Understanding how pharmacies and medications work in Italy is essential knowledge for anyone relocating. The Italian pharmacy system differs significantly from the American model in ways that are mostly positive for the consumer, but the differences require some adjustment, particularly around prescription practices and bringing medications from abroad.
The Italian Pharmacy (Farmacia)
Italian pharmacies are easily identified by their illuminated green cross sign. They are found in every neighborhood, every town, and every village. Pharmacies in Italy serve a broader role than their American counterparts: beyond dispensing medications, pharmacists provide basic health consultations, measure blood pressure, perform simple diagnostic tests (blood glucose, cholesterol), and offer medical advice. For minor ailments, many Italians consult their pharmacist before visiting a doctor.
Pharmacists in Italy are highly trained healthcare professionals with a five-year university degree plus a state examination. They can recommend treatments for common conditions and will tell you when you need to see a doctor instead. Building a relationship with your local pharmacist is one of the practical pillars of healthcare in Italy.
Prescription vs. Over-the-Counter
Italian medications are classified into several categories. Classe A medications are fully covered by the SSN (national health service) when prescribed by a doctor. These include medications for chronic conditions, serious illnesses, and essential treatments. The patient typically pays nothing or a small co-payment (ticket) that varies by region (EUR 0 to 5 per prescription). Classe C medications require a prescription but are not covered by the SSN and must be paid for out of pocket. SOP/OTC medications (senza obbligo di prescrizione/over the counter) are available without a prescription but must be requested from the pharmacist at the counter. Parafarmaci are health and wellness products (vitamins, supplements, cosmetics) available without pharmacist involvement, also sold in parafarmacia shops and supermarkets.
A key difference from the US: many medications that are available over the counter in America require a prescription in Italy, and vice versa. For example, some antibiotics that Americans might expect to need a prescription for are occasionally available more informally (though this practice varies), while some medications Americans buy freely (certain strong anti-inflammatories, for instance) require a prescription in Italy.
Getting Prescriptions
Prescriptions in Italy are issued by your medico di base (general practitioner) through the national health service. For SSN-covered medications (Classe A), the doctor issues an electronic prescription (ricetta elettronica) that is transmitted directly to the pharmacy system. You receive a code (NRE) that any pharmacy can use to retrieve and fill your prescription.
For specialist medications, a specialist doctor issues the initial prescription, which your medico di base can then continue renewing for ongoing treatment.
Prescription renewals for chronic conditions are typically issued for up to 6 months of supply at a time, reducing the need for frequent doctor visits. Your medico di base can often renew prescriptions by phone or email and transmit them electronically to the pharmacy.
Bringing Medications from the US
If you take prescription medications in the US and are moving to Italy, plan this transition carefully.
Before you move: Obtain a letter from your US doctor listing all current medications with generic names (not brand names, as these differ between countries), dosages, and the medical conditions they treat. Bring a supply sufficient for your transition period (typically 90 days is the maximum allowed for personal import without issues). Keep medications in their original packaging with your name on the label.
Controlled substances: If you take medications classified as controlled substances (certain pain medications, ADHD medications like Adderall or Ritalin, benzodiazepines, sleep medications), Italian regulations are stricter. Some medications available in the US are not available or are more tightly controlled in Italy. For example, amphetamine-based ADHD medications (Adderall) are not approved in Italy; methylphenidate-based alternatives (Ritalin/Concerta) are available but restricted. Bring documentation from your US doctor and consult an Italian doctor early to establish continuity of care.
Once in Italy: Register with the SSN and choose a medico di base as soon as possible. Bring your US doctor’s letter to your first appointment. Your Italian doctor will evaluate your medications and issue Italian prescriptions for equivalent treatments. Most common medications have direct Italian/European equivalents, though brand names will differ.
Pharmacy Hours and Access
Standard pharmacy hours follow typical Italian retail patterns: morning opening (8:30 or 9:00), possible lunch closure (13:00 to 15:30) in smaller towns, and evening closing (19:30 or 20:00). However, Italy maintains a mandatory rotation system (turni) ensuring that at least one pharmacy is always open in every area, including nights, Sundays, and holidays.
The on-duty pharmacy (farmacia di turno) is posted on the door of every pharmacy and listed on municipal websites and pharmacy apps. In cities, multiple pharmacies may operate extended hours or 24-hour service. In rural areas, the nearest farmacia di turno may be in a neighboring town.
Costs and Savings
Medication costs in Italy are generally lower than in the US, often dramatically so. SSN-covered prescriptions (Classe A) cost little or nothing out of pocket. Even non-covered medications (Classe C) and OTC products are typically priced below US equivalents, as Italian and EU regulations provide more price controls.
Generic medications (farmaci equivalenti or generici) are widely available and pharmacists are required to inform you of generic alternatives when dispensing prescriptions. Choosing generics can further reduce costs for non-covered medications.
Parafarmacia
Italy also has parafarmacie, shops that sell non-prescription health products, supplements, cosmetics, and some OTC medications at often lower prices than traditional pharmacies. They cannot dispense prescription medications. They are commonly found in shopping centers and commercial areas.
Useful Digital Tools
The Fascicolo Sanitario Elettronico (FSE), accessible via SPID, is Italy’s electronic health record system. It stores your prescriptions, test results, and medical history. Not all regions have fully implemented it, but where available, it provides convenient access to your health information and prescription history.
Several apps help locate pharmacies, check turni schedules, and compare prices: “Farmacia Aperta” and “Trova Farmacie” are among the most used.
PortaleItaly helps Americans plan every practical aspect of relocation, from citizenship recognition to healthcare setup. Contact us for guidance.