Pharmacies and Medication: Big Differences in the USA and Italy


This morning my kid woke up with a horrific cough.  We decided to give him some cough syrup.  Here were the options:

This happy colored box with  easy to understand directions that were written not only on the box, but also the bottle (just in case you lose the box).

or this:


This very serious (and frankly kind of boring) box with no directions on the box or the bottle.  But there WAS the leaflet.  Ah yes…the “leaflet.”  Uggg!  This thing was more like a dissertation.  Remember the “hold the mail” request?  The five-page “form” to ask the Postmaster to hold your mail, as compared with the American 3 line form?  This was the same.  Italians just can’t do concise, clear and straight to the point, even when taking medicine.  But maybe that is what makes them so fun and lovable?

Anyway, after our cough syrup situation this morning, I got to thinking about differences not only as it relates to instructions for medicine, but the entire approach to meds in the States and Italy.

farm med

First of all there is the marketing importance of the over the counter drugs I mentioned.  Look above at this colorful aisle of pain and cold medicines from Texas.  So bright, so cheerful, just screaming: “Buy Me!  Buy Me!”  What do the aisles of medicine look like in Italy?  I don’t have a photo because all the medicine is kept in the back of pharmacy and only the pharmacist has access to it.  You go to the pharmacist, tell them what the ailment is, and they choose what to give you or you can also ask for what you want – but you can’t just go pick it off the shelf.  And when you do get your medicine, it will always come in the serious box – because medicine is serious stuff after all.

So speaking of pharmacies.  Here is one in America and right next to it, one in Turin.  Another difference between pharmacies is that in America you can buy beer, food, magazines, wrapping paper and household items.  In Italy you will find personal care items, beauty products, perfumes and baby products – no beer or snickers.  But the trade-off is that sometimes there will be chandeliers at the pharmacy!  Keep in mind that some of these places have literally been around for hundreds of years.

In America, medication seems to be big business.  During our trip home this summer, we saw commercial after commercial for prescription medication.  All of them asking you to self diagnose, then to discuss your own diagnose with your doctor and not only that, but suggest to your doctor the possibility of this medicine you saw on tv as a solution.  Here is an example.  (But I have to admit I DO love those little Zoloft guys…they are so cute).

In Italy you will never see this kind of commercial.  They have commercials for over the counter medication, but they certainly don’t encourage you to talk to your doctor about prescription medication.

Along the same lines, Italian doctors really don’t like to medicate.  I understand this may be an attempt to keep costs down, but in the States, wow…those docs (at least mine) loved, loved, loved trying to dope me up.  Anti-anxiety was their script of choice for me.  Do I talk a mile a minute?  Yes.  Do I talk a lot?   Yes.   Am I a little high-strung?  Ummm…yes.    Do I worry about stuff that is probably never going to happen?  Err…ok…yes.   Does that mean I need a drug to “fix” this?  NO!  ….no Italian doctor has ever offered me an anti-anxiety drug.

In the end, every country has its own way.  My sis was living in Dubai and could buy antibiotics without a prescription.

But back to the pharmacies, I admit some of them are truly beautiful.  On your next trip to Italy, make sure to stroll into a few in the city center – it is always nice to take a step back in time – even if you have a headache.


American pharmacy photo courtesy of Mark Turnauckas

32 Comments on “Pharmacies and Medication: Big Differences in the USA and Italy

  1. Exactly the same in Dubai. I HATE how the bottles don’t give dosage info. I threw so much stuff out when we came home b/c I couldn’t remember what they were for. And I know what you mean about those leaflets – don’t they have the chemical equations of the compound in them? haha. One thing I noticed was the price was exponentially lower. No need for prescription insurance really. Antibiotics were jut $7 on their own. Made me really wonder what is going on with the pharmaceutical companies over here.

    • LYNDA! those horrible informationless bottles….yes….I regularly throw stuff out because I no longer have the instructions….grrrrrr (wait…is informationless a word??) 🙂

  2. We have both pharmacies and drug stores here in the NL. Of the two drug stores (that I know of), one limits more to hair, skin, makeup, OTC medicines and such, while the other branches out slightly more with candles and various odds and ends a bit more like a US drug store, but not as extensive. But the variety of OTC drugs is definitely much more limited here than in the US. I guess that’s an EU thing. I do appreciate that they don’t give out drugs willy nilly here, though I do miss antihistamines when I have a cold.

    • Hi Alison…yes…I noticed that when we were in Amsterdam….and yes…..when you need your antihistamines….ya just need ’em….it can be a little frustrating sometimes. I usually stock up when we go home.

  3. It sounds like Italian doctors are similar to Dutch doctors! Dutch doctors would not easily give medicine prescription unless they think it is extremely needed. Indonesian way seemed similar to US😀 – at least that’s before I left Indonesia for Europe. Indonesians could find medicines in the malls and there were a lot of TV commercials about medicines, especially the ones that can combat flu and headache😀 Great post! I did not realize it until reading your post🙂
    Have a nice weekend!!

    • Hi Indah! Yes….Alison (who lives in The Netherlands) was saying the same thing as you. Anyway..I guess the important thing is to get what you need to stay well. Winter is coming, so let’s hope we all have a flu free season…

  4. In the UK you can easily get antidepressants, at least it is easier than it would be in Italy. Even children can sometimes be prescribed them which I think is crazy. For other types of medicines like antibiotics you would not get them unless you really need them.
    You can pick medicines from the shelf like Calpol or similar stuff and you can find them in most supermarkets too. Like in America the packaging is “better” and they all look pretty, colourful and promising.
    People seem to take medicines just like they were sweeties and many children grow up on “Calpol” (which is the English version of Tachipirina).
    Well, good article my dear, you made a good point here.

    • Ciao Alida….can I tell you that they are dishin’ out the meds to the kids BIG TIME in America…..I think it is sad….because I think most of these kids are probably just being…well….kids! Especially boys….let’s face it…they can be a little rambunctious! Anyway…I guess I would rather a more conservative approach like they do here…still sometimes I miss being able to freely buy Tylenol PM right off the shelf. 🙂

  5. The over-medicating and power of the pharma industry in America is a truly scary thing! Did you hear about the hedge fund trader that bought an AIDS drug that’s patent had expired and jacked the price from $13.50 to $750 per tablet overnight?? Crazy, greedy, and I think, would only happen in America.😦

    Here in Korea, there’s a big mix of traditional (herbs, acupuncture etc) and pharmaceuticals, but here, the doctor prescribes only what you need, and each dose is packaged individually for you in a small paper packet. So, you could have 1 pack with anti-inflammatory, antibiotic and pain killer that you take all at once, and they give you only what you need and nothing extra…🙂

    • I agree…over-medicating (and over-marketing, which is where all the colorful packaging comes from) is not a good thing. And it might only exist in America? Not sure if there are other countries that do this.

      • Visit, Moscow, Russia. The same picture. You can enter a pharmacy and ask for an antibiotic. They, “Do you have a prescription?” “Yes.” They give you this medication without asking to show this prescription.

    • Hi Shelley…I did NOT hear about that horrible AIDS drug story. YUK! Anyway….I am a big fan of herbs and acupuncture……I really like the idea of treating the WHOLE body, not just the symptom with a quick fix, harsh drug. And I am not slamming pharmaceuticals – they totally have their place and save lives…still…the way they are handed out in the USA is a little over the top to me.

  6. I think that the doctors are heavily influenced by the pharmaceutical companies. That is how is seems to be here in Aus. I think it is a big problem that is getting bigger.

  7. Maybe Americans need to self diagnose and medicate because their national health system is so appalling? Or perhaps because the basic wage is so low, the working class cannot afford to go to the doctor?

    I love Italian Farmacie- so serious, an important business! I managed to get over the counter antibiotics in a pharmacy in Sicily last time- perhaps just for foreigners.

    • Awesome that they gave you the antibiotic. I guess they use common sense. I do have to say, there is a topical cream that I use, that in the USA, I would need to get a refill prescription for every time I want a new tube, but here, they just give it to me.

  8. We get those ads sometimes on the American channels here, and they always make me laugh, because they suggest self-diagnosing and suggesting this incredible medication to your doctor, but then they proceed to list every single possible side effect of the medication. Seems like it would be a total turn off to me! One other thing about Italian med dispensing, I believe you can only buy meds, even over the counter ones, in the farmacia. No headache relief at the big box grocery store-except vino! Ciao, Cristina

    • I know Cristina…the side effects list is always super long so the announcer starts talking really fast….ha, ha, ha. Anyway…..yes……headache relief only in the form of vino at the store. But sometimes if I drink too much of that, I need to go to the real farmacia the next day. 🙂

  9. You’ve brought an interesting point to light, and it’s nice how you don’t seem to take sides — just stated your observations as is.

    I have definitely had my eyes open to the Big Business of medication in the US. It’s very unfortunate, and it’s also hard to talk to people from the US about it (you really have to live outside for a while to get perspective).

    All in all, I like the feeling of going into a pharmacy with a problem, telling the pharmacist, and she gives you what you need. Or, going to the doctor, getting a “ricetta,” and then getting the meds at no cost. Though am I mistaken– you can get meds like OKI without a prescription (and sometimes they’re in a small pharmaceutical section in a big supermarket)?

    • Hi Diana! yes – you know the whole pharmacy experience is different here….those people all know me – unlike in the States….and I too like their help and knowledge. We have an IPER near our home that recently opened a para farmacia where we can pick our OKI off the shelf. I DO like that convenience. And I am able to get the OKI at the pharmacy without a prescription, but it just isn’t there for me to pick off the shelf.

      I do I have to say that I miss Walgreens a lot. Yes…I guess when I was feeling a little down, I could always go to a Walgreens and walk out feeling a little better. Just lingering in there looking at magazines or maybe buying a greeting card…or even some cheap make-up. I miss that over here.

  10. Pharmacies (we call them chemists!) in Australia blend a bit of both US and Italian elements so maybe they’ve been less of a culture shock for me. But yes, I do agree about the lack of concise instructions on things like cough syrup here! Love the chandeliers though!

    • I love, love love the word “chemist.” My best friend here is from Australia…love when she asks if I need anything from “the chemist.”

      • I think I scared an American friend of mine when I was living in France when I mentioned my need to go to the ‘chemist’. Looked at me like I was a mad scientist or something!

  11. The Italian pharmacies sound just like the Dutch ones! Some of them are very lovely, but you can barely even buy pain killers without having an in-depth conversation about it with the pharmacist😛 (Ok mild exaggeration) This is fine in theory, but if you need something desperately and it’s not in the limited range of things you can grab from the shelves, and there’s line of 5 people waiting to have a chatty talk with the ONE pharmacist on duty … groan!! But I do think it’s good that drugs are not something that is so easily prescribed and so easily sold – at first I was resistant to the idea, but after 3+ years of living here, I have to admit that perhaps they’re onto something.

    • Hi Sophie….it is true…it does seem to be a better way of doing things. Also…ha, ha, would Walter White and Jesse survive in Italy??? (If you watch “Breaking Bad”)

  12. I remember my first experience in a pharmacy in Rome. I had the flu, and needed relief. I expected the aisle of theraflu-type options, but oh no….nothing out there but, like you said, perfumes, toiletries and baby products and…sunglasses, racks of them. So I talked to the pharmacist and he brought out a medication that proved to be awesome. It worked like a charm. So, I guess I can live this way:)

    • YAY Susan…glad they were able to help you. I DO admit I miss NyQuil…..the only sleeping aids here over the counter are homeopathic….and sometimes I need something a little stronger. Still…..the health care here and approach to medicine works well for us. Buon weekend!

  13. Great article ! Yes, shopping differences mean cultural differences, absolutely, which is nice (if you think at the universal banality of the big fashion stores).
    About the leaflet inside the box, I remeber my parents (both of them medical doctors), used to call it “il bugiardino”, ‘the small liar’ (because there are so many information, especially with all the possible side effects you must list by law, that noone really cares or believe it), so that I grew up convinced this was the real name !

    • So funny!!!! “Il bugiardino”! Love it! What a nice story about your parents….thanks so much for stopping by!

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