What schedule are antibiotics in South Africa?
Common antibiotics such as amoxicillin, azithromycin and doxycycline are Schedule 4 in South Africa, so they need a prescription. Why that matters.
Antibiotics are Schedule 4 – prescription only
The oral antibiotics commonly used in South Africa – including amoxicillin, amoxicillin/clavulanate, azithromycin, doxycycline, ciprofloxacin, cephalexin and penicillin V – are listed as Schedule 4 on the DoseStreaks formulary. Schedule 4 is prescription-only, so a pharmacy cannot sell them over the counter without a prescription from an authorised prescriber.
Why antibiotics are controlled
Antibiotics only work on bacterial infections. Most sore throats, colds and flu are caused by viruses, and unnecessary antibiotics add side effects and drive antibiotic resistance. A prescriber decides whether an antibiotic is needed and which one.
Schedule 4 antibiotics on the formulary include:
Amoxicillin — Amoxil, Betamox, Moxypen, Ospamox
Upper and lower respiratory tract infections; UTIs; skin infections; otitis media; H. pylori eradication
Amoxicillin-Clavulanate (Co-amoxiclav) — Augmentin, Adco-Amoclav, Curam, Clavulin
Complicated skin infections; sinusitis; lower respiratory infections; UTIs with resistant organisms
Azithromycin — Zithromax, Azomycin, Adco-Azithromycin, Zithrocin
Respiratory tract infections; chlamydia (single dose 1 g); MAC prophylaxis in HIV
Doxycycline — Doximal, Cyclidox, Adco-Doxycycline, Vibramycin
STIs (chlamydia, syphilis); atypical pneumonia; malaria prophylaxis; tick bite fever; acne (low dose)
Ciprofloxacin — Ciprobay, Ciproxin, Adco-Cipro, Cifloc
UTIs; GI infections; complicated skin infections; typhoid
Cephalexin — Keflex, Adco-Cephalexin, Keforal, Sporidex
Skin infections; UTIs; mild respiratory infections
Phenoxymethylpenicillin (Penicillin V) — Pen-VK, Penicillin V Lennon
Streptococcal pharyngitis; rheumatic fever prophylaxis; skin infections
Using a prescribed antibiotic
- Take it exactly as prescribed and finish the course unless told otherwise.
- Do not save leftovers or use someone else's antibiotics.
- Tell the prescriber about allergies, especially to penicillin.
- Return to the clinic if you are not improving as expected.
Allergic reactions need urgent help
Common questions
- What schedule is amoxicillin in South Africa?
- Amoxicillin is Schedule 4, which means it needs a prescription.
- Can I buy antibiotics over the counter in South Africa?
- No. Common antibiotics are Schedule 4 and need a prescription from an authorised prescriber.
Sources
- Medicines and Related Substances Act 101 of 1965, and SAHPRA scheduling guidanceSouth African Health Products Regulatory Authority
- Medicines Online Directory and approved patient information leafletsSouth African Health Products Regulatory Authority
- Primary Healthcare Standard Treatment Guidelines and Essential Medicines ListNational Department of Health, South Africa
Sources last checked 6 October 2026.