Reading medicine boxes, leaflets (prospecto) and prescriptions

Terms used

• Prospecto — The prospecto is the information leaflet inside a medicine box, covering dose, warnings and side effects.
• Posología — The posología is the leaflet section telling you how much to take and how often.
• Receta electrónica — The receta electrónica is a prescription stored electronically in the health system, so you do not need a paper copy.
• Tarjeta sanitaria — The tarjeta sanitaria is your public health card, which you show at the pharmacy and the doctor.
• Hoja de medicación activa — The hoja de medicación activa is a printed summary of your current treatment, dose and duration.
• Aportación — The aportación is the copayment you pay at the pharmacy toward a prescribed medicine.
• EFG — EFG marks a generic medicine, the equivalent of a branded one.
• Cupón precinto — The cupón precinto is a sticker on the box with the national code, used when dispensing.

Key rules

• Overdose: If you take too much of a medicine, call the Servicio de Información Toxicológica on 91 562 04 20.
• Pharmacies only: Even non-prescription medicines such as ibuprofen are sold only in pharmacies, not supermarkets.
• Private prescription: A private prescription means you pay the full price.
• Driving pictogram: A car in a coloured triangle means the medicine may affect your driving; red is the stronger warning.

Start with the leaflet's dosage section

The leaflet inside the box is the prospecto. Look for the section called posología. It tells you how much to take and how often. Read it before your first dose, even if your doctor told you what to do.

Common timing phrases:

• Cada 8 horas: every 8 hours, so three times a day at even intervals.
• Cada 12 horas: twice a day.
• Una vez al día: once a day.
• En ayunas: on an empty stomach, usually 30 to 60 minutes before eating.
• Con las comidas / antes de las comidas / después de las comidas: with, before or after meals.
• Con un vaso de agua: take it with a glass of water.
• Tragar entero sin masticar: swallow whole, do not chew.

The form of the medicine is also named: comprimidos (tablets), cápsulas, sobres (sachets), gotas (drops) and jarabe (syrup). The route is vía oral (by mouth), vía tópica (on the skin) or vía rectal.

Warnings to look for

The leaflet sections that matter most:

• Contraindicaciones: when you must not use it.
• Advertencias y precauciones: things to be careful about.
• Efectos adversos: side effects, listed as frecuentes (common), raros (rare) or muy raros (very rare).
• Interacciones: problems with other drugs or alcohol.
• Embarazo y lactancia: pregnancy and breastfeeding.
• Conducción y uso de máquinas: driving and operating machinery.
• Si olvidó una dosis: what to do after a missed dose.
• Sobredosis: overdose. If you take too much, call the Servicio de Información Toxicológica on 91 562 04 20.
• Conservación: how to store it.

Every leaflet ends with a reminder to keep the medicine out of children's sight and reach (fuera del alcance y de la vista de los niños).

Symbols and marks on the box

• EFG: a generic medicine.
• Car in a triangle: the medicine may affect your driving. Yellow means minor effects, red means major.
• Pregnancy pictogram: warns of risks in pregnancy.
• Triángulo negro (▼): the medicine is under extra monitoring. Report any suspected side effects.
• CAD: the expiry date (caducidad). Lote is the batch number.
• Cupón precinto: a sticker with the código nacional (CN). The pharmacy uses it when dispensing.
• Con receta or "Medicamento sujeto a prescripción médica": you need a prescription.
• Uso hospitalario and Diagnóstico hospitalario: restricted to hospital use or to treatment started after a hospital diagnosis.
• TLD: a long-term treatment.

How the electronic prescription works

With a receta electrónica, your doctor records the treatment in the regional health system. You do not get a paper slip. At the pharmacy you show your tarjeta sanitaria, or the regional app or ID where that is accepted. The pharmacist pulls up your active prescriptions and scans the barcode.

You can ask for a hoja de medicación activa. It is a printed summary of your treatment, dose and duration. Your doctor can also give you one at a visit.

The copayment (aportación) depends on your income and status. Pensioners pay a capped monthly amount. Active workers pay a percentage of the price. Some groups pay nothing. A private prescription, on paper or electronic, means you pay the full price.

A prescription from one region can usually be dispensed in another through the national system. Some regions still have gaps, so ask your doctor or pharmacy before you travel.

Prescription or not

Antibiotics, most strong painkillers, antidepressants, hormonal contraceptives and statins need a prescription. Emergency contraception does not. Low-dose paracetamol, ibuprofen, antacids, antihistamines and cough and cold remedies need no prescription, but are sold only in pharmacies, not supermarkets.

For a minor ailment, ask the pharmacist. They can recommend a non-prescription medicine, check for interactions and dosing, and send you to a doctor if symptoms are serious or persist. They may refuse a sale if it is unsafe.

The checklist, warnings and questions below cover the steps at the counter and common mistakes.

Checklist

• Check that the medicine handed over matches your electronic prescription before you pay.

• Pay your copayment (aportación) at the pharmacy, or the full price if the prescription is private.

• Ask the pharmacist for advice on a minor ailment before buying a non-prescription medicine.

• See a doctor if symptoms are serious or do not go away after the pharmacist's advice.

What to watch out for

• Driving pictogram ignored: A car in a coloured triangle means the medicine may affect your ability to drive. Yellow means minor effects and red means major effects. Do not drive until you know how the medicine affects you, and ask the pharmacist if the triangle is red.

• Generic mistaken for a different medicine: EFG on the box means a generic medicine. Taking a generic and the brand version together can double your dose. Check the active ingredient on every box and never combine two boxes with the same one.

• Prescription-only medicines without a prescription: Antibiotics, strong painkillers, antidepressants, hormonal contraceptives and statins need a prescription. A pharmacist may refuse to sell if it is unsafe. Get a prescription first. Emergency contraception is the exception and is sold without one.

• Buying medicines in the wrong place: Non-prescription medicines such as paracetamol, ibuprofen and antihistamines are sold only in pharmacies, not supermarkets. Go to a farmacia and ask the pharmacist, who will check doses and interactions.

• Expired or wrong batch: CAD is the expiry date and Lote is the batch number. An expired medicine may not work or may be unsafe. Check CAD before taking a dose, and do not use the medicine after that date.

Frequently asked questions

What does the black inverted triangle on a medicine box mean?

The black inverted triangle (▼) means the medicine is under additional monitoring. It does not mean the medicine is unsafe. If you notice a suspected side effect, report it, and ask the pharmacist how.

Do I pay full price when I collect a medicine on a receta electrónica?

No, with a public receta electrónica you pay only a copayment (aportación), which depends on your income and status. Pensioners pay a capped monthly amount, active workers pay a percentage of the price, and some groups pay nothing. A private prescription is paid at full price.

Can I use my receta electrónica in another region of Spain?

Yes, prescriptions can usually be dispensed in another region through the national system, but some regions still have gaps. Show your tarjeta sanitaria at the pharmacy. If the pharmacist cannot see your treatment, ask your doctor for the printed medication sheet.

What should I do if I take too much of a medicine?

Call the Servicio de Información Toxicológica on 91 562 04 20 and keep the box and leaflet at hand. Look for the section called sobredosis in the prospecto.