Medication Names in Spain: US and UK Brand Equivalents (2026)

Medication Names in Spain: US and UK Brand Equivalents (2026)

Tylenol is Gelocatil. Advil is Neobrufen. Lipitor is Cardyl. A verified, AEMPS-sourced directory of what your medication is called in a Spanish pharmacy.

A box of paracetamol in Madrid says Gelocatil on the front. The exact same molecule in Manchester says Panadol; in Manhattan it says Tylenol. None of the three boxes mention the others. For a tourist trying to refill medication or buy something familiar, this is the central problem of foreign pharmacy: the active ingredient is the same, the dose is often the same, but every country has overwritten the box with a different commercial name.

This directory matches roughly 80 of the medications that tourists, expats and digital nomads most often look for in Spain to their US and UK brand equivalents. Every Spanish brand has been verified against the AEMPS database CIMA (the Spanish drug regulator) or Vademecum, and is currently marketed in Spain. US brands are verified against the FDA Orange Book and DailyMed; UK brands against the BNF and MHRA.

Two things to internalise before reading the tables. First: Spanish pharmacists work from the principio activo (active ingredient), not the brand. Show them the box and they will find the local equivalent in seconds. Second: a medication being a familiar OTC purchase at home does not guarantee it is OTC in Spain — and vice versa. Codeine combinations, salbutamol inhalers and 600 mg ibuprofen all need a Spanish prescription. Paracetamol 1 g, ulipristal emergency contraception and most antihistamines do not.

~80 medications cross-mapped between Spain, the US and the UK, with current Rx/OTC status verified against AEMPS CIMA

1. Why brand names differ across countries

A pharmaceutical brand is a marketing licence, not a global trademark. When a drug is approved in each country, the originator company (or a licensee) registers a local name that the national regulator accepts. Sometimes the same name travels — Viagra, Augmentin and Imodium are recognisable almost everywhere — but more often, marketing strategy, trademark conflicts, language preferences and local acquisitions produce different brands for the identical molecule.

Three forces drive divergence specifically between Spain, the US and the UK:

Generic substitution rules. Spanish law obliges pharmacists to dispense the cheapest bioequivalent generic unless the prescriber writes no sustituir. Most boxes carry a generic name (for example Omeprazol Cinfa or Atorvastatina Normon) plus the EFG mark (Equivalente Farmacéutico Genérico). The originator brand is dispensed less often, which means the "famous" Spanish name is sometimes a generic-house brand rather than the original.

Different licence holders. Lipitor in Spain is sold as Cardyl and Zarator (both Pfizer); Synthroid in Spain is Eutirox (Merck); Reglan is Primperan (Sanofi). The patent owner often licenses a different brand to a different European partner, producing parallel names that never made the jump across the Atlantic.

USAN vs INN. The US Adopted Name occasionally differs from the international nonproprietary name used in Europe. The two pairs that catch travellers most often: acetaminophen (US) = paracetamol (Spain and UK), and albuterol (US) = salbutamol (Spain and UK). The molecule is identical; only the nomenclature differs.

If you only remember one rule: read the box for the active ingredient. The Latin-rooted versions used in Spain are usually obvious from the English (atorvastatina, amoxicilina, omeprazol, sertralina, levotiroxina). When in doubt, hand the pharmacist the original package.

2. Quick reference: 20 most-searched medications

The fastest answer for the most common questions. Each row is expanded in the category sections that follow, with prescription status, Spanish-specific notes and ambiguity flags.

Active ingredient🇪🇸 Spain🇺🇸 US🇬🇧 UKUse
Paracetamol / acetaminophenGelocatil, TermalginTylenolPanadol, CalpolPain, fever
IbuprofenNeobrufen, EspidifenAdvil, MotrinNurofen, BrufenPain, fever, inflammation
Metamizol (dipyrone)NolotilNot licensedNot licensedModerate–severe pain, fever
Aspirin / acetylsalicylic acidAspirina, Adiro (100 mg cardio)Bayer, EcotrinAspirin, DisprinPain, antiplatelet
Amoxicillin + clavulanic acidAugmentineAugmentinAugmentin, Co-amoxiclavAntibiotic
AzithromycinZitromaxZithromax (Z-Pak)ZithromaxAntibiotic
FosfomycinMonurolMonurolMonurilUTI (single dose)
Salbutamol / albuterolVentolinProAir, Proventil, Ventolin HFAVentolin, SalamolAsthma rescue inhaler
Fluticasone (inhaled)FlixotideFlovent, Arnuity ElliptaFlixotideAsthma preventer
LoratadineClarityneClaritinClaritynAntihistamine
CetirizineZyrtec, AlerlisinZyrtecZirtek, PiritezeAntihistamine
OmeprazoleLosec, Omeprazol EFGPrilosecLosecAcid reflux
LoperamideFortasecImodium A-DImodiumDiarrhoea
AtorvastatinCardyl, ZaratorLipitorLipitorCholesterol
MetforminDianbenGlucophageGlucophageType 2 diabetes
LevothyroxineEutiroxSynthroidEltroxin, LevothyroxineHypothyroidism
SertralineBesitranZoloftLustralSSRI antidepressant
LorazepamOrfidal, IdalpremAtivanLorazepam (generic)Anxiety
SildenafilViagraViagraViagraErectile dysfunction
Levonorgestrel (emergency)Norlevo, PostinorPlan B One-StepLevonelleMorning-after pill

3. Pain relief and fever

Spain's painkiller shelf reflects a continental European prescribing culture: 1 g paracetamol is standard, ibuprofen is mostly bought as 400 mg, and metamizol (Nolotil) — a drug not licensed in the US or UK at all — outsells paracetamol in Spanish primary care. Codeine combinations require a prescription in Spain, unlike in the UK where co-codamol 8/500 is a pharmacy purchase.

Active ingredient🇪🇸 Spain🇺🇸 US🇬🇧 UKUse / classRx in Spain?
Paracetamol / acetaminophenStandard adult dose in Spain: 1 gGelocatil, Termalgin, Apiretal (paediatric drops), EfferalganTylenolPanadol, Calpol (paediatric)Analgesic / antipyreticOTC
Ibuprofen 400 mgNeobrufen, Espidifen (mint sachet, arginate salt), Ibuprofeno EFG, Dalsy (paediatric)Advil, MotrinNurofen, BrufenNSAIDOTC
Ibuprofen 600 mgNeobrufen 600, Espidifen 600Rx genericRx genericNSAID, higher doseRx
Metamizol (dipyrone) 575 mgNolotil (Boehringer), Algi-Mabo, Metamizol EFGNot approvedNot approvedPyrazolone analgesic / antipyretic / spasmolyticRx (since AEMPS 2018 restriction)
Aspirin / acetylsalicylic acid 500 mgAspirina, AAS EFGBayer, Bufferin, EcotrinAspirin, DisprinNSAID / antiplateletOTC
Acetylsalicylic acid 100 mg (cardioprotective)Adiro 100, TromalytBayer Low Dose, Ecotrin 81 mgAspirin 75 mg dispersibleAntiplatelet, secondary preventionRx
Dexketoprofen 25 mgEnantyum (Menarini), Quiralam, KetesseNot approvedKeral (Rx)NSAID, fast-actingRx
Naproxen 500 / 550 mgNaprosyn, Antalgin, Naproxeno EFGAleve (OTC), Naprosyn (Rx)Naprosyn, Naproxen (Rx)NSAID, longer half-lifeRx
Diclofenac 50 mgVoltaren, Diclofenaco EFGVoltaren (oral Rx; gel OTC)Voltarol, Voltarol Emulgel (OTC)NSAIDRx (gel OTC)
Paracetamol + codeineCod-Efferalgan, Termalgin CodeínaTylenol with Codeine #3 (Rx)Co-codamol 8/500 (P, OTC); higher strengths RxOpioid combination analgesicRx
Tramadol 50 mgAdolonta, Zaldiar (with paracetamol)Ultram, UltracetZydol, TramacetOpioid analgesicRx (controlled)
Tourist warning — codeine. Anything containing codeine, dihydrocodeine or tramadol requires a prescription in Spain. British visitors used to picking up Nurofen Plus or co-codamol 8/500 from a UK pharmacy counter cannot do the same here. Bring a supply, or expect to see a doctor.

Need a prescription in Spain?

PrescribeMe connects tourists and expats with licensed Spanish doctors. Online consultation, Spanish e-prescription sent to your phone.

Get a prescription → From €15 · Licensed Spanish physicians · Valid at any pharmacy

4. Antibiotics

Every antibiotic in Spain requires a prescription — there are no exceptions, despite older travel guides suggesting otherwise. Pharmacist dispensing without a prescription has been actively restricted under AEMPS rules since the antimicrobial-stewardship reforms of the last decade.

Active ingredient🇪🇸 Spain🇺🇸 US🇬🇧 UKCommon useRx in Spain?
AmoxicillinClamoxyl, Amoxicilina EFGAmoxilAmoxil, AmoxicillinRespiratory, dental, ENT infectionsRx
Amoxicillin + clavulanic acidAugmentine (GSK)AugmentinAugmentin, Co-amoxiclavSinusitis, dental abscess, complicated UTIRx
AzithromycinZitromax (Pfizer), Azitromicina EFGZithromax, Z-PakZithromaxAtypical pneumonia, chlamydiaRx
ClarithromycinKlacid, BremonBiaxinKlaricidMacrolide alternative, H. pyloriRx
CiprofloxacinBaycip (Bayer), Cetraxal (otic), Ciprofloxacino EFGCiproCiproxinUTI, traveller's diarrhoea, otitis externaRx
Fosfomycin trometamol 3 gMonurolMonurolMonurilUncomplicated UTI, single doseRx
NitrofurantoinFurantoínaMacrobid, MacrodantinMacrobid, MacrodantinUTI prophylaxis and treatmentRx
DoxycyclineVibracina (Pfizer), Doxiclat, ProdermaVibramycin, Doryx, Oracea (low-dose rosacea)Vibramycin-D, Efracea (rosacea)Acne, rosacea, atypical infections, malaria prophylaxisRx
MetronidazoleFlagylFlagylFlagylAnaerobic, bacterial vaginosis, dental, giardiasisRx
ClindamycinDalacin, Clinwas (topical)CleocinDalacin CSkin, dental (penicillin allergy)Rx
CephalexinKefloridina, Cefalexina EFGKeflexKeflex (limited UK use)Skin and soft tissue infectionsRx
Trimethoprim + sulfamethoxazoleSeptrinBactrim, SeptraSeptrin, Co-trimoxazoleUTI, PCP prophylaxisRx

5. Respiratory and allergy

Spain uses the international name salbutamol everywhere; the US uses albuterol for the same molecule. Ventolin is the dominant inhaler brand in both Spain and the UK. ProAir and Proventil are US-only brands that do not exist in Spanish pharmacies — bring an extra inhaler if your prescription is for one of these.

Active ingredient🇪🇸 Spain🇺🇸 US🇬🇧 UKUse / classRx in Spain?
Salbutamol (= albuterol) inhalerVentolin (GSK), Salbuair (nebules)ProAir HFA, Proventil HFA, Ventolin HFAVentolin, Salamol, AiromirShort-acting β2 agonist, asthma rescueRx
Fluticasone propionate inhalerFlixotide (pMDI and Accuhaler)Flovent HFA / Flovent Diskus (US Flovent discontinued by GSK in January 2024 in favour of an authorised generic fluticasone propionate)FlixotideInhaled corticosteroid, asthma preventerRx
Fluticasone + salmeterolSeretide, Anasma, PlusventAdvair Diskus, Advair HFA, AirDuoSeretideICS + LABA combinationRx
Budesonide + formoterolSymbicort, RilastSymbicortSymbicort, FostairICS + LABA combinationRx
MontelukastSingulair, Montelukast EFGSingulairSingulairLeukotriene receptor antagonistRx
LoratadineClarityne (Bayer / Organon), Loratadina CinfaClaritinClaritynSecond-generation antihistamineOTC
CetirizineZyrtec (UCB), Alerlisin (Menarini), ReactineZyrtecZirtek, Piriteze, Benadryl Allergy (UK)Second-generation antihistamineOTC (most 10 mg packs)
Bilastine 20 mgBilaxten (FAES), Ibis, ObalixNot FDA-approved (Hikma and FAES Farma signed an exclusive US licence agreement to commercialise bilastine tablets, announced 20 September 2021)Ilaxten (Menarini)Non-sedating antihistamine, Spanish-discoveredOTC
EbastineEbastelNot approvedNot licensedSecond-generation antihistamineRx
PseudoephedrineFrenadol (combination), Pseudoefedrina CinfaSudafedSudafed (P, behind counter)Nasal decongestantPharmacy-only (P), restricted quantities
DiphenhydramineSoñodor (sleep aid)BenadrylNytolFirst-generation antihistamine / sleep aidOTC (limited products)

Brand-name Benadryl means different molecules in different countries. In the US and Canada, Benadryl is diphenhydramine. In the UK and Spain, Benadryl-branded products generally contain cetirizine or acrivastine. Read the active ingredient before assuming the box delivers what you remember.

6. Gastrointestinal

Active ingredient🇪🇸 Spain🇺🇸 US🇬🇧 UKUse / classRx in Spain?
Omeprazole 20 mgLosec (Cheplapharm), Omeprazol Cinfa / Normon EFG, PepticumPrilosec (OTC and Rx)Losec, Omeprazole (OTC at pharmacy)Proton pump inhibitorRx (20 mg); 10 mg OTC
Pantoprazole 20 / 40 mgPantecta, Anagastra (Takeda), Pantoprazol EFGProtonixPantoloc Control 20 mg (OTC); pantoprazole generics RxProton pump inhibitorRx
EsomeprazoleNexiumNexium (24HR OTC and Rx)Nexium Control (OTC)Proton pump inhibitorRx
RanitidineWithdrawn (NDMA contamination, 2019–2020)WithdrawnWithdrawnH2 blocker
FamotidineFamotidina EFG, PepcidPepcid ACPepcidH2 blockerRx
LoperamideFortasec (Kenvue), Loperamida EFGImodium A-DImodiumAnti-diarrhoealOTC
Metoclopramide 10 mgPrimperan (Sanofi)ReglanMaxolonAntiemetic / prokineticRx (short-term use only since EMA 2014 restriction)
Domperidone 10 mgMotiliumNot FDA-approvedGeneric domperidoneAntiemetic / prokineticRx
Hyoscine butylbromideBuscapinaNot FDA-approved (Levsin is the related US drug)BuscopanAntispasmodic for GI crampsOTC
RacecadotrilTiorfanNot approvedNot licensedAnti-secretory for acute diarrhoeaOTC
Almagate / aluminium-magnesium antacidsAlmaxMaalox, MylantaMaalox, GavisconAntacidOTC

7. Cardiovascular and metabolic

Long-term medication for blood pressure, cholesterol, diabetes and thyroid is where the brand-translation question matters most for expats. Every drug in this section requires a Spanish prescription, but a Spanish doctor can issue one for any of the molecules below within a single consultation.

Active ingredient🇪🇸 Spain🇺🇸 US🇬🇧 UKUse / class
AtorvastatinCardyl, Zarator (Pfizer)LipitorLipitorStatin
SimvastatinZocor (MSD), Pantok, BelmalipZocorZocor (mostly generic)Statin
RosuvastatinCrestor, ProvisacorCrestorCrestorStatin
AmlodipineNorvas (Viatris), AstudalNorvascIstin (historical); generic amlodipineCalcium-channel blocker
RamiprilAcovil (Sanofi/Zentiva)AltaceTritaceACE inhibitor
EnalaprilRenitec, AcetensilVasotecInnovaceACE inhibitor
LosartanCozaarCozaarCozaarARB
BisoprololEmconcor, EuradalZebetaCardicor, Emcorβ-blocker
PropranololSumialInderalInderalNon-selective β-blocker
FurosemideSegurilLasixLasix, FrusolLoop diuretic
HydrochlorothiazideEsidrex; mostly as combinations (Co-Renitec, Co-Diovan)MicrozideGeneric HCTZ (rare alone)Thiazide diuretic
WarfarinAldocumarCoumadin, JantovenMarevan, WarfarinVitamin K antagonist
ApixabanEliquisEliquisEliquisDOAC
MetforminDianbenGlucophage, Fortamet, RiometGlucophageBiguanide, type 2 diabetes
LevothyroxineEutirox (Merck), LevothroidSynthroid, Levoxyl, Unithroid, TirosintEltroxin, Levothyroxine genericThyroid hormone replacement

Need a prescription in Spain?

PrescribeMe connects tourists and expats with licensed Spanish doctors. Online consultation, Spanish e-prescription sent to your phone.

Get a prescription → From €15 · Licensed Spanish physicians · Valid at any pharmacy

8. Antivirals and antifungals

Active ingredient🇪🇸 Spain🇺🇸 US🇬🇧 UKUseRx in Spain?
Aciclovir oral 200 / 400 / 800 mgZovirax (Haleon), Aciclovir EFGZoviraxZovirax, generic aciclovirHerpes simplex, zosterRx
Aciclovir 5% cream (cold sores)Zovirax labial, HerpoticumZovirax cream, SitavigZovirax cold sore creamHSV labialisOTC
Valaciclovir 500 / 1000 mgValtrex (GSK), Valaciclovir EFGValtrexValtrex, generic valaciclovirHerpes simplex, zoster, suppressionRx
Fluconazole 150 mg single doseDiflucan (Pfizer), Fluconazol EFGDiflucanDiflucan, Canesten Oral 150 mg (OTC)Vulvovaginal candidiasisRx
Clotrimazole vaginal cream / pessaryGine-Canestén (Bayer)Gyne-Lotrimin, Mycelex-7CanestenVaginal candidiasisOTC
Clotrimazole 1% skin creamCanestén cremaLotrimin AFCanestenTinea, dermatophyte infectionsOTC
Terbinafine 1% creamLamisilLamisil ATLamisil ATAthlete's foot, ringwormOTC
OseltamivirTamifluTamifluTamifluInfluenza antiviralRx
Nystatin oral suspensionMycostatinMycostatin, NystopNystanOral / oesophageal candidiasisRx

9. Reproductive health and contraception

Spain liberalised access to emergency contraception in September 2009 (levonorgestrel) and April 2015 (ulipristal). Both are sold over the counter at any pharmacy with no age restriction and no consultation required. Daily oral contraceptives, by contrast, require a prescription — they have never been OTC in Spain.

Active ingredient🇪🇸 Spain🇺🇸 US🇬🇧 UKUseRx in Spain?
Levonorgestrel 1.5 mg (emergency)Norlevo (HRA), Postinor (Gedeon Richter)Plan B One-Step, Next Choice One Dose, My WayLevonelle, UpostelleMorning-after pill, ≤72 hOTC, no age limit
Ulipristal acetate 30 mg (emergency)ellaOneellaellaOneMorning-after pill, ≤120 hOTC since 2016
Ethinylestradiol + levonorgestrelMicrogynon, Loette, OvoplexLessina, Levora, AvianeMicrogynon, Rigevidon, OvranetteCombined oral contraceptiveRx
Ethinylestradiol + drospirenoneYasmin, Yasminelle, YazYaz, Yasmin, BeyazYasmin, Yaz, EloineCombined oral contraceptiveRx
Desogestrel 75 µgCerazet, AzaliaSlynd (drospirenone analogue)Cerazette, CerelleProgestogen-only pillRx
MifepristoneMifegyne (hospital only)MifeprexMifegyneMedical termination of pregnancyRx, hospital dispensing
CondomsSupermarket and pharmacySupermarket and pharmacySupermarket and pharmacyBarrier methodOTC, no pharmacy required

10. Mental health, anxiety and sleep

Antidepressants, anxiolytics and hypnotics all require a Spanish prescription. Benzodiazepines and Z-drugs (zolpidem) carry the additional receta blanca con visado rule for some controlled-list quantities. Spanish doctors are generally cautious about issuing new benzodiazepine prescriptions to short-term visitors without records of prior use.

Active ingredient🇪🇸 Spain🇺🇸 US🇬🇧 UKUse / classRx in Spain?
SertralineBesitran (Pfizer), Aremis (Esteve), Sertralina EFGZoloftLustralSSRIRx
EscitalopramCipralex, EsertiaLexaproCipralexSSRIRx
CitalopramPrisdal, SeropramCelexaCipramilSSRIRx
FluoxetineProzac, Adofen, ReneuronProzac, SarafemProzacSSRIRx
VenlafaxineVandral, DobupalEffexor XREfexor XLSNRIRx
DuloxetineCymbalta, XeristarCymbaltaCymbaltaSNRIRx
BupropionElontril, Zyntabac (smoking cessation)Wellbutrin XL, ZybanZyban (smoking cessation only)NDRIRx
Lorazepam 1 mgOrfidal (Pfizer), IdalpremAtivanGeneric lorazepamBenzodiazepineRx (controlled)
AlprazolamTrankimazinXanaxXanax, generic alprazolamBenzodiazepineRx (controlled)
DiazepamValium, Diazepam ProdesValiumValium, DiazemulsBenzodiazepineRx (controlled)
ClonazepamRivotrilKlonopinRivotril, generic clonazepamBenzodiazepineRx (controlled)
Zolpidem 10 mgStilnox (Sanofi), Dalparan, Zolpidem EFGAmbien, Ambien CR, EdluarStilnoctZ-drug hypnoticRx (controlled)
ZopicloneDatolan, LimovanLunesta (eszopiclone, the active enantiomer)ZimovaneZ-drug hypnoticRx
Melatonin 2 mg PRCircadin (medicinal); supplement brands <2 mg: Aquilea Sueño, Forté Pharma 1.9 mg, ZzzQuil NaturaNatrol, Nature Made (supplement, OTC)Circadin, Slenyto (all melatonin POM in UK)Insomnia<2 mg OTC (food supplement); ≥2 mg Rx

11. Erectile dysfunction

Active ingredient🇪🇸 Spain🇺🇸 US🇬🇧 UKUseRx in Spain?
SildenafilViagra (Pfizer/Viatris), Sildenafilo EFGViagraViagra, Viagra Connect 50 mg (OTC at pharmacy since 2018)PDE5 inhibitorRx
TadalafilCialis (Lilly), Tadalafilo EFGCialis, Adcirca (PAH)CialisPDE5 inhibitor, longer half-lifeRx
VardenafilLevitraLevitra, StaxynLevitra (limited availability)PDE5 inhibitorRx
AvanafilSpedraStendraSpedraPDE5 inhibitor, fast onsetRx

Sildenafil 50 mg is a pharmacy-counter purchase in the UK under the brand Viagra Connect. In Spain, all PDE5 inhibitors require a prescription. A short telemedicine consultation is the usual route.

12. Dermatology, eye, ear and emergency

Active ingredient🇪🇸 Spain🇺🇸 US🇬🇧 UKUseRx in Spain?
Hydrocortisone 1% creamLactisona, HidrocortisonaCortizone 10HC45, Pharmacy HydrocortisoneMild eczema, dermatitisRx (1%); some 0.5% pharmacy
Mometasone furoate creamElocomEloconEloconModerate-potency topical steroidRx
Betamethasone topicalCelestoderm, DiprodermDiprolene, BetadermBetnovate, DiprosoneTopical steroidRx
Mupirocin 2% ointmentBactroban, PlasimineBactroban, CentanyBactrobanTopical antibacterial (impetigo)Rx
Permethrin 5% creamPermecure, SarcopElimiteLyclearScabies treatmentRx
Epinephrine (adrenaline) auto-injector 300 µgAltellus, Jext (ALK-Abelló); Anapen (Bioprojet)EpiPen, Auvi-Q, generic epinephrine auto-injectorEpiPen, Jext, Emerade (relaunched UK 2024)Anaphylaxis rescueRx
Salbutamol nebules 2.5 / 5 mgVentolín Respirador, SalbuairAccuNeb, Proventil nebuliser solutionSalamol, Ventolin nebulesSevere asthma, nebulisedRx
Tobramycin eye dropsTobrexTobrexTobrexBacterial conjunctivitisRx
Chloramphenicol eye dropsLimited use in SpainRarely usedOptrex Infected Eyes / Chloramphenicol (P, OTC)Bacterial conjunctivitisRx in Spain
Ciprofloxacin ear dropsCetraxal, Baycip ÓticoCetraxal, Ciprodex (with steroid)Cilodex, CetraxalOtitis externaRx
EpiPen note. The Mylan/Viatris EpiPen is not the dominant adrenaline auto-injector in Spain. Pharmacies stock Altellus, Jext or Anapen — same molecule (adrenaline / epinephrine), same emergency function, different device. The injection technique varies slightly between devices. If you carry an EpiPen, ask the pharmacist to walk through the Spanish device's grip before relying on it in an emergency.

13. The Nolotil situation

Nolotil — the Boehringer Ingelheim brand of metamizol (also known internationally as dipyrone) — is the most-prescribed analgesic in Spanish primary care, used for moderate-to-severe pain, fever and visceral cramps. It is not licensed for sale in the United States, the United Kingdom, Sweden, Denmark, Finland, Canada or Australia.

The reason for the split is one specific adverse reaction: agranulocytosis, a sudden, often unpredictable drop in white blood cells that leaves the body unable to fight bacterial infection. Untreated, it can kill within days. Published estimates of incidence vary dramatically between countries and study designs. The Berlin Case-Control Surveillance Study (Huber et al., European Journal of Clinical Pharmacology, 2015) reported a population incidence of 0.96 cases per million per year (95% CI 0.95–0.97). A Spanish pharmacoepidemiology study by Maciá-Martínez et al. (2024) — the source AEMPS communications typically cite — places the order of magnitude at one to ten cases per million users. At the higher end, Hedenmalm and Spigset (European Journal of Clinical Pharmacology, 2002), using Swedish spontaneous-report data from 1996–1999, estimated one case per 1,439 prescriptions (95% CI 1:850–1:4,684) — figures that contributed to Sweden withdrawing metamizole from the market in 1999.

The British dimension is the reason this drug appears in tourist-facing guides. From 2017 onward, a campaign by Valencia-based medical translator Cristina García del Campo collected 120-plus case reports of mostly British patients who developed serious side effects after Nolotil prescriptions in Spain, with a number of fatalities. Researchers at the Costa del Sol Hospital had earlier observed that metamizole-induced agranulocytosis appeared more often in British patients than in Spanish ones; Boehringer Ingelheim has stated that there is no scientific evidence that specific populations are more susceptible.

AEMPS responded with a 2018 safety review and updated prescribing guidance: metamizol should not be given to patients with a history of agranulocytosis, should not be used as long-term treatment, and should be prescribed cautiously to short-term visitors from countries where the drug is not normally available. The EMA's safety committee PRAC followed with EU-wide label changes strengthening warnings and requiring clinicians to instruct patients to stop the drug and seek immediate medical attention at the first sign of fever, chills, sore throat or mouth ulcers.

Practical guidance for UK and US travellers. If a Spanish doctor prescribes Nolotil for short-term pain, the drug is not inherently unsafe — millions of doses are taken in Spain every year. Three rules apply: use it only for the prescribed duration (usually a few days), stop immediately and seek medical attention if you develop unexplained fever or a sore throat, and do not bring leftover Nolotil home to self-medicate where no UK or US doctor can monitor for the rare but serious blood reaction. Paracetamol, ibuprofen and dexketoprofen (Enantyum) are reasonable alternatives that cover most of the same indications.

14. Medications OTC in one country but Rx in another

The OTC/Rx line is regulatory, not pharmacological. The same molecule at the same dose can be a supermarket purchase in one country and a controlled medication in another. The patterns that catch tourists in Spain:

MedicationStatus in SpainStatus in USStatus in UKWhy it matters
Codeine combinationsRx, alwaysRx (Tylenol with Codeine)OTC: co-codamol 8/500, Nurofen Plus, Solpadeine (P-medicine)British visitors cannot replenish co-codamol at a Spanish pharmacy counter.
Salbutamol inhalerRx (some pharmacies still sell without)RxRxBring a backup; replacement requires a Spanish prescription.
Sildenafil 50 mgRxRxOTC at pharmacy (Viagra Connect, since 2018)UK travellers can no longer buy it off the shelf in Spain.
Fluconazole 150 mg (thrush)RxRxOTC at pharmacy (Canesten Oral, Diflucan One)UK women used to a single-pill OTC purchase cannot do the same here.
Ibuprofen 600 mgRxRxRxOTC ceiling is 400 mg in Spain.
Omeprazole 20 mgRx (10 mg OTC; pharmacist discretion in practice)OTC (Prilosec OTC)OTC at pharmacyStrict reading of Spanish rules requires Rx; practice varies.
Melatonin ≥2 mgRx (Circadin)OTC (supplement, no FDA drug oversight)Rx (POM, all strengths)US visitors used to 5–10 mg gummies will not find them; Spain caps OTC supplement at <2 mg.
Levonorgestrel emergency contraceptionOTC, no age limit (since September 2009)OTC, no age limit (since 2013)OTC at pharmacy after consultationEasier access in Spain than most travellers expect.
Ulipristal emergency contraceptionOTC (since April 2015)Rx (ella)OTC at pharmacyUS visitors can obtain ulipristal without a prescription in Spain.
Metamizol (Nolotil)RxNot licensedNot licensedNo US/UK equivalent; see dedicated section.
Domperidone (Motilium)RxNot approvedGeneric RxReturning travellers may struggle to find it at home.
BilastineOTC (20 mg)Not approved (Hikma US licence agreement announced 20 September 2021)OTC (Ilaxten 20 mg)US visitors cannot find this antihistamine at home.

Need a prescription in Spain?

PrescribeMe connects tourists and expats with licensed Spanish doctors. Online consultation, Spanish e-prescription sent to your phone.

Get a prescription → From €15 · Licensed Spanish physicians · Valid at any pharmacy

15. FAQ

What is Tylenol called in Spain?

Tylenol is the US brand of acetaminophen, the same molecule Europeans call paracetamol. Spanish pharmacies sell it as Gelocatil, Termalgin or simply paracetamol genérico, normally as 1 g tablets — the Spanish standard adult dose. The paediatric drop formulation is Apiretal.

What is the Spanish equivalent of Advil?

Ibuprofen 400 mg, sold over the counter as Neobrufen, Espidifen (a fast-onset mint sachet) or generic ibuprofen. The 600 mg version requires a prescription.

Is Nolotil safe?

For most patients in short-term use, yes — Spain has decades of clinical experience with it. The rare-but-serious side effect is agranulocytosis. AEMPS recommends caution in short-stay visitors from countries where the drug is not licensed. Do not self-medicate with Nolotil after returning home where no doctor will monitor for blood reactions.

Is paracetamol the same as acetaminophen?

Yes. Two names, one molecule (N-acetyl-para-aminophenol). Tylenol, Panadol, Calpol, Gelocatil and Termalgin all contain it.

Can I bring my own medication to Spain?

Yes, in personal-use quantities for the duration of your trip. Keep it in original packaging and bring the prescription or a doctor's letter. Controlled substances (strong opioids, ADHD stimulants, certain benzodiazepines) may need a Schengen certificate from your home country pharmacy or a customs declaration on arrival.

Will Spanish pharmacies recognise my US or UK medication?

Almost always, by active ingredient rather than brand. Atorvastatin is atorvastatina, sertraline is sertralina, amoxicillin is amoxicilina — the Spanish word is usually obvious. Hand the pharmacist the original box.

What if I forget my prescription medication and need a refill in Spain?

You will need a Spanish prescription. Options are a public Centro de Salud appointment (cheapest if you have a European Health Insurance Card), a private GP visit, or a telemedicine consultation such as PrescribeMe from €15. Bring photos of the medication box and your home prescription to speed up the consultation.

Are Spanish generics the same quality as US or UK brands?

Yes. Spanish generics carry the EFG mark (Equivalente Farmacéutico Genérico) and must demonstrate bioequivalence under EMA standards. Most are made by the same multinational generic manufacturers (Sandoz, Teva, Mylan/Viatris, Stada, Cinfa, Normon) that supply the UK NHS and US pharmacies.

Salbutamol or albuterol?

The same molecule. Albuterol is the US adopted name; salbutamol is used everywhere else. Ventolin is the dominant brand in both Spain and the UK. ProAir and Proventil are US-only brand names that do not exist in Spanish pharmacies.

What is the Spanish equivalent of Plan B?

Plan B One-Step is levonorgestrel 1.5 mg. In Spain, the same drug is sold over the counter as Norlevo or Postinor, no prescription and no age restriction. The alternative ulipristal acetate — sold as ella in the US — is sold in Spain as ellaOne, also over the counter.

Why does Spain sell paracetamol 1 g when the US uses 500 mg?

The AEMPS-approved adult label for 1 g paracetamol (for example Gelocatil 1 g) permits 1 g per dose up to 3 g per day. US OTC labels cap single doses at 325–500 mg, largely to limit acetaminophen overdose risk in a population accustomed to self-medication. The pharmacology is identical; the convention is regulatory.

How do I know if a Spanish medication is the same as my home one?

Match the active ingredient and strength on the box, not the brand. The AEMPS database CIMA at cima.aemps.es lists every medicine sold in Spain by molecule, with downloadable patient leaflets. Vademecum.es also publishes international equivalence tables.

16. What is genuinely ambiguous, recently changed, or contested

The honest answer to a few common questions is "it depends" or "it changed recently". Flagging these explicitly:

Nolotil safety in British and Northern European patients. The AEMPS-led safety reviews tightened prescribing in 2018 and the EMA/PRAC has strengthened EU-wide warnings since. Whether genuine ethnic susceptibility exists, or whether the apparent over-representation of British cases reflects reporting bias from a large British expatriate population unfamiliar with the drug's risks, is not settled in the published literature. Treat the practical guidance — short-term use only, vigilant monitoring for fever and sore throat — as the operative rule.

Salbutamol inhaler OTC status. Salbutamol inhalers are technically prescription-only across Spain, but historical pharmacy practice in tourist areas has often allowed sale without a prescription. Enforcement has tightened. Do not rely on being able to buy one over the counter, particularly outside coastal tourist towns.

Omeprazole 20 mg OTC status. Strict reading of AEMPS rules makes 20 mg omeprazole a prescription product (only 10 mg is licensed OTC). In practice many Spanish pharmacies dispense 20 mg without seeing a prescription. This is pharmacist discretion, not a national policy, and may change.

EpiPen availability. The Mylan/Viatris EpiPen is not the dominant adrenaline auto-injector in Spain. Altellus and Jext (both ALK-Abelló) and Anapen (Bioprojet) are the marketed devices. The Bayer/Bausch+Lomb Emerade auto-injector was withdrawn from the Spanish market in 2023 over a device quality issue. UK travellers carrying EpiPens should familiarise themselves with the Spanish device design before relying on it.

Ranitidine. Ranitidine (Zantac) was withdrawn worldwide in 2019–2020 over NDMA contamination concerns and remains off the market in Spain, the US and the UK. Famotidine has replaced it as the standard H2 blocker.

Domperidone (Motilium). The EMA's PRAC restricted domperidone across the EU on 7 March 2014: limited to nausea and vomiting, maximum 30 mg per day, maximum seven days of treatment, because of QT prolongation and arrhythmia risk. Not FDA-approved in the United States.

Metoclopramide (Primperan / Reglan). EMA limited it to short-term use (up to 5 days) in 2013 because of the risk of neurological side effects. Long-term use is no longer recommended.

Atorvastatin patent. Pfizer's US compound patent on atorvastatin (Lipitor) expired on 30 November 2011, opening the US market to generic atorvastatin. In Spain, generic competition arrived earlier (Actavis launched atorvastatin magnesium in October 2009 against Pfizer's Cardyl/Zarator); the calcium-salt patent expired in July 2010.

Fluticasone propionate inhalers in the US. GSK discontinued the originator Flovent HFA and Flovent Diskus in the US in January 2024, replacing them with an authorised generic fluticasone propionate. The molecule is unchanged; the brand-name product is gone.

PrescribeMe Medical Team Licensed Physicians · Registered with the Colegio Oficial de Médicos

PrescribeMe is an online medical consultation service staffed by licensed Spanish physicians. We help tourists, expats and digital nomads access prescription medication in Spain through fast, regulated video consultations. From €15.

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