Medicine names and dose wording that differ in Spain

Key rules

• Match three things: Match the active ingredient, the strength per unit and the form before you treat a Spanish medicine as the same as yours.
• Decimal comma: A comma is a decimal point in Spain, so 0,5 mg is half a milligram.
• Extended release: Retard, LP, SR and similar labels mean extended release, so do not crush or split those tablets unless the leaflet says so.
• Pharmacist swaps: A pharmacist can often swap a brand for a cheaper generic, but you pay the difference if you insist on a pricier brand.
• Dose changes: Never change your dose on your own; ask a doctor or pharmacist.

Start with the active ingredient, not the brand

Brand names change from country to country. The active ingredient (principio activo) is what you match. Find it on your box or leaflet, then look for the same ingredient, the same strength per unit and the same form in Spain.

Some medicines are not sold in Spain at all. Combination products may also have a different mix of ingredients. If a prescription-only medicine is not sold in Spain, a doctor can talk you through the options. Do not change your dose without a doctor's advice.

Names that differ from the US or UK

Spain uses international non-proprietary names, which mostly match UK and EU usage. The US often differs. Here are the ones you are most likely to meet:

• Paracetamol is acetaminophen in the US.
• Salbutamol is albuterol in the US.
• Adrenalina is epinephrine in the US.
• Noradrenalina is norepinephrine.
• Ciclosporina is cyclosporine.
• Furosemida is furosemide.
• Levotiroxina is levothyroxine.
• Glibenclamida is glyburide in the US.
• Ácido acetilsalicílico is aspirin. The brand is Aspirina.
• Metamizol is sold in Spain as Nolotil. You may know it as dipyrone, which is not sold in the US or UK.

Many others are spelled almost the same, with Spanish endings: ibuprofeno, amoxicilina, omeprazol, simvastatina, metformina, sertralina, lidocaína.

Dose and unit traps

• Form matters. A comprimido is a tablet. A cápsula is a capsule. A comprimido efervescente dissolves in water. A comprimido bucodispersable melts in your mouth. A sobre is a powder sachet you dissolve in water. These are not interchangeable.
• Strength is per unit. A box says "cada comprimido contiene" followed by the amount in one tablet. "Envase de 20 comprimidos" only tells you how many are in the pack.
• Liquids need the volume. Strength is written as mg/ml or mg per 5 ml. Check both numbers.
• Drops (gotas) do not convert. 1 ml is not a fixed number of drops. Follow the instructions for that product.
• Spoons are not a measure. A cucharada is not standard. Use the spoon or syringe in the box.
• Commas are decimal points. 0,5 mg means 0.5 mg.
• Extended release. Retard, prolongado, LP, liberación modificada and SR all mean extended release. Do not crush or split these unless the leaflet says you can.
• Strength variants. Forte and plus versions, and paediatric versus adult versions of the same brand, have different strengths.
• Schedule wording. Pauta means schedule. "Cada 8 horas" means every 8 hours. "c/12h" means every 12 hours.

What the pharmacist may swap

If the prescription names the active ingredient, the pharmacist must give you the cheapest option, usually a generic (EFG). If it names a brand, the pharmacist may swap in a cheaper medicine with the same ingredient, dose and form.

Some medicines cannot be swapped, such as certain anticoagulants, antiepileptics, levothyroxine and some inhalers. Your doctor can also mark a prescription as not substitutable for a justified reason.

If you insist on a brand that costs more than the reference price (precio de referencia), you pay the difference. On public prescriptions you also pay the usual copayment, which depends on your income and age.

The decision, checklist and questions below walk you through these steps.

Choosing between options

What do you do when the pharmacy offers a different brand from your usual medicine?

• Accept the generic: The ingredient, strength per unit and form all match, and the medicine is not on the no-substitution list.

• Ask for your usual brand: You prefer a specific brand and accept paying the difference if its price is above the reference price (precio de referencia).

• Ask your doctor to mark it as not substitutable: Your medicine is one where switching is restricted, such as levothyroxine, certain anticoagulants or antiepileptics, or your doctor has a justified reason.

• Check with the pharmacist before taking it: The strength, form or dose wording looks different, for example a forte version, a liquid in mg/ml or an extended-release tablet.

Take a swap only if the active ingredient, strength per unit and form are identical. If any of these differ, or the medicine is restricted from substitution, ask the pharmacist or doctor first.

Checklist

• Find the active ingredient (principio activo) on your home medicine's box or leaflet.

• Search the Spanish medicines database CIMA, run by the national medicines agency, by active ingredient, dose and form to see Spanish brands, generics and leaflets.

• Match the active ingredient, the strength per unit and the form (tablet, syrup, extended release) before treating a Spanish product as the same.

• Bring the box or leaflet to a pharmacist and ask them to confirm the Spanish equivalent.

• Check whether the medicine needs a Spanish prescription, and whether it is sold in Spain at all.

• Check the form: comprimido (tablet), cápsula, efervescente (dissolves in water), bucodispersable (melts in the mouth) and sobre (powder sachet) are different products.

• Check the volume on liquids: strength is written as mg/ml or mg per 5 ml, and drops do not convert to ml in a fixed way.

• Read decimals with a comma as a decimal point, so 0,5 mg means 0.5 mg.

• Check for forte, plus, paediatric or adult versions, because they have different strengths.

• Measure with the spoon or syringe supplied, not a kitchen spoon, and keep your dose unless a doctor changes it.

Frequently asked questions

Is metamizol the same as the painkiller I know as dipyrone?

Yes, metamizol is the Spanish name for dipyrone, and it is sold in Spain under the brand Nolotil. It is not available in the US or UK, so check with a pharmacist before assuming a home painkiller has an equivalent.

Why did my pharmacist give me a different brand than the one on my prescription?

If the doctor wrote the active ingredient, the pharmacist must hand over the cheapest available option, usually a generic (EFG). If a brand was written, they may swap it for a cheaper one with the same ingredient, dose and form. If you insist on a more expensive brand, you pay the difference.

Can I crush or split a tablet marked retard?

No, a tablet marked retard, prolongado, LP, SR or liberación modificada is extended release and should not be crushed or split unless the leaflet says so. Ask your pharmacist if you struggle to swallow it.