Migraine treatment in Spain: triptan prescriptions and follow-up

Migraine treatment in Spain works in two layers: simple pain relief you can buy at any pharmacy, and migraine-specific medicines called triptans, which are prescription-only. A GP licensed in Spain can assess your headaches by video and, where clinically appropriate, issue a private electronic prescription. A headache diary makes that assessment, and every follow-up after it, far more accurate.

What is a migraine, and how is it different from other headaches?

A migraine is a moderate to severe throbbing pain, often on one side of the head, that gets worse when you move. It can come with nausea, vomiting and sensitivity to light or sound. Some people get an aura first, such as flashing lights or blind spots. Knowing the type of headache helps the doctor decide what is safe:

• Tension-type headache: a dull, tight band of pressure on both sides of the head, forehead or neck, without strong nausea or aura.
• Medication-overuse headache: headaches on most days, caused by taking pain medicine too often. It can happen with simple painkillers taken on 15 or more days a month, and with triptans on 10 or more days a month.

A doctor also checks that your headache really is a migraine. Some headaches are a sign of another problem that needs different care. The NHS migraine page gives a plain overview of symptoms and triggers.

Which headache medicines need a prescription in Spain?

Medicine	In a Spanish pharmacy
Paracetamol	No prescription needed
Ibuprofen	Lower-strength packs: no prescription. Higher strengths: prescription only
Aspirin	Pain-relief packs: no prescription. Not for children under 16
Triptans (migraine-specific)	Prescription only
Anti-nausea medicines	Most need a prescription

Use pain medicine on no more than a few days a week. Taking it too often can itself cause daily headaches. Useful words at the counter: receta (prescription), ¿Necesita receta? (does it need a prescription?), efectos secundarios (side effects), prospecto (the leaflet in the box), dolor de cabeza (headache), ataque de migraña (migraine attack). Our prescription status of common medicines in Spain covers other everyday medicines.

Do triptans need a prescription in Spain?

Yes. Triptans sold in Spain include sumatriptan, rizatriptan, zolmitriptan, eletriptan, almotriptan and naratriptan, and all are prescription-only, so the pharmacy needs a valid prescription. This surprises UK visitors: in the UK a small pack of sumatriptan can be bought from a pharmacist by people already diagnosed with migraine. In Spain, you need a prescription. For that one medicine, read our guide to sumatriptan in Spain.

Triptans narrow the blood vessels around the brain and are thought to reverse the brain changes behind an attack. They are not safe for everyone. They are not suitable for people with heart disease or a past stroke, and high blood pressure needs checking first, because triptans are not suitable if it is moderate, severe or not under control. Tell the doctor which triptan you normally use and in what form (tablet, melt, nasal spray or injection).

Side effects of triptans

Common ones include feeling warm, tingling, flushing, and heaviness or tightness in the face, limbs or chest. These are often mild and settle on their own. Sumatriptan can also cause nausea, sleepiness or dizziness. Do not take two different triptans together, or a triptan with ergotamine. Read the leaflet, or check it on CIMA (AEMPS), the Spanish medicines database. If you get chest pain that is severe or does not go away, call 112.

What is the difference between acute and preventive migraine treatment?

Acute treatment is what you take when an attack starts: simple pain medicine first, a triptan if the doctor has prescribed one, and sometimes an anti-nausea medicine. Preventive treatment is a daily approach to reduce how often attacks come. It is considered when attacks are frequent or disabling, or when acute medicine is needed too often. Options range from lifestyle changes and trigger control to several classes of prescription medicine, chosen case by case; a neurologist is involved when needed. Dosing and choice of medicine are decided with your doctor, never from a web page.

How does an online GP treat migraine in Spain?

In a video visit, Dr. Pedro Yelamo, a GP licensed in Spain (Colegiado No. 484814280):

• Asks about your headaches: how often, how long, any aura, what has helped before, plus your heart health and blood pressure.
• Checks for warning signs that need in-person or emergency care.
• Discusses treatment. If clinically indicated after the assessment, he can issue a private electronic prescription under Spanish law, for example a triptan or an anti-nausea medicine, dispensed in any Spanish pharmacy. A prescription is never guaranteed.
• Talks through triggers: sleep, regular meals, fluids, alcohol, heat and long screen time.
• Plans ahead: preventive options and, when needed, a referral to a neurologist.

The urgent care video consultation lasts 15 minutes and costs €50, with an itemised invoice. It is for urgent, non-emergency care, every day from 07:30 to 20:30 Spain time. Choose an available time in the live calendar. Treatment and prescriptions are issued solely at the doctor's discretion, where clinically appropriate, following a genuine evaluation.

What to prepare before the visit

• Your headache diary, or at least dated notes: attacks, duration, what you took.
• The medicines you take now or have tried; a photo of the box or leaflet helps. Say whether they helped and any side effects.
• Any heart problems, high blood pressure, past stroke, pregnancy or breastfeeding.
• A recent blood pressure reading if you have a home monitor.
• A quiet, dim room for the call if you are mid-attack.

How do you keep a headache diary for migraine follow-up?

Record what happened, what you took and how the headache affected your day, with dates. Bring the original notes and a short summary; the summary should not replace the details. If your clinician gave you a template, keep using it. Otherwise these fields work:

Diary field	What to record	How to keep it clear
Date and timing	When the headache started and ended	Mark estimates as estimates
Your description	Where you felt pain and what it was like	Your own words; no self-diagnosis
Other symptoms	Nausea, aura, light sensitivity, anything else	What happened and when
Medicines taken	Name, strength, amount and time	Copy from the packaging
What happened afterwards	Changes after medicine, rest or another action	Record without assuming the cause
Daily impact	Activities stopped, missed or done with difficulty	A specific example beats "severe"
Context	Poor sleep, travel, heat, skipped meals	Context, not proven causes
Uncertainty	Missing times or unclear details	Write "unknown" rather than guess

Keep it unambiguous and honest

Write the month in words when sharing records across countries. Note your location if you moved between countries during the period. Write what you noticed before what you think caused it: "slept badly the night before" is an observation, not a verdict. One dated entry per day works well, including a brief note on headache-free days. Mark a missed day as unrecorded rather than assuming it was headache-free.

Two totals that matter

Prepare two separate totals for the recorded period, with start and end dates: days with a headache, and days you took medicine for a headache. They answer different questions and help the doctor spot medication-overuse headache. They are not a reason to change treatment yourself.

Which diary format?

Format	Advantage	Limitation
Paper notebook	Entries together, no device needed	Handwriting or photos can be hard to read
Spreadsheet	Consistent columns and dates	Needs access to the file and some setup
Phone notes	Simple while travelling	Separate notes become hard to review together
Diary app	Structured entries	Check export options and privacy settings

Choose consistency over features. Before sharing a digital diary, check what will appear on screen and remove unrelated messages or other people's details. Distinguish notes written during an attack from notes added later from memory, and flag unfamiliar product names so you can check the packaging.

What does a migraine follow-up review cover?

A follow-up reviews your diary, how acute treatment is working, side effects, how often you need medicine, your blood pressure and whether a preventive plan or a neurology referral makes sense now. Prepare three priority questions, for example: what do my records show, is an examination needed, and what should I record before the next review?

Bring your current medicine list with allergies, letters from your usual GP or specialist, and the details of your current plan. Records from a doctor outside Spain are welcome; keep the originals and bring a photo of labelled packaging if a medicine name differs between countries. A video follow-up cannot perform a hands-on examination, so the doctor decides whether local assessment, specialist input or another step is needed. Before the call ends, ask what to record next and whether the next step is video or in person. Do not delay care to finish a diary. Neither issuance nor acceptance of a certificate is guaranteed, and the same applies to prescriptions.

What should you do during a migraine attack?

• Take your usual pain medicine at the first sign of an attack, as the leaflet says.
• Lie down in a dark, quiet, cool room. Most people find this helps the most.
• Put a cold compress on your forehead and take small sips of water, especially in hot weather.
• Keep away from bright screens.
• Note the attack in your diary once you can.

Emergencies

Some headaches are a sign of a serious problem in the brain. Call 112 (or 061 in regions that use it) or go to hospital urgencias straight away if you have:

• A sudden, explosive "thunderclap" headache that reaches full strength within seconds.
• A headache with fever, a stiff neck and confusion.
• New weakness in an arm, a drooping face, trouble speaking or loss of vision.
• A new headache after the age of 50, with a tender scalp or pain over the temples.
• A headache after a head injury, or if you are very drowsy or hard to wake.
• Severe chest pain after taking a triptan.

This practice does not provide emergency care. See emergency numbers in Spain.

Frequently asked questions