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Costa Rica has pharmacies everywhere, but buying medicine here works differently from back home. This guide covers what needs a prescription, what medicine costs, how the Caja fits in, and what to pack when you move.
You’re never far from a pharmacy in Costa Rica. Fischel, La Bomba and Sucre have branches all over the country, and the bigger stores sell everything from sunscreen to baby products. Sucre even sells pet food.
Everyday medicine is easy to buy. Antibiotics are a different story. Since November 2025, you can’t get them without a digital prescription from a doctor in Costa Rica.
Prices can be a surprise too. Common generic pills often cost more at a Costa Rican pharmacy than at a US discount pharmacy, and the cheapest way to get long-term medicine here is through the Caja, the public health system.
Key Takeaways
- Basic painkillers like acetaminophen and ibuprofen are easy to buy.
- Antibiotics need a prescription from a Costa Rican doctor, sent to your phone or email as a code that only works for three business days.
- Once you’re a resident in the Caja, medicines on its list come at no extra cost, one month at a time.
- Generic losartan costs ₡270 a tablet at Walmart Costa Rica, about US$0.60, while Cost Plus Drugs in the US charges under two cents.
- Fischel, La Bomba and Sucre are the big chains, and La Bomba is the discount one.
- Pack no more than a month’s supply of strong painkillers, sleeping pills or ADHD medicine, with a Spanish translation of your prescription and a recent report from your doctor.
- Skip weight-loss injections sold on social media, where fake ones turned up in 2026.
How Pharmacies Work in Costa Rica
For a cold, a rash or a repeat of something you already take, the pharmacy is usually the first stop in the Costa Rican healthcare system. Only a pharmacist can hand over prescription medicine, so there’s always someone to ask about doses or what mixes badly with what.
The Big Chains
Fischel and La Bomba belong to the same company, and Sucre is their main competitor.
- Fischel: the oldest, dating back to 1927, with branches from San José to Tamarindo. Many open from 9am to 9pm.
- La Bomba: the discount chain.
- Sucre: a big network of neighborhood pharmacies, with its own free delivery line.
Prices differ between them, so compare before you settle on one for a monthly refill.
Supermarkets
Walmart has a pharmacy section and lists its medicines online with prices. That makes it a handy place to check what something costs before you shop around.
Hospital Pharmacies
The big private hospitals run their own pharmacies. Clínica Bíblica‘s pharmacies never close, at any of its three locations around San José.
Small-Town Pharmacies
Outside the cities, the local farmacia is usually a small independent shop. Long-time expats give the same advice about these again and again. Pick one and get to know the pharmacist, who can usually order in a medicine the shop doesn’t normally stock.
Do You Need a Prescription?
For everyday things, no. For antibiotics and strong medicines, yes, and pharmacies won’t bend on those.
Over-the-Counter Medicine
Basic painkillers are sold freely, including:
- Acetaminophen, up to 750mg a tablet
- Ibuprofen 200mg
- Naproxen 220mg
- Diclofenac gel for aches and sprains
On paper, most other medicines need a prescription. In practice, plenty of expats say their local pharmacist will sell them a repeat of something they already take, like a thyroid pill, if they bring the box or an old prescription. That’s up to the pharmacist.
Antibiotics
Antibiotics always need a prescription, and since November 8, 2025, it has to be a digital one. The same goes for antiviral, antifungal and antiparasitic medicine.
You won’t get a paper slip. The doctor enters the prescription into a government system, and you get a code by text message or email. Show the code at any pharmacy, private or Caja, and they’ll give you the medicine.
Tip: The code expires after three business days, so fill it the same day or the next. A code you get on a Friday won’t wait for you until the following Thursday.
Strong Painkillers, Sleeping Pills and ADHD Medicine
These controlled medicines have worked with digital codes since 2017. Anti-anxiety pills like Xanax or Valium fall in the same group.
Not every pharmacy keeps them in stock, and doctors tend to prescribe a month at a time. If you take one of these every day, expect a monthly doctor’s visit.
How to Get a Prescription
You can get a prescription through the Caja or from a private doctor, and the cost is very different. The Caja is slower but covers the medicine. A private doctor is quicker, and you pay pharmacy prices.
Through the Caja
Once you have residency, you join the Caja and pay a monthly contribution. Caja doctors prescribe from an official list of medicines, and you collect them at the clinic pharmacy for no extra charge.
The list covers common long-term medicines like metformin and omeprazole, usually as generics. You get one month’s supply at a time, and in the EDUS app you can ask for next month’s to be prepared a few days before your pickup date, so it’s ready when you arrive.
Good to Know: Some private doctors take part in a Caja program called medicina mixta. You pay for the private visit, and the Caja still provides the medicines and lab tests. Our guide on using the Caja as a retiree explains how to sign up.
From a Private Doctor
A private GP visit usually costs US$40 to US$80, and a specialist around US$80 to US$150. After that, you pay the pharmacy for the medicine, so check whether your health insurance pays you back.
Video appointments are another option. Emergencias Médicas has a plan at ₡17,250 plus tax a month, about US$38, with unlimited online consultations and a doctor’s home visit. Because antibiotic prescriptions now arrive as a code, a video call can end with medicine you pick up at any pharmacy.
With a Prescription From Home
A US or Canadian prescription won’t get you antibiotics or controlled medicine, because only doctors in Costa Rica can issue the digital codes. For those, you’ll need to see a local doctor.
For everyday medicine, some pharmacists will work from a foreign prescription or the original box. Bring both, and write down the generic name of everything you take, since brand names often differ here.
Prices
Don’t assume medicine is cheap in Costa Rica. A government study found that wholesalers here add an average 85% margin to medicine, against 17% across the 50 countries it compared.
These are prices listed on September 14, 2026, at about ₡450 to US$1. Cost Plus Drugs is a US online discount pharmacy, and its prices don’t include order fees.
| Medicine | Walmart Costa Rica | Cost Plus Drugs (US) |
|---|---|---|
| Losartan 50mg, generic, 30 tablets | ₡8,100 (US$18) | US$0.45 |
| Metformin 1000mg, generic, 30 tablets | ₡5,020 (US$11) | US$0.51 |
| Omeprazole 20mg, generic, 30 tablets | ₡9,300 (US$21) | Not listed |
| Jardianz Duo 12.5mg/850mg, brand, 60 tablets | ₡28,360 (US$63) | Not listed |
Brand names cost more again. Walmart sells Cozaar HF, a brand-name blood pressure pill, at ₡20,220 for 15 tablets, about US$45.
If you take medicine every day, that gap is one of the best reasons to join the Caja. Our breakdown of the cost of retiring in Costa Rica shows where it fits in a monthly budget.
Tip: La Bomba is the discount chain, so check its price before you commit to a monthly refill at Fischel or Sucre.
Generic or Brand Name?
Generics are the cheaper choice, and they’re what the Caja mostly hands out. On pharmacy shelves, you’ll often find a generic such as Losaraven next to the brand-name version of the same drug.
A few medicines deserve more care. With blood thinners, epilepsy medicine and drugs taken after a transplant, small differences in how a pill is absorbed can matter. Not every generic sold in Costa Rica has been tested against the original, so ask your doctor before switching, and stick with one brand once it works.
Good to Know: Some pharmacies sell single tablets. Walmart prices losartan and omeprazole per tablet, which is handy when you’re trying something new.
Fake Medicines
Fakes do turn up, and right now weight-loss injections are the main problem. In September 2026, the Ministry of Health warned about fake tirzepatide, the drug sold as Mounjaro. Diario Extra had found the fake version for sale on social media, in beauty clinics and even in some San José pharmacies.
It isn’t only diet drugs. In July 2026, two fake batches of a cancer medicine were caught as well.
Because fakes have reached a few pharmacies too, these habits lower the risk rather than remove it:
- Buy from a real pharmacy: never from a social media seller or a beauty clinic.
- Get weight-loss injections on prescription: the genuine Mounjaro pen is listed on La Bomba’s website.
- Keep the box: health warnings identify fakes by batch number, and that number is on the packaging.
Late-Night Pharmacies
Don’t count on a chain pharmacy late at night. Most Fischel branches close between 8pm and 10pm.
Around San José, a private hospital is your best bet, and Clínica Bíblica’s pharmacies stay open all night. In beach towns and the countryside, late-night options are thin, so keep a few days’ spare of anything you can’t skip.
Delivery
All three big chains deliver, which beats sitting in traffic:
- Fischel: order online, by phone at 800-800-4000 or on WhatsApp at 2519-0594. Delivery is free on orders of ₡10,000 or more, and the driver may ask to see your prescription.
- La Bomba: call 800-522-6622 between 8am and 9:30pm any day, or use its app.
- Sucre: call 800-327-6224 for free delivery, Monday to Saturday from 9am to 9pm.
- Clínica Bíblica: delivers to homes and offices around San José.
Shipping Medicine From Home
Having medicine mailed to you is slow and fiddly. Anything that comes through a courier needs a Ministry of Health permit, and you can’t get one without a prescription.
WebBox, one of the local mailbox services, charges US$15 for the permit plus US$12 for storage, before shipping and taxes, and suggests ordering no more than five units. Our guide to shipping to Costa Rica covers the couriers.
Bringing Medication Into Costa Rica
Everyday prescription medicine is simple to bring. Keep it in its original packaging with a copy of the prescription, so customs can see what it is.
Strong painkillers, sleeping pills, anti-anxiety pills and ADHD medicine need more paperwork:
- Your prescription, with the original ready to show at customs
- A report from your doctor, written in the last three months
- Your ID, plus the pharmacy receipt if you have it
- A Spanish translation of all of it
You can bring up to a month’s supply of these. For anything longer, the Ministry of Health has to approve it first.
Tip: If you take one of these medicines, book a local doctor in your first few weeks, since your supply won’t last beyond a month. Our guide to moving to Costa Rica has the rest of the first-month to-do list.
Taking Medication Back to the US
Medicine bought in Costa Rica doesn’t automatically get through US customs. The FDA can allow up to three months’ supply for your own use, and it helps to carry the prescription.
Controlled medicine has a much tighter limit. If you live in the US, you can bring back no more than 50 pills or doses in total of controlled medicine bought abroad.
Common Mistakes
A month’s supply goes quickly, and pharmacies won’t bend on antibiotics:
- Arriving without a local doctor: a month’s supply of a controlled medicine goes fast.
- Relying on a prescription from home for antibiotics: pharmacies need the Costa Rican code.
- Assuming medicine is cheaper here: for the generics in the table above, it isn’t, and the real savings come through the Caja.
- Expecting your usual brand: some aren’t sold here, and imported brands can cost more than at home. One expat found a nasal spray cost about three times what they paid in the US.
- Buying injections online: social media is where the fake weight-loss drugs turned up.
- Sitting on a digital code: it expires after three business days.
If you’re still choosing where to live, check how far each town is from a Caja clinic and a pharmacy that delivers. Our list of the best places to retire in Costa Rica is a good place to start.
Frequently Asked Questions
Do I need a prescription to buy medicine in Costa Rica?
Not for basic painkillers like acetaminophen and ibuprofen. Antibiotics and controlled medicines always need one, and officially most other medicines do too.
Can I buy antibiotics without a prescription?
No. You need a digital prescription from a doctor or dentist in Costa Rica, which arrives as a code on your phone or by email.
What are the main pharmacy chains in Costa Rica?
Fischel, La Bomba and Sucre. Fischel and La Bomba have the same owner, and La Bomba aims for lower prices.
Is medicine cheaper in Costa Rica than in the US?
Often not at a private pharmacy. Thirty tablets of generic losartan cost about US$18 at Walmart Costa Rica and under US$1 at Cost Plus Drugs. Through the Caja, though, medicines on its list come at no extra cost.
Does the Caja pay for prescriptions?
Yes, for medicines on its official list prescribed by a Caja doctor or through medicina mixta. You need residency and Caja membership first.
Can I get medicine delivered?
Yes. Fischel, La Bomba and Sucre all deliver, and the driver may ask to see your prescription for anything that needs one.
Are any pharmacies open 24 hours?
Hospital pharmacies are your best bet, and Clínica Bíblica’s stay open around the clock. Most Fischel branches close by 10pm.
Can I bring my medication into Costa Rica?
Yes. Keep everyday medicine in its original packaging with the prescription. Strong painkillers, sleeping pills and ADHD medicine are limited to a month’s supply and need a doctor’s report and Spanish translations.
Sources Cited
- Costa Rica’s General Health Law: only pharmacists hand over prescription medicine.
- Ministry of Health over-the-counter medicine list: painkillers sold without a prescription.
- CR Hoy: digital prescriptions for antibiotics from November 8, 2025.
- La Nación: how patients receive and use the code.
- Colegio de Cirujanos Dentistas de Costa Rica: codes valid for three business days.
- La Nación: digital prescriptions for controlled medicines since 2017.
- CCSS official medicine list 2025: medicines covered by the Caja.
- Delfino: requesting monthly refills in the EDUS app.
- Dra. Lidia Pérez: how medicina mixta works.
- The Tico Times: private doctor visit costs.
- La Nación: government study on medicine margins.
- Semanario Universidad: generics that haven’t been tested against the original.
- Diario Extra: fake tirzepatide warning, September 2026.
- CR Hoy: fake cancer medicine batches, July 2026.
- International Narcotics Control Board: Costa Rica’s rules for travelers carrying controlled medicine.
- US Food and Drug Administration: bringing medicine into the US.
- US federal regulations: 50-dose limit on controlled medicine bought abroad.
- Walmart Costa Rica and Cost Plus Drugs: prices checked September 14, 2026.
