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cephalexin

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Brand names: Keflex

First-Generation Cephalosporin Rx

Cephalexin is an antibiotic medicine. It fights bacterial infections in your body.

Drug Pricing (NADAC)

Generic Price

$0.05/unit

Generic Available

Yes (13 manufacturers)

Pricing data from NADAC (CMS), effective December 18, 2024. Compare all drug costs →

What it does

Cephalexin treats infections caused by bacteria.

Common side effects

Diarrhea, Nausea, Vomiting

Key warnings

Cephalexin can cause severe allergic reactions.

How It Works

Cephalexin belongs to a class of drugs called cephalosporins. It works by stopping the growth of bacteria. This helps your body fight off the infection.

How to Take It

Take cephalexin capsules as your doctor tells you. Adults usually take 250 mg every 6 hours, or 500 mg every 12 hours. Children's doses are based on their weight. You should take this medicine for 7 to 14 days.

Pregnancy & Breastfeeding

Tell your doctor if you are pregnant or breastfeeding. Studies haven't shown harm to the baby, but talk to your doctor about the risks and benefits. Cephalexin passes into breast milk, but the amount is very low.

Missed Dose

If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue with your regular schedule.

Storage

Store cephalexin capsules at room temperature, away from moisture and heat.

Side Effects (from patient reports)

Based on 13,809 FDA adverse event reports.

Long-term kidney disease
2,155
Kidney failure
1,554
Sudden kidney damage
1,538
Pain
1,363
Diarrhea
1,350
Tiredness
1,240
Feeling sick to your stomach
1,220
Difficulty breathing
1,165
Worry
1,131
Skin rash
1,093

FDA Adverse Event Report Analysis

Detailed analysis of 20,636 reports from the FDA Adverse Event Reporting System (FAERS). Reports span 2003–2025.

Total Reports

20,636

Death-Related Reports

1,749

Hospitalization Reports

7,230

Top Indication

Product Used For Unknown Indication

Gender Distribution

Female 12,477 (64%)
Male 6,958 (36%)

Age Distribution

0–17 705
18–44 2,815
45–64 4,575
65–74 2,809
75+ 2,683

Most Reported Adverse Reactions (FAERS)

# Reaction Reports
1 CHRONIC KIDNEY DISEASE 2,155
2 RENAL FAILURE 1,554
3 ACUTE KIDNEY INJURY 1,538
4 PAIN 1,365
5 DIARRHOEA 1,350
6 FATIGUE 1,239
7 NAUSEA 1,220
8 DYSPNOEA 1,164
9 ANXIETY 1,132
10 RASH 1,093
11 HEADACHE 1,089
12 DRUG INEFFECTIVE 988
13 OFF LABEL USE 854
14 VOMITING 837
15 DIZZINESS 828

Reactions in Death Reports

DEATH 685
RENAL FAILURE 268
CHRONIC KIDNEY DISEASE 264
ACUTE KIDNEY INJURY 235
DYSPNOEA 165
END STAGE RENAL DISEASE 165
ANXIETY 141
PAIN 118
PNEUMONIA 116
CARDIAC ARREST 97

Reactions in Hospitalization Reports

PAIN 695
DYSPNOEA 686
ACUTE KIDNEY INJURY 619
ANXIETY 573
RENAL FAILURE 573
CHRONIC KIDNEY DISEASE 547
NAUSEA 532
DIARRHOEA 508
URINARY TRACT INFECTION 462
FALL 445

Source: FDA FAERS (Adverse Event Reporting System) FDA FAERS (Adverse Event Reporting System) Reports are voluntary and do not establish causation

Serious Warnings

Cephalexin can cause severe allergic reactions. Tell your doctor if you are allergic to penicillin or other cephalosporin antibiotics. This medicine can also cause severe diarrhea. If you get diarrhea, tell your doctor right away. People with kidney problems may need a lower dose to prevent seizures.

Known Drug Interactions

moderate probenecid

( 7.1 ) Probenecid-The renal excretion of cephalexin is inhibited by probenecid. Co-administration of probenecid with cephalexin is not recommended. 7.2 Probenecid The renal excretion of cephalexin is inhibited by probenecid.

Mechanism: Probenecid blocks your kidneys from removing cephalexin from your body. This causes the antibiotic to build up to higher levels than intended.

What to do: You should not take these two medications together unless specifically directed by your doctor.

7 DRUG INTERACTIONS Metformin: increased metformin concentrations. ( 7.3 ) 7.1 Metformin Administration of cephalexin with metformin results in increased plasma metformin concentrations and decreased renal clearance of metformin. Careful patient monitoring and dose adjustment of metformin is recommended in patients concomitantly taking cephalexin and metformin [see Clinical Pharmacology (12.3) ].

Mechanism: Cephalexin makes it harder for your kidneys to remove metformin from your body. This causes the metformin to stay in your blood longer and reach higher levels than usual.

What to do: Your doctor should monitor you carefully and may need to lower your metformin dose while you are taking the antibiotic. Watch for signs of low blood sugar or other side effects during treatment.

Common Questions

Can I take cephalexin if I'm allergic to penicillin?
You should tell your doctor if you are allergic to penicillin. Up to 10% of people allergic to penicillin are also allergic to cephalosporins like cephalexin.
Can cephalexin cause diarrhea?
Yes, diarrhea is a common side effect. If you get severe diarrhea, tell your doctor.
How long should I take cephalexin?
You should take cephalexin for as long as your doctor tells you, usually 7 to 14 days.
What should I do if I miss a dose?
Take the missed dose as soon as you remember. If it's close to your next dose, skip the missed dose.
Can I take cephalexin with food?
You can take cephalexin with or without food.
Does cephalexin interact with other medicines?
Yes, cephalexin can interact with metformin and probenecid. Tell your doctor about all the medicines you take.
Can cephalexin affect my blood sugar?
Cephalexin can increase the amount of metformin in your blood, which can lower your blood sugar. If you take metformin, monitor your blood sugar closely.
Can cephalexin cause a false positive urine glucose test?
Yes, cephalexin can cause a false positive result if you are testing your urine for glucose.
What if I still feel sick after taking cephalexin for a few days?
Contact your doctor if your symptoms do not improve or get worse while taking cephalexin.
Can I drink alcohol while taking cephalexin?
It is best to avoid alcohol while taking cephalexin, as it could worsen some side effects.
What are the common side effects of cephalexin?
The most commonly reported side effects of cephalexin include Diarrhea, Nausea, Vomiting, Upset stomach, Stomach pain. Based on 13,809 FDA adverse event reports. Always consult your healthcare provider about potential side effects.
Does cephalexin interact with other medications?
Yes, cephalexin has 2 known drug interactions. Notable interactions include probenecid, metformin. Always inform your doctor about all medications you are taking.
What drug class is cephalexin?
cephalexin belongs to the First-Generation Cephalosporin drug class. It requires a prescription (Rx). Cephalexin treats infections caused by bacteria.
Is cephalexin safe during pregnancy?
Tell your doctor if you are pregnant or breastfeeding. Studies haven't shown harm to the baby, but talk to your doctor about the risks and benefits. Always consult your healthcare provider before using any medication during pregnancy or breastfeeding.
Has cephalexin been recalled?
There are 4 recalls associated with cephalexin products. Failed Impurities/Degradation Specifications An out-of-specification result was observed in the related substance test at the sixth month of stability analysis. Check the recalls section below for full details and affected products.

Active Recalls

Class II May 23, 2025

Failed Impurities/Degradation Specifications An out-of-specification result was observed in the related substance test at the sixth month of stability analysis. The individual impurity was identified to be Cephalexin Glucose Adduct.

Ascend Laboratories, LLC

Class III May 10, 2024

Labeling: Not Elsewhere Classified: Back label states Each contains: cephalexin monohydrate, USP equivalent to 2.5g' instead of Each Bottle contains: cephalexin monohydrate, USP equivalent to 5g

Bryant Ranch Prepack, Inc.

Class III May 10, 2024

Labeling: Not Elsewhere Classified: Back Label states Each contains: cephalexin monohydrate, USP equivalent to 5g' on the back label instead of Each Bottle contains: cephalexin monohydrate, USP equivalent to 5g'

Bryant Ranch Prepack, Inc.

Class II April 12, 2021

Failed Impurities/degradation specifications: Repackager recall due to Out of Specification detected by manufacturer for Individual Unidentified Impurity found during related substance test analysis of Cephalexin

Preferred Pharmaceuticals, Inc.

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Medication Guides

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What the FDA Data Shows for cephalexin

The FDA label for cephalexin (sold under brand names such as Keflex) classifies it as a prescription-only medication in the First-Generation Cephalosporin class. Cephalexin treats infections caused by bacteria. Official labeling lists 5 commonly reported side effects, including Diarrhea, Nausea, Vomiting.

Post-market surveillance from the FDA Adverse Event Reporting System (FAERS) captures real-world experience. For this drug, FAERS contains 13,809 voluntary reports. The database also lists 2 documented drug interactions derived from FDA labeling, with the top-flagged interaction rated moderate severity. NADAC pricing from CMS shows a generic unit cost of $0.05.

Report counts do not establish causation — a FAERS entry documents a temporal association, not proof that the drug produced the outcome. Widely prescribed medications naturally accumulate more reports than niche therapies, so raw totals must be interpreted alongside total exposure. Shortage status, recall history (currently 4 recall records on file), and patent information further shape supply and switching decisions. This page summarizes public FDA data for educational purposes only and is not a substitute for professional medical advice — always consult a licensed healthcare provider before starting, stopping, or changing any medication.

Data Sources

Drug labeling: FDA Drug Labels (SPL/DailyMed). Adverse events: FDA Adverse Event Reporting System (FAERS). Pricing: CMS National Average Drug Acquisition Cost (NADAC).

FAERS reports are voluntary and do not establish causation. Drug interactions are derived from FDA labeling and clinical references. Always consult a healthcare professional before making medication decisions.

Last updated: February 11, 2025

All federal data sources used on this page