small sticker affixed to the paper booklet or the equivalent log update in the app.³¹

Entries also note how to take the drug, the prescribed period of use, and side effects where relevant.⁷ The booklet carries medication allergies, past negative reactions, and history notes the pharmacist reuses at the next fill.⁷¹

A single entry, fill by fill

Hand over the booklet with the prescription and the pharmacist does the recording.³¹ You keep the booklet and bring it back next time.

The record grows fill by fill into a cross-provider history. That accumulated list is what the next pharmacist reads before dispensing.¹

Why One Shared Record Matters

Japan has no gatekeeping GP, so care can split across a clinic, a specialist, and a dentist in parallel, each writing its own prescription.¹ Those prescriptions may be filled at whichever pharmacy was closest that day.

Without a shared record, each pharmacy only knows what it personally dispensed.¹ Showing one shared booklet lets any pharmacist work from the same full history instead.⁵¹

This applies nationwide under the same separation framework. Individual pharmacy app choice varies by chain, but the any-pharmacy read and update practice does not.⁶¹

How the pharmacist uses it before dispensing

Before dispensing, the pharmacist checks the booklet for interactions between the new drug and current drugs.¹⁷⁶ The same check covers duplicate prescriptions from different doctors and noted allergies or prior reactions.¹⁷⁶

When that review leads to an actual prescription change, the pharmacy bills a prevention add-on of 50 points (about 500 yen before coinsurance) when the registered かかりつけ薬剤師 (kakaritsuke yakuzaishi, "regular pharmacist") catches it and 30 points (about 300 yen) for another pharmacist at the same pharmacy (as of 2026-06-01; confirm current figures with the Japan Pharmaceutical Association or MHLW).⁵⁸ A separate leftover-medication adjustment add-on follows the same 50-point or 30-point split when the fix is adjusting day count to use up medicine already at home (as of 2026-06-01).⁵⁸

The check is system level, not personal advice

The pharmacist review described here is a safety check against the shared list. Medication decisions for a specific condition belong with a licensed physician or pharmacist, not with this article.

Paper Booklet vs App

The electronic okusuri techo is the same record managed in a smartphone app instead of paper.⁴ MHLW describes it as the paper record carried by app, with added functions beyond the medication list such as health entries and pharmacist messaging.⁴

Either format does the same core job: a pharmacist reads what is logged, then adds the new fill before you leave the counter.¹ Both paper and app versions count for the presentation discount below, and either is issued free at any dispensing pharmacy on request.⁵

The counseling fee table below shows the current presentation gap as a whole (as of 2026-06-01; confirm current figures with the Japan Pharmaceutical Association or MHLW).⁵⁸

Item	Amount	As of	Notes
Counseling fee with qualifying techo presentation	45 points (about 450 yen before insurance)	2026-06-0158	Same pharmacy within 3 months
Counseling fee without qualifying presentation	59 points (about 590 yen before insurance)	2026-06-0158	Gap is 14 points
Saving per fill at 30 percent coinsurance	about 40 yen	2026-06-0159	About 140 yen before coinsurance

Pick the format you will actually carry to the counter.¹ A booklet lives in a bag and an app lives on a phone, and the one present at the visit is the one that works (limitation: practical guidance from resident sources, not a government rule).¹

Chain apps and hospital integration

Each major pharmacy chain operates its own app, with examples including the EPARK medication history app and Okusuri Plus.⁷ Other named options in resident guides include Nihon Chozai Okusuri Techo Plus and Kusuri no Shiori.⁹ App features vary by vendor and include sending a prescription photo to the usual pharmacy in advance, calendar reminders, managing OTC drugs alongside prescription drugs, and keeping family records together.⁷

Some electronic notebooks link with MyNa Portal with patient consent to pull dispensing records from each facility, and pharmacies compatible with electronic prescriptions can show the record in real time.⁴ MHLW publishes a conforming-service list under its electronic notebook guideline, observed updated 2026-08-01 (as of 2026-08-01).⁴ English-capable options named for residents include EPARK and Kusuri no Shiori, so confirm language support in the store listing before relying on it.⁹

Use one app the same way as one booklet

If you go digital, register one app and show it everywhere. Installing a second app for a second chain splits the history the same way a second paper booklet does.⁵

How to Get and Use It

Ask for an お薬手帳 at the first pharmacy visit and the pharmacist starts logging that day's medication immediately.¹⁵ If you already hold one from a previous pharmacy, bring it rather than accepting a second one.⁵

At the counter, hand over the prescription plus insurance proof plus the booklet together.³¹⁰ Pharmacies routinely ask for the booklet alongside the health insurance card.³

The flow from first issue onward looks like this.

The diagram shows the single-booklet loop the rest of this section follows. Each visit reuses the same record instead of starting a new one.⁵¹

Bring it to every clinic and pharmacy visit

Bring the same booklet to every pharmacy, not only the issuing one.¹ Any dispensing pharmacy can read and add to it, which is the entire reason it exists.¹

Bring it to every clinic visit too, including eye and dental clinics, so the record stays current across the whole care team.³⁹ For residents who arrived with overseas medication, the booklet is where matched local equivalents belong once a Japanese pharmacy has mapped them.⁵

In an emergency or at an unfamiliar facility, the booklet hands over history instantly without relying on memory or translation.¹ In travel or disaster settings the pharmacist needs the full history to fill safely, and after facility-record loss the carried record substitutes for unreachable systems.⁷²⁵

Good to know

Bring the same booklet to every pharmacy, not one per pharmacy

One booklet covering all clinics is the point.⁵ Each pharmacy only knows its own dispensing unless you show the rest, so a second notebook re-creates the gap the first one closed.¹⁵

In an emergency the booklet speaks when you cannot

Carry the booklet to urgent or unfamiliar visits, not only routine refills.¹ It lets covering staff read drug names, doses, allergies, and side-effect notes directly instead of reconstructing them by interview.¹⁵

This matters most when the usual pharmacy is unreachable. After the 2011 earthquake, carried records filled the gap left by lost facility systems, which is why disaster guides still treat the booklet as part of emergency preparation.²⁵

If you lose the booklet, start a new one at the next fill

A lost booklet loses the paper history inside it but not the ability to continue.¹ The next pharmacy issues a new one and logging restarts from that visit.¹

Paper has no backup unless you also used an app or a MyNa Portal linked record.⁴¹ App users avoid this single-copy risk, though no vendor guarantees recovery in every case.

See also

• How Japanese Pharmacies Work
• What to Bring to a Doctor's Visit
• Generics (Jeneriku) and the Cost Question
• The Yakkan Shomei Import Certificate
• Drugstores and Mail-Order: When Each Makes Sense
• OTC vs. Prescription Drugs in Japan

References

Footnotes

1. TokyoPharmacies. "What Is an Okusuri Techo, and Why Keep One in Japan?" TokyoPharmacies, last reviewed 2026-07-24. https://tokyopharmacies.com/articles/okusuri-techo-medication-notebook ↩ ↩² ↩³ ↩⁴ ↩⁵ ↩⁶ ↩⁷ ↩⁸ ↩⁹ ↩¹⁰ ↩¹¹ ↩¹² ↩¹³ ↩¹⁴ ↩¹⁵ ↩¹⁶ ↩¹⁷ ↩¹⁸ ↩¹⁹ ↩²⁰ ↩²¹ ↩²² ↩²³ ↩²⁴ ↩²⁵ ↩²⁶ ↩²⁷ ↩²⁸ ↩²⁹ ↩³⁰ ↩³¹

2. Ura H, Senoo M, Kubota K, Sadamoto K. "The Current Status of Utilizing a Medication Record Handbook for Evaluating Shared Medication History." Cureus, 2024-04-26. PMCID: PMC11129530. https://pmc.ncbi.nlm.nih.gov/articles/PMC11129530/ ↩ ↩² ↩³ ↩⁴ ↩⁵ ↩⁶ ↩⁷

3. SEMI Sapporo (Sapporo English Medical Interpreters). "How to have your prescription filled." SEMI Sapporo, last reviewed 2025-05-19. https://semi-sapporo.com/sickness/prescription/ ↩ ↩² ↩³ ↩⁴ ↩⁵ ↩⁶ ↩⁷

4. Ministry of Health, Labour and Welfare (MHLW). 「電子版お薬手帳」 (Electronic medication notebook page). MHLW, updated 2026-08-01 and 2026-02-18 entries observed. https://www.mhlw.go.jp/stf/seisakunitsuite/bunya/e-okusuritecho.html ↩ ↩² ↩³ ↩⁴ ↩⁵ ↩⁶

5. Japan Care Concierge. "Using Japanese Pharmacies as a Senior: Okusuri Techo, Kakaritsuke Pharmacists, and Home Visits." Japan Care Concierge, published 2026-07-05, updated and source-checked 2026-07-13. https://japancareconcierge.com/en/blog/pharmacy-system-japan-seniors-okusuri-techo/ ↩ ↩² ↩³ ↩⁴ ↩⁵ ↩⁶ ↩⁷ ↩⁸ ↩⁹ ↩¹⁰ ↩¹¹ ↩¹² ↩¹³ ↩¹⁴ ↩¹⁵ ↩¹⁶ ↩¹⁷ ↩¹⁸ ↩¹⁹ ↩²⁰

6. Zainichi Life Navi Editorial Team (MRI Co., Ltd.). "Pharmacies, Prescriptions and OTC Medicine in Japan [2026]." Published 2026-06-09, updated 2026-07-02. https://life.m-ri.co.jp/en/pharmacy-guide.html ↩ ↩² ↩³ ↩⁴

7. MATCHA. "Japanese Pharmacy Basics: Prescription Record Books And Generic Medicine." MATCHA, published 2020-08-17. https://matcha-jp.com/en/9924 ↩ ↩² ↩³ ↩⁴ ↩⁵ ↩⁶ ↩⁷

8. Japan Pharmaceutical Association (Nippon Pharmacists Association). 「調剤報酬点数表 (Dispensing fee schedule, effective 2026-06-01)」 (Japanese, PDF, via Japan Care Concierge citation). Published 2026-04-02. https://www.nichiyaku.or.jp/files/co/pharmacy-info/2026/20260402_01.pdf ↩ ↩² ↩³ ↩⁴ ↩⁵

9. RISE Corp. "English-speaking clinics and hospitals in Tokyo and how to see a doctor in Japan." RISE Corp, updated 2026-06-05. https://rise-corp.tokyo/zh-CN/pages/englishspeaking-hospitals-tokyo ↩ ↩² ↩³ ↩⁴

10. Relocation Japan (Live in Japan Planning). "Foreigners Using Japanese Pharmacies: Objective Procedures for Submitting Prescriptions and Using the Medicine Notebook." Accessed 2026-09. https://relocation-japan.com/en/japan-pharmacy-prescription-okusuri-techo/ ↩