Case reports of drug-induced liver injury caused by Kampo medicines are on the rise, but most of them are noted for related symptoms such as jaundice. Usually, severe liver injury is detected by chance upon routine medical checkup. Recently, we noted 3 cases of suspected drug-induced liver injury caused by orengedokuto, saikokeishikankyoto and bofutsushosan. In these 3 cases, maximum ALT was under 100 IU/l and no symptoms related to liver injury were observed. Early detection by blood test was useful, and appropriate treatment quickly improved and normalized the abnormal values associated with liver injury. We should always be alert for drug-induced liver injury caused by Kampo medicines, especially when prescribing formulations that include Scutellariae Radix. We also emphasize the importance of scheduling blood tests when prescribing these formulations.

To assess the safety of molnupiravir capsules (MOV) and the adherence of patients taking these capsules, we conducted a survey of patients who were dispensed MOV at the Maruzen Pharmacy from January 1st to September 30th, 2022. In the survey, a sample of 134 patients were requested to complete a questionnaire, from whom we received 56 responses (response rate: 41.8%). Among the respondents, 11 (19.6%) failed to complete their medication, and those aged 60 years or older tended to have poor adherence (P<0.001). Apart from age, we detected no statistical differences with respect to other assessed factors (gender, capsule size, occurrence of side effects, and evaluation of pharmacist’s explanations). Side effects were reported by 11 individuals (19.6%) taking the drug, although these were mainly consistent with those that have been reported in clinical trials. In addition, 20 individuals (35.7%) experienced COVID-19 after-effects after taking MOV. When requested to evaluate pharmacies and pharmacists, five individuals (8.9%) reported feeling dissatisfied. Although the results obtained in this survey are based on a limited number of patients, they do reveal a concerning lack of adherence among patients over 60 years of age; and there are needs for future improvements in the size of MOV capsules.