By Upolife Editorial Team. Originally published October 29, 2025. Substantially updated and reviewed October 23, 2026.
What Roihi-Tsuboko Big patches are
Roihi-Tsuboko Pain Relief Patches Large Size 78 (product number RT78) are round, medicated warming patches manufactured by Nichiban, Japan. Each patch is 3.9 cm in diameter—approximately twice the area of the regular Roihi-Tsuboko size—and each box contains 78 patches. Nichiban classifies this product as a Class 3 OTC medicine (第3類医薬品) under Japanese pharmaceutical regulations.
According to Nichiban, the larger diameter makes the patch easier to apply to broad areas such as the middle and lower back, while still allowing targeted placement on specific stiff spots.
Active ingredients and how Nichiban describes their action
Nichiban states that Roihi-Tsuboko Big contains three key ingredients working together:
- 4-Hydroxy-3-methoxybenzyl Nonylic Acid Amide – a substance similar to compounds found in chili peppers; Nichiban states it produces heat stimulation that encourages blood circulation in the affected area.
- Methyl salicylate – described by Nichiban as contributing to amelioration of stiffness.
- L-Menthol – listed by Nichiban as an anti-inflammatory ingredient working in combination with the above.
Nichiban's stated intended effect is ameliorating stiffness through this combination of heat stimulation and anti-inflammatory action. These are manufacturer claims for this specific formulation; they are not independent clinical claims about the finished product.
Intended use areas
According to Nichiban, Roihi-Tsuboko Big is designed for use on broad areas including:
- Middle and lower back
How to apply — manufacturer directions
- Pull the lifted part of the backing film to peel the patch off.
- Calmly aim for the stiff spot and attach the patch to clean, dry skin.
- Apply a suitable number of times per day to the affected area (1日数回患部にはってください — the Japanese leaflet states "apply to the affected area several times a day").
- When the stimulating heat sensation stops, remove the patch.
Children: The Japanese leaflet states that when used by children, application must be under the supervision and guidance of a parent or guardian.
Sensitive skin patch test: The Japanese leaflet instructs people with sensitive skin to apply the patch to a small area on the inside of the arm for 1–2 hours before first use, and to confirm that no rash, redness, or itching occurs before proceeding.
Bathing and heat — critical cautions from the manufacturer
Nichiban's Japanese package leaflet gives the following precautions:
- Remove at least one hour before bathing. The Japanese text reads: 入浴する時は1時間以上前にはがしてください ("When bathing, remove the patch at least one hour before."). Use the stricter instruction on the Japanese package leaflet.
- Do not apply immediately after bathing. The Japanese leaflet states: 入浴直後の使用はさけてください ("Avoid use immediately after bathing.").
- Do not use heating devices over the patch. The Japanese leaflet states: 患部をコタツや電気毛布等で温めないでください ("Do not warm the affected area with a kotatsu, electric blanket, etc."). The English page additionally lists electric carpets, disposable heating pads, and electric blankets as examples. Using heat-generating devices together with the patch may intensify heat stimulation.
Where not to apply — manufacturer warnings
According to the official Japanese leaflet, do not apply Roihi-Tsuboko Big to:
- The area around the eyes or mucous membranes
- Skin with eczema, contact dermatitis (かぶれ), or rashes
- Wounds or broken skin
When to consult a doctor, pharmacist, or registered seller
The Japanese leaflet specifies the following situations requiring professional consultation:
- Before use: If you have ever experienced an allergic reaction to a medicine or other product.
- Stop use immediately and consult a professional (bringing the box) if any of the following appear after application: rash, redness, itching, or pain on the skin.
- Stop use and consult a professional if symptoms do not improve after 5–6 days of use.
Product specifications
| Detail | Specification |
|---|---|
| Product number | RT78 |
| JAN code | 4987167059101 |
| Patch shape | Round |
| Patch diameter | 3.9 cm |
| Count per box | 78 patches |
| Manufacturer | Nichiban, Japan |
| Regulatory class (Japan) | 第3類医薬品 (Class 3 OTC medicine) |
Common mistakes to avoid
- Applying immediately after a bath or shower (skin is more sensitive; prohibited by the leaflet)
- Forgetting to remove the patch before bathing — remove at least one hour before
- Using alongside a kotatsu, electric blanket, heating pad, or other heat source
- Applying to broken skin, eczema, rashes, or wounds
- Applying near the eyes or mucous membranes
- Ignoring early signs of irritation — stop use and consult a professional
- Continuing use beyond 5–6 days without improvement — consult a professional
Frequently asked questions
What size are Roihi-Tsuboko Big patches, and how do they differ from the regular size?
According to Nichiban, each Roihi-Tsuboko Big patch is 3.9 cm in diameter — approximately twice the area of the regular-sized Roihi-Tsuboko patch. Nichiban states the larger size makes it easier to apply to broad areas such as the middle and lower back. The box (product RT78) contains 78 patches.
How does Nichiban describe how these patches work?
Nichiban states that 4-Hydroxy-3-methoxybenzyl Nonylic Acid Amide (similar to substances in chili peppers) produces heat stimulation that encourages blood circulation in the affected area. This works in combination with methyl salicylate and L-Menthol, which Nichiban describes as anti-inflammatory ingredients, to ameliorate stiffness.
How long before bathing must I remove the patch?
The official Japanese leaflet states you must remove the patch at least one hour before bathing (入浴する時は1時間以上前にはがしてください). The leaflet also states you should avoid applying the patch immediately after bathing. Nichiban warns that bathing with the patch attached may cause a burning sensation.
Can I use a heating pad or electric blanket while wearing the patch?
No. The Japanese leaflet explicitly states not to warm the affected area with a kotatsu, electric blanket, or similar devices while wearing the patch. Nichiban's English page also lists electric carpets, disposable heating pads, and electric blankets as examples to avoid, as combining them with the patch may intensify heat stimulation.
When should I stop using the patches and consult a professional?
Per the official Japanese leaflet: stop use immediately and consult a doctor, pharmacist, or registered seller (bring the box) if rash, redness, itching, or pain appears after application. Also stop and consult a professional if symptoms do not improve after 5–6 days of use. Before first use, anyone who has previously experienced an allergic reaction to a medicine should consult a professional.
Sources
- Nichiban: Roihi-Tsuboko Big, 78 plasters
- Nichiban: Roihi-Tsuboko Big official instructions (Japanese)
For general information only; not medical advice. Follow the manufacturer’s directions and warnings for the exact product. Read our editorial policy.
