Alpitan and Goreisan: what it means to sell an 1,800-year-old formula
The five-herb Kampo formula that Japan's Ministry of Health, Labour and Welfare still reimburses in 2026 — what it is, where it comes from, and why Kobayashi packages it in granule sachets for every Japanese drugstore.
By YOAKE editorial
Alpitan is the strangest product on our shelf.
The bottle ones — Hepalyse, Ukon no Chikara, Lipovitan — are functional beverages with modern ingredient panels. Alpitan is a box of granule sachets. Each sachet is 1.0 g of herbal concentrate. You dissolve it in warm water and drink it.
The formula inside is called Goreisan (五苓散). It was written down in a Chinese medical text called the Shang Han Lun (傷寒論), compiled around 200 CE by the physician Zhang Zhongjing. It is roughly 1,800 years old. It is still part of regulated Japanese medicine today.
This is a deep read on what Goreisan actually is, how Kobayashi Pharmaceutical packages it for OTC retail, and what it means to buy a product with that kind of time-depth baked in.
What Kampo is
Kampo (漢方) is Japan's regulated tradition of herbal medicine. The word literally translates to "Han method" — Han as in the Han Dynasty of ancient China, from whose medical classics Kampo descends.
It is not the same as Traditional Chinese Medicine (TCM). Over a thousand years of Japanese clinical practice, the formulas evolved — in diagnostic framework, in typical dosing, in preparation methods — into a distinct tradition. A Kampo physician in Tokyo and a TCM practitioner in Beijing would recognize many shared ingredients, but the clinical approach differs.
Kampo is also not a fringe alternative medicine in Japan. It is mainstream. The Japanese Ministry of Health, Labour and Welfare (MHLW) regulates the quality of Kampo ingredients. 148 specific Kampo formulas are covered by Japanese national health insurance when prescribed by a licensed physician. There are tens of thousands of medical doctors in Japan who prescribe Kampo alongside Western medicine.
What Goreisan is
Goreisan (五苓散) is one of the oldest Kampo formulas still in clinical use. The name means "Five-Ling Powder" — five herbs ground and prepared together. The original reference is the Shang Han Lun, the Han dynasty text from around 200 CE, where the formula appears with specific indications written out in classical Chinese.
The five herbs: takusha (Alisma rhizome), chorei (Polyporus sclerotium), bukuryo (Poria cocos), byakujutsu (Atractylodes rhizome), and keihi (cinnamon bark). The traditional proportions have been preserved across centuries: 5 : 3 : 3 : 3 : 2 of crude drug weight.
The formula's classical diagnostic framing is around what Kampo calls suidoku (水毒) — a concept that loosely translates to "water imbalance," though the English phrase loses most of the meaning. Modern Japanese clinical research has examined Goreisan for a range of indications, and a handful of published studies have been covered in Japanese medical journals. None of those indications are approvable in the US, so we don't repeat them on the product page.
Kobayashi and the retail version
Kobayashi Pharmaceutical was founded in Osaka in 1886. It is 140 years old. The company is a household name in Japanese consumer health, known for everyday products like Netsusama Sheet (the cooling forehead patches), Sarasaty (feminine care), and Kabanorikiya (heel balm). Kobayashi trades on the Tokyo Stock Exchange.
Alpitan is Kobayashi's OTC retail packaging of the Goreisan formula, sold in a 12-sachet box designed for pharmacy-counter and drugstore shelves. The granule format dissolves in water and absorbs faster than a pressed tablet.
There are other Japanese manufacturers that produce Goreisan — Tsumura makes the pharmaceutical-grade version prescribed by physicians under national health insurance; Kracie makes a tablet version. Kobayashi's Alpitan is the consumer retail line: same classical formula, packaged for direct shelf sale rather than prescription dispensing.
What it is not
Alpitan is classified as a dietary supplement containing traditional herbal ingredients in the US. It is not a drug. It has not been approved or evaluated by the FDA. We make no Kampo-specific medical claims for the US market.
The traditional-medicine context above is educational background, not clinical guidance. If you are interested in Kampo for a specific health question, work with a licensed practitioner — in the US that is typically an acupuncturist with additional herbal training, or a Kampo-trained physician in select clinics.
Alpitan contains lactose (a milk-derived excipient) in its granule base. Not suitable for the lactose-intolerant.
Kampo formulations can interact with prescription medications, particularly diuretics, some blood pressure medications, and certain heart medications. Alpitan's herbs include Alisma and Polyporus, which have diuretic effects in traditional use. Talk to your doctor or pharmacist before combining with any prescription medication.
Why we carry it
Alpitan is the product on our shelf with the strongest cultural story and the highest educational burden. Most Americans we've shown it to have never heard of Kampo. Most have never seen Japanese herbal granules in a sachet. The format is unfamiliar.
That is also why we wanted it on the first shelf. Hepalyse, Ukon, and Lipovitan are the commercial konbini-shelf story. Alpitan is the older, quieter story — the classical-medicine half of the same pharmacy aisle that most visitors walk past without noticing.
$28 for the 12-sachet retail pack during the first reservation window.