Yellow A, green M, a tube or something to insert: which Borraginol should you pick up in a Japanese drugstore? First check whether self-care is appropriate, then choose the formula and delivery method. Rectal bleeding or pain does not establish a diagnosis of hemorrhoids. A bleeding-relief claim on a box is not a reason to skip medical assessment.
I’m Irene, a Taiwan-born, Japan-licensed pharmacist working in a Japanese drugstore. Let’s separate the letters from the shapes, so the box you choose also makes sense when you open it.
Sources checked October 12, 2026. This guide covers five Japan-market products: three in the A range and two in the M range. Premium formulas, oral products and constipation medicines are outside its scope.
Check symptoms before choosing a box
- Heavy or non-stop bleeding, feeling faint or fainting: seek emergency help.
- New, unexplained, recurrent or persistent rectal bleeding, or black, tarry stool: seek prompt medical assessment. Bright red blood does not rule out a serious cause.
- Severe pain, fever, pus, substantial swelling or a protruding lump, or feeling generally unwell: get assessed rather than assuming this is an ordinary hemorrhoid flare.
- All five products are for ages 15 and over. Do not use below 15, or after an allergic reaction to the product or an ingredient.
Consult a doctor, pharmacist or registered OTC salesperson first if you are receiving medical treatment or have a history of reactions to medicines. Do not use an A product on a pus-producing affected area. Pregnancy or possible pregnancy requires advice before A products; M suppositories also have specific consultation requirements for pregnancy, older age, edema, kidney disease, high blood pressure and heart disease.
Already have M ointment 20g? Check the lot
A 2026 recall concerned Borraginol M ointment 20g, lots 720 and 800–813, after its glycyrrhetinic acid content fell slightly outside specification. On the date checked, PMDA listed the recall as completed. That does not make a recalled tube kept at home suitable for use.
Look for 製造番号 on the bottom of the box or the crimped end of the tube; the expiry is on the box bottom. If the lot matches, do not use it and consult AMATO using its updated notice. Never use an expired product. Some affected lots expire in April 2027, so an unexpired date alone is not enough. The notice concerns specified lots of M ointment 20g, not every M product; current return acceptance should be confirmed with the manufacturer.
A short way to narrow the choice
Once a professional has confirmed that short-term self-care is appropriate:
- For application outside or around the anus: compare A ointment and M ointment. Ordinary ointment tubes are not applicators to insert.
- When treatment inside the anus is appropriate: compare A prefilled applicators with A or M suppositories. One squeezes in ointment; the other melts after insertion.
- If you want a nonsteroidal option: M is steroid-free, but M suppositories have a different safety profile from M ointment. “Nonsteroidal” does not mean suitable for everyone.
If you are unsure where the problem is, describe it to a professional. The comparison below is not a test for diagnosing internal or external hemorrhoids.
| Japanese package name | Dose and route, ages 15+ | Key distinction |
|---|---|---|
| ボラギノールA軟膏 | Appropriate amount externally, 1–3 times daily | Contains a steroid |
| ボラギノールA注入軟膏 | Internally: one applicator, 1–2 times daily; externally: appropriate amount, 1–3 times daily | Steroid; route-specific directions |
| ボラギノールA坐剤 | One unwrapped suppository into the anus, 1–2 times daily | Contains a steroid |
| ボラギノールM軟膏 | Appropriate amount externally, 1–3 times daily | Nonsteroidal; check 20g lots |
| ボラギノールM坐剤 | One unwrapped suppository into the anus, 1–2 times daily | Nonsteroidal; additional systemic safety warnings |
A is a Japanese designated Class 2 OTC medicine; M is Class 2. These categories are not an effectiveness ranking. The frequencies above are for individual products, not limits you can add together when combining them.
What changes between A and M?
A contains the corticosteroid prednisolone acetate. M uses glycyrrhetinic acid, a nonsteroidal anti-inflammatory ingredient. Both ranges also contain lidocaine for local pain and itching relief, allantoin and tocopherol acetate (vitamin E acetate).
A is labeled to relieve pain, bleeding, swelling and itching from hemorrhoids and anal fissures. M is labeled for pain and itching. This helps compare medicines after the cause is established; it should never turn unexplained bleeding into an automatic A purchase.
A and M ointment: a tube for external application
Both are smooth, oily, white to slightly yellowish-white ointments. With a clean finger, apply enough to cover the affected area, or spread onto gauze and place it on the area. Use 1–3 times daily, only around the anus. If cold storage makes the ointment stiff, gently warm the tube in your hand.
- A, per 1g: prednisolone acetate 0.5mg, lidocaine 30mg, allantoin 10mg, tocopherol acetate 25mg.
- M, per 1g: lidocaine 30mg, glycyrrhetinic acid 15mg, allantoin 10mg, tocopherol acetate 25mg.
The manufacturer lists 20g and two 6g tubes for each. Pack size does not change the formula’s strength. Store stock has not been verified.
A prefilled applicators: two routes, two frequencies
The Japanese word 注入 means delivering the ointment through the anus here; this is not a needle injection. Each 2g applicator contains prednisolone acetate 1mg, lidocaine 60mg, allantoin 20mg and tocopherol acetate 50mg.
For internal use, remove the cap and squeeze a little ointment onto the tip. Insert only the nozzle, slowly squeeze in the full amount, and withdraw while keeping the body compressed. Use one applicator per dose, 1–2 times daily. Do not insert the whole container or split an internal dose into two sessions.
For external use, apply an appropriate amount 1–3 times daily. Once an applicator has been used externally, do not subsequently use that same unit internally. The current listed packs contain 10, 30 or 50 applicators of 2g each. There is no M applicator in this range. The manufacturer’s illustrated instructions show the movement in detail.
A and M suppositories: think about storage before travelling
坐剤 means suppository. Each weighs 1.75g. For either product, remove the foil completely and insert one suppository, pointed end first, into the anus, 1–2 times daily. Never insert the wrapper or swallow it. The manufacturer suggests after a bowel movement, after bathing or before bed, within the daily frequency.
- A, per suppository: prednisolone acetate 1mg, lidocaine 60mg, allantoin 20mg, tocopherol acetate 50mg.
- M, per suppository: lidocaine 60mg, glycyrrhetinic acid 30mg, allantoin 20mg, tocopherol acetate 50mg.
An A suppository and an A applicator contain the same amounts of their active ingredients per unit, but in a 1.75g suppository versus 2g of ointment. Their total weights do not establish which is stronger. A suppositories are listed in packs of 10, 20 and 30; M in packs of 10 and 30.
Keep both types at 1–30°C, away from sunlight, pointed ends down in their box, with the box upright as marked. Avoid temperatures of 0°C or below. A hot car or suitcase can exceed their storage range. If a suppository is too soft, cool it as directed, without freezing it. Melted oily material may leak and stain clothing after use.
M suppositories have their own safety checks
Do not use M suppositories continuously for a long period. Before using them, seek professional advice if pregnant or possibly pregnant, older, receiving treatment, prone to medicine allergies, experiencing edema, or diagnosed with kidney disease, high blood pressure or heart disease.
Their leaflet lists rare pseudoaldosteronism and myopathy. Stop and get medical attention for gradually worsening limb heaviness, numbness, tightness or stiffness with weakness or muscle pain. These are specific warnings for M suppositories; they must not be dismissed because the product lacks a steroid, or automatically copied onto M ointment’s label.
Pregnancy and breastfeeding
AMATO states that M ointment may be used during pregnancy; the other four products require consultation first. New symptoms in pregnancy still deserve a discussion with your maternity clinician or pharmacist. The M ointment exception does not apply to M suppositories.
The manufacturer’s FAQ allows these five products during breastfeeding when used as directed and stopped once symptoms improve. Other product-specific restrictions still apply.
Combinations, stopping and everyday handling
- Do not independently combine ointments, applicators and suppositories. The manufacturer warns that overlapping ingredients in external hemorrhoid medicines can lead to excessive dosing. Show the pharmacist any other medicines you use.
- Stop and seek advice for a new rash, redness, itching, swelling or irritation. Pus also needs medical assessment.
- The A applicator, A suppository and M suppository leaflets list rare anaphylaxis. Hives, hoarseness, breathing difficulty, palpitations or clouded consciousness soon after use need immediate medical care. A severe allergic reaction needs urgent care whatever the formulation.
- For every product, stop and consult if symptoms have not improved after about 10 days. Do not wait ten days with bleeding, severe pain, fever or pus. A products and M suppositories must not be used continuously long term. Repeatedly buying M ointment is also no substitute for assessing persistent symptoms.
- Keep ointments capped in a cool place away from sunlight; suppositories additionally require 1–30°C. Retain original containers, keep medicines away from children and check expiry dates. Do not flush applicators or packaging down the toilet.
What to tell the pharmacist
Bring three things: when symptoms started and whether there is blood or pus; your medicines, medical conditions and pregnancy status; and the full product name you are considering. That is more useful than asking for “the yellow one.”
If constipation is also part of your trip, read travel constipation self-care and when to get help. A hemorrhoid medicine does not replace assessment of constipation or bleeding.
Sources
- AMATO: A ointment, A applicators, A suppositories, M ointment, M suppositories, with Japanese leaflets linked on each page.
- PMDA Japanese product information: A ointment, A applicators, A suppositories, M ointment, M suppositories.
- AMATO: FAQ, updated recall notice; PMDA: recall 2-12741 details, recall status list.
- Japan Society of Coloproctology: rectal bleeding and diagnosis; AMATO physician interviews: symptoms that need medical attention.
- NHS: Rectal bleeding emergency guidance.
