Pharmacies and Medication in Ecuador — What You Can Buy, Where, and How Much It Costs

If you take medication in the United States, prepare for a pleasant shock. Ecuador's pharmacy system is dramatically more accessible, dramatically cheaper, and dramatically less bureaucratic than what you're used to. Drugs that cost you $200/month with insurance in the US might cost $8 here. Medications you needed a doctor's appointment and prescription for are sitting on the shelf behind the counter, available by just asking.

But there are limits, gotchas, and things you need to understand before you walk in and start asking for medications by name.

The Big Difference: Prescription vs OTC

Ecuador's controlled substance laws are much narrower than the US. The vast majority of drugs that require a prescription in the United States are available over the counter (OTC) in Ecuador. The pharmacist will hand them to you if you ask — no prescription, no doctor visit, no insurance authorization.

Available without a prescription in Ecuador:

• Antibiotics: Amoxicillin, azithromycin (Z-pack), ciprofloxacin, metronidazole, cefalexin, doxycycline — essentially all common antibiotics
• Blood pressure medications: Losartan, amlodipine, enalapril, metoprolol, hydrochlorothiazide
• Cholesterol medications: Atorvastatin (Lipitor), simvastatin, rosuvastatin
• Diabetes medications: Metformin, glibenclamide (not insulin — insulin requires a prescription)
• Muscle relaxants: Cyclobenzaprine, methocarbamol, tizanidine
• Anti-inflammatories: Prescription-strength ibuprofen, diclofenac, meloxicam, naproxen, celecoxib
• Stomach/GI medications: Omeprazole, pantoprazole, ranitidine alternatives, metoclopramide
• Antiparasitics: Albendazole, mebendazole, ivermectin, secnidazole (you'll use these — parasites are a reality in Ecuador)
• Birth control: Pills, emergency contraception (Plan B equivalent), all available without prescription
• Allergy medications: Loratadine, cetirizine, fexofenadine, plus prescription-strength options
• Eye drops: Antibiotic eye drops, steroid eye drops, anti-allergy drops
• Antifungals: Fluconazole, ketoconazole, terbinafine
• Thyroid medication: Levothyroxine
• Asthma inhalers: Salbutamol (albuterol), budesonide, beclomethasone — all OTC
• Some anxiety medications: Low-dose benzodiazepines are technically prescription-only but enforcement varies by pharmacy

Still require a prescription (receta médica):

• Opioid pain medications: Tramadol, codeine combinations, morphine, oxycodone
• Strong benzodiazepines: Higher-dose alprazolam, clonazepam, diazepam (enforcement tightened in 2024)
• ADHD stimulants: Methylphenidate (Ritalin), amphetamine salts — these are extremely difficult to get in Ecuador even with a prescription. If you take ADHD medication, bring a large supply
• Antipsychotics: Quetiapine, risperidone, olanzapine
• Some psychiatric medications: Certain antidepressants at higher doses, mood stabilizers like lithium
• Insulin: Requires a prescription, but it's cheap ($15–30 per vial vs $300+ in the US)
• Controlled narcotics: Anything classified as a narcotic under Ecuador's CONSEP regulations

Major Pharmacy Chains

Not all pharmacies are created equal. Here's what you'll encounter.

Fybeca — The closest thing to a US pharmacy. Clean, well-organized, computerized inventory, loyalty card program. They carry the widest selection of both local and imported brands. Prices are slightly higher than smaller chains but still cheap by US standards. Good for specialty items and imported products. Locations in every major city, often inside or near Megamaxi supermarkets.

Pharmacys — A major chain with an extensive network across the country. Similar to Fybeca in terms of product range and organization. Their loyalty program (Club Pharmacys) offers meaningful discounts. They operate some 24-hour locations in major cities. Reliable and professional.

Cruz Azul — Ecuador's pharmacy franchise model. Independently owned but standardized branding and product ranges. Quality varies by location — some are excellent, others feel like a closet with pills. Generally cheaper than Fybeca and Pharmacys. Ubiquitous — there's one in almost every neighborhood.

Sana Sana — The budget chain. Consistently the cheapest prices, especially for generics. Smaller locations, less selection, but hard to beat on price for common medications. Owned by the same group as Fybeca but positioned as the discount option.

Medicity — Another mid-range chain, common in larger cities. Good selection, reasonable prices. Often located near hospitals and clinics.

Independent farmacias — Small neighborhood pharmacies still exist everywhere. The pharmacist behind the counter often knows your family, remembers your medications, and will recommend treatments. Prices vary — sometimes cheaper, sometimes higher than chains. Worth cultivating a relationship with a good neighborhood farmacéutico.

Real Prices (2026)

These prices will make Americans weep — or laugh — or both.

Medication	US Price (without insurance)	Ecuador Price
Amoxicillin 500mg (21 capsules)	$25–50	$3–5
Azithromycin 500mg (3 tablets)	$40–80	$4–7
Omeprazole 20mg (30 capsules)	$20–40	$3–6
Losartan 50mg (30 tablets)	$30–60	$4–8
Atorvastatin 20mg (30 tablets)	$50–150	$5–12
Metformin 850mg (30 tablets)	$15–40	$3–5
Ibuprofen 600mg (20 tablets)	$10–20	$1.50–3
Levothyroxine 100mcg (30 tablets)	$30–60	$4–8
Salbutamol inhaler	$50–90	$4–8
Ciprofloxacin 500mg (14 tablets)	$30–80	$4–7
Diclofenac 50mg (20 tablets)	$15–30	$2–4
Fluconazole 150mg (1 capsule)	$15–40	$1.50–3

Most medications run 70–90% cheaper than US prices. Even brand-name versions are dramatically less expensive. Generic (genérico) versions are cheaper still.

How to Get Your US Medications in Ecuador

Step 1: Know the generic name. Brand names in Ecuador are different from the US. Your "Lipitor" is sold as atorvastatin, or under local brand names like Atorvastatina MK or Lipox. The active ingredient (principio activo) is the same — that's what you ask for. Before you leave the US, make a list of every medication you take with the generic name, dosage, and frequency.

Step 2: Bring your US prescription bottles. Walk into any pharmacy with your labeled prescription bottle showing the drug name, dosage, and your doctor's name. The pharmacist will match it. This isn't legally required for OTC medications, but it eliminates any confusion and helps the pharmacist verify the correct medication.

Step 3: Ask for the genérico. Say "Tiene [drug name] en genérico?" (Do you have the generic version?) Generic medications in Ecuador are manufactured under the same quality standards as brand names — the ARCSA (Agencia Nacional de Regulación, Control y Vigilancia Sanitaria) regulates pharmaceutical quality. Generics cost 30–60% less than brand-name versions.

Step 4: For controlled substances, see a local doctor first. If you take ADHD medication, strong anxiety medication, or any controlled substance, you need an Ecuadorian doctor's prescription. Schedule an appointment with a psychiatrist — a private consultation costs $40–70. Bring your US medical records, prescription history, and a letter from your US doctor explaining your diagnosis and treatment plan. Be aware that some medications (particularly ADHD stimulants) have limited availability even with a local prescription.

The Farmacéutico: Your Informal Doctor

Here's something that surprises Americans: in Ecuador, the pharmacist behind the counter routinely acts as an informal healthcare provider. This is culturally normal and genuinely useful.

Walk into any pharmacy with a complaint — sore throat, stomach bug, skin rash, urinary tract infection, eye infection — and the pharmacist will examine you (informally), recommend a medication, tell you the dosage, and sell it to you on the spot. No appointment, no waiting room, no copay. Total cost: the price of the medication, usually $3–10.

This system works well for straightforward ailments. The pharmacist knows drugs and dosages. For anything complex, unusual, or persistent, they'll tell you to see a doctor. Trust their judgment on that — if they say "go to a doctor," go.

This is especially valuable when you first arrive and haven't established a relationship with a local physician yet.

Compounding Pharmacies

Compounding pharmacies (farmacias magistrales) exist in Cuenca and Quito and can prepare custom formulations. This includes specific dosage combinations, topical creams with custom concentrations, and medications in forms not commercially available. Useful if you take a non-standard dosage or need a medication prepared in a specific way.

In Cuenca, ask your doctor for a referral to a compounding pharmacy — there are several near Hospital Monte Sinaí. In Quito, the area around Hospital Metropolitano has options. Expect to wait 1–3 days for preparation and pay $10–40 depending on the formulation.

Controlled Substances: The Hard Truth

If you depend on certain medications, Ecuador can be challenging.

ADHD medications (methylphenidate, amphetamine salts): These are classified as controlled psychotropic substances in Ecuador. Ritalin and Concerta exist but are difficult to get — limited stock, few prescribers, and pharmacies often don't carry them. Adderall (mixed amphetamine salts) is essentially unavailable in Ecuador. If you take ADHD medication, bring the maximum supply your US doctor will prescribe (typically 90 days), carry a letter from your doctor explaining the medical necessity, and keep medications in original labeled bottles. Plan your US visits around restocking.

Benzodiazepines: Low-dose formulations are sometimes available OTC (enforcement varies), but higher doses of alprazolam, clonazepam, and diazepam officially require prescriptions. An Ecuadorian psychiatrist can prescribe these — bring your US medical records to expedite the process.

Opioid pain medications: If you have chronic pain managed with opioids, discuss this with an Ecuadorian doctor immediately after arrival. Pain management approaches in Ecuador lean toward non-opioid treatments. Tramadol is available with a prescription. Stronger opioids are highly restricted.

Bringing Medication From the US

In your luggage: Bring up to a 90-day supply of any medication in original, labeled prescription bottles. Keep medications in carry-on luggage, not checked bags. Carry a doctor's letter listing all medications, especially controlled substances. Ecuador customs rarely inspects personal medication, but having documentation prevents problems.

Mailed from the US: Technically legal in small quantities for personal use, but unreliable. Packages containing medication can get flagged by SENAE (Ecuador customs), delayed for weeks, or confiscated. Customs officers don't always distinguish between legal personal-use shipments and illegal imports. If someone is mailing you medication from the US, use a courier service (DHL, FedEx) rather than USPS — couriers handle customs clearance and have fewer lost packages. Include a copy of your prescription and a letter from your doctor inside the package.

The practical solution: Bring a 3-month supply when you move, then either find local equivalents (most medications are available) or stock up during trips back to the US.

Pharmacy Delivery

Most pharmacies in major cities deliver via WhatsApp. You send a photo of what you need (or just type the medication name), they confirm availability and price, and a motorcycle courier shows up in 30–60 minutes. Fybeca and Pharmacys both have apps for ordering with delivery. Delivery is usually free for orders over $10, or $1–2 for smaller orders.

This is especially useful when you're sick and don't want to leave the house — which is exactly when you need a pharmacy.

Practical Tips

• Pharmacy hours: Most chain pharmacies are open 8am–10pm. Some Fybeca and Pharmacys locations operate 24 hours — know where your nearest 24-hour pharmacy is before you need it at 2am.
• Payment: Cash, credit card, or debit card accepted at chain pharmacies. Small neighborhood pharmacies may be cash-only.
• Loyalty programs: Fybeca's "Fybeca Club" and Pharmacys's "Club Pharmacys" cards give 5–15% discounts on most purchases. Free to sign up — just ask at the register.
• Expiration dates: Check the "fecha de vencimiento" (expiration date) on packaging, especially at smaller pharmacies. Stock rotation is generally good at chains but inconsistent at smaller shops.
• Ask the pharmacist about interactions. If you take multiple medications, ask "Hay alguna interacción?" (Are there any interactions?). Ecuadorian pharmacists are trained to check for drug interactions and will warn you.
• Antibiotics without a prescription: Just because you can buy antibiotics OTC doesn't mean you should take them for everything. Antibiotic resistance is a growing problem in Ecuador partly because of overuse. Use them when appropriate — not for every cold and cough.