Infectious Disease Book

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Cephalexin

Aka: Cephalexin, Keflex
  1. Indications
    1. See First Generation Cephalosporins
    2. Skin and Soft Tissue Infection
    3. Streptococcal Pharyngitis
    4. Simple Urinary Tract Infections (Acute Cystitis)
    5. Not indicated for Otitis Media (inadequate coverage due to resistance)
  2. Formulations
    1. Capsule
      1. Strengths: 250,500,750 mg (generics available)
    2. Tablet
      1. Strengths: 250,500 mg (generics available)
    3. Oral Suspension
      1. Strengths: 125,250 mg/5ml (generics available)
  3. Dosing: Higher Dose (GFR >60 ml/min)
    1. Indications
      1. Pneumonia
      2. Genitourinary Infection
      3. Skin and Soft Tissue Infection
    2. Dose
      1. Adults (age >15 years): 250-500 mg orally four times daily (max 4 g/day)
      2. Children: 25-50 mg/kg/day (max 100 mg/kg/day) divided four times daily
  4. Dosing: Lower Dose (GFR >60 ml/min)
    1. Indications
      1. Simple Urinary Tract Infection (treat for 5-7 days)
      2. Streptococcal Pharyngitis (treat for 10 days)
    2. Dose
      1. Adults (age >15 years): 500 mg orally twice daily
      2. Children: 25-50 mg/kg/day (max 100 mg/kg/day) divided twice daily
  5. Dosing: Renal
    1. CrCl 30-60 ml/min
      1. Adults: 250 mg orally 3-4 times daily (maximum 1000 mg/day)
    2. CrCl 15-30 ml/min
      1. Adults: 250 mg orally 2-3 times daily (maximum 750 mg/day)
    3. CrCl <15 ml/min
      1. Adults: 250 mg orally daily (take a second dose as needed after Dialysis)
  6. Precautions
    1. Pregnancy
      1. All Trimesters - Category B
    2. Lactation
      1. Safe in Lactation
  7. Pharmacokinetics
    1. Absorption: Not affected by meals
    2. Peak Activity: >1 hours
    3. Primary Elimination: Renal
  8. Resources
    1. DailyMed
      1. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=5681d4d2-9b67-4cac-9b94-8368f9978231
      2. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=2bfd2bd5-d044-4363-9dde-f63182fa2eea
  9. References
    1. Hamilton (2020) Tarascon Pocket Pharmacopoeia
Medication Costs
Cephalexin (on 6/18/2017 at Walmart.com)
Cephalexin 250mg #28 capsules for $4.00 $0.14 each
Cephalexin 250mg #84 capsules for $10.00 $0.12 each
Cephalexin 500mg #30 capsules for $4.00 $0.13 each
Cephalexin 500mg #90 capsules for $10.00 $0.11 each
cephalexin (on 5/17/2017 at Medicaid.Gov Pharmacy Drug pricing)
CEPHALEXIN 125 MG/5 ML SUSP Generic $0.14 per ml
CEPHALEXIN 250 MG CAPSULE Generic $0.08 each
CEPHALEXIN 250 MG/5 ML SUSP Generic $0.15 per ml
CEPHALEXIN 500 MG CAPSULE Generic $0.08 each
FPNotebook does not benefit financially from showing this medication data or their pharmacy links. This information is provided only to help medical providers and their patients see relative costs. Insurance plans negotiate lower medication prices with suppliers. Prices shown here are out of pocket, non-negotiated rates. See Needy Meds for financial assistance information.

Cephalexin (C0007716)

Definition (CHV) an antibiotic drug
Definition (CHV) an antibiotic drug
Definition (NCI) A beta-lactam, first-generation cephalosporin antibiotic with bactericidal activity. Cephalexin binds to and inactivates penicillin-binding proteins (PBP) located on the inner membrane of the bacterial cell wall. Inactivation of PBPs interferes with the cross-linking of peptidoglycan chains necessary for bacterial cell wall strength and rigidity. This results in the weakening of the bacterial cell wall and causes cell lysis. Compared to second and third generation cephalosporins, cephalexin is more active against gram-positive and less active against gram-negative organisms.
Definition (NCI_NCI-GLOSS) An antibiotic drug that belongs to the family of drugs called cephalosporins.
Definition (MSH) A semisynthetic cephalosporin antibiotic with antimicrobial activity similar to that of CEPHALORIDINE or CEPHALOTHIN, but somewhat less potent. It is effective against both gram-positive and gram-negative organisms.
Definition (PDQ) A beta-lactam, first-generation cephalosporin antibiotic with bactericidal activity. Cephalexin binds to and inactivates penicillin-binding proteins (PBP) located on the inner membrane of the bacterial cell wall. Inactivation of PBPs interferes with the cross-linking of peptidoglycan chains necessary for bacterial cell wall strength and rigidity. This results in the weakening of the bacterial cell wall and causes cell lysis. Compared to second and third generation cephalosporins, cephalexin is more active against gram-positive and less active against gram-negative organisms. Check for "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=43417&idtype=1" active clinical trials or "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=43417&idtype=1&closed=1" closed clinical trials using this agent. ("http://nciterms.nci.nih.gov:80/NCIBrowser/ConceptReport.jsp?dictionary=NCI_Thesaurus&code=C356" NCI Thesaurus)
Concepts Antibiotic (T195) , Organic Chemical (T109)
MSH D002506
SnomedCT 54887004, 387304003
LNC LP15264-2, MTHU005030
English Cefalexin, Cephalexin, 5-Thia-1-azabicyclo(4.2.0)oct-2-ene-2-carboxylic acid, 7-((aminophenylacetyl)amino)-3-methyl-8-oxo-, (6R-(6alpha,7beta(R*)))-, cephalexin, cephalexin (medication), CEPHALEXIN, Cephalexin [Chemical/Ingredient], cefalexin, Cephalexin (product), Cephalexin (substance)
Swedish Cefalexin
Czech cefalexin
Finnish Kefaleksiini
German Cefalexin, Cephalexin
Russian TSEFALEKSIN, ЦЕФАЛЕКСИН
Japanese セファレキシン
Croatian CEFALEKSIN
Polish Cefaleksyna
Spanish cefalexina (producto), cefalexina (sustancia), cefalexina, Cefalexina
French Céfalexine
Italian Cefalexina
Portuguese Cefalexina
Sources
Derived from the NIH UMLS (Unified Medical Language System)


Keflex (C0700517)

Concepts Antibiotic (T195) , Organic Chemical (T109)
English Keflex, keflex
Sources
Derived from the NIH UMLS (Unified Medical Language System)


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