ENPain medication in Germany surprises many visitors, expats and patients coming for treatment: familiar tablets are sold only in a pharmacy (Apotheke), often under other brand names, and many of them only on prescription.
This page covers over-the-counter painkillers, prescription drugs, strong opioids, bringing your own medicines and where to turn when tablets no longer help. It gives no doses: the dose is set by a doctor or pharmacist.
Over-the-Counter Pain Relief in German Pharmacies
Most painkillers, even simple ones, are sold only in pharmacies, not in supermarkets: by law they are “pharmacy-only” (apothekenpflichtig). The pharmacist will ask what the medicine is for and must check that it suits the person who will take it; they may suggest another product or a doctor and must refuse to sell if misuse is suspected.
Without a prescription, pharmacies usually sell ibuprofen, paracetamol and acetylsalicylic acid (aspirin): ibuprofen only as low-strength tablets, paracetamol only in small packs; stronger tablets and larger packs need a prescription. These drugs are not harmless: ibuprofen and aspirin can cause stomach ulcers and bleeding, and a paracetamol overdose damages the liver.
At night, on Sundays and on public holidays only on-duty pharmacies (Notdienst-Apotheke) are open, and every closed pharmacy displays the nearest ones. Brand names often differ from those at home, so it helps to know the active ingredient: the pharmacist can then find the right product.
Prescription Painkillers and Opioids
A prescription is needed for higher strengths, many combinations and drugs with serious side effects. A doctor in a practice or hospital writes it; the page on how to see a doctor in Germany explains how to get an appointment. Patients without German health insurance receive a private prescription (Privatrezept) and pay the pharmacy in full.
Metamizole (one brand name is Novalgin) is a German peculiarity: the most commonly prescribed painkiller in Germany, used for severe pain. Many countries have not approved it, and the United States withdrew it from the market because of agranulocytosis, a rare but dangerous side effect: white blood cells called granulocytes drop sharply and the body loses its defence against infections. If fever or a sore throat appears, stop the drug and see a doctor at once. The European Medicines Agency reviewed the risk, found the benefits still outweigh it and strengthened the warnings.
Strong opioids such as morphine, oxycodone and fentanyl patches fall under the Narcotics Act (Betäubungsmittelgesetz): they are prescribed only on a special numbered form that the Federal Institute for Drugs and Medical Devices (BfArM) issues to each doctor personally; their use is strictly documented. They treat severe pain after major operations and in cancer but work less well in chronic back pain. Cancer pain is taken seriously in Germany: there is no need to endure it, the risk of addiction to prescribed opioids is comparatively low, and fear should not leave anyone in pain.
Travelling to Germany with Your Own Pain Medication
Ordinary painkillers for personal use may be brought in amounts that match normal personal needs, ideally in the original pack with the leaflet and with a copy of the prescription or a doctor’s letter in English or German, so border officials and pharmacists can see what they are.
Opioids and other narcotic drugs face stricter rules, though you may carry as much as the journey requires. Residents of Schengen countries need a certificate under Article 75 of the Schengen Implementing Convention, filled in by their doctor and authenticated by the authorities at home before the trip; it is valid for a maximum of 30 days, one certificate per drug. Outside the Schengen Area there are no harmonised rules: BfArM recommends the guidelines of the International Narcotics Control Board, which cover journeys of up to 30 days and call for a multilingual doctor’s certificate with the active ingredient, doses and length of the trip. See the BfArM page on travelling with narcotic drugs.
Tell the clinic in Germany in advance which painkillers you take, so the doctors can continue treatment without a gap or arrange a substitute if your medicine cannot be brought in.
When Tablets Are Not Enough: Specialist Pain Therapy
Pain that lasts for months, needs ever higher doses or causes side effects is a reason to see a pain specialist (Schmerztherapeut): a doctor with additional training in special pain therapy, for example an anaesthetist, since pain treatment is part of that specialty. Treatment and hospitals are described on the pages pain clinic in Germany and back pain treatment.
Examples among partner hospitals: at Würzburg University Hospital, the Centre for Interdisciplinary Pain Medicine is led by its spokesperson Prof. Heike Rittner, an anaesthetist specialising in pain therapy and palliative medicine. At Ulm University Hospital, Dr Hannes Hofbauer heads the Pain Therapy Section. The m&i Specialty Clinic Bad Heilbrunn has a Centre for Pain Disorders that also treats chronic spinal pain.
Frequently asked questions
Is there a special German medicine for back pain?
No. German pharmacies sell the same active ingredients as other countries under different brand names, and doctors first look for the cause of the pain. The main treatment is staying active and exercising; painkillers are recommended only as an addition, for example to get moving again during severe pain, and as briefly as possible.
Does paracetamol help with back pain?
Probably not much: in a large study it worked no better than a placebo for back pain, so it is no longer recommended for it. It is still sold over the counter for mild to moderate pain and fever, but an overdose damages the liver.
Are painkiller injections used for back pain in Germany?
Painkiller injections into a muscle, such as diclofenac, are not recommended for back pain: they work no better than tablets but can cause abscesses or nerve damage. Targeted injections near a nerve root under X-ray guidance are different: pain centres use them, after an examination, when pain radiates into an arm or leg.
How AlenMed Helps Patients with Pain
Before the trip, AlenMed translates your medication list and prescriptions, asks the clinic which drugs can be continued and explains which documents you need for the journey.
In Germany, AlenMed books appointments with a pain specialist or the relevant department, provides an interpreter at the consultation and the pharmacy, and explains private prescriptions. A doctor decides which pain medication in Germany suits you, and AlenMed helps you follow the plan. The company office is in Munich.
This material is for information only, not an offer and not a recommendation to take any medicine: the medicine and its dose are decided by a doctor after an in-person examination.