Japan approves OTC ‘morning-after’ pill for first time, widening access to emergency contraception

Japan for the first time has approved what is known as the ‘morning-after’ pill without a prescription. (representative image)

Japan has taken a landmark step in women’s health policy by approving the emergency contraceptive pill Norlevo for over-the-counter sale, the first time such a move has been made in the socially conservative country. The approval means women and girls in Japan will now be able to buy the “morning-after” pill without a doctor’s prescription, a change long demanded by women’s rights groups.

The move, announced by ASKA Pharmaceutical and confirmed by Japan’s Ministry of Health, Labour and Welfare, brings Japan in line with more than 90 countries that already allow non-prescription access to emergency contraception, according to a report by Medical Xpress.

What is the morning-after pill?
The “morning-after” pill is a form of emergency contraception that prevents unwanted pregnancy after unprotected sex or contraceptive failure, such as a broken condom or missed birth-control pill. It can also be used in cases of sexual assault. The pill works by delaying ovulation and is most effective when taken as soon as possible after intercourse — ideally within 24 hours, but up to 72 hours later. It does not terminate an existing pregnancy. Common side effects include nausea, dizziness, fatigue, breast tenderness and irregular menstrual bleeding.

According to ASKA Pharmaceutical, the company received manufacturing and marketing approval from Japan’s health ministry to sell Norlevo as a “medicine requiring guidance.” This means that women must take the pill in the presence of a pharmacist, but there will be no age restrictions or requirement for parental consent. While no firm launch date has been announced, the pill is expected to reach pharmacies within this fiscal year. During a pilot in 2023, ASKA sold the pill at 145 pharmacies — less than 0.2 per cent of all pharmacies in Japan — at prices ranging between $47 and $60 (Rs 4,136–Rs 5,280), according to The Straits Times.

Why Japan’s decision marks a turning point

Japan has long imposed strict regulations on access to emergency contraception, requiring women to obtain a doctor’s prescription through a gynaecology clinic. Women’s health advocates have criticised this as an unnecessary barrier, especially for rape survivors and younger women. The Japanese government first discussed easing restrictions in 2017, but progress stalled amid concerns from conservative lawmakers that easier access would encourage “irresponsible use.” The World Health Organization, however, has said that emergency contraception “should be routinely included within all national family planning programmes.”

Despite the reform, certain restrictions remain. The requirement for pharmacist supervision could still pose challenges for women in remote areas, and the pill will not be covered by Japan’s national health insurance, meaning users must pay the full cost out of pocket. The exact price and rollout details are still being finalised.

Women’s rights groups have hailed the move as a breakthrough that could empower Japanese women and expand reproductive choice. Advocates note that while it is a significant step forward, true accessibility will depend on how widely pharmacies participate and how affordable the product becomes.

For a nation known for its conservative stance on gender and sexuality, Japan’s decision signals a shift toward recognising women’s autonomy and reproductive rights.