What is Keimakakuhanto?

Keimakakuhanto is a Japanese Kampo herbal formula. It is taken for a cold that drags on with mild fever, chills and little or no sweat. It is also used for itchy skin and hives (raised itchy welts).

Keimakakuhanto is the Japanese name written in our letters. The mix joins half of one classic cold recipe with half of another. Seven dried plants go into it, including ephedra herb and licorice root.

It is one of the 148 Kampo formulas approved for insurance use in Japan by the MHLW (the Japanese health ministry). Long use is not proof that a remedy works. No human trials of this formula have been published, so we cannot say how well it works.

How does Keimakakuhanto work?

No one has tested how this formula works in people, so the account below is an idea, not a proven path.

In Kampo thinking, the mix warms the body and lets out a light sweat. That is said to move a lingering cold along and calm itchy skin.

In plain drug terms, ephedra herb holds ephedrine. Ephedrine is a stimulant that can open the airways, raise the heart rate and raise blood pressure. Cinnamon, ginger and apricot kernel are the warming and cough-easing parts of the recipe.

What forms does Keimakakuhanto come in?

In Japan it is sold mainly as a dried extract granule in single-dose sachets. Tablets and fine powders are also made.

Some practitioners still boil the raw sliced herbs into a tea, which is the older way. Outside Japan you are most likely to find granules or capsules from a Kampo supplier.

Where it comes from:

The recipe comes from the Shanghan Lun, a Chinese medical book written around 200 CE. It is a half-and-half blend of two older formulas from the same text.

Japanese doctors took up these classics and shaped them into Kampo, Japan's own herbal system. Today the formula sits on Japan's list of 148 insurance-approved Kampo formulas, though it is used far less than the big-name cold remedies.

What does Keimakakuhanto help with?

• A cold that lingers with mild fever and chills: This is the classic use. Kampo texts point to it when a cold has not cleared, the fever stays mild and you do not sweat. There are no published trials in people for this formula, so we cannot tell you how often it helps.
• Chills and fever that come and go, with no sweat: The old texts describe this exact pattern, with a slight flush of the face and mild body ache. Practitioners still choose the formula on that picture. The support here is tradition and case experience only.
• Itchy skin: Kampo practitioners sometimes use it for itch that comes with a warm, dry skin pattern. Evidence is limited to tradition and doctor reports. Long-lasting itch can have many causes, so get it checked before you self-treat.
• Hives (raised itchy welts): This is a recognised Kampo use in Japan, often in short courses. No controlled trial has tested it. Hives that come with swelling of the lips, tongue or throat are an emergency and need care now, not herbs.
• Mild cough and blocked nose with a cold: Apricot kernel and ephedra are the parts aimed at cough and stuffiness. Ephedrine can open airways, but that has been studied as a single drug, not as this formula. Treat this as traditional use, not proven benefit.

Which foods are rich in Keimakakuhanto?

1. Licorice sweets and licorice tea: they add the same licorice compound and can push your potassium down
2. Coffee, tea and energy drinks: caffeine adds to the stimulant kick of ephedra
3. Cinnamon and ginger in cooking: the same plants, but food amounts are small and not a worry

What are the side effects of Keimakakuhanto?

• Trouble sleeping
• Feeling jittery or shaky
• A fast or pounding heart beat
• Higher blood pressure
• Sweating more than usual
• Nausea, stomach upset or loss of appetite
• Headache
• Trouble passing urine
• Swelling in the face, hands or legs
• Weak muscles and cramps from low potassium
• Rash or itch from an allergy to one of the plants
• Rare liver injury, with yellow skin or eyes, dark urine and deep tiredness

Good to know:

Most people who take it for a few days have no trouble. The stimulant effects of ephedra are the usual complaint: a racing heart, shaky hands and poor sleep.

The licorice problems build up slowly. Low potassium, swelling and higher blood pressure matter most if you take it for weeks. Older people and people on water pills reach that point sooner.

Liver injury is rare but real with herbal products. Stop and get checked if your skin or eyes turn yellow.

How much Keimakakuhanto should you take?

• Recommended daily: There is no dose set by trials. In Japan, adults commonly take about 7.5 g of the dried extract granules per day, split into two or three doses. Follow the label on your own product or the dose your practitioner gives you. Doses for children are lower and should be set by a doctor.
• Best time of day: Spread the doses through the day, before or between meals. Take the last dose well before bed, as the ephedra can keep you awake.
• With or without food: Kampo granules are usually taken on an empty stomach, before or between meals, with warm water. If it upsets your stomach, take it with a little food.
• Time to effect: For cold symptoms, people often expect a change within a day or two. For skin symptoms it may take one to two weeks. If nothing shifts, stop and ask a doctor.
• How long to take it: For a cold, it is meant for short use. A few days is normal, and you should stop once the fever and chills go. For itch or hives, a practitioner may run two to four weeks and then check again. Do not take it for months on end, because the licorice risk grows with time.