Prescription rules compared: Spain, the UK and the US, 116 common medicines
Of 116 medicines people most often ask about, 80 need a prescription in Spain, 10 are sold freely and 26 depend on the strength or pack. The same medicines are over the counter in the UK in 28 cases and fully over the counter in the US in 14 (16 more without a prescription at some strengths); 12 are not approved in the US at all. The full table, the method and a downloadable file are below.
- 116 medicines, 3 countries
- Spain data reviewed on 2 Oct 2026
- CSV and JSON download, free to cite
Key figures
- need a prescription in Spain
- 80 of 116
- are over the counter in the UK but prescription-only in Spain
- 8
- are over the counter in the US (at least some forms) but prescription-only in Spain
- 6
- are sold without a prescription in Spain but need one in the US
- 5
- are not approved for sale in the US
- 12
- change status in Spain depending on strength or pack
- 26
What this dataset shows
Expats and visitors in Spain are often surprised at the pharmacy counter. A medicine they buy freely at home needs a prescription here, or the other way round. This page puts the three sets of rules side by side so you can check a medicine before you travel, before you move, or before you assume your usual product is available.
The Spain column is the law that applies at any Spanish pharmacy: whether at least one marketed pack of that medicine can be dispensed without a prescription. The UK and US columns show the legal category of the same medicine at home, so you can see where the rules differ. A medicine marked 'depends' changes category with the strength, pack size or form (a cream against a tablet, for example).
The table is for orientation only. It does not say whether a medicine is right for you, and it never replaces the advice of a doctor or pharmacist. In Spain, a prescription-only medicine is issued only where clinically appropriate, following a genuine evaluation; neither issuance nor acceptance is guaranteed.
The full table: 116 medicines, three countries
Search by name (English or Spanish), filter by a pattern or by group. Every row is on the page for crawlers and screen readers; the filters only hide rows.
All 116 medicines shown
| Medicine | Group | Spain | Details in Spain | UK | US |
|---|---|---|---|---|---|
| Paracetamol | Pain and fever | Depends on strength/pack | 500 mg and 1 g tablets and oral solutions sold without prescription; some packs need one | Over the counter500 mg; small packs | OTCOral forms OTC under the FDA monograph; intravenous and opioid combinations Rx only. |
| IbuprofenIbuprofeno | Pain and fever | Depends on strength/pack | 200–400 mg without prescription; 600 mg needs one | Over the counter200–400 mg | Depends200 mg tablets/liquids OTC (switched 1984); 400-800 mg tablets Rx only. |
| AspirinÁcido acetilsalicílico | Pain and fever | Depends on strength/pack | 500 mg without prescription; low-dose heart packs need one | Over the counter | OTCOTC under the FDA monograph; Rx only in some combinations. |
| NaproxenNaproxeno | Pain and fever | Prescription only | All marketed single-ingredient packs need a prescription | Partly over the counterMostly prescription (low-dose period-pain packs from pharmacies) | DependsNaproxen sodium 220 mg OTC (Aleve, 1994); naproxen 250-500 mg and higher strengths Rx only. |
| DiclofenacDiclofenaco | Pain and fever | Depends on strength/pack | Gels and topical solutions without prescription; tablets need one | Partly over the counterGel over the counter; tablets prescription | Depends1% topical gel OTC (Voltaren Arthritis Pain, 2020); oral tablets/capsules and other forms Rx only. |
| DexketoprofenDexketoprofeno | Pain and fever | Depends on strength/pack | 12.5–25 mg in small packs without prescription; others need one | Prescription only | Not approvedNo FDA-approved product. |
| MetamizoleMetamizol | Pain and fever | Prescription only | Prescription only | Not marketedNot licensed in the UK | Not approvedWithdrawn from the US market in 1977; no approved product for people. |
| Tramadol | Pain and fever | Prescription only | Prescription only (controlled) | Prescription onlycontrolled | Controlled RxDEA Schedule IV since August 2014. |
| CodeineCodeína | Pain and fever | Prescription only | Prescription only | Partly over the counterLow-dose combinations from pharmacies; otherwise prescription | Controlled RxSchedule II alone; Schedule III in combinations; Schedule V cough syrups need a prescription in most states. |
| Hyoscine butylbromideButilescopolamina | Pain and fever | Depends on strength/pack | 10 mg tablets and suppositories without prescription; others need one | Over the counter10 mg | Not approvedNo FDA-approved product; the US scopolamine patch is a different prescription medicine. |
| CetirizineCetirizina | Allergy, colds and cough | Depends on strength/pack | Some 10 mg packs without prescription; most need one | Over the counter | OTCOral tablets/syrup OTC since 2007; injection (Quzyttir) and eye drops (Zerviate) Rx. |
| LoratadineLoratadina | Allergy, colds and cough | Depends on strength/pack | One 10 mg pack without prescription; most need one | Over the counter | OTCOTC since 2002 (Claritin). |
| DesloratadineDesloratadina | Allergy, colds and cough | Depends on strength/pack | Some 5 mg packs without prescription; most need one | Prescription only | Rx onlyClarinex and generics Rx only. |
| EbastineEbastina | Allergy, colds and cough | Depends on strength/pack | Some 10–20 mg packs without prescription; most need one | Not marketedNot marketed in the UK | Not approvedNo FDA-approved product. |
| BilastineBilastina | Allergy, colds and cough | Depends on strength/pack | Some 20 mg packs without prescription; most need one | Prescription only | Not approvedNo FDA-approved product. |
| FexofenadineFexofenadina | Allergy, colds and cough | Depends on strength/pack | One 120 mg pack without prescription; others need one | Over the counter120 mg | OTCOTC since 2011 (Allegra); a few legacy Rx labels remain. |
| DexchlorpheniramineDexclorfeniramina | Allergy, colds and cough | Prescription only | Prescription only | Not marketedNot marketed (chlorphenamine sold over the counter) | Rx onlyIn the FDA OTC antihistamine monograph, but the single-ingredient US products are labelled Rx only. |
| HydroxyzineHidroxizina | Allergy, colds and cough | Prescription only | Prescription only | Prescription only | Rx onlyTablets, capsules, syrup, injection all Rx only. |
| Oxymetazoline nasal sprayOximetazolina (spray nasal) | Allergy, colds and cough | Without prescription | Without prescription | Over the counter | OTC0.05% nasal spray OTC under the FDA monograph. |
| Xylometazoline nasal sprayXilometazolina (spray nasal) | Allergy, colds and cough | Without prescription | Without prescription | Over the counter | OTCIn the FDA OTC nasal decongestant monograph; few products are actually marketed in the US. |
| FluticasoneFluticasona | Allergy, colds and cough | Depends on strength/pack | One nasal spray without prescription; inhalers and others need one | Partly over the counterNasal spray over the counter; inhalers prescription | DependsNasal sprays OTC (Flonase 2015, Sensimist 2017); inhalers (Flovent, Advair) and skin products Rx only. |
| MometasoneMometasona | Allergy, colds and cough | Prescription only | Prescription only (nasal and skin) | Partly over the counterMostly prescription | DependsNasal spray OTC (Nasonex 24HR, 2022); cream/ointment/lotion and inhalers Rx only. |
| BudesonideBudesonida | Allergy, colds and cough | Depends on strength/pack | One 64 µg nasal spray without prescription; inhalers need one | Partly over the counterMostly prescription | DependsNasal spray OTC (Rhinocort Allergy, 2015); inhalers, nebulizer suspension and oral forms Rx only. |
| DextromethorphanDextrometorfano | Allergy, colds and cough | Without prescription | Without prescription | Over the counter | OTCOTC cough medicine under the FDA monograph. |
| AcetylcysteineAcetilcisteína | Allergy, colds and cough | Depends on strength/pack | Many 600 mg packs without prescription; others need one | Prescription only | Rx onlyApproved inhalation and intravenous forms are Rx only; oral NAC is sold only as a dietary supplement. |
| Ambroxol | Allergy, colds and cough | Depends on strength/pack | Many syrups and lozenges without prescription | Not marketedNot marketed in the UK | Not approvedNo FDA-approved product. |
| OmeprazoleOmeprazol | Stomach and gut | Depends on strength/pack | 20 mg in packs of 14 without prescription; others need one | Over the counter20 mg, small packs | Depends20 mg delayed-release tablets OTC (Prilosec OTC, 2003); capsules 10/20/40 mg and suspension Rx only. |
| PantoprazolePantoprazol | Stomach and gut | Depends on strength/pack | A few 20 mg packs without prescription; most need one | Over the counter20 mg, small packs | Rx onlyDelayed-release tablets and injection Rx only. |
| EsomeprazoleEsomeprazol | Stomach and gut | Depends on strength/pack | A few 20 mg packs without prescription; most need one | Over the counter20 mg, small packs | Depends20 mg OTC (Nexium 24HR, 2014); 40 mg capsules, suspension and IV Rx only. |
| FamotidineFamotidina | Stomach and gut | Depends on strength/pack | 10 mg without prescription; higher strengths need one | Prescription only | Depends10 mg and 20 mg OTC (Pepcid AC); 40 mg tablets, suspension and injection Rx only. |
| Almagate (antacid)Almagato (antiácido) | Stomach and gut | Without prescription | Without prescription | Not marketedNot marketed (other antacids over the counter) | Not approvedNo FDA-approved product. |
| LoperamideLoperamida | Stomach and gut | Without prescription | Without prescription | Over the counter | OTC2 mg tablets, caplets and liquid OTC (Imodium A-D); some 2 mg capsules carry Rx labelling. |
| RacecadotrilRacecadotrilo | Stomach and gut | Depends on strength/pack | One 100 mg pack without prescription; others need one | Prescription only | Not approvedNo FDA-approved product. |
| MetoclopramideMetoclopramida | Stomach and gut | Prescription only | Prescription only | Prescription only | Rx onlyTablets, solution, injection Rx only. |
| DomperidoneDomperidona | Stomach and gut | Prescription only | Prescription only | Prescription only | Not approvedNot FDA-approved for any human use; available only through an expanded-access programme. |
| OndansetronOndansetrón | Stomach and gut | Prescription only | Prescription only | Prescription only | Rx onlyTablets, ODT, solution, injection Rx only. |
| Dimenhydrinate (travel sickness)Dimenhidrinato (mareo) | Stomach and gut | Without prescription | Without prescription | Not marketedNot marketed (other travel-sickness tablets over the counter) | OTCOTC under the FDA monograph (Dramamine). |
| BisacodylBisacodilo | Stomach and gut | Without prescription | Without prescription | Over the counter | OTCTablets and suppositories OTC under the FDA laxative monograph. |
| LactuloseLactulosa | Stomach and gut | Prescription only | Prescription only (as a registered medicine) | Over the counter | Rx onlyOral solution Rx only in the US. |
| Macrogol | Stomach and gut | Prescription only | Single-ingredient medicines need a prescription | Over the counter | DependsPEG 3350 powder OTC; PEG-electrolyte bowel-prep solutions (GoLYTELY) Rx only. |
| AmoxicillinAmoxicilina | Antibiotics | Prescription only | Prescription only | Prescription only | Rx onlyAll oral forms Rx only. |
| Co-amoxiclav (amoxicillin + clavulanic acid)Amoxicilina + ácido clavulánico | Antibiotics | Prescription only | Prescription only | Prescription only | Rx onlyAugmentin and generics Rx only. |
| AzithromycinAzitromicina | Antibiotics | Prescription only | Prescription only | Prescription only | Rx onlyTablets, suspension, IV, eye drops Rx only. |
| ClarithromycinClaritromicina | Antibiotics | Prescription only | Prescription only | Prescription only | Rx onlyTablets, ER tablets, suspension Rx only. |
| DoxycyclineDoxiciclina | Antibiotics | Prescription only | Prescription only | Prescription only | Rx onlyAll forms Rx only. |
| CiprofloxacinCiprofloxacino | Antibiotics | Prescription only | Prescription only | Prescription only | Rx onlyTablets, suspension, IV, eye and ear drops Rx only. |
| LevofloxacinLevofloxacino | Antibiotics | Prescription only | Prescription only | Prescription only | Rx onlyTablets, solution, IV, eye drops Rx only. |
| CefuroximeCefuroxima | Antibiotics | Prescription only | Prescription only | Prescription only | Rx onlyTablets, suspension and injection Rx only. |
| FosfomycinFosfomicina | Antibiotics | Prescription only | Prescription only | Prescription only | Rx onlyFosfomycin tromethamine 3 g granules (Monurol) Rx only. |
| NitrofurantoinNitrofurantoína | Antibiotics | Prescription only | Prescription only | Prescription only | Rx onlyMacrocrystal/monohydrate capsules and suspension Rx only. |
| MetronidazoleMetronidazol | Antibiotics | Prescription only | Prescription only | Prescription only | Rx onlyTablets, capsules, IV, vaginal gel, topical Rx only; no approved OTC product. |
| ClindamycinClindamicina | Antibiotics | Prescription only | Prescription only | Prescription only | Rx onlyCapsules, injection, topical, vaginal Rx only; no approved OTC product. |
| Mupirocin creamMupirocina (crema) | Antibiotics | Prescription only | Prescription only | Prescription only | Rx only2% cream and ointment (Bactroban) Rx only. |
| Fusidic acid creamÁcido fusídico (crema) | Antibiotics | Prescription only | Prescription only | Prescription only | Not approvedNo FDA-approved fusidic acid product in any form. |
| Tobramycin eye dropsTobramicina (colirio) | Antibiotics | Prescription only | Prescription only | Prescription only | Rx only0.3% eye drops and ointment (Tobrex) and all other forms Rx only. |
| FluconazoleFluconazol | Antifungals and antivirals | Prescription only | Prescription only, including the 150 mg thrush capsule | Over the counter150 mg for thrush | Rx onlyTablets (including the 150 mg single dose), suspension and IV Rx only. |
| ClotrimazoleClotrimazol | Antifungals and antivirals | Depends on strength/pack | Creams and vaginal products mostly without prescription | Over the counter | Depends1% cream and vaginal products OTC; troches (lozenges) and clotrimazole-betamethasone cream Rx only. |
| MiconazoleMiconazol | Antifungals and antivirals | Prescription only | Marketed packs need a prescription | Over the countercreams, oral gel | DependsCreams, powders, vaginal products OTC; buccal tablet (Oravig) Rx; oral gel not marketed in US. |
| TerbinafineTerbinafina | Antifungals and antivirals | Depends on strength/pack | Cream without prescription; tablets need one | Partly over the counterCream over the counter; tablets prescription | Depends1% cream/spray OTC (Lamisil AT, switched 1999); 250 mg tablets Rx only. |
| Aciclovir | Antifungals and antivirals | Depends on strength/pack | Cold-sore cream without prescription; tablets need one | Partly over the counterCream over the counter; tablets prescription | Rx onlyCream, ointment, tablets, capsules, suspension all Rx; no FDA-approved OTC acyclovir (docosanol is the OTC cold-sore drug). |
| Valaciclovir | Antifungals and antivirals | Prescription only | Prescription only | Prescription only | Rx onlyTablets (Valtrex and generics) Rx only. |
| Oseltamivir (Tamiflu)Oseltamivir | Antifungals and antivirals | Prescription only | Prescription only | Prescription only | Rx onlyCapsules and oral suspension Rx only. |
| Salbutamol inhaler (Ventolin)Salbutamol (Ventolin) | Asthma, heart and long-term conditions | Prescription only | Prescription only | Prescription only | Rx onlyAll albuterol inhalers/nebules Rx only (the OTC Primatene Mist is epinephrine, not albuterol). |
| Montelukast | Asthma, heart and long-term conditions | Prescription only | Prescription only | Prescription only | Rx onlyTablets, chewables, granules (Singulair, generics) Rx only; boxed warning. |
| AtorvastatinAtorvastatina | Asthma, heart and long-term conditions | Prescription only | Prescription only | Prescription only | Rx onlyTablets Rx only; no OTC statin approved in the US. |
| SimvastatinSimvastatina | Asthma, heart and long-term conditions | Prescription only | Prescription only | Prescription only | Rx onlyTablets Rx only. |
| RosuvastatinRosuvastatina | Asthma, heart and long-term conditions | Prescription only | Prescription only | Prescription only | Rx onlyTablets (Crestor, generics) Rx only. |
| AmlodipineAmlodipino | Asthma, heart and long-term conditions | Prescription only | Prescription only | Prescription only | Rx onlyTablets and combinations Rx only. |
| Enalapril | Asthma, heart and long-term conditions | Prescription only | Prescription only | Prescription only | Rx onlyTablets (Vasotec, generics) Rx only. |
| Ramipril | Asthma, heart and long-term conditions | Prescription only | Prescription only | Prescription only | Rx onlyCapsules Rx only. |
| LosartanLosartán | Asthma, heart and long-term conditions | Prescription only | Prescription only | Prescription only | Rx onlyTablets (Cozaar, generics) Rx only. |
| Bisoprolol | Asthma, heart and long-term conditions | Prescription only | Prescription only | Prescription only | Rx onlyTablets and bisoprolol/HCTZ Rx only. |
| HydrochlorothiazideHidroclorotiazida | Asthma, heart and long-term conditions | Prescription only | Prescription only | Prescription only | Rx onlyTablets, capsules and combinations Rx only. |
| FurosemideFurosemida | Asthma, heart and long-term conditions | Prescription only | Prescription only | Prescription only | Rx onlyTablets, oral solution, injection Rx only. |
| ApixabanApixabán | Asthma, heart and long-term conditions | Prescription only | Prescription only | Prescription only | Rx onlyTablets (Eliquis, generics) Rx only. |
| Acenocoumarol (Sintrom)Acenocumarol (Sintrom) | Asthma, heart and long-term conditions | Prescription only | Prescription only | Prescription onlywarfarin more common | Not approvedNot marketed in the US (warfarin is the US coumarin). |
| Clopidogrel | Asthma, heart and long-term conditions | Prescription only | Prescription only | Prescription only | Rx onlyTablets (Plavix, generics) Rx only. |
| MetforminMetformina | Asthma, heart and long-term conditions | Prescription only | Prescription only | Prescription only | Rx onlyIR/ER tablets, solution and combinations Rx only. |
| Insulin glargineInsulina glargina | Asthma, heart and long-term conditions | Prescription only | Prescription only | Prescription only | Rx onlyLantus, Basaglar, Semglee, Toujeo etc. Rx only (unlike some OTC human regular/NPH insulins). |
| Semaglutide (Ozempic, Wegovy)Semaglutida (Ozempic, Wegovy) | Asthma, heart and long-term conditions | Prescription only | Prescription only | Prescription only | Rx onlyOzempic, Wegovy injections and Rybelsus tablets all Rx only. |
| Tirzepatide (Mounjaro)Tirzepatida (Mounjaro) | Asthma, heart and long-term conditions | Prescription only | Prescription only | Prescription only | Rx onlyMounjaro and Zepbound (pen and vial) Rx only. |
| Levothyroxine (Eutirox)Levotiroxina (Eutirox) | Asthma, heart and long-term conditions | Prescription only | Prescription only | Prescription only | Rx onlyTablets, capsules, solution and injection Rx only. |
| AllopurinolAlopurinol | Asthma, heart and long-term conditions | Prescription only | Prescription only | Prescription only | Rx onlyTablets Rx only. |
| ColchicineColchicina | Asthma, heart and long-term conditions | Prescription only | Prescription only | Prescription only | Rx onlyTablets, capsules (Colcrys, Mitigare, Lodoco) Rx only. |
| PrednisonePrednisona | Asthma, heart and long-term conditions | Prescription only | Prescription only | Prescription onlyprednisolone more common | Rx onlyTablets and oral solution Rx only. |
| PrednisolonePrednisolona | Asthma, heart and long-term conditions | Prescription only | Prescription only | Prescription only | Rx onlyOral forms and eye drops Rx only. |
| Adrenaline auto-injectorAdrenalina (autoinyector) | Asthma, heart and long-term conditions | Prescription only | Prescription only | Prescription only | Rx onlyEpiPen/EpiPen Jr, Auvi-Q, generics and neffy nasal spray Rx only; OTC epinephrine is only Primatene Mist inhaler. |
| SertralineSertralina | Mental health, sleep and nerves | Prescription only | Prescription only | Prescription only | Rx onlyTablets, capsules, oral concentrate Rx only. |
| FluoxetineFluoxetina | Mental health, sleep and nerves | Prescription only | Prescription only | Prescription only | Rx onlyCapsules, tablets, solution Rx only. |
| Escitalopram | Mental health, sleep and nerves | Prescription only | Prescription only | Prescription only | Rx onlyTablets and oral solution Rx only. |
| Citalopram | Mental health, sleep and nerves | Prescription only | Prescription only | Prescription only | Rx onlyTablets and solution Rx only. |
| MirtazapineMirtazapina | Mental health, sleep and nerves | Prescription only | Prescription only | Prescription only | Rx onlyTablets and ODT Rx only. |
| Diazepam | Mental health, sleep and nerves | Prescription only | Prescription only (controlled) | Prescription onlycontrolled | Controlled RxDEA Schedule IV (CIV); tablets, oral solution, rectal gel, nasal spray, injection. |
| Lorazepam | Mental health, sleep and nerves | Prescription only | Prescription only (controlled) | Prescription onlycontrolled | Controlled RxDEA Schedule IV (CIV); tablets, oral concentrate, injection. |
| Alprazolam | Mental health, sleep and nerves | Prescription only | Prescription only (controlled) | Prescription onlycontrolled | Controlled RxDEA Schedule IV (CIV); tablets, ER, ODT, oral solution. |
| Zolpidem | Mental health, sleep and nerves | Prescription only | Prescription only (controlled) | Prescription onlycontrolled | Controlled RxDEA Schedule IV (CIV); tablets, ER, sublingual, oral spray. |
| MelatoninMelatonina | Mental health, sleep and nerves | Depends on strength/pack | Some 3–5 mg medicines without prescription; 2 mg prolonged-release needs one | Prescription only | OTCSold as a dietary supplement, not an approved drug; no Rx melatonin product in the US. |
| SumatriptanSumatriptán | Mental health, sleep and nerves | Prescription only | Prescription only | Over the counter50 mg, pharmacy | Rx onlyTablets, nasal spray/powder, injection Rx only. |
| RizatriptanRizatriptán | Mental health, sleep and nerves | Prescription only | Prescription only | Prescription only | Rx onlyTablets and ODT (Maxalt, generics) Rx only. |
| PregabalinPregabalina | Mental health, sleep and nerves | Prescription only | Prescription only | Prescription onlycontrolled | Controlled RxDEA Schedule V (CV); capsules, oral solution, ER tablets. |
| GabapentinGabapentina | Mental health, sleep and nerves | Prescription only | Prescription only | Prescription onlycontrolled | Rx onlyNot federally scheduled; several states schedule it or require monitoring. |
| Methylphenidate (ADHD)Metilfenidato (TDAH) | Mental health, sleep and nerves | Prescription only | Prescription only (controlled) | Prescription onlycontrolled | Controlled RxDEA Schedule II (CII); IR/ER tablets, capsules, patch, solution. |
| Morning after pill (levonorgestrel 1.5 mg)Píldora del día después (levonorgestrel 1,5 mg) | Sexual and reproductive health | Without prescription | 1.5 mg emergency pill without prescription | Over the counterpharmacy | OTCPlan B One-Step and generics OTC with no age restriction since 20 June 2013. |
| Ulipristal acetate (ellaOne)Acetato de ulipristal (ellaOne) | Sexual and reproductive health | Without prescription | 30 mg emergency pill without prescription | Over the counterpharmacy | Rx onlyella 30 mg tablet Rx only. |
| Estradiol (HRT)Estradiol (THS) | Sexual and reproductive health | Prescription only | Prescription only | Partly over the counterMostly prescription (low-dose vaginal tablets from pharmacies) | Rx onlyTablets, patches, gels, vaginal cream/insert/ring all Rx only. |
| Sildenafil (Viagra)Sildenafilo (Viagra) | Sexual and reproductive health | Prescription only | Prescription only | Over the counter50 mg, pharmacy | Rx onlyViagra, Revatio and generics Rx only. |
| Tadalafil (Cialis)Tadalafilo (Cialis) | Sexual and reproductive health | Prescription only | Prescription only | Prescription only | Rx onlyCialis, Adcirca and generics Rx only; no OTC switch approved as of 2026. |
| FinasterideFinasterida | Sexual and reproductive health | Prescription only | Prescription only | Prescription only | Rx only1 mg (Propecia) and 5 mg (Proscar) tablets Rx only. |
| TamsulosinTamsulosina | Sexual and reproductive health | Prescription only | Prescription only | Partly over the counterOver the counter for some men (pharmacy) | Rx only0.4 mg capsules and dutasteride/tamsulosin Rx only. |
| Hydrocortisone creamHidrocortisona (crema) | Skin, parasites and other | Depends on strength/pack | 0.5% creams without prescription; stronger ones need one | Over the counter1% | Depends0.5% and 1% creams/ointments OTC; 2.5% and hydrocortisone butyrate/valerate Rx only. |
| BetamethasoneBetametasona | Skin, parasites and other | Prescription only | Prescription only | Prescription only | Rx onlyDipropionate/valerate creams, ointments, lotions Rx only. |
| Permethrin cream (scabies)Permetrina (crema, sarna) | Skin, parasites and other | Prescription only | Prescription only | Over the counterpharmacy | Depends5% cream (scabies) Rx only; 1% creme rinse/lotion (Nix, lice) OTC. |
| Mebendazole (threadworms)Mebendazol (oxiuros) | Skin, parasites and other | Prescription only | Prescription only | Over the counterpharmacy | Rx onlyEmverm/Vermox 100 mg and 500 mg chewable tablets Rx only; the OTC US pinworm drug is pyrantel pamoate. |
| Nicotine replacementSustitutos de nicotina | Skin, parasites and other | Without prescription | Patches, gum and sprays without prescription | Over the counter | OTCPatches, gum, lozenges OTC; Nicotrol nasal spray and inhaler remain Rx only. |
| Cytisinicline (stop smoking)Citisiniclina (dejar de fumar) | Skin, parasites and other | Prescription only | Prescription only | Prescription only | Not approvedNo FDA-approved product as of October 2026. |
| Vitamin D (colecalciferol) medicinesVitamina D (colecalciferol), medicamentos | Skin, parasites and other | Prescription only | Registered medicines need a prescription; food supplements are sold separately | Partly over the counterSupplements widely sold; high-dose medicines prescription | DependsCholecalciferol and low-dose D2 sold OTC as dietary supplements; ergocalciferol 50,000 IU (1.25 mg) capsules Rx only. |
This dataset describes legal dispensing categories, not treatment advice. It does not include doses, and it does not say whether a medicine is suitable for you. Controlled medicines (strong painkillers, sedatives, sleeping tablets and stimulants) are listed for information only: they are not prescribed in an online consultation. Spanish pharmacies may ask for a prescription for packs that are technically free to sell, and products change category over time.
Always follow the leaflet in the box and your doctor or pharmacist. For urgent, non-emergency problems you can book a video consultation; in an emergency call 112.
The differences that catch people out
Generated from the table. Each list names the medicines behind the figures above.
Over the counter in the UK, prescription only in Spain (8)
Lactulose · Macrogol · Fluconazole · Miconazole · Sumatriptan · Sildenafil (Viagra) · Permethrin cream (scabies) · Mebendazole (threadworms)
Over the counter in the US, at least in some forms, prescription only in Spain (6)
Naproxen · Mometasone · Macrogol · Miconazole · Permethrin cream (scabies) · Vitamin D (colecalciferol) medicines
Sold without a prescription in Spain, prescription only in the US (5)
Desloratadine · Acetylcysteine · Pantoprazole · Aciclovir · Ulipristal acetate (ellaOne)
Common in Spain, not approved in the US (12)
Dexketoprofen · Metamizole · Hyoscine butylbromide · Ebastine · Bilastine · Ambroxol · Almagate (antacid) · Racecadotril · Domperidone · Fusidic acid cream · Acenocoumarol (Sintrom) · Cytisinicline (stop smoking)
Method
Spain: each of the 116 medicines was checked by Dr. Pedro Yelamo Vera, GP licensed in Spain (Colegiado No. 484814280), against CIMA, the official medicines database of the Spanish Medicines Agency (AEMPS), pack by pack. A medicine counts as 'without prescription' when at least one marketed pack is authorised for dispensing without a prescription. The review was completed on 2 October 2026 and is published in full in the guide linked below.
UK: the legal category of the same medicine (general sale, pharmacy or prescription only) from the UK product information held by the MHRA and the BNF, recorded in the same review.
US: the status of the same active ingredient from FDA sources (Drugs@FDA, OTC monographs and Rx-to-OTC switch notices), DailyMed labels and MedlinePlus, checked on 25 October 2026. The source page used for each row is included in the CSV and JSON downloads.
Counting: a medicine is 'over the counter' in the UK when its general-sale or pharmacy category covers the common strength; 'OTC' in the US when an FDA monograph or OTC application covers it; 'depends' when only some strengths or forms are sold without a prescription. Controlled medicines are counted as prescription only. Rules change and packs differ: the dataset carries its update date and is refreshed when a status changes.
Sources
- AEMPS — CIMA, Centro de Información de Medicamentos (Spain)
- Dr. Pedro Yelamo Vera — Which medicines need a prescription in Spain? 116 medicines checked (reviewed 2 Oct 2026)
- MHRA — Medicines and Healthcare products Regulatory Agency (UK legal categories)
- BNF — British National Formulary
- FDA — Drugs@FDA
- FDA — Prescription to Nonprescription Switch List
- DailyMed — US National Library of Medicine (product labels)
- MedlinePlus — Drug information
Frequently asked questions
Why does a medicine that is over the counter at home need a prescription in Spain?
Each country classifies medicines on its own. Spain's AEMPS decides pack by pack; the UK's MHRA and the US FDA decide for their markets. Antifungal tablets, the morning-after pill, some migraine tablets and several laxatives are classic examples of a medicine that is free to buy in one country and prescription-only in another. The table shows the three rules side by side.
Can I use my UK or US prescription at a Spanish pharmacy?
No. Spanish pharmacies can only dispense prescription medicines against a Spanish prescription, or an EU cross-border prescription issued in another EU country. A doctor licensed in Spain can assess you by video and, where clinically appropriate, following a genuine evaluation, issue a Spanish private e-prescription. Neither issuance nor acceptance is guaranteed.
What does 'depends on strength or pack' mean?
The same active ingredient is sold in several products. In Spain some of them (usually the lower strength or the small pack) are authorised for sale without a prescription, while others need one. The 'Details in Spain' column says which.
Which medicines in the table are not sold in the US at all?
Several everyday Spanish medicines have no FDA-approved product, for example metamizole (Nolotil), dexketoprofen (Enantyum), ebastine, bilastine, ambroxol, racecadotril and acenocoumarol (Sintrom). Visitors from the US will not recognise them, and Americans living in Spain cannot take them home as a US prescription. Filter the table by 'Not approved in the US' for the full list.
How often is the dataset updated?
The Spain column follows the reviewed guide it comes from, which is re-checked whenever a status changes in CIMA. The US column carries its own check date. The update date is printed above the download links and inside the files.
Can I republish the table or quote the figures?
Yes. The dataset is CC BY 4.0: quote the figures, embed the table or build on the files, with a credit to Dr. Pedro Yelamo Vera and a link to this page. For comment or an updated figure, email the practice.
Every day · 07:30–20:30Need a Spanish prescription or advice on a medicine you take at home?
Book a video consultation with a GP licensed in Spain. A private e-prescription is issued only where clinically appropriate, following a genuine evaluation. Emergencies: call 112.
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