Zithromax in Spain: Azithromycin, Prescription Rules
Medically Reviewed by Dr. Pedro Yelamo Vera, MD
Licensed Physician No. 484814280 · Official Medical College of Bizkaia (Spain)Last reviewed: 4 November 2026
Zithromax is sold in Spain as Zitromax and generic azitromicina.
You don't have to figure this out alone
Dr. Pedro Yelamo Vera is an independent, bilingual GP licensed in Spain. Book a 15-minute video consultation in English or Spanish for €50, with a private electronic prescription issued under Spanish law when clinically appropriate.
You will not find Z-Pak in Spain, and Zithromax is spelled Zitromax here. Ask for azitromicina. It needs a prescription in Spain. This guide is by Dr. Pedro Yelamo Vera, an English-speaking GP licensed in Spain (Colegiado No. 484814280) who sees patients by video in English and Spanish.
In short
- Z-Pak is not sold in Spain. Pfizer's brand here is Zitromax, and there are many generics called Azitromicina.
- Azithromycin needs a prescription in Spain. Pharmacies will not sell it without one.
- It treats some infections caused by bacteria. It does not work for colds or flu.
- In practice, Spanish pharmacies refuse UK and US prescriptions. A doctor licensed in Spain has to issue a Spanish one.
What is Zithromax called in Spain?
Zithromax and Z-Pak are US and UK brand names. The NHS lists Zithromax as a brand of azithromycin. In Spain, the medicine is called azitromicina.
CIMA, the database of the Spanish medicines agency (AEMPS), lists Pfizer's brand as Zitromax. It comes as tablets, capsules and an oral liquid. CIMA also lists many generics. Their names follow a pattern: Azitromicina, then the maker, then "EFG". Examples are Azitromicina Teva, Normon, Cinfa and Stada.
EFG means a generic with the same active ingredient. The Z-Pak name and pack do not exist in Spain. Show the pharmacist the word azitromicina, not the US brand. Our guide to medicines in Spain explains other brand differences.
Do you need a prescription for azithromycin in Spain?
Yes. Azithromycin is an antibiotic, and it needs a prescription in Spain. A pharmacy will not sell it over the counter. This rule helps slow down antibiotic resistance.
Leftover tablets from home are not a safe shortcut. Your infection may need a different antibiotic, or none at all.
What is azithromycin used for?
Azithromycin belongs to a group of antibiotics called macrolides. It stops the growth of bacteria that are sensitive to it. The Spanish Zitromax capsule leaflet lists these uses:
- Throat, tonsil, ear or sinus infections.
- Bronchitis and mild to moderate pneumonia.
- Mild to moderate skin and soft tissue infections.
- Infections of the urethra or the cervix, such as chlamydia.
The Spanish leaflets make one point clear. Antibiotics treat bacterial infections only. They do not help viral infections such as flu or a cold. Many sore throats and coughs are viral and get better on their own.
The liquid form is used in children from six months of age. A Spanish leaflet says safety is not proven in younger babies.
Who should not take azithromycin?
Do not take it if you are allergic to azithromycin or erythromycin. The same applies to any other macrolide or ketolide antibiotic. The NHS says to check with a doctor first if you have:
- Liver or kidney problems.
- Heart problems, including an irregular heartbeat.
- Had diarrhoea with antibiotics before.
- Myasthenia gravis, a muscle-weakness condition. Azithromycin can make it worse.
- Diabetes, because the liquid contains sugar.
Spanish leaflets also warn about a long QT interval, a heart rhythm finding on an ECG. Some medicines do not mix well with azithromycin. Examples are ergotamine for migraine and some heart rhythm medicines. Some antidepressants and antipsychotics also matter. Antacids can interfere too. Always share your full medicine list.
Tell the doctor if you are pregnant. The Zitromax leaflet says azithromycin passes into breast milk. It is not recommended while breastfeeding.
Some people feel dizzy or sleepy on azithromycin. Fits and sight or hearing problems have also been reported. Take care when driving.
When should you see a doctor?
See a doctor today if you think you have a bacterial infection. Signs include:
- Earache with a fever.
- Sinus pain that keeps getting worse.
- Burning when you pee, or unusual discharge.
- A red, hot skin wound that is spreading.
Also get help today if you get severe or bloody diarrhoea during or after a course of antibiotics.
Call 112 if you get sudden wheezing or trouble breathing. The same applies to swelling of the eyelids, face or lips, or a widespread rash.
Can you use a foreign prescription for azithromycin in Spain?
In practice, no. Spanish pharmacies refuse prescriptions from the UK, the US and other countries. A doctor licensed in Spain has to issue a Spanish private electronic prescription.
Your old prescription or box is still useful. Bring it to your visit. It shows the doctor what you took before. The doctor will still need to assess you first.
Frequently asked questions
Is Zitromax the same as Zithromax?
Yes. Both are Pfizer brands of azithromycin. The pack and the forms on sale may be different. Spanish generics labelled azitromicina have the same active ingredient.
Can I buy azithromycin over the counter in Spain?
No. It is an antibiotic and needs a prescription in Spain. Pharmacies will not sell it without one.
Can I get azithromycin after a video visit?
The doctor can assess your symptoms by video. A Spanish private e-prescription is issued only where clinically appropriate, following a genuine evaluation. Some cases need a face-to-face exam or tests instead.
Can children take azithromycin?
Liquid forms are used in children from six months, but only if a doctor decides it is right. Never give a child an adult's tablets.
In an emergency, call 112.
Treatment and prescriptions are issued solely at the doctor's discretion, where clinically appropriate, following a genuine evaluation.
Getting a medical assessment
Dr. Yelamo offers same-day video appointments for urgent, non-emergency care. He sees adults, children and pregnant patients in English or Spanish, every day from 07:30 to 20:30 (Spain time). An Urgent Care video visit lasts 15 minutes and costs €50. He will ask about your symptoms, allergies and other medicines. Then he will explain whether an antibiotic is right for you. Book a video visit.
Related guides
Sources
This content is written and reviewed by a licensed physician with reference to the following sources.
