In Japan, pharmacists as well as patients often have problems distinguishing one ethical tablet from another because they can be very similar in color. In an attempt to solve this problem, we hypothesized using a background sheet of dark gray identified by N3.5 on the Munsell color system (Munsell CS). The colors of 369 and 656 ethical tablets in Japan and the USA, respectively, were measured. On the Munsell CS, the Japanese tablets were localized mostly in the range of hues between 10R∼10Y with values ≧8 and chroma ≦4, while the colors of the American tablets were scattered over the hue spectrum with a variety of values and chroma. Based on these findings, we examined the effects of background colors on discrimination between 5 tablets classified into yellow, yellow red, red, or mixed groups that represented typical domestic Japanese tablets. Background colors of light, medium, and dark gray, purple, blue, and blue green were selected based on a general concept on color discrimination. The influence of white 10 mm-ruled squares on background sheets was examined as well. Under JIS Z8723 conditions, 42 volunteers used a 4-point scale to evaluate how clearly they could discriminate between each set of tablets on each of the background sheets. Variance analysis of the obtained data with SPSS^® demonstrated that with healthy vision, use of a dark gray background sheet with or without ruled squares enabled the sharpest and most feasible discrimination between all sets of tablets. A similar test with dark gray and white clearly demonstrated that the former works as a practical background color for discrimination among different domestic Japanese tablets.