The antibiotic with the alcohol warning people actually need to follow.
Explained by a GMC-registered GP, not a leaflet
Honest about what we can and cannot prescribe remotely
Side effects given the same weight as benefits
Your NHS records in the room, with your consent
Care led personally by Dr Khan
Attentive, unhurried care that listens properly
Five-star Google reviews from the people we have looked after
Registered with the Care Quality Commission
Metronidazole works against anaerobic bacteria — those that thrive without oxygen — and against certain protozoa. It is taken up by these organisms and converted into compounds that break their DNA.
Human cells and normal aerobic bacteria do not perform that conversion, which is what makes it selective.
That narrow spectrum is useful: it targets the organisms causing bacterial vaginosis, dental abscesses and gut infections while leaving much else alone.
Do not drink alcohol during the course or for 48 hours afterwards. The combination can cause flushing, throbbing headache, vomiting and palpitations — a genuinely unpleasant reaction.
The evidence for this effect is more debated than the warning suggests, but the reaction is reported often enough, and is unpleasant enough, that following the advice is straightforward and sensible. It also applies to alcohol in mouthwash and some medicines.
Breastfeeding is usually manageable, though it can affect the taste of milk. The vaginal gel produces far lower blood levels than tablets and is often preferred.
No routine monitoring for a short course, other than INR checks for anyone on warfarin. Repeated or prolonged courses prompt review for nerve symptoms.
Yes, for bacterial vaginosis and trichomoniasis where the picture is clear, and for dental infection pending dental treatment.
Bacterial vaginosis has a characteristic history — a thin grey-white discharge with a fishy odour, often worse after sex, and typically without itching or soreness. That pattern is distinctive enough to treat on history.
Itching and soreness point instead to thrush, and a different treatment. Getting that distinction right is most of the consultation.
For dental infection: antibiotics buy time, they do not treat the tooth. Dental treatment is what resolves it, and we will say so plainly.
Metronidazole tablets are a cheap generic and a private course usually costs less than the England NHS prescription charge.
Vaginal gel costs considerably more than tablets but causes far less nausea and no metallic taste, which many people consider worth the difference.
Bacterial vaginosis treatments are not available over the counter in the UK, though pH self-test kits are.
Complete the course, and keep off alcohol for 48 hours afterwards.
Recurrence is common and frustrating, and repeat antibiotic courses alone rarely solve it. Avoiding douching and scented washes matters, since both disturb the vaginal flora that treatment is trying to restore. Longer suppressive regimens are used where recurrence is frequent.
The reaction is reported often enough to take seriously, even though the evidence is more mixed than the warning implies. Avoiding alcohol for a week is easy; the reaction is not pleasant. Follow the advice.
A thin grey discharge with a fishy smell and little itching is usually bacterial vaginosis. Thick white discharge with itching and soreness is usually thrush. They are treated completely differently, which is why the distinction matters more than the discharge itself.
For trichomoniasis, yes — always. For bacterial vaginosis, male partners do not need treatment; female partners may.
A well-known effect that resolves after the course. The vaginal gel largely avoids it.
No — they hold it while you get dental treatment. The tooth is the problem and needs a dentist. Facial swelling, difficulty swallowing or swelling closing the eye needs urgent care.
Clinically reviewed by Dr Mohammad Zubair Khan, GMC 7563469
Last reviewed
August 30, 2026
On this page
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Your NHS record in the room
Written treatment plan
Told when a test isn’t needed
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Same day, usually
20 minutes
Yes, with your consent
Included
Yes, and told why
£40 for 20 minutes
Varies by practice
Typically 10 minutes
Yes, your full record
Not routinely
Usually
Free
Same day
Often 10 to 15 minutes
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Same-day access is usually available, from 6am to 10pm, seven days a week. You choose a time that suits you rather than waiting on hold at 8am.
Yes. Care is led personally by Dr Mohammad Khan, so you are not passed between clinicians. Continuity is the point of a small practice: someone who knows your history and is listening attentively rather than working through a checklist.
Yes, with your consent. We can access your Summary Care Record during the consultation, so your current medications, allergies and significant history are in the room. That means fewer questions you have already answered elsewhere, and safer prescribing.
No. We are not here to replace GPs, only to support them. Your NHS practice remains responsible for your ongoing care, and with your consent we write to them after the consultation. We are useful when you need to be seen sooner, or want more time than a standard appointment allows.
Twenty unhurried minutes and a comprehensive assessment. A written treatment plan is included, along with any prescription, sick note or referral letter arising from the consultation, at no extra charge.
£40 for 20 minutes, self-pay. Membership is optional and never required. Priced for fairness, because we are not here to charge extortionate amounts for access to a doctor.
It means the diagnosis can usually be made from your history and photographs, and that treatment can be arranged safely without examining you. Where a condition is not marked treatable online, it is because examination is the diagnosis — listening to a chest, feeling an abdomen, examining an ear or a joint — or because a procedure or device is needed.
Yes, where there is a genuine bacterial infection — cellulitis, impetigo, bacterial urine infections, confirmed strep throat. We will also frequently tell you that you do not need one. Most sore throats, coughs, colds and earaches are viral, and an antibiotic gives you the side effects with none of the benefit.
If your problem turns out to be genuinely outside what we can do remotely, the doctor will tell you straight away, point you to the right service, and refund your fee in full. We would rather do that than fill twenty minutes to justify the charge.
Call 999 or go to A&E — do not book an online appointment and do not wait for a reply to an email. For urgent problems that are not emergencies, NHS 111 is available 24 hours a day, online or by phone, and can direct you to the right service.
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