Thailand Pharmacy Guide: What You Can Buy OTC (And What to Avoid)

Thailand pharmacies are a backpacker superpower. Things that need prescriptions in the West are OTC here — antibiotics, antiparasitics, even malaria prophylaxis. You can walk into any Boots or Watsons and walk out with meds that would cost triple at home. But with great pharmacy access comes responsibility: knowing what's safe to buy, when to actually see a doctor, and how to communicate your symptoms.

Why Thailand's OTC System Works

Thai pharmacists are highly trained (4-year pharmacy degree, same as the West). The system assumes responsible traveler behavior: don't just grab random antibiotics because you feel sick. Use your brain, know what you're treating, and ask the pharmacist questions. In return, you get affordable access to medications that genuinely help when travel throws a health curveball at you.

The Pharmacy Chains: Where to Shop

Boots (Most Reliable)

• English labels: Yes, nearly always
• English-speaking staff: Good chance (Bangkok/touristy areas: high; rural: medium)
• Price: Most expensive of the big chains
• Typical cost for common meds: Amoxicillin 250mg × 21 = 150-200B, Doxycycline × 10 = 120-150B
• Why go here: If you're nervous about language barriers or want Western-style branding reassurance, Boots is your answer

Watsons (Similar to Boots)

• English labels: Usually yes
• English-speaking staff: Similar to Boots
• Price: Slightly cheaper than Boots
• Typical cost: Amoxicillin 250mg × 21 = 120-180B
• Why go here: Nearly as reliable as Boots, slightly better prices

Local Independent Pharmacies

• English labels: Hit or miss (50/50)
• English-speaking staff: Hit or miss (but many speak some English)
• Price: Cheapest option (30-50% less than Boots)
• How to navigate: Show your phone screen with English symptoms, use Google Translate, point at products
• Why go here: If you're on a tight budget and comfortable with a bit of improvisation

Hospital Pharmacies

• Price: Cheapest of all
• Quality: Best — medications come directly from official supplier chains
• Catch: Usually only open during hospital hours (often 8am-6pm)
• How to access: Walk into any public hospital, ask at the main desk for "pharmacy" (ร้านขายยา — "ran kai ya")
• Why go here: If you have time and want to save 40-60% on meds

What You Can Buy Without a Prescription

Thailand's "no prescription needed" system is real, but it's not a free-for-all. The items below are genuinely available OTC. Use them responsibly.

Antibiotics (The Big Win)

Amoxicillin 250mg (most common)

• Use for: Chest infections, ear infections, dental infections, UTIs
• Cost: ~100-150B for 21 tablets
• Why it works: Broad-spectrum, kills most bacteria travelers encounter

Doxycycline (the traveler's best friend)

• Use for: Malaria prophylaxis (1 daily while in risk area + 4 weeks after), skin infections, respiratory infections
• Cost: ~100-150B for 10 tablets
• Pro tip: Cheaper to buy here than in your home country — stock up if you're doing multiple countries

Azithromycin (the GI specialist)

• Use for: Traveler's diarrhea caused by bacteria, giardia, other GI infections
• Cost: ~100-120B
• Typical dose: 1 tablet immediately, then 1 daily for 2-3 days

Ciprofloxacin 500mg (the nuclear option)

• Use for: Severe GI infections that won't quit, resistant bacteria
• Cost: ~80-120B for 6 tablets
• When to use: Only if milder antibiotics aren't working — resistance is a real problem if you overuse this

CRITICAL WARNING: Antibiotic resistance is a global crisis. Only use antibiotics if you're certain you have a bacterial infection. Don't take them for viral illnesses (common cold, flu). If you're unsure, ask the pharmacist or see a doctor first.

Antiparasitics (For When Things Get Weird)

Mebendazole

• Use for: Worms (hookworms, roundworms) — usually picked up from unwashed produce
• Cost: ~50-80B per dose
• Typical use: 1 dose, repeat after 2 weeks

Metronidazole (Flagyl)

• Use for: Giardia (common in travelers — causes bloating, foul-smelling diarrhea, sulfur burps), amoebic dysentery
• Cost: ~60-100B
• Typical dose: 1-2 tablets 3 times daily for 5-7 days
• Note: Avoid alcohol while taking (will make you very sick)

Antifungals (For Tropical Conditions)

Clotrimazole cream 1%

• Use for: Fungal skin infections, athlete's foot, jock itch (common in humid tropics)
• Cost: ~30-50B
• Application: Twice daily until clear

Fluconazole 150mg

• Use for: Thrush (yeast infection), especially common if you've been on antibiotics
• Cost: ~60-100B for 1-2 tablets
• Typical dose: 1 tablet, repeat after 3 days if needed

Stomach Relief (The Daily Toolkit)

Oral Rehydration Salts (ORS) sachets — THE ESSENTIAL

• Use for: Any diarrhea or vomiting — this prevents dehydration better than water alone
• Cost: ~30-50B for 5 sachets
• Why: Dissolve in 1L water, sip constantly. This is your first line of defense.

Imodium (Loperamide)

• Use for: Non-infectious diarrhea (i.e., NOT bacterial), reduces cramping
• Cost: ~30-60B
• Caution: Don't use if you suspect bacterial infection (no fever? no blood? probably safe)

Omeprazole 20mg

• Use for: Heartburn, reflux, acid stomach from spicy food
• Cost: ~40-80B for 10 tablets
• Typical use: 1 tablet in morning before meals

Buscopan (Hyoscine butylbromide)

• Use for: Stomach cramps, IBS-like symptoms
• Cost: ~30-50B
• Why it works: Antispasmodic — stops cramping fast

Pain & Fever

Paracetamol (Acetaminophen) 500mg

• Cost: ~15-25B for 10 tablets
• Most affordable pain reliever in Thailand
• Use for: Fever, headaches, muscle aches

Ibuprofen 400mg

• Cost: ~20-35B
• Better for: Inflammatory pain, period cramps

Mefenamic acid 250mg (Thai favorite)

• Cost: ~25-40B
• Similar to Ibuprofen — local choice, widely stocked

Skin Treatments

Hydrocortisone cream 1%

• Use for: Inflammatory skin conditions, eczema, minor rashes
• Cost: ~40-70B

Antibiotic cream (Fucidin or Neosporin-style)

• Use for: Minor cuts, infections, prevention of infection
• Cost: ~40-80B

Antihistamine cream

• Use for: Mosquito bites, itching, allergic reactions
• Cost: ~30-60B

Antihistamines (For Allergies & Sleep)

Cetirizine (non-drowsy)

• Use for: Allergies, hay fever, itching from bites
• Cost: ~30-50B for 10 tablets
• Why: Won't make you drowsy

Chlorpheniramine (old-school)

• Use for: Allergies, itching
• Cost: ~15-25B (cheapest option)
• Side effect: Makes you drowsy

Promethazine (the multi-tool)

• Use for: Nausea, allergies, sleep aid
• Cost: ~40-70B
• Why travelers like it: Works for motion sickness AND helps you sleep on long buses

Eye Drops

Visine (tetrahydrozoline)

• Use for: Red eyes, irritation
• Cost: ~30-50B

Antibiotic eye drops (chloramphenicol or similar)

• Use for: Conjunctivitis ("pink eye")
• Cost: ~50-90B per bottle

Malaria Prophylaxis (The Game-Changer)

If you're going to malaria risk areas (borders of Thailand, especially Thailand-Myanmar border), buy Doxycycline here:

• Cost: 100-150B for 10 tablets (at home: $50-80 USD for the same)
• Typical regimen: 1 daily, starting 1-2 days before arrival, continuing daily while in risk area, then 4 weeks after leaving
• Where to get it: Any chain pharmacy — ask "I want Doxycycline for malaria" or show the pharmacist your trip dates

Thailand's public health doesn't push aggressive malaria prophylaxis (many locals don't take it), so you'll need to ask specifically. Pharmacists understand.

What You CANNOT Buy OTC

Know the limits:

• Tramadol & opioids: Strictly controlled. Cannot buy OTC, and bringing them into Thailand is a serious crime.
• Benzodiazepines (Valium, Xanax): Prescription only. Not available OTC.
• Insulin: Prescription only, requires doctor consultation.
• Strong decongestants (pseudoephedrine): Restricted in many pharmacies due to methamphetamine precursor regulations.

How to Communicate Your Symptoms

English speakers in major cities understand "I have diarrhea," "I have a headache," "I have a chest infection." But in smaller towns, you might need a workaround.

The Phone Screen Method (Works everywhere):

1. Go to Google Translate on your phone
2. Type your symptom in English
3. Show the Thai translation to the pharmacist
4. Let them recommend something

Essential Thai Phrases:

• "ยาอะไรดีสำหรับ..." (yaa a-rai dee sum-rap...) — "What medicine is good for...?" [your symptom]
• "ฉันมีอาการท้องเสีย" (chan mee a-gaan tong sia) — "I have diarrhea"
• "ฉันมีไข้" (chan mee kai) — "I have a fever"
• "ฉันเป็นหวัด" (chan pen huat) — "I have a cold"
• "เสมหัวใจ" (sem hua jai) — "I have a headache"

Most urban pharmacists speak basic English. Rural areas: use the phone translation method.

How to Spot a Bad Pharmacy

Red flags:

• Expired medications on the shelf (check dates on boxes)
• No labels in English or Thai on any boxes
• Vaccines stored at room temperature (vaccines must be refrigerated — if you see vaccine boxes sitting on a shelf, don't buy vaccines there)
• Dirty shelves or disorganized stock
• Pressuring you to buy things you didn't ask for

Good pharmacies: clean, organized, labels visible, pharmacist asks questions before selling.

Bring From Home vs. Buy in Thailand

CHEAPER in Thailand (by 50-70%):

• Doxycycline
• Amoxicillin
• Imodium
• Paracetamol
• Most antibiotics & antiparasitics

BUY FROM HOME (not worth the effort in Thailand):

• Specialty inhalers or medications requiring prescriptions
• Medications for chronic conditions (bring your own supply)
• EpiPens or critical emergency medications
• Medications not sold OTC in Thailand (benzodiazepines, tramadol, insulin)

Strategy: Bring a small emergency kit for the first 2-3 days (basic pain relief, stomach relief, antihistamine). Buy everything else in Thailand once you're settled.

Pharmacy Geography: Where to Find Them

Cities (Bangkok, Chiang Mai, Phuket): Boots and Watsons on every corner. Hospital pharmacies easy to access.

Beach towns: Boots and Watsons in main areas. Independent pharmacies in quieter zones.

Islands and rural areas: Pharmacy availability drops significantly. Stock up on essentials in larger towns before heading to remote areas. Smaller islands might only have 1-2 pharmacies with limited stock.

Quick Reference: Common Costs

| Medicine | Typical Cost | |----------|--------------| | Paracetamol 500mg (10 tabs) | 15-25B | | Imodium (6 tabs) | 30-60B | | Amoxicillin 250mg (21 tabs) | 100-150B | | Doxycycline (10 tabs) | 100-150B | | Ciprofloxacin (6 tabs) | 80-120B | | Metronidazole (12 tabs) | 60-100B | | ORS sachets (5 pack) | 30-50B | | Ibuprofen 400mg (10 tabs) | 20-35B | | Omeprazole 20mg (10 tabs) | 40-80B | | Cetirizine (10 tabs) | 30-50B |

The Bottom Line

Thailand's pharmacy system is genuinely excellent for travelers. Use it wisely: know what you're treating, ask questions, and don't overuse antibiotics. If you're unsure whether you need a prescription-strength antibiotic, see a doctor first (Thai clinics are cheap and good). Otherwise, Thai pharmacies are a smart resource that can save you money, time, and travel disruption when unexpected health issues hit.

Safe travels, and stock up on ORS.