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Cephalexin is a first-generation cephalosporin antibiotic that compounding pharmacies prepare by prescription as oral liquids and other oral forms.
Cephalexin is a first-generation cephalosporin, a beta-lactam antibiotic that kills susceptible bacteria by blocking cell-wall synthesis. It does not treat viral infections such as colds or flu. Generic cephalexin capsules (for example Teva) are FDA-approved for respiratory tract infections, otitis media, skin and skin structure infections, bone infections and genitourinary tract infections caused by susceptible bacteria, and cephalexin is also manufactured as tablets and an oral suspension. Methicillin-resistant staphylococci and most enterococci are resistant to it. A prescriber may order cephalexin compounded when a patient needs a strength, flavor or allergen-free vehicle that is not manufactured. Compounded preparations are not FDA-approved and require a prescription.
Cephalexin has no boxed warning. Do not take it if you are allergic to cephalexin or other cephalosporins, and tell your prescriber about any penicillin or other beta-lactam allergy, because serious allergic reactions can occur. Watery or bloody diarrhea during treatment, or two or more months after stopping, can signal C. difficile infection; call your prescriber. Seizures are possible, especially with kidney problems, which may need a lower dose. Cephalexin can raise metformin levels, probenecid is not recommended with it, and it can cause a false-positive urine glucose test. Decades of pregnancy data have not established a risk of birth defects or miscarriage. LactMed says milk levels are low and not expected to harm a breastfed infant, though diarrhea or thrush has occasionally been reported with cephalosporins. Get help right away for rash, swelling or trouble breathing; otherwise talk to your prescriber or pharmacist about side effects.
Cephalexin is bactericidal through inhibition of bacterial cell-wall synthesis (Teva label); StatPearls describes binding to penicillin-binding proteins. It is acid stable and may be given without regard to meals, with peak serum levels at about 1 hour. Protein binding is 10% to 15%, and over 90% of a dose is excreted unchanged in urine within 8 hours by glomerular filtration and tubular secretion. StatPearls reports a serum half-life of 1 to 2 hours that lengthens markedly with severely reduced creatinine clearance, and recommends renal dose adjustment. Labeled indications: respiratory tract infections, otitis media, skin and skin structure, bone and genitourinary infections caused by susceptible isolates, used only for confirmed or strongly suspected bacterial infections. In a single-dose study, cephalexin increased metformin Cmax and AUC by an average of 34% and 24%, so monitor glucose. Dosing is per prescriber. Monitor renal function, hypersensitivity and early signs of severe skin reactions, and C. difficile-associated diarrhea; evaluate new anemia for drug-induced hemolysis (Coombs seroconversion is a labeled warning). Cephalexin is not a controlled substance.
Compounded at Bayview
Patient guides for the preparations we make most often. Each one is compounded to order and requires a prescription.
We do not have a patient page for this ingredient yet. That does not mean we cannot make it. Bayview compounds this ingredient to a prescriber's order, and our full compounding formulary lists every preparation we make. Viewing the formulary requires a prescriber account.
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Every preparation in our formulary that contains this ingredient. Strength, base and dose form are set by the prescription.
Other salt forms of this molecule, and ingredients commonly compounded alongside it.
This page describes an active pharmaceutical ingredient, not a finished drug product. Bayview Pharmacy compounds preparations containing it only on a prescriber's order for an individual patient.
Compounded preparations are not FDA-approved, and the FDA has not evaluated them for safety, effectiveness, or manufacturing quality. Nothing on this page is a claim that any preparation is effective for any condition.
A valid prescription is required. Availability depends on Bayview's licensure in your state. This page is general information, not medical advice. Discuss your situation with a licensed healthcare provider.
Our pharmacists work with prescribers to build preparations around a patient's dose, form and tolerances. Ask us what is possible with this ingredient.
