Amoxicillin for Gonorrhea: Everything You Need to Know

Amoxicillin pill bottle toppled over with pills spilling out.
  • Amoxicillin can be used to treat gonorrhea, although it is not the preferred treatment method for this disease.

  • Doctors typically prescribe 500 mg of amoxicillin three times daily for a week for patients with gonorrhea.

  • The Centers for Disease Control and Prevention (CDC) recommends ceftriaxone, an injectable antibiotic, to treat gonorrhea.

  • Individuals with penicillin allergies should not use amoxicillin or ceftriaxone to treat gonorrhea and should look at alternative antibiotics – like doxycycline or azithromycin.

  • Proper treatment of gonorrhea is important to avoid future health complications and infertility issues.

Gonorrhea is a sexually transmitted infection (STI) that can spread through unprotected sex and both men and women can be affected. Research suggests that its prevalence in the U.S. is higher among women than men.

The World Health Organization (WHO) reported 82 million gonorrhea infections in 2020, making it one of the most common STIs worldwide.

There are different treatments available for gonorrhea including oral antibiotics such as amoxicillin and doxycycline, and injectable antibiotics such as ceftriaxone.

In this article, we’ll explore the use of amoxicillin to effectively treat gonorrhea and suggest alternative medications for people who cannot use this antibiotic.

What is Amoxicillin?

Amoxicillin is an antibiotic that inhibits the growth of bacteria and it belongs to the penicillin class of drugs.

This antibiotic works by preventing bacteria from building cell walls. Without these walls, bacteria can’t survive and the body’s immune system can eliminate it.

Amoxicillin can be prescribed for a variety of bacterial infections, including gonorrhea and chlamydia. Some other common infections that can be treated with amoxicillin include:

  • Ear infections
  • Sinusitis
  • Strep throat
  • Dental infections
  • Skin infections
  • Lower respiratory tract infections
  • Urinary tract infections

What is Gonorrhea?

Sometimes referred to colloquially as ‘the clap,’ gonorrhea is an STI caused by the bacterium Neisseria gonorrhoeae.

Someone with gonorrhea can also be said to have a gonococcal infection.

Data from the CDC suggest that young adults, sexually active teenagers, and African Americans have the highest risk of being infected with this disease.

How Often Should I Get Tested for Gonorrhea?

Because many people with gonorrhea don’t show any symptoms, routine STI screenings are important if you are sexually active.

Read the CDC’s recommendations for STD testing to find out how often you should get tested for gonorrhea based on your age and lifestyle choices.

People with multiple sexual partners, pregnant women, and men who have sex with men have an increased risk of infection and should get tested regularly.

At LifeMD, we offer discreet STD testing services. After your online consultation, a healthcare provider can order a lab test at a partner location near you.

You’ll have your results within 3–5 business days after your test.

Positive gonorrhea test.

Is Amoxicillin an Effective Treatment for Gonorrhea?

Research has shown that amoxicillin is effective at treating gonorrhea, but it’s not the recommended first-line treatment for this disease. Doctors also won’t prescribe amoxicillin to anyone allergic to penicillin.

Once you start taking amoxicillin, you may still experience gonorrhea symptoms, such as discharge, but you should be cured within seven days.

Remember to follow your doctor’s dosage instructions and to contact them if you experience any issues during treatment or after you’ve finished your course of amoxicillin.

What other STDs can amoxicillin treat?

People who do not have penicillin allergies can also use amoxicillin to treat chlamydia. However, amoxicillin is not the preferred treatment for this disease.

Always consult your doctor before starting antibiotic treatment. They’ll ensure that you’re using the right antibiotic and dosage to treat sexually transmitted infections.

How to Take Amoxicillin for Gonorrhea

Your doctor will typically prescribe 500 mg amoxicillin every 8 hours for 7–10 days to treat gonorrhea. This means you will need to take 21 to 30 pills over the course of roughly a week.

Not everyone can commit to taking this many pills, so other combination therapies or the single-dose injection of ceftriaxone may be better options.

Be sure to discuss all the alternatives with your doctor before deciding on the best treatment plan for you.

How long does it take for gonorrhea to go away with amoxicillin?

You can start feeling better within a few days after starting amoxicillin, but it’s important to complete the entire course of antibiotics even if your symptoms have already disappeared.

The CDC recommends that individuals avoid sexual contact for seven days after treatment. They also advise retesting for gonorrhea every three months post-treatment, as reinfection is possible.

Studies with active follow-ups showed that men who had gonorrhea had a 7% chance of being reinfected. This shows how vital it is to complete your treatment and practice safe sex to avoid reinfection.

Amoxicillin and Gonorrhea: Potential Side Effects

All medications have side effects and amoxicillin is no different. If you have any concerns, be sure to raise them with your doctor.

It’s also important to disclose any medications you’re currently taking before starting amoxicillin.

Common side effects of amoxicillin include:

  • Oral or vaginal thrush (yeast infections)
  • Gastrointestinal issues, like nausea, vomiting, or diarrhea
  • Itchy skin or rashes

Rare or serious side effects include:

  • Skin peeling or blistering
  • Painful rashes that appear red or purple
  • Swollen lymph nodes
  • Yellowing of the eyes (jaundice) and dark urine — this is a symptom of liver damage
  • Breathing difficulties — this may be a sign of anaphylaxis and requires emergency medical attention
Amoxicillin side effect rash on skin.
Key Point: Who Should Not Be Using Amoxicillin for Gonorrhea?

Individuals who are allergic to penicillin or have become resistant to this antibiotic will need to use alternative treatments.

Certain drugs also interact with amoxicillin, so it’s important to give your current medication list to your doctor before you start your course of antibiotics.

Amoxicillin interacts with the following medications:

  • Warfarin
  • Allopurinol
  • Probenecid
  • Certain live vaccines, such as Vaxchora and Vivotif
  • Birth control pills
  • Other antibiotics

An important note on alcohol:

As a general rule, you should not mix alcohol with medications — especially antibiotics.

Alcohol can change the way your body breaks down antibiotics, which may decrease their effectiveness or increase their toxicity.

Alcohol may also cause the same side effects as antibiotics do, which can create a really unpleasant experience when you take them together.

How to Treat Gonorrhea

Sexually transmitted infections can lead to serious health complications — including infertility — if left untreated.

Gonorrhea treatment is important and people who suspect they’ve been exposed should seek medical attention as soon as possible. Treatment regimens typically involve a course of antibiotics.

The CDC’s treatment and care guidelines for gonorrhea recommend a single, 500 mg intramuscular injection of the antibiotic ceftriaxone.

If ceftriaxone is not available, other injectable cephalosporins, such as 500 mg of either ceftizoxime or cefotaxime, may be used.

How to treat gonorrhea and chlamydia coinfection

If you are diagnosed with gonorrhea, you may also be given treatment for chlamydia as there is a high coinfection rate for these diseases — this means you stand a good chance of being infected with gonorrhea and chlamydia simultaneously.

One study showed that coinfection rates among men were higher than among women. Your doctor will have you tested for chlamydia if they suspect co infection based on your symptoms and risk factors.

If you’ve been infected with both chlamydia and gonorrhea, the CDC recommends the following treatment regime:

  • A 100 mg oral dose of doxycycline twice a day for 7 days
  • A single 500 mg intramuscular injection of ceftriaxone, or 1 g of ceftriaxone for individuals weighing more than 150 kg

When Should I Use Amoxicillin to Treat Gonorrhea?

Amoxicillin has been proven to be an effective treatment for gonorrhea, but only if you follow your doctor’s instructions and complete your entire antibiotic course.

CDC statistics show that 28% of the annual antibiotic courses prescribed in the U.S. are not necessary. Overuse of antibiotics contributes to antibiotic resistance, which is an issue with serious consequences for health care systems.

As mentioned earlier, using amoxicillin to treat gonorrhea may involve taking up to 30 pills over a period of one week — not everyone can commit to this.

So if you’re someone who’s likely to forget to take your medication, a single-dose injectable antibiotic, like ceftriaxone, may be your preferred option. Be sure to explore all possible treatment regimens with your health care provider to decide on the right one for you.

Alternative Treatments: What If You Can’t Take Amoxicillin or Ceftriaxone?

Individuals with penicillin allergies should steer clear of amoxicillin.

The CDC also advises anyone with a penicillin allergy to avoid taking ceftriaxone, even though there’s a chance that they might not have an allergic reaction to this antibiotic.

Your physician may recommend alternative treatment regimens for gonorrhea that include drugs like:

  • Azithromycin
  • Doxycycline
  • Gentamycin — although research shows that this drug may not be able to eradicate gonorrhea on its own
  • Combination therapies such as oral azithromycin and oral gemifloxacin

What is the best oral antibiotic for gonorrhea?

The CDC recommends a 500 mg intramuscular injection of ceftriaxone to treat gonorrhea.

If ceftriaxone is unavailable, or if you are allergic to penicillin, oral antibiotics are an option.

Above, we mentioned several alternatives to amoxicillin and ceftriaxone. Your doctor will have to determine the best oral antibiotic for treating gonorrhea based on your health, potential drug interactions with other medications they’re taking, and coinfections with other STIs.

Key Point: Can You Develop Resistance to Amoxicillin?

You can develop a resistance to amoxicillin — especially if this antibiotic is used too frequently or you do not adhere to your doctor’s instructions.

Antimicrobial resistance (AMR) occurs when microorganisms like bacteria, fungi, viruses, and parasites develop resistance to the agents that used to kill them.

Antibiotic resistance (AR) is a subset of antimicrobial resistance. It refers to the ability of bacteria to resist the effects of antibiotics that were once effective at killing them.

When antibiotic resistance occurs, these bacteria can no longer be eliminated by a particular antibiotic, making infections more difficult to treat.

The CDC’s Antibiotic Resistance (AR) Threats Report states that more than 35,000 people die due to antimicrobial-resistant infections per year.

People who develop antibiotic resistance to amoxicillin must consider alternative antibiotics.

Gonorrhea and Pregnant Women: Special Considerations

Amoxicillin and ceftriaxone are both deemed safe for treating gonorrhea in pregnant women.

They are classified under Category B in the FDA’s Pregnancy Guidelines, indicating that animal studies have not identified any risks associated with these drugs.

Where Can I Learn More About Gonorrhea Treatments?

If you suspect you’ve been exposed to gonorrhea, be sure to seek medical attention immediately. At LifeMD, a doctor or nurse practitioner can order a lab for gonorrhea testing at a location near you.

Trained health care providers will ensure that you receive safe, effective treatment for gonorrhea. Book your appointment today to get started.

In the case that you are experiencing pain or other severe symptoms, seek immediate emergency care.

Jarrod Nero, MSN, APRN, FNP-C

Jarrod, a board-certified Family Nurse Practitioner, earned his B.S. in Nursing from William Carey University and an M. S. in Family Health Nursing from the Southern University of Baton Rouge. He lives in New Orleans with his partner and son.

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This article is intended for informational purposes only and should not be considered medical advice. Consult a healthcare professional or call a doctor in the case of a medical emergency.

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