Keflex, the brand name for cephalexin, is a first-generation cephalosporin antibiotic used to treat susceptible bacterial infections. Clinicians often prescribe it for skin and soft tissue infections such as cellulitis, impetigo, and infected wounds, where common culprits include streptococci and methicillin-sensitive Staphylococcus aureus. Keflex is also frequently used for streptococcal pharyngitis (strep throat) in patients who cannot take penicillin, for certain respiratory infections like uncomplicated bacterial sinusitis, and for acute otitis media.
In the urinary tract, Keflex can treat uncomplicated UTIs caused by susceptible organisms such as E. coli, Proteus mirabilis, and Klebsiella pneumoniae. It may also be used for bone infections (osteomyelitis) in specific scenarios and as prophylaxis for certain dental or procedural indications when recommended by a clinician. Its spectrum targets many Gram-positive organisms and some Gram-negative bacteria, but not all. Culture and sensitivity testing, when available, guide more precise therapy.
Because Keflex, like all antibiotics, does not work against viruses (for example, colds, most sore throats, or the flu), using it only when bacterial infection is likely helps prevent antibiotic resistance and unnecessary side effects. The decision to use cephalexin should be based on clinical evaluation, local resistance patterns, and patient-specific risks.
Your prescriber will choose a dose and duration based on the infection type, its severity, your kidney function, and age. Keflex is available as capsules, tablets, and oral liquid suspension. Many adult regimens use 250 mg to 500 mg taken every 6 to 12 hours, with total daily doses often ranging from 1 to 4 grams. For strep throat and skin infections, common adult dosing is 500 mg every 12 hours or 250–500 mg every 6 hours. More severe infections may require higher doses within approved limits. In children, dosing is weight-based and divided throughout the day.
Keflex can be taken with or without food; taking it with a snack may reduce stomach upset. Swallow capsules with a full glass of water. If you are using the oral suspension, shake well before each dose and measure with a marked device rather than a household spoon to ensure accuracy. Take doses at evenly spaced intervals to maintain steady antibiotic levels in your system.
Always complete the full course exactly as prescribed, even if you feel better sooner. Stopping early can allow the infection to return and may contribute to antibiotic resistance. Do not save leftover antibiotics or share them with others.
Tell your clinician and pharmacist if you have ever had an allergic reaction to cephalexin, other cephalosporins (such as cefazolin or cefuroxime), or penicillins. Cross-reactivity can occur in people with a history of immediate hypersensitivity to penicillin, so your care team may choose an alternative antibiotic if your allergy was severe (for example, anaphylaxis, hives with breathing difficulties, or angioedema).
If you have kidney problems, your dose may need adjustment to prevent drug accumulation. Older adults and those with significant renal impairment require careful monitoring. Let your care team know if you are pregnant, planning to become pregnant, or breastfeeding. Cephalexin has been widely used during pregnancy and is generally considered compatible; during breastfeeding, small amounts pass into milk and infants should be observed for loose stools, diaper rash, or thrush.
Report a history of severe intestinal disease, particularly Clostridioides difficile-associated diarrhea. Like many antibiotics, Keflex can disrupt the gut microbiome and, rarely, trigger C. difficile overgrowth, leading to persistent or severe diarrhea. If you develop watery or bloody stools, abdominal cramping, or fever during or after treatment, seek medical care promptly.
Discuss all prescription drugs, OTC medications, and supplements you take. Certain interactions can alter how cephalexin or other drugs work, and timing adjustments or monitoring may be recommended.
Keflex is contraindicated in individuals with a known serious hypersensitivity to cephalexin or other cephalosporin antibiotics. Patients with a documented history of severe, immediate-type hypersensitivity to penicillin may be at increased risk for reactions to cephalosporins; in such cases, the risks and benefits must be weighed carefully, and alternative agents may be preferred.
Additionally, if you have experienced severe cutaneous adverse reactions to beta-lactam antibiotics (such as Stevens-Johnson syndrome or toxic epidermal necrolysis), cephalexin should be avoided. For those with significant renal impairment without the ability to monitor and adjust dosing, using Keflex without guidance is not appropriate.
Most people tolerate Keflex well. Common side effects include gastrointestinal upset such as nausea, vomiting, abdominal discomfort, and diarrhea. Headache, dizziness, and fatigue can occur. A mild skin rash or itching may develop and typically resolves after the drug is discontinued; inform your clinician if rash appears, as it may signal hypersensitivity.
Less common effects include vaginal yeast infection or oral thrush due to changes in normal flora. Laboratory changes like transient increases in liver enzymes or slight shifts in blood counts are occasionally seen. Rare but serious adverse reactions include severe allergic reactions (anaphylaxis), angioedema, severe skin reactions, hemolytic anemia, interstitial nephritis, and seizures, particularly in the context of renal insufficiency or very high doses. Seek immediate medical attention if you experience wheezing, swelling of the face or throat, fainting, blistering skin, intense rash, or difficulty breathing.
Any persistent diarrhea, especially if watery or bloody, may indicate C. difficile-associated colitis and needs urgent evaluation. Probiotics may help with antibiotic-associated GI symptoms in some individuals, but discuss this with your clinician to ensure safety and appropriate timing.
Cephalexin has a favorable interaction profile, but important interactions exist. Concomitant use with warfarin or other anticoagulants may increase bleeding risk; close INR monitoring is advisable when starting or stopping antibiotics. Probenecid can increase cephalexin levels by reducing renal excretion. Cephalexin can elevate metformin concentrations in some cases; monitoring for hypoglycemia or gastrointestinal side effects may be warranted.
Antibiotics can reduce the effectiveness of live attenuated typhoid vaccine; avoid administering the vaccine during and shortly after antibiotic therapy. While food does not meaningfully reduce cephalexin absorption, taking the drug alongside certain minerals or binding agents rarely poses issues compared with some other antibiotics, though spacing doses away from large amounts of zinc, iron, or calcium may minimize any theoretical absorption concerns.
Cephalexin can interfere with certain laboratory tests, including causing false-positive urine glucose tests when non-enzymatic methods are used. Inform your care team and laboratory if you are on Keflex so results are interpreted correctly.
If you miss a dose, take it as soon as you remember. If it is close to the time of your next dose, skip the missed dose and resume your regular schedule. Do not double up to “catch up,” as taking doses too close together may increase side effects without improving effectiveness. Keeping a dosing reminder on your phone or using a pill organizer can help maintain consistent antibiotic levels, which is essential for clearing infection.
Taking more cephalexin than prescribed can increase the risk of nausea, vomiting, diarrhea, abdominal pain, and, in severe cases, neurological symptoms such as agitation, confusion, or seizures, especially in those with kidney impairment. If an overdose is suspected, contact your clinician, call Poison Control at 1-800-222-1222 (U.S.), or seek emergency care immediately. Supportive treatment is typically provided, and in the context of significant renal dysfunction, hemodialysis may enhance elimination under professional supervision.
Store Keflex capsules or tablets at room temperature, ideally 68°F to 77°F (20°C to 25°C), away from moisture, excess heat, and direct light. Keep the bottle tightly closed and out of reach of children and pets. For the oral suspension, your pharmacist will prepare the medication by mixing the powder with water; the reconstituted suspension is typically kept refrigerated and discarded after 14 days. Shake the suspension well before each use to ensure even distribution.
Never use expired antibiotics, and do not flush unused medication. Ask your pharmacist about take-back programs or safe disposal options in your community.
In the United States, Keflex (cephalexin) is a prescription-only antibiotic. That means it cannot be legally dispensed without a valid prescription from a licensed clinician. If you came here searching for how to buy Keflex without prescription, it’s important to know that U.S. law requires a proper medical evaluation to determine whether an antibiotic is appropriate and safe for your condition. This protects patients from incorrect treatment, harmful interactions, and antibiotic resistance.
Randy’s Compounding Pharmacy offers a legal, structured pathway to care—without cutting corners. Our team can coordinate streamlined access to licensed medical professionals for timely evaluation, including telehealth when appropriate. If Keflex is clinically indicated, a legitimate prescription can be issued and filled promptly. For patients with swallowing difficulties, allergies to certain excipients, or specific dosing needs, we also provide customized cephalexin compounds formulated to the prescriber’s specifications.
We prioritize safety, privacy, and convenience. From verifying drug interactions to counseling on proper use and side effects, our pharmacists support you through the entire course of therapy. Reach out to Randy’s Compounding Pharmacy to learn about compliant options for accessing care, obtaining the right prescription, and receiving your medication quickly and discreetly—while staying fully within U.S. regulations and best-practice antibiotic stewardship.
Note: Antibiotics should never be used for self-diagnosed conditions or kept on hand “just in case.” The right drug, dose, and duration depend on your diagnosis, medical history, local resistance patterns, and laboratory data when available. Our pharmacy team is here to help you navigate these decisions safely and legally.
Keflex is the brand name for cephalexin, a first-generation cephalosporin antibiotic used to treat skin and soft tissue infections, strep throat, uncomplicated urinary tract infections, certain ear and dental infections, and some bone infections caused by susceptible bacteria.
Cephalexin kills bacteria by binding penicillin-binding proteins and blocking bacterial cell wall synthesis; it is bactericidal with time-dependent activity.
It covers many streptococci and methicillin-susceptible Staphylococcus aureus (MSSA), plus some Gram-negatives like E. coli, Proteus mirabilis, and Klebsiella pneumoniae; it does not cover MRSA, Enterococcus, Pseudomonas, atypicals, or most anaerobes.
Yes, cephalexin is effective for streptococcal pharyngitis and is a common alternative when penicillin or amoxicillin is not suitable; courses are typically 10 days.
Yes, Keflex is often first-line for nonpurulent cellulitis, impetigo, and infected wounds caused by streptococci and MSSA; it is not reliable for MRSA.
Yes, cephalexin can treat uncomplicated cystitis due to susceptible organisms because it concentrates in urine; it is less suitable for kidney infections.
Many people notice improvement within 24 to 48 hours; finish the full course even if you feel better to prevent relapse and resistance.
Common effects include nausea, diarrhea, stomach upset, headache, rash, and vaginal yeast infections; these are usually mild and temporary.
Seek urgent care for signs of severe allergy (hives, swelling, trouble breathing), severe or bloody diarrhea (possible C. difficile infection), jaundice, or severe skin reactions.
Many with non-severe penicillin allergy can safely take cephalexin; the cross-reactivity risk is low (about 1%). Avoid it if you’ve had anaphylaxis or severe skin reactions to penicillins and consult your clinician.
Typical prescriptions are 250–500 mg every 6 hours or 500 mg every 8–12 hours, with a maximum of 4 g per day; dosing varies by infection and kidney function.
Yes, cephalexin is cleared by the kidneys and dosing intervals are extended as kidney function declines; your prescriber will adjust based on eGFR.
There is no direct interaction; moderate alcohol is generally safe but may worsen stomach upset or dizziness. Avoid heavy drinking.
Cephalexin does not reduce hormonal contraceptive effectiveness, but vomiting or severe diarrhea can compromise absorption; use backup if you have significant GI upset.
Cephalexin is generally considered safe in pregnancy and compatible with breastfeeding; a small amount enters breast milk and may cause mild GI changes in infants.
Probenecid can increase cephalexin levels; cephalexin may enhance warfarin’s effect (monitor INR) and can raise metformin concentrations; provide your full medication list to your clinician.
Take it as soon as you remember unless it’s almost time for the next dose; don’t double up; try to keep doses evenly spaced.
No; complete the prescribed course to ensure full eradication of the infection and reduce the risk of resistance unless your clinician tells you otherwise.
Store capsules at room temperature away from moisture. Refrigerate the reconstituted liquid and discard after the labeled beyond-use date (often 10–14 days).
Yes, like other antibiotics, it can disrupt gut bacteria and lead to C. difficile–associated diarrhea; seek care for persistent watery or bloody stools, fever, or abdominal cramps.
Both are first-generation oral cephalosporins with similar spectra against MSSA and streptococci; cefadroxil has a longer half-life allowing once or twice daily dosing, while cephalexin is usually taken more frequently. Choice often depends on dosing convenience, cost, and availability.
Cefazolin is an injectable first-generation cephalosporin used for surgical prophylaxis and serious MSSA infections due to higher serum/tissue levels; Keflex is oral and suited for outpatient, mild to moderate infections. They are not interchangeable by route.
Cefuroxime (second-generation) adds better coverage of H. influenzae and some Gram-negatives common in respiratory infections; cephalexin is stronger for MSSA skin infections. For sinusitis or otitis with beta-lactamase–producing organisms, cefuroxime is often preferred.
Cefdinir (third-generation oral) has broader Gram-negative coverage but weaker activity against MSSA and lower bioavailability; Keflex often outperforms for skin infections. Cefdinir is commonly used for some respiratory infections and may cause red stools when taken with iron.
Cefpodoxime offers better H. influenzae and Moraxella coverage than cephalexin and is often chosen for sinusitis; Keflex remains a strong option for strep throat and skin infections.
Both treat MSSA and streptococcal skin infections; cefprozil (second-generation) has improved activity against some respiratory pathogens. Cephalexin is usually less expensive and widely available.
Cefaclor has been linked to serum sickness–like reactions, especially in children. Cephalexin generally has a more favorable tolerability profile for skin infections and strep throat, though both can be effective.
Cefixime (third-generation) is stronger against some Enterobacterales but weaker for staphylococci and streptococci; cephalexin is good for uncomplicated cystitis if the organism is susceptible. Local resistance patterns should guide selection.
Ceftibuten focuses on Gram-negative urinary and respiratory pathogens and has limited Gram-positive coverage; Keflex is better for MSSA and streptococcal skin infections. Choose based on the site of infection and likely bacteria.
Ceftriaxone is a once-daily injectable third-generation cephalosporin with broad coverage used for more serious infections; Keflex is an oral, narrower option for mild to moderate outpatient infections. They serve different roles.
Ceftaroline (fifth-generation, IV) covers MRSA and resistant pneumococcus; Keflex does not. Ceftaroline is reserved for specific serious infections; Keflex is for susceptible, less severe infections.
Both are effective for uncomplicated cystitis when organisms are susceptible; cefadroxil’s longer half-life allows once or twice daily dosing, which may improve adherence compared with cephalexin’s more frequent dosing.
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