Two medicines, side by side
Nitrofurantoin vs cephalexin
Nitrofurantoin and cephalexin are both labeled for bacterial infections and urinary tract infections. Drugs@FDA records approvals of nitrofurantoin since 1953 and of cephalexin since 1971. Pharmacies paid $0.165 per nitrofurantoin mcr 50 mg capsule and $0.120 per cephalexin 500 mg capsule (NADAC, October 7, 2026); the strengths differ, so the two prices are not like for like. In FDA's classes, nitrofurantoin is a nitrofuran antibacterial and cephalexin a cephalosporin antibacterial.
Check it at the source: the nitrofurantoin FDA label on DailyMed (effective June 24, 2026); the cephalexin FDA label on DailyMed (effective December 31, 2020).
Highlights of the nitrofurantoin record
Nitrofurantoin (Macrobid) · label of June 24, 2026
Used for
From the label: indicationsNitrofurantoin capsules (monohydrate/macrocrystals) are indicated only for the treatment of acute uncomplicated urinary tract infections (acute cystitis) caused by susceptible strains of Escherichia coli or Staphylococcus saprophyticus. Nitrofurantoin is not indicated for the treatment of pyelonephritis or perinephric abscesses. […]
On the market
- Earliest approval on file
- February 6, 1953
- Generic labelers
- 47 labelers
- Pharmacy cost
- $0.165 per capsule
Supply and safety
- Shortage
- A presentation being discontinued
- Recalls
- 13
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
Source: FDA drug labels via openFDA (Nitrofurantoin label of June 24, 2026, Cephalexin label of December 31, 2020); NDC Directory, Drugs@FDA, NADAC, FDA shortages and recalls (October 8, 2026)
How do nitrofurantoin and cephalexin differ on the record?
In FDA's classes, nitrofurantoin is a nitrofuran antibacterial and cephalexin a cephalosporin antibacterial.
How each works, in its label's words: Nitrofurantoin, “Mechanism of Action The mechanism of the antimicrobial action of nitrofurantoin is unusual among antibacterials.”; Cephalexin, “Cephalexin is a cephalosporin antibacterial drug [see Microbiology ( 12.4 )].”
Generics: nitrofurantoin since 1970; cephalexin since 1976 (Drugs@FDA).
| Nitrofurantoin | Cephalexin | |
|---|---|---|
| Labeled for | Urinary tract infections, Bacterial infections | Bacterial infections, Urinary tract infections |
| Pharmacologic class | Nitrofuran Antibacterial | Cephalosporin Antibacterial |
| How it works (label) | Mechanism of Action The mechanism of the antimicrobial action of nitrofurantoin is unusual among antibacterials. | Cephalexin is a cephalosporin antibacterial drug [see Microbiology ( 12.4 )]. |
| Half-life (label) | n/a | n/a |
| Earliest approval on file (Drugs@FDA) | February 6, 1953 | January 4, 1971 |
| First generic approved | September 30, 1970 | April 26, 1976 |
| Generic labelers (NDC) | 47 labelers | 35 labelers |
| Pharmacy cost (NADAC, each one's most listed form; strengths differ) | $0.165 per capsule (Nitrofurantoin mcr 50 mg capsule) | $0.120 per capsule (Cephalexin 500 mg capsule) |
| 12-month price change | -12% | -6% |
| Boxed warning | No | No |
| Shortage now | A presentation being discontinued | No current entry |
| Recalls recorded | 13 | 22 |
| FAERS reports (a report is not proof of cause; counts follow how widely a medicine is used) | 22,755 | 21,515 |
| 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 nitrofurantoin
- every medicine labeled for the same conditions