Norlevo and Lesoeru 72: Emergency Contraception in Japan

If you had sex without contraception, or contraception failed, Japan now has emergency contraceptive pills you can get at a pharmacy without a prescription: Norlevo (ノルレボ) and Lesoeru 72 (レソエル72). Each is a single tablet, and you need to take it within 72 hours after sex.

They are not on the regular shelf. Only a pharmacist who has completed special training on emergency contraception can sell them, and you take the tablet right there, in front of that pharmacist. This page explains the rules, from the package inserts and check sheets.

For prices and your other options, such as a clinic, see Life Abroad's guide to the morning-after pill in Japan.

Norlevo and Lesoeru 72: The Same Ingredient

Left: Norlevo. Right: Lesoeru 72. Each box holds 1 tablet.

Both contain levonorgestrel 1.5 mg in one tablet, and their package inserts give the same rules. Norlevo is sold by Daiichi Sankyo Healthcare, and Lesoeru 72 by Alinamin Pharmaceutical. Both are Pharmacist-Guidance Drugs (要指導医薬品).

According to the Norlevo package insert, levonorgestrel is thought to prevent pregnancy by suppressing ovulation, hindering fertilization, and preventing a fertilized egg from implanting in the uterus.

Who Can't Take It

The package inserts say not to take it if you:

• Have ever had an allergic reaction to this medicine or its ingredients.
• Have been diagnosed with liver disease.
• Are pregnant. If you are already pregnant, it has no effect.
• Are male.

Breastfeeding? Don't take it, or don't breastfeed for at least 24 hours after taking it.

Talk to the pharmacist first if you:

• Are being treated by a doctor.
• Have ever had an allergic reaction to a medicine.
• Have been diagnosed with heart disease, kidney disease, or a severe digestive disease that stops food or medicine from being absorbed.
• Take food products containing St. John's wort (セイヨウオトギリソウ), which are sold as supplements in Japan.

How to Get It at a Pharmacy, Step by Step

Step 1: Find a store and call ahead

• Only some pharmacies and drugstores with a trained pharmacist sell it. Both makers have a store finder on their websites (links below).
• You can't buy it when the trained pharmacist isn't there. The makers ask you to call before you go, to check the stock and when you can come.

Step 2: Answer the check sheet

• The Norlevo check sheet is available in English, Chinese (simplified and traditional), Korean, and Portuguese on Daiichi Sankyo Healthcare's product page. Lesoeru 72's is in Japanese, on paper or online.
• It asks when you had sex (the date and time), whether you agree to take the tablet in front of the pharmacist, your health, and your periods: when your last period started, your usual cycle, and whether you had sex at other times.
• It also asks questions that are not used to decide whether you can buy it, but to decide whether to give you information about support: whether you are under 16, whether you have taken emergency contraception before, and whether you will still be in Japan 3 weeks later.
• You may need to take a pregnancy test when you buy it. Depending on your situation, you may not be able to buy it. The trained pharmacist decides.

Step 3: Talk to the trained pharmacist and take it there

• The pharmacist checks your answers and explains what to watch for after taking it.
• You buy one tablet and take it right there, in front of the pharmacist.
• Lesoeru 72's website says minors can buy it too.

After You Take It

• It doesn't fully prevent pregnancy. Both check sheets say that in a clinical trial in Japan, taking emergency contraception within 72 hours prevented pregnancy in 81% of cases.
• You won't know right away whether it worked. Three weeks later, use a pregnancy test or see a doctor. If the test is positive, see a doctor as soon as possible.
• If you vomit within 2 hours of taking it, see a doctor promptly.
• If you get lower abdominal pain or genital bleeding after taking it, see a doctor. The check sheet explains that an ectopic pregnancy (a pregnancy outside the uterus) can look like a period or a miscarriage and can be serious.
• It only works for sex that has already happened. Taking it before sex doesn't prevent pregnancy, and you can still get pregnant after taking it. For planned contraception, the package inserts recommend a more effective method, such as taking low-dose birth control pills continuously.

Talk to a doctor or pharmacist promptly, bringing the package insert, if:

• Your period is 7 or more days later than expected (about one month after your last period started, for a 28-day cycle).
• Period-like bleeding, or symptoms like headache, nausea, tiredness, or sleepiness that you'd get with a period or early pregnancy, last 7 days or more.
• Your period comes earlier than expected, or the amount of bleeding is different from usual.

Possible side effects listed in the package inserts include nausea or vomiting, lower abdominal pain, diarrhea, headache, sleepiness, dizziness, anxiety, irregular bleeding, heavier or late periods, tiredness, breast tenderness, and swelling of the hands or feet. If they appear, talk to a doctor or pharmacist and bring the package insert.

FAQ

Sources & Documents

• Norlevo: package insert (Japanese PDF), check sheet (Japanese PDF)
• Lesoeru 72: package insert (Japanese PDF), check sheet (Japanese PDF)
• Norlevo product page (Daiichi Sankyo Healthcare): check sheets in English and other languages, and the store finder
• Lesoeru 72 page (Alinamin Pharmaceutical): online check sheet and the store finder