A common penicillin antibiotic. The rash it causes in glandular fever is the source of countless mistaken allergy labels.
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Amoxicillin is a penicillin antibiotic. It kills bacteria by preventing them from building a functioning cell wall.
It is broad-spectrum, well absorbed by mouth, inexpensive and generally well tolerated, which is why it is one of the most prescribed antibiotics in the UK. It has no effect whatsoever on viruses.
It does not treat colds, flu, or most sore throats and coughs, because those are viral.
Usually three times daily, spaced as evenly as you reasonably can across the day.
With or without food.
Finish the course as prescribed. The older advice to always complete every course is now more nuanced — for some infections shorter courses are equally effective — but the decision belongs to the prescriber, not to how well you feel on day three.
If you miss a dose, take it as soon as you remember unless the next is nearly due. Do not double up.
Common: nausea, diarrhoea, and thrush — oral or vaginal — because the antibiotic disrupts normal flora alongside the infection.
The rash deserves its own explanation, because it causes a great deal of lasting confusion.
Amoxicillin causes a florid, widespread rash in a large majority of people who have glandular fever. This is not a true penicillin allergy. It is a specific interaction with the Epstein-Barr virus. But it is routinely recorded as an allergy, and that label then follows someone for decades, pushing them towards broader-spectrum antibiotics that are less effective and more likely to cause resistance and C. difficile.
Around 10% of people report a penicillin allergy. When formally tested, more than 90% of them are not allergic. If your label came from a childhood rash nobody can quite remember, it is worth having reviewed.
A genuine allergic reaction — hives, swelling of the face or throat, wheeze, difficulty breathing — is a medical emergency. Call 999.
Care is needed with kidney impairment, where the dose may need reducing.
It is not suitable for a viral illness, which covers most coughs, colds and sore throats. Taking an antibiotic you do not need is not a neutral act — it carries side effects, disrupts your gut flora for months, and makes your own bacteria more resistant next time.
Methotrexate — amoxicillin can raise its levels and toxicity.
Warfarin — INR can be affected and may need checking.
Allopurinol taken together increases the likelihood of a rash.
On the contraceptive pill: current UK guidance is that most antibiotics, including amoxicillin, do not reduce the effectiveness of combined hormonal contraception. Additional precautions are only needed if vomiting or diarrhoea occur. This changed some years ago and the old advice still circulates widely.
No routine monitoring is needed for a short course.
Yes, where an infection is genuinely likely to be bacterial and antibiotics are the right answer.
What that involves: a proper assessment of how long you have been unwell, the pattern of symptoms, and whether the picture fits a bacterial cause. For sore throats we use the FeverPAIN or Centor criteria rather than judging by how unwell someone feels.
What we will often do instead is explain why an antibiotic will not help, and what will. Sometimes we will offer a delayed prescription — held for two or three days and used only if things worsen. Most people never fill it, and outcomes are the same.
We will not prescribe antibiotics on request for a viral illness. The fee covers the assessment, and being told with reasons that this will settle on its own is a legitimate and useful outcome.
This page is information, not an offer to supply.
Amoxicillin is one of the cheapest antibiotics there is. On a private prescription the drug cost plus dispensing fee is usually less than the England NHS prescription charge of around £10, and NHS prescriptions are free in Wales.
Most coughs, colds, sore throats and earaches are viral and get better on their own. Paying for a consultation in the hope of an antibiotic is often paying for a course you did not need and a set of side effects you could have avoided.
A pharmacist can assess sore throats, earache and sinus symptoms free of charge under the NHS Pharmacy First scheme in England, and supply antibiotics where they are genuinely indicated. That is the cheaper and usually better first step.
Do not keep leftover antibiotics or take someone else's. The wrong antibiotic at the wrong dose for the wrong infection is how resistance spreads and how a treatable infection becomes a difficult one.
Take the course exactly as prescribed, for the length prescribed. Modern courses are deliberately short — often five days — because shorter courses work as well for most infections and cause less collateral damage.
Stopping early because you feel better means stopping at the point the drug is still finishing the job. Feeling better on day three is expected, not a signal to stop.
A flat, blotchy rash appearing several days into amoxicillin is common, particularly in children and especially in glandular fever — and it is usually not an allergy.
A raised, intensely itchy hive-like rash, or any swelling of the lips, tongue or throat, is different and does mean allergy. Stop and seek help.
Getting this distinction right matters, because a wrongly applied penicillin allergy label follows you for decades and pushes you towards broader, less effective antibiotics.
Yes — take it as prescribed. Courses are already kept as short as the evidence allows.
Feeling better after two or three days is normal and is not a reason to stop.
Possibly not. The great majority of people carrying a penicillin allergy label turn out not to be allergic when properly assessed — many labels come from a childhood rash during a viral illness.
It is worth unpicking, because the label pushes you towards broader antibiotics that work less well and cause more problems.
Hives, swelling of the lips, tongue or throat, wheeze, or collapse — usually within an hour of a dose.
A flat blotchy rash appearing on day five is usually not allergy, though it should still be reported so it can be assessed properly rather than assumed either way.
No. Colds, most sore throats, most coughs and most earaches are viral, and antibiotics do nothing for them.
They will still give you diarrhoea, thrush and a contribution to resistance — all cost, no benefit.
No. That advice changed years ago and persists anyway.
Only enzyme-inducing antibiotics such as rifampicin affect it — though vomiting or severe diarrhoea from any cause can reduce absorption.
Yes, with amoxicillin. The blanket "no alcohol with antibiotics" rule applies to metronidazole, not to this one.
Heavy drinking while unwell is a bad idea for other reasons.
Because it kills off the harmless bacteria that keep yeast in check. Oral and vaginal thrush are both common.
It is easily treated from a pharmacy and is not a reason to stop the course.
The evidence is mixed and not strong. Some people find it reduces the diarrhoea; it is unlikely to do harm.
It is not something to spend a great deal on.
Take it when you remember, unless the next is nearly due. Do not double up.
Spread the remaining doses as evenly as you reasonably can.
Clinically reviewed by Dr Mohammad Zubair Khan, GMC 7563469
Last reviewed
August 24, 2026
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