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Healthcare and prescription rules in Spain

Spain runs healthcare through its seventeen autonomous communities rather than one national service: Catalonia has CatSalut, the Basque Country has Osakidetza, Andalusia the Servicio Andaluz de Salud, Madrid SERMAS, the Canaries and Balearics their own island services, and so on. The practical consequence for a visitor is that entitlement paperwork, appointment systems and language of service differ depending on which region you are standing in, even though the underlying rights are national. EU, EEA and Swiss visitors with an EHIC — or a UK GHIC — can use public primary care and emergency departments on resident terms, presenting the card with photo ID.

Antibiotics and most other prescription-only medicines cannot legally be sold over the counter in Spain. Pharmacies are prohibited from dispensing amoxicillin, ciprofloxacin, fosfomycin and similar drugs without a valid prescription from a licensed doctor, and a pharmacy that does so faces penalties — enforcement has tightened substantially in recent years as part of Spain's response to antimicrobial resistance. Visitors who could once buy a course at the counter can no longer do so, which is the single most common surprise for travellers who need treatment for a UTI, a chest infection or an infected wound. From 2026 Spain is also phasing in smaller antibiotic pack sizes matched to standard course lengths, with full rollout expected by 2027; prescriptions remain mandatory throughout. Outside opening hours a rota pharmacy — the farmacia de guardia — is posted in the window of every closed chemist, and 112 is the emergency number nationwide.

An online consultation is not emergency care. Anywhere in Spain, call 112 if symptoms are severe or life-threatening.

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