Two medicines, side by side
Cephalexin vs ciprofloxacin
Cephalexin and ciprofloxacin are both labeled for bacterial infections and urinary tract infections. Drugs@FDA records approvals of cephalexin since 1971 and of ciprofloxacin since 1987. Pharmacies paid $0.120 per cephalexin 500 mg capsule and $0.123 per ciprofloxacin HCl 500 mg tablet (NADAC, October 7, 2026). Ciprofloxacin's other strengths are brand-only: $1.25 per mL (Cipro 5% suspension). In FDA's classes, cephalexin is a cephalosporin antibacterial and ciprofloxacin a fluoroquinolone antibacterial.
Check it at the source: the cephalexin FDA label on DailyMed (effective December 31, 2020); the ciprofloxacin FDA label on DailyMed (effective March 2, 2026).
Highlights of the cephalexin record
Cephalexin (Keflex) · label of December 31, 2020
Used for
From the label: indicationsCephalexin is a cephalosporin antibacterial drug indicated for the treatment of the following infections caused by susceptible isolates of designated bacteria: Respiratory tract infection ( 1.1 ) Otitis media ( 1.2 ) Skin and skin structure infections ( 1.3 ) Bone infections ( 1.4 ) Genitourinary tract infections ( 1.5 ) To reduce the development of drug-resistant bacteria and maintain the effectiveness of […]
On the market
- Earliest approval on file
- January 4, 1971
- Generic labelers
- 35 labelers
- Pharmacy cost
- $0.120 per capsule
Supply and safety
- Shortage
- No current entry
- Recalls
- 22
Highlights of the ciprofloxacin record
Ciprofloxacin (Cipro) · label of March 2, 2026
SERIOUS ADVERSE REACTIONS INCLUDING TENDINITIS, TENDON RUPTURE, PERIPHERAL NEUROPATHY, CENTRAL NERVOUS SYSTEM EFFECTS AND EXACERBATION OF MYASTHENIA GRAVIS
Fluoroquinolones, including CIPRO ® , have been associated with disabling and potentially irreversible serious adverse reactions that have occurred together [see Warnings and Precautions ( 5.1 )], including:
Tendinitis and tendon rupture [see Warnings and Precautions ( 5.2 )].
Peripheral neuropathy [see Warnings and Precautions ( 5.3 )].
Used for
From the label: indicationsCIPRO is a fluoroquinolone antibacterial indicated in adults (18 years of age and older) with the following infections caused by designated, susceptible bacteria and in pediatric patients where indicated: • Skin and Skin Structure Infections ( 1.1 ) • Bone and Joint Infections ( 1.2 ) • Complicated Intra-Abdominal Infections ( 1.3 ) • Infectious Diarrhea ( 1.4 ) • Typhoid Fever (Enteric Fever) ( 1.5 ) • […]
On the market
- Earliest approval on file
- October 22, 1987
- Generic labelers
- 54 labelers
- Pharmacy cost
- $0.123 per tablet
Supply and safety
- Shortage
- No current entry
- Recalls
- 14
Source: FDA drug labels via openFDA (Cephalexin label of December 31, 2020, Ciprofloxacin label of March 2, 2026); NDC Directory, Drugs@FDA, NADAC, FDA shortages and recalls (October 8, 2026)
How do cephalexin and ciprofloxacin differ on the record?
In FDA's classes, cephalexin is a cephalosporin antibacterial and ciprofloxacin a fluoroquinolone antibacterial.
How each works, in its label's words: Cephalexin, “Cephalexin is a cephalosporin antibacterial drug [see Microbiology ( 12.4 )].”; Ciprofloxacin, “Ciprofloxacin is a member of the fluoroquinolone class of antibacterial agents [see Microbiology ( 12.4 )].”
Only the ciprofloxacin label carries a boxed warning.
Generics: cephalexin since 1976; ciprofloxacin since 2004 (Drugs@FDA).
| Cephalexin | Ciprofloxacin | |
|---|---|---|
| Labeled for | Bacterial infections, Urinary tract infections | Diarrhea, Urinary tract infections, Bacterial infections |
| Pharmacologic class | Cephalosporin Antibacterial | Fluoroquinolone Antibacterial, Quinolone Antimicrobial |
| How it works (label) | Cephalexin is a cephalosporin antibacterial drug [see Microbiology ( 12.4 )]. | Ciprofloxacin is a member of the fluoroquinolone class of antibacterial agents [see Microbiology ( 12.4 )]. |
| Half-life (label) | n/a | The serum elimination half-life in subjects with normal renal function is approximately 4 hours. |
| Earliest approval on file (Drugs@FDA) | January 4, 1971 | October 22, 1987 |
| First generic approved | April 26, 1976 | March 16, 2004 |
| Generic labelers (NDC) | 35 labelers | 54 labelers |
| Pharmacy cost (NADAC, each one's most listed form; strengths differ) | $0.120 per capsule (Cephalexin 500 mg capsule) | $0.123 per tablet (Ciprofloxacin HCl 500 mg tablet) |
| 12-month price change | -6% | -9% |
| Boxed warning | No | Yes |
| Shortage now | No current entry | No current entry |
| Recalls recorded | 22 | 14 |
| FAERS reports (a report is not proof of cause; counts follow how widely a medicine is used) | 21,515 | 96,726 |
| DEA schedule | none | none |
Source: Drugs@FDA, FDA NDC Directory, CMS NADAC of October 7, 2026, FDA shortages and recalls, FAERS via openFDA (FDA files October 8, 2026)
What next?
- Alternatives to cephalexin
- every medicine labeled for the same conditions