Cephalexin
/api/v1/drug/cephalexinMechanism of action
Sourced from openFDACephalexin is a cephalosporin antibacterial drug [see Microbiology (12.4) ] .
Indications
Sourced from openFDA- Cephalexin capsules are 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 cephalexin capsules and other antibacterial drugs, cephalexin capsules should be used only to treat infections that are proven or strongly suspected to be caused by bacteria. ( 1.6 ) 1.1 Respiratory Tract Infections Cephalexin capsules are indicated for the treatment of respiratory tract infections caused by susceptible isolates of Streptococcus pneumoniae and Streptococcus pyogenes.ICD-10: H66.90
Contraindications
Sourced from openFDA- Cephalexin capsules are contraindicated in patients with known hypersensitivity to cephalexin or other members of the cephalosporin class of antibacterial drugs. Patients with known hypersensitivity to cephalexin or other members of the cephalosporin class of antibacterial drugs.contraindicated
Dosage & administration
Sourced from openFDAAdults and patients at least 15 years of age The usual dose is 250 mg every 6 hours, but a dose of 500 mg every 12 hours may be administered ( 2.1 ) Pediatric patients (over 1 year of age) Otitis media: 75 to 100 mg/kg in equally divided doses every 6 hours ( 2.2 ) All other indications: 25 to 50 mg/kg given in equally divided doses ( 2.2 ) In severe infections: 50 to 100 mg/kg may be administered in equally divided doses ( 2.2 ) Duration of therapy ranges from 7 to 14 days depending on the infection type and severity. ( 2 ) Dosage adjustment is required in patients with severe and end stage renal disease (ESRD) defined as creatinine clearance below 30 mL/min. ( 2.3 ) 2.1 Adults and Pediatric Patients at Least 15 Years of Age The usual dose of oral cephalexin capsules is 250 mg every 6 hours, but a dose of 500 mg every 12 hours may be administered. Treatment is administered for 7 to 14 days. For more severe infections larger doses of oral cephalexin capsules may be needed, up to 4 grams daily in two to four equally divided doses. 2.2 Pediatric Patients (over 1 year of age) The recommended total daily dose of oral cephalexin capsules for pediatric patients is 25 to 50 mg/kg given in equally divided doses for 7 to 14 days. In the treatment of β-hemolytic streptococcal infections, duration of at least 10 days is recommended. In severe infections, a total daily dose of 50 to 100 mg/kg may be administered in equally divided doses. For the treatment of otitis media, the recommended daily dose is 75 to 100 mg/kg given in equally divided doses.
Warnings & precautions
Sourced from openFDASerious hypersensitivity (anaphylactic) reactions : Prior to use, inquire regarding history of hypersensitivity to beta-lactam antibacterial drugs. Discontinue the drug if signs or symptoms of an allergic reaction occur and institute supportive measures. ( 5.1 ) Clostridium difficile -associated diarrhea (CDAD ): Evaluate if diarrhea occurs. ( 5.2 ) Direct Coombs’ Test Seroconversion : If anemia develops during or after cephalexin therapy, evaluate for drug-induced hemolytic anemia. ( 5.3 ) Seizure Potential : Use lower dose in patients with renal impairment. ( 5.4 ) 5.1 Hypersensitivity Reactions Allergic reactions in the form of rash, urticaria, angioedema, anaphylaxis, erythema multiforme, Stevens-Johnson syndrome, or toxic epidermal necrolysis have been reported with the use of cephalexin. Before therapy with cephalexin is instituted, inquire whether the patient has a history of hypersensitivity reactions to cephalexin, cephalosporins, penicillins, or other drugs. Cross-hypersensitivity among beta-lactam antibacterial drugs may occur in up to 10% of patients with a history of penicillin allergy. If an allergic reaction to cephalexin occurs, discontinue the drug and institute appropriate treatment. 5.2 Clostridium difficile -Associated Diarrhea Clostridium difficile - associated diarrhea (CDAD) has been reported with use of nearly all antibacterial agents, including cephalexin, and may range in severity from mild diarrhea to fatal colitis. Treatment with antibacterial agents alters the normal flora of the colon leading to overgrowth of C. difficile . C.
Adverse reactions
Sourced from openFDAThe following serious events are described in greater detail in the Warning and Precautions section: Hypersensitivity reactions [see Warning and Precautions (5.1) ] Clostridium difficile -associated diarrhea [see Warnings and Precautions (5.2) ] Direct Coombs’ Test Seroconversion [see Warnings and Precautions (5.3) ] Seizure Potential [see Warnings and Precautions (5.4) ] Effect on Prothrombin Activity [see Warnings and Precautions (5.5) ] Development of Drug-Resistant Bacteria [see Warnings and Precautions (5.6) ] The most common adverse reactions associated with cephalexin include diarrhea, nausea, vomiting, dyspepsia and abdominal pain . ( 6 ) To report SUSPECTED ADVERSE REACTIONS, contact Aurobindo Pharma USA, Inc. at 1-866-850-2876 or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch . 6.1 Clinical Trials Experience Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in practice. In clinical trials, the most frequent adverse reaction was diarrhea. Nausea and vomiting, dyspepsia, gastritis, and abdominal pain have also occurred. As with penicillins and other cephalosporins, transient hepatitis and cholestatic jaundice have been reported.
Use in specific populations
Sourced from openFDARenal Impairment: Monitor patients longer for toxicity and drug interactions due to delayed clearance. (8.6) 8.1 Pregnancy Risk Summary Available data from published epidemiologic studies and pharmacovigilance case reports over several decades with cephalosporin use, including cephalexin use in pregnant women have not established drug-associated risks of major birth defects, miscarriage, or adverse maternal or fetal outcomes (see Data) . Animal reproduction studies with mice and rats using oral doses of cephalexin that are 0.6- and 1.2-times the maximum recommended human dose (MRHD) based on body surface area during organogenesis revealed no evidence of harm to the fetus (see Data). The estimated background risk of major birth defects and miscarriage for the indicated population is unknown. All pregnancies have a background risk of birth defect, loss, or other adverse outcomes. In the U.S. general population, the estimated background risk of major birth defects and miscarriage in clinically recognized pregnancies is 2% to 4% and 15% to 20%, respectively.
Pharmacokinetics
Sourced from openFDA- Metabolism
- Absorption: Cephalexin is acid stable and may be given without regard to meals. Following doses of 250 mg, 500 mg, and 1 g, average peak serum levels of approximately 9, 18, and 32 mcg/mL, respectively, were obtained at 1 hour.
Overdosage
Sourced from openFDASymptoms of oral overdose may include nausea, vomiting, epigastric distress, diarrhea, and hematuria. In the event of an overdose, institute general supportive measures. Forced diuresis, peritoneal dialysis, hemodialysis, or charcoal hemoperfusion have not been established as beneficial for an overdose of cephalexin.
Approval history
Sourced from openFDA- Feb 13, 1987ANDAANDA062702Teva
- Feb 13, 1987ANDAANDA062703Teva
- Jan 12, 1989ANDAANDA063024Teva
- Feb 24, 2005ANDAANDA065152Chartwell Rx
- Aug 17, 2005ANDAANDA065234Lupin
- Nov 16, 2005ANDAANDA065253Aurobindo Pharma
- Nov 25, 2005ANDAANDA065229Lupin
- Jul 25, 2007ANDAANDA065336Yung Shin Pharm
FAERS reports
- 1Chronic Kidney Disease2,15710%
- 2Renal Failure1,5587.4%
- 3Acute Kidney Injury1,5447.3%
- 4Pain1,3856.6%
- 5Diarrhoea1,3836.6%
- 6Fatigue1,2716.0%
- 7Nausea1,2626.0%
- 8Dyspnoea1,1935.7%
- 9Anxiety1,1445.4%
- 10Rash1,1285.3%
- 11Headache1,1215.3%
- 12Drug Ineffective1,0224.8%
- 13Off Label Use8944.2%
- 14Vomiting8544.0%
- 15Dizziness8514.0%
Literature
Recent PubMed references pinned to Cephalexin as a MeSH major topic. Citations link to pubmed.ncbi.nlm.nih.gov.
- The New Delhi Metallo-β-lactamase-1 Covalent Inhibitors Derived from Cephalexin Effectively Reverse Meropenem Resistance.Journal of medicinal chemistry · 2026 · Liu W, Liu C, Guo Y, et al.PMID 42138890DOI 10.1021/acs.jmedchem.6c00314
- The integration of transcriptomics, intestinal microbiota and physiology reveals the toxic mechanism of cephalexin in rainbow trout.Aquatic toxicology (Amsterdam, Netherlands) · 2026 · Zhao C, Fan P, Huang T, et al.PMID 42008853DOI 10.1016/j.aquatox.2026.107828
- Deciphering β-lactam stress response in anammox systems: Off-target enzyme binding, electron transfer compensation and microbial collaboration.Bioresource technology · 2026 · Bamanu B, Liu Y, Wan H, et al.PMID 41946403DOI 10.1016/j.biortech.2026.134561
- Postoperative oral cephalexin and metronidazole effectiveness in preventing complications in obese pregnant women undergoing cesarean delivery: A systematic review and meta-analysis.European journal of obstetrics, gynecology, and reproductive biology · 2026 · Oliveira JA, Lemos MJ, Dias YJM, et al.PMID 41785716DOI 10.1016/j.ejogrb.2026.115039
- Rational Design of Amperometric Sensor Based on Magnesium Oxide and Reduced Graphene Oxide Hybrid for Ultralow Detection of Cephalexin in Complex Biological Matrices.Analytical chemistry · 2026 · Buledi JA, Ali S, Golovynska I, et al.PMID 41773624DOI 10.1021/acs.analchem.5c07739
- Amoxicillin-induced Erythema Scarlatiniforme Desquamativum Recidivans with cross-reactivity to cefadroxil in a child: A case report and review of literature.British journal of clinical pharmacology · 2026 · Bouraoui H, Mansour K, Jemmeli N, et al.PMID 41689210DOI 10.1002/bcp.70495
- Reactive oxygen species-sensitive release of cephalexin from hyaluronic acid-g-cephalexin dimer copolymer for treatment of inflammation and infection of oral soft tissue cells.Scientific reports · 2025 · Kim CY, Kim W, Kook MS, et al.PMID 41372315DOI 10.1038/s41598-025-30912-7
- Chitosan coated yeast microcapsules for efficient delivery of cefadroxil for the treatment of inflammatory bowel disease.International journal of biological macromolecules · 2026 · Mohammed AISG, Hmingthansanga V, Das P, et al.PMID 41308768DOI 10.1016/j.ijbiomac.2025.149162
Clinical trials
The 10 most recently updated of 115 ClinicalTrials.gov registrations naming Cephalexin as an intervention. Registration is not evidence of efficacy or safety — reference crosswalk only.
- Effects of Treatments on Atopic DermatitisRecruiting · Phase 2 · Interventional · 130 enrolled · National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)NCT01631617updated 2026-06-09
- Optimizing the Diagnostic Approach to Cephalosporin Allergy TestingRecruiting · Phase 2 · Interventional · 300 enrolled · Massachusetts General HospitalNCT06406114updated 2026-05-26
- Oral Amoxicillin and Cephalexin PK/PD in NeonatesCompleted · Phase 1 · Interventional · 72 enrolled · University of Colorado, DenverNCT04916951updated 2026-05-19
- Preventive Effect of Prophylactic Oral Antibiotics Against Cholangitis After Kasai PortoenterostomyRecruiting · Interventional · 356 enrolled · Children's Hospital of Fudan UniversityNCT05925309updated 2026-05-15
- Extended Oral Antibiotic Prophylaxis in Diabetic Fracture PatientsRecruiting · Phase 4 · Interventional · 40 enrolled · Texas Tech University Health Sciences Center, El PasoNCT07561541updated 2026-05-08
- Postoperative Antibiotic Management Duration Following Surgery for Intravenous Drug Abuse (IVDA) Endocarditis (OPTIMAL)Terminated · Phase 4 · Interventional · 5 enrolled · West Virginia UniversityNCT05156437updated 2026-05-05
- Antibiotic Prophylaxis in RhinoplastyEnrolling by invitation · Phase 3 · Interventional · 864 enrolled · Stanford UniversityNCT04194216updated 2026-04-24
- A Clinical Trial of Extended (High) Treatment Dose Antibiotics in Combination With Methenamine Hippurate Compared to the Standard of Care (Either Prophylactic (Low) Dose Antibiotic Treatment or Methenamine Hippurate) in Females With Chronic Urinary Tract InfectionRecruiting · Phase 2 · Interventional · 192 enrolled · University College, LondonNCT07202949updated 2026-04-23
- Pharmacokinetics, Pharmacodynamics, and Safety Profile of Understudied Drugs Administered to Children Per Standard of Care (POPS)Recruiting · Observational · 5,000 enrolled · Duke UniversityNCT04278404updated 2026-04-06
- The Effect of Losartan on CephalexinRecruiting · Phase 1 · Interventional · 12 enrolled · Aleksi TornioNCT07300670updated 2026-03-25
Structural analogs
Ranked by 2D fingerprint (Tanimoto) similarity over PubChem structures. Structural proximity only — not a claim of therapeutic equivalence.
Frequently asked questions
- How does Cephalexin work?
- Cephalexin is a cephalosporin antibacterial drug [see Microbiology (12.4) ] .
- What is Cephalexin used for?
- According to FDA labeling, Cephalexin carries indications including: Cephalexin capsules are 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 cephalexin capsules and other antibacterial drugs, cephalexin capsules should be used only to treat infections that are proven or strongly suspected to be caused by bacteria. ( 1.6 ) 1.1 Respiratory Tract Infections Cephalexin capsules are indicated for the treatment of respiratory tract infections caused by susceptible isolates of Streptococcus pneumoniae and Streptococcus pyogenes.. This is a reference summary of labeled uses, not medical advice or a treatment recommendation.
- What class of drug is Cephalexin?
- Cephalexin is classified as First-generation cephalosporins, Enzyme Inhibitors, Decreased Cell Wall Synthesis & Repair.
- What are the brand names for Cephalexin?
- Cephalexin is marketed under brand names including Keflex, Rilexine.
- What are the contraindications for Cephalexin?
- Cephalexin labeling lists contraindications including: Cephalexin capsules are contraindicated in patients with known hypersensitivity to cephalexin or other members of the cephalosporin class of antibacterial drugs. Patients with known hypersensitivity to cephalexin or other members of the cephalosporin class of antibacterial drugs.. Always consult the full prescribing information and a clinician.
cephalexin is illustrative MVP content compiled from public sources. pharmacopeia is for educational and informational use only and is not a substitute for professional medical advice.