Cephalexin

Keflex

FDA ApprovedAnti-InfectivesCephalosporins
Half-life: Approximately 1 hourPregnancy: Category B

Overview

Cephalexin is a first-generation oral cephalosporin antibiotic used to treat susceptible bacterial infections of the skin, respiratory tract, urinary tract, and bone.

Indications

  • Skin and soft tissue infections
  • Streptococcal pharyngitis
  • Urinary tract infections
  • Bone infections

Contraindications

  • Hypersensitivity to cephalosporins
  • History of severe penicillin allergy (caution)

Classification

Mechanism of Action

Binds penicillin-binding proteins and inhibits the final transpeptidation step of bacterial cell wall peptidoglycan synthesis, leading to cell lysis; it is bactericidal.

Pharmacodynamics

Time-dependent bactericidal activity against many gram-positive cocci and some gram-negative organisms, particularly useful for skin and soft tissue infections.

Pharmacokinetics

Absorption
Well absorbed orally and acid stable.
Distribution
Distributes into most tissues; relatively low protein binding.
Metabolism
Not significantly metabolized.
Excretion
Excreted largely unchanged in urine via renal tubular secretion.
Half-life
Approximately 1 hour
Bioavailability
Approximately 90%
Protein Binding
Approximately 10-15%

Dosage

Typical dosage: 250-500 mg every 6-12 hours

Available Forms

  • Capsule
  • Tablet
  • Oral suspension

Side Effects

Common

  • Diarrhea
  • Nausea
  • Abdominal pain
  • Rash

Serious

  • Anaphylaxis
  • Clostridioides difficile colitis

Rare

  • Stevens-Johnson syndrome
  • Interstitial nephritis

Drug Interactions

Metforminmoderate

Cephalexin may increase metformin plasma levels by competing for renal tubular secretion.

Probenecidmoderate

Reduces renal excretion of cephalexin, raising and prolonging its serum concentration.

Warnings

Pregnancy

Category B

Toxicity

Generally low toxicity; overdose may cause nausea, vomiting, and diarrhea.

Overdose

Provide supportive care and hydration; hemodialysis may help remove the drug in severe renal impairment.

References

Looking for patient-friendly information? Visit RemedyDoor for easy-to-read guides about this medication.