Thank you for asking Edaravone treatment. It is my honor to help ALS patients with Edaravone. If you are considering Edaravone treatment at my clinic, please read the followings. If your question is not included, please do not hesitate to ask me.

Edaravone treatment at Yoshino Neurology Clinic

　

1 Efficacy

Edaravone cannot cure the disease, but can make the progression of the disease slower approximately 30-40% compared to placebo, if the patient is in early stage (duration of the illness is within 2 years, does not require assistance for daily life, and percent force vital capacity is more than 80). On the other hand, efficacy is not proved for patients with advanced stage.
　

2 Safety

Edaravone may cause renal failure if it is used under severe dehydration. Also Edaravone sometimes cause elevation of liver enzymes. Patients are recommended to check liver enzymes and kidney parameters once a month. Edaravone may also cause mild skin eruption or headache.
　

3 Procedure

Edaravone, 3-methyl-1-phenyl -2-pyrazolin-5-one, is a novel free radical scavenger which removes free radicals such as hydroxyl radicals or peroxyl radicals. These free radicals are assumed to be involved with the mechanism of amyotrophic lateral sclerosis. The solution Edaravone prevents the progression of this disease and approved for the treatment of amyotrophic lateral sclerosis since June 2015 in Japan and May 2017 in USA. Oral form of Radicut has been approved in Japan since April 2023 in Japan.

In Cycle 1, 60mg (2 ampules) of Edaravone dissolved with 200 ml of normal saline will be administered in one hour for 14 days followed by a 2-week drug-free period. In Cycle 2 and thereafter, Edaravone will be administered for 10 days within a 14 day period, followed by a 2-week drug-free period. If you feel the disease is progressing worse during drug-free period, 14 days free period can be shorten 7 days or even few days. Drug free period is inserted because of safety consideration. When we started Edaravone clinical trial for ALS in 2001, Edaravone was said to be toxic to liver and kidney, so we decided to insert 14 days drug-free period in phase 2 trials and following trials. Now we know Edaravone is safe drug. Under monitoring liver enzymes and kidney parameters at least once a month, 14 days drug free period can be shorten.

One bottles of Radicut oral suspension contains 35ml or 50ml of Edaravone. Patients take 5ml of Radicut every morning one hour before breakfast for 14days,then take 14days rest period. From the second cycle and thereafter, patients take 5ml of Radicut for 10days in 14days followed by 14days rest period.
This medicine ORS needs to be held at 2-8 C degrees and therefore requires gel cold packs to keep it cool.

　

4 How long the treatment should be continued?

In two phase 3 studies, most patients received 12 cycles, about one year. From my experience, if well responded patient stops Edaravone treatment suddenly, the progression will start again. I therefore recommend to the patient if his or her progression of the disease becomes milder, better to continue the treatment. Patient can pick up several months Edaravone supply together with the certification letter for Customs. Please check how much supply you can bring into your country. It is different among countries.
　

5 Cost and payment

First Consultation Fee：JPY 10,000

Follow Up Consultation Fee:
(Directly to Ms. Claudine/Yoshino Clinic): JPY5,000
(Others via Representative): JPY3,000

Medical /Consultation in Person：
Within 30 minutes only
More than 30 minutes onwards: JPY 10,000

Documentation Fee: JPY 3,300 (Certification/Prescription/Memo/Others)

Medicines Cost :

・Edaravone ampule: JPY 1,500/ampule
・Radicut ampule: JPY 4,000/ampule
・Radicut Oral Suspension: 35 ml/bottle x 2 bottles: JPY 210,000
・Radicut Oral Suspension: 50 ml/bottle: JPY 150,000
・Riluzole Tablets: JPY 46,200(56 tablets per box)
・Rilutek Tablets: JPY 42,000(28 tablets per box)
・Ketas /Ibudilast: JPY 3,300(100 tablets per box)

Patient can pay by cash(Japanese yen) or by credit card.
NOTE:Prices are subject to change without further notice.
　

6 Accommodation

My clinic is small and does not have accommodation. Please find some hotels at west side of Chiba or East side of Tokyo.
　

7 Location and Access

The address of the clinic is 3-3-16 Kohnodai, Ichikawa-city, Chiba 272-0827, locating in-between Narita and Haneda international airport. Take Keikyu line from Haneda airport, or Keisei line from Narita airport and get off at Yagiri station. It will take about 60 minutes ride on both train. From Yagiri station, it will take about 15 minutes walk to my clinic. Or you can use taxi from either airport to the clinic.
　

8 Language

If patient cannot speak English, somebody who can speak English or Japanese must accompany with the patient.
　

9 If the patient’s health condition is not good to travel to Japan

On behalf of the patient, family member or friend may come and pick up Edaravone to the patient. Medical record is necessary in this situation. Please remind that the efficacy of Edaravone is not demonstrated in the advanced stage.