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Revision as of 09:44, 27 October 2011 editBeetstra (talk | contribs)Edit filter managers, Administrators172,031 edits Script assisted update of identifiers for the Chem/Drugbox validation project (updated: 'DrugBank').← Previous edit Latest revision as of 08:23, 19 October 2024 edit undo2601:642:c303:f370:845f:745f:fee:4663 (talk) Reclassified to Clostridioides in 2016. CE 
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{{Short description|Beta-lactam antibiotic}}
{{Use dmy dates|date=October 2021}}
{{cs1 config |name-list-style=vanc |display-authors=6}}
{{Drugbox {{Drugbox
| Watchedfields = changed
| verifiedrevid = 443507819
| verifiedrevid = 457630940
| IUPAC_name = (6''R'',7''R'')-7-{amino}- 3-methyl-8-oxo-5-thia-1-azabicyclooct-2-ene- 2-carboxylic acid
| image = Cefalexin.svg | image = Cefalexin.svg
| alt =
| image2 = Cefalexin-from-xtal-3D-bs-17.png
| alt2 =
| BAN = cephalexin
| USAN = cephalexin


<!--Clinical data--> <!-- Clinical data -->
| pronounce = {{IPAc-en|ˌ|s|ɛ|f|ə|ˈ|l|ɛ|k|s|ᵻ|n}}
| tradename =
| tradename = Keflex, others
| Drugs.com = {{drugs.com|international|cefalexin}}
| Drugs.com = {{Drugs.com|monograph|cephalexin}}
| MedlinePlus = a682733
| DailyMedID = Cephalexin
| pregnancy_AU = A | pregnancy_AU = A
| pregnancy_AU_comment = <ref name="Drugs.com pregnancy">{{cite web | title=Cephalexin Use During Pregnancy | website=Drugs.com | date=28 December 2018 | url=https://www.drugs.com/pregnancy/cephalexin.html | access-date=7 February 2020 | archive-date=7 February 2020 | archive-url=https://web.archive.org/web/20200207073035/https://www.drugs.com/pregnancy/cephalexin.html | url-status=live }}</ref>
| pregnancy_US = B
| pregnancy_category =
| routes_of_administration = ]
| class = ]
| ATC_prefix = J01
| ATC_suffix = DB01
| ATC_supplemental = {{ATCvet|J51|DB01}}

| legal_AU = S4 | legal_AU = S4
| legal_CA = Rx-only
| legal_CA_comment =
| legal_UK = POM | legal_UK = POM
| legal_US = Rx-only
| routes_of_administration = Oral
| legal_EU = Rx-only
| legal_EU_comment = <ref name="Lexylan PI" />


<!--Pharmacokinetic data--> <!-- Pharmacokinetic data -->
| bioavailability = Well absorbed | bioavailability = Well absorbed
| protein_bound = 15% | protein_bound = 15%
| metabolism = 80% excreted unchanged in urine within 6 hours of administration | metabolism = 80% excreted unchanged in urine within 6 hours of administration
| elimination_half-life = For an adult with normal renal function, the serum half-life is 0.5-1.2 hours<ref>McEvoy, G.K. (ed.). American Hospital Formulary Service - Drug Information 95. Bethesda, MD: American Society of Hospital Pharmacists, Inc., 1995 (Plus Supplements 1995)., p. 166</ref> | elimination_half-life = 0.6–1.2 hours<ref>McEvoy, G.K. (ed.). American Hospital Formulary Service — Drug Information 95. Bethesda, MD: American Society of Hospital Pharmacists, Inc., 1995 (Plus Supplements 1995)., p. 166</ref>
| excretion = ] | excretion = ]


<!--Identifiers--> <!-- Identifiers -->
| CASNo_Ref = {{cascite|correct|CAS}}
| CAS_number_Ref = {{cascite|correct|??}} | CAS_number_Ref = {{cascite|correct|??}}
| CAS_number = 15686-71-2 | CAS_number = 15686-71-2
| ATC_prefix = J01
| ATC_suffix = DB01
| ATC_supplemental = {{ATCvet|J51|DA01}}
| PubChem = 2666 | PubChem = 2666
| IUPHAR_ligand = 4832
| DrugBank_Ref = {{drugbankcite|correct|drugbank}} | DrugBank_Ref = {{drugbankcite|correct|drugbank}}
| DrugBank = DB00567 | DrugBank = DB00567
Line 40: Line 59:
| ChEMBL_Ref = {{ebicite|correct|EBI}} | ChEMBL_Ref = {{ebicite|correct|EBI}}
| ChEMBL = 1727 | ChEMBL = 1727
| synonyms = cephalexin


<!--Chemical data--> <!-- Chemical data -->
| IUPAC_name = (7''R'')-3-methyl-7-(α-D-phenylglycylamino)-3-cephem-4-carboxylic acid monohydrate
| C=16 | H=17 | N=3 | O=4 | S=1
| C=16 | H=17 | N=3 | O=4 | S=1
| molecular_weight = 347.39 g/mol
| smiles = O=C2N1/C(=C(\CS12NC(=O)(c3ccccc3)N)C)C(=O)O | smiles = O=C2N1/C(=C(\CS12NC(=O)(c3ccccc3)N)C)C(=O)O
| InChI = 1/C16H17N3O4S/c1-8-7-24-15-11(14(21)19(15)12(8)16(22)23)18-13(20)10(17)9-5-3-2-4-6-9/h2-6,10-11,15H,7,17H2,1H3,(H,18,20)(H,22,23)/t10-,11-,15-/m1/s1
| InChIKey = ZAIPMKNFIOOWCQ-UEKVPHQBBS
| StdInChI_Ref = {{stdinchicite|correct|chemspider}} | StdInChI_Ref = {{stdinchicite|correct|chemspider}}
| StdInChI = 1S/C16H17N3O4S/c1-8-7-24-15-11(14(21)19(15)12(8)16(22)23)18-13(20)10(17)9-5-3-2-4-6-9/h2-6,10-11,15H,7,17H2,1H3,(H,18,20)(H,22,23)/t10-,11-,15-/m1/s1 | StdInChI = 1S/C16H17N3O4S/c1-8-7-24-15-11(14(21)19(15)12(8)16(22)23)18-13(20)10(17)9-5-3-2-4-6-9/h2-6,10-11,15H,7,17H2,1H3,(H,18,20)(H,22,23)/t10-,11-,15-/m1/s1
| StdInChIKey_Ref = {{stdinchicite|correct|chemspider}} | StdInChIKey_Ref = {{stdinchicite|correct|chemspider}}
| StdInChIKey = ZAIPMKNFIOOWCQ-UEKVPHQBSA-N | StdInChIKey = ZAIPMKNFIOOWCQ-UEKVPHQBSA-N
| melting_point = 326.8
}}
}}
'''Cefalexin''' (]) or more commonly '''cephalexin''' ({{IPAc-en|icon|ˌ|s|ɛ|f|ə|ˈ|l|ɛ|k|s|ɨ|n}}) is a first-generation ] ] introduced in 1967 by ].<ref name=Martindale>{{Cite book|editor=Sweetman, Sean C. |chapter=Antibacterials|title=] |edition=36th |year=2009 |pages=218–9 |publisher=Pharmaceutical Press |location=London|isbn=978-0-85369-840-1}}</ref><ref name=Sneader>{{Cite book|last=Sneader |first=Walter |title=Drug discovery: a history |publisher=Wiley |location=New York |year=2005 |chapter=Cephalosporin analogues |chapterurl=http://books.google.com/books?id=mYQxRY9umjcC&pg=PA324|pages=324 |isbn=0-471-89980-1 |accessdate=2009-06-26}}</ref> It is an orally administered agent with a similar antimicrobial spectrum to the intravenous agents ] and ]. It was first marketed as '''Keflex''' (Lilly), and now is also sold under several other trade names.<ref name=Martindale/>


<!-- Definition -->
As of 2008, cefalexin was the most popular cephalosporin antibiotic in the United States, with more than 25 million prescriptions of its generic versions alone, for US$255 million in sales (though less popular than two other antibiotics, ] and ], each with 50 million prescriptions per year).<ref>{{PDFlink||332.8&nbsp;KB}}. ''Drug Topics'' (May 26, 2009). Retrieved on July 24, 2009.</ref><ref>{{PDFlink||399.4&nbsp;KB}}. ''Drug Topics'' (May 26, 2009). Retrieved on July 24, 2009.</ref>
'''Cefalexin''', also spelled '''cephalexin''', is an ] that can treat a number of ].<ref name=AHFS2014/> It kills ] and some ] by disrupting the growth of the bacterial cell wall.<ref name=AHFS2014/> Cefalexin is a ] within the class of first-generation ]s.<ref name=AHFS2014/> It works similarly to other agents within this class, including intravenous ], but can be taken ].<ref>{{cite book| vauthors = Brunton LL |title=Goodman & Gilman's pharmacological basis of therapeutics.|date=2011|publisher=McGraw-Hill|location=New York|isbn=978-0071624428 |edition=12th |chapter= Chapter 53: Penicillins, Cephalosporins, and Other β-Lactam Antibiotics}}</ref>


==Medical uses== <!-- Medical uses -->
Cefalexin can treat certain bacterial infections, including those of the ], ] and ], ], and ].<ref name=AHFS2014/> It may also be used for certain types of ] and ] and to prevent ].<ref name=AHFS2014/> Cefalexin is not effective against infections caused by ] (MRSA), most '']'', or '']''.<ref name=AHFS2014/> Like other antibiotics, cefalexin cannot treat ]s, such as the ], ] or ].<ref name=AHFS2014/> Cefalexin can be used in those who have mild or moderate allergies to ].<ref name=AHFS2014/> However, it is not recommended in those with severe penicillin allergies.<ref name=AHFS2014/>
Cefalexin is used to treat a number of ]s including: ], ], bone and joint infections, ], ], and ]s.<ref name=AHFS>{{cite web|title=Cephalexin|url=http://www.drugs.com/monograph/cephalexin.html|work=The American Society of Health-System Pharmacists|accessdate=3 April 2011}}</ref> It may be used to prevent ].<ref name=AHFS/>


<!-- Side effects -->
===Infections===
Common ]s include ] and ].<ref name=AHFS2014/> ]s or infections with ], a cause of diarrhea, are also possible.<ref name=AHFS2014/> Use during ] or ] does not appear to be harmful to the fetus.<ref name=AHFS2014/><ref name=TGA2014>{{cite web|title=Prescribing medicines in pregnancy database|url=http://www.tga.gov.au/hp/medicines-pregnancy.htm|work=Australian Government|access-date=22 April 2014|date=3 March 2014|url-status=live|archive-url=https://web.archive.org/web/20140408040902/http://www.tga.gov.au/hp/medicines-pregnancy.htm#.U1Yw8Bc3tqw|archive-date=8 April 2014}}</ref><ref name=Breast2013>{{cite book|title=Breastfeeding and Medication|date=2013|publisher=Routledge|isbn=9781136178153|page=227|url=https://books.google.com/books?id=0Y8lbCnF1mgC&pg=PA227| vauthors = Jones W |url-status=live|archive-url=https://web.archive.org/web/20170908135050/https://books.google.com/books?id=0Y8lbCnF1mgC&pg=PA227|archive-date=8 September 2017}}</ref> It can be used in children and those over 65 years of age.<ref name=AHFS2014/> Those with ] may require a decrease in dose.<ref name=AHFS2014>{{cite web|title=Cephalexin|url=https://www.drugs.com/monograph/cephalexin.html|publisher=The American Society of Health-System Pharmacists|access-date=21 April 2014|url-status=live|archive-url=https://web.archive.org/web/20140501202910/http://www.drugs.com/monograph/cephalexin.html|archive-date=1 May 2014}}</ref>
In addition to being a rational ] for ], it is a useful alternative to ]s in patients with penicillin ]. In patients with mild or questionable history of penicillin allergy, cephalasporins are now thought to be relatively safe.<ref>{{Cite journal|author=Pichichero ME |title=Use of selected cephalosporins in penicillin-allergic patients: a paradigm shift |journal=Diagnostic Microbiology and Infectious Disease |volume=57 |issue=3 Suppl |pages=13S–18S |year=2007 |month=March |pmid=17349459 |doi=10.1016/j.diagmicrobio.2006.12.004}}</ref> Caution should always be taken when prescribing cephalosporins to those with strong history of true penicillin hypersensitivity, however, because cefalexin and other first-generation cephalosporins are known to have a modest cross-allergy in patients with penicillin hypersensitivity.


<!-- History, Society and Culture -->
Cefalexin may not be effective against bacteria that incorporate a gene for beta-lactamase on their R-plasmid as the beta-lactam ring is present in the chemical structure of cephalosporin derivitives.{{fact|date=October 2011}}
Cefalexin was developed in 1967.<ref>{{cite book | veditors = Hey E |title=Neonatal formulary 5 drug use in pregnancy and the first year of life |date=2007 |publisher=Blackwell |isbn=9780470750353 |page=67 |url=https://books.google.com/books?id=aumIBqHmChwC&pg=PA67 |edition=5th |url-status=live |archive-url=https://web.archive.org/web/20170908135050/https://books.google.com/books?id=aumIBqHmChwC&pg=PA67 |archive-date=8 September 2017 }}></ref><ref>{{cite patent |country=US |number=3275626 |status=patent |title=Penicillin conversion via sulfoxide |pubdate=1966-09-27 |gdate=1966-09-27 |fdate=1962-07-31 |pridate=1962-07-31 | inventor = Morin RB, Jackson BG |assign1=Eli Lilly and Co |url=https://worldwide.espacenet.com/publicationDetails/biblio?CC=US&NR=3275626&KC=&FT=E&locale=en_EP }} {{Cite web |url=https://worldwide.espacenet.com/publicationDetails/biblio?CC=US&NR=3275626&KC=&FT=E&locale=en_EP |title=Espacenet - Bibliographic data |access-date=3 March 2020 |archive-date=25 September 2022 |archive-url=https://web.archive.org/web/20220925035539/https://worldwide.espacenet.com/publicationDetails/biblio?CC=US&NR=3275626&KC=&FT=E&locale=en_EP }}</ref><ref>{{cite patent |country=US |number=3507861 |status=patent |title=Certain 3-methyl-cephalosporin compounds |pubdate=1970-04-21 |gdate=1970-04-21 |fdate=1966-09-14 |pridate=1966-09-14 | inventor = Morin RB, Jackson BG |assign1=Eli Lilly and Co |url=https://worldwide.espacenet.com/publicationDetails/biblio?CC=US&NR=3507861&KC=&FT=E&locale=en_EP }} {{Cite web |url=https://worldwide.espacenet.com/publicationDetails/biblio?CC=US&NR=3507861&KC=&FT=E&locale=en_EP |title=Espacenet - Bibliographic data |access-date=3 March 2020 |archive-date=25 September 2022 |archive-url=https://web.archive.org/web/20220925035539/https://worldwide.espacenet.com/publicationDetails/biblio?CC=US&NR=3507861&KC=&FT=E&locale=en_EP }}</ref> It was first marketed in 1969 under the brand name '''Keflex'''.<ref name=McP2007>{{cite book| vauthors = McPherson EM | chapter = Cefalexin |title=Pharmaceutical Manufacturing Encyclopedia.|date=2007|publisher=Elsevier|location=Burlington|isbn=9780815518563|page=915| chapter-url=https://books.google.com/books?id=_J2ti4EkYpkC&pg=PA915|edition=3rd|url-status=live|archive-url=https://web.archive.org/web/20170908135051/https://books.google.com/books?id=_J2ti4EkYpkC&pg=PA915|archive-date=8 September 2017}}</ref><ref>{{cite book|last=Ravina|first=Enrique|title=The evolution of drug discovery : from traditional medicines to modern drugs|date=2011|publisher=Wiley-VCH|location=Weinheim|isbn=9783527326693|page=267|url=https://books.google.com/books?id=iDNy0XxGqT8C&pg=PA267|edition=1. Aufl.|url-status=live|archive-url=https://web.archive.org/web/20170908135051/https://books.google.com/books?id=iDNy0XxGqT8C&pg=PA267|archive-date=8 September 2017}}</ref> It is available as a ].<ref name=AHFS2014/><ref>{{cite book | vauthors = Hanlon G, Hodges N |title =Essential Microbiology for Pharmacy and Pharmaceutical Science |date=2012 |publisher=Wiley |location=Hoboken |isbn=9781118432433 |page=140 |url=https://books.google.com/books?id=P4Ucifn76PUC&pg=PT140 |url-status=live|archive-url=https://web.archive.org/web/20170908135051/https://books.google.com/books?id=P4Ucifn76PUC&pg=PT140|archive-date=8 September 2017}}</ref> It is on the ].<ref name="WHO23rd">{{cite book | vauthors = ((World Health Organization)) | title = The selection and use of essential medicines 2023: web annex A: World Health Organization model list of essential medicines: 23rd list (2023) | year = 2023 | hdl = 10665/371090 | author-link = World Health Organization | publisher = World Health Organization | location = Geneva | id = WHO/MHP/HPS/EML/2023.02 | hdl-access=free }}</ref> In 2022, it was the 101st most commonly prescribed medication in the United States, with more than 6{{nbsp}}million prescriptions.<ref>{{cite web | title=The Top 300 of 2022 | url=https://clincalc.com/DrugStats/Top300Drugs.aspx | website=ClinCalc | access-date=30 August 2024 | archive-date=30 August 2024 | archive-url=https://web.archive.org/web/20240830202410/https://clincalc.com/DrugStats/Top300Drugs.aspx | url-status=live }}</ref><ref>{{cite web | title = Cephalexin Drug Usage Statistics, United States, 2013 - 2022 | website = ClinCalc | url = https://clincalc.com/DrugStats/Drugs/Cephalexin | access-date = 30 August 2024 }}</ref> In Canada, it was the fifth most common antibiotic used in 2013.<ref>{{Cite web|url = http://publications.gc.ca/collections/collection_2014/aspc-phac/HP37-20-2013-eng.pdf|title = Human Antimicrobial Drug Use Report 2012/2013|date = November 2014|access-date = 24 February 2015|publisher = Public Health Agency of Canada (PHAC)|url-status = live|archive-url = https://web.archive.org/web/20150321041930/http://publications.gc.ca/collections/collection_2014/aspc-phac/HP37-20-2013-eng.pdf|archive-date = 21 March 2015}}</ref> In Australia, it was one of the top 10 most prescribed medications between 2017 and 2023.<ref>{{cite web | title=Medicines in the health system | website=Australian Institute of Health and Welfare | date=2 July 2024 | url=https://www.aihw.gov.au/reports/medicines/medicines-in-the-health-system | access-date=30 September 2024}}</ref>


===Formulations=== ==Medical uses==
]
Cefalexin is marketed by ] manufacturers under a wide range of brand names, including: Apo-Cephalex, Biocef, Cefanox, Ceforal, Cephabos, Cephalexin, Cephorum, Ceporex, Cilex, Ialex, Ibilex, Kefexin, Keflet, Keflex, Rekosporin, Keforal, Keftab, Keftal, Lopilexin, Larixin, Novo-Lexin, Ospexin, Tenkorex, Zephalexin, Panixine Disperdose, and Sporidex.


Cefalexin can treat a number of bacterial infections including ], ], bone and joint infections, ], ], and ]s.<ref name=AHFS2014/> It may be used to prevent ].<ref name=AHFS2014/> It can also be used for the prevention of recurrent urinary-tract infections.<ref name=AHFS2014/>
A version of Keflex 750&nbsp;mg capsules is marketed for twice-daily dosage, to improve ]. However, it is not a ] formulation, and since it is more expensive than the older strengths, some physicians prescribe three 250&nbsp;mg capsules to be taken twice daily, as a cheaper alternative.{{Citation needed|date=March 2008}}


Cefalexin does not treat ] infections.<ref name=AHFS2014/>
In Finland, cefalexin is marketed under several names. ] markets Kefexin.<ref>http://spc.nam.fi/indox/nam/html/nam/humpil/2/244412.pdf.</ref><ref>http://spc.nam.fi/indox/nam/html/nam/humspc/2/244362.shtml.</ref>

Cefalexin is a useful alternative to penicillins in patients with penicillin intolerance. For example, penicillin is the treatment of choice for respiratory tract infections caused by ''Streptococcus'', but cefalexin may be used as an alternative in penicillin-intolerant patients.<ref name=AHFS2014/> Caution must be exercised when administering cephalosporin antibiotics to penicillin-sensitive patients, because cross-sensitivity with β-lactam antibiotics has been documented in up to 10% of patients with a documented penicillin allergy.<ref name=FDA>{{cite web|title=FDA Cephalexin drug label|url=http://www.accessdata.fda.gov/drugsatfda_docs/label/2012/063024s022lbl.pdf|access-date=18 April 2014|url-status=live|archive-url=https://web.archive.org/web/20140418220539/http://www.accessdata.fda.gov/drugsatfda_docs/label/2012/063024s022lbl.pdf|archive-date=18 April 2014}}</ref>

===Pregnancy and breastfeeding===
It is categorized in category A in Australia meaning that no evidence of harm has been found after being taken by many pregnant women.<ref name=AHFS2014/><ref name=TGA2014/> Use during ] is generally safe.<ref name=Breast2013/>


==Adverse effects== ==Adverse effects==
The most common adverse effects of cefalexin, like other oral cephalosporins, are gastrointestinal (stomach area) disturbances and hypersensitivity reactions. Gastrointestinal disturbances include ], ], and ], the latter being the most common.<ref>{{cite web|title=Cephalexin Side Effects|url=https://www.drugs.com/sfx/cephalexin-side-effects.html|website=Drugs.com|access-date=9 February 2015|url-status=live|archive-url=https://web.archive.org/web/20150208030513/http://www.drugs.com/sfx/cephalexin-side-effects.html|archive-date=8 February 2015}}</ref> ]s include skin rashes, ], ], and ].<ref name=AHFS2014/> ] and '']'' have been reported with use of cefalexin.<ref name=AHFS2014/> Less common and more serious side effects include bruising of the skin and yellowing of the skin or eye whites.<ref name="auto">{{cite web |title=Cefalexin |url=https://www.nhs.uk/medicines/cefalexin/ |website=NHS |date=31 March 2020 |publisher=Crown |access-date=14 November 2022}}</ref>
Adverse effects from cefalexin include ], dizziness, agitation, headache, indigestion, joint pain, stomach pain (usually mild) and tiredness. The drug can also cause yellowing of the eyes or skin; red, blistered, swollen or peeling skin; unusual bruising or bleeding; decreased urination; severe cramps and confusion. An allergic reaction to this medicine is unlikely. Symptoms of an allergic reaction include rash, itching, swelling, or trouble breathing.


Signs and symptoms of an ] include rash, itching, swelling, trouble breathing, or red, blistered, swollen, or peeling skin. Overall, cefalexin allergy occurs in less than 0.1% of patients{{Citation needed|date=August 2023|reason=The claim that adverse side effects only in 0.1% of patients is simply not credible}}. Evidence suggests that it is seen in 1% to 10% of patients with a penicillin allergy.<ref name="AustriaCodex">{{cite book|title=Austria-Codex|editor=Haberfeld, H|publisher=Österreichischer Apothekerverlag|location=Vienna|year=2009|edition=2009/2010|isbn=978-3-85200-196-8|language=de}}</ref>
{{clear}}


==References== == Interactions ==
{{Reflist|2}}


Like other ]s, renal excretion of cefalexin is delayed by ].<ref name=AHFS2014/> It is also not recommended to take cefalexin with ], live ], ], and ].<ref>{{cite web |title=Cephalexin (Oral Route) |url=https://www.mayoclinic.org/drugs-supplements/cephalexin-oral-route/side-effects/drg-20073325?p=1 |website=Mayo Clinic |publisher=Mayo Foundation for Medical Education and Research |access-date=14 November 2022}}</ref> ] consumption reduces the rate at which it is absorbed.<ref>{{cite journal | vauthors = Barrio Lera JP, Alvarez AI, Prieto JG | title = Effects of ethanol on the pharmacokinetics of cephalexin and cefadroxil in the rat | journal = Journal of Pharmaceutical Sciences | volume = 80 | issue = 6 | pages = 511–516 | date = June 1991 | pmid = 1941538 | doi = 10.1002/jps.2600800602 }}</ref> Cefalexin also interacts with ], an ],<ref name=AHFS2014/> and this can lead to higher concentrations of metformin in the body.<ref name=AHFS2014/><ref>{{cite journal | vauthors = Jayasagar G, Krishna Kumar M, Chandrasekhar K, Madhusudan Rao C, Madhusudan Rao Y | title = Effect of cephalexin on the pharmacokinetics of metformin in healthy human volunteers | journal = Drug Metabolism and Drug Interactions | volume = 19 | issue = 1 | pages = 41–48 | year = 2002 | pmid = 12222753 | doi = 10.1515/dmdi.2002.19.1.41 | s2cid = 26919498 }}</ref> ]s like ] and ] may reduce the ] of cefalexin by delaying its ] and altering its antimicrobial ].<ref name="GraysonCosgrove2017" /> Zinc and zinc supplements also interact with cefalexin and may reduce the amount of cefalexin in the body.<ref name="auto"/>
==External links==
*


==Pharmacology==
{{CephalosporinAntiBiotics}}

===Mechanism of action===
Cefalexin is a β-lactam antibiotic of the cephalosporin family.<ref name = "Botara_2006">{{cite book | vauthors = Bothara SS, Kadam KR, Mahadik KG | title = Principles of Medicinal Chemistry | volume = 1 | year = 2006 | publisher = Nirali Prakashan | location = Pune | isbn = 8185790043 | page = 81 | edition = 14th | chapter = Antibiotics | chapter-url = https://books.google.com/books?id=b2KJZksQrzoC&q=antibiotics+cephalosporin+family+Cephalexin&pg=PA81 | access-date = 7 October 2020 | archive-date = 25 September 2022 | archive-url = https://web.archive.org/web/20220925035538/https://books.google.com/books?id=b2KJZksQrzoC&q=antibiotics+cephalosporin+family+Cephalexin&pg=PA81 | url-status = live }}</ref> It is ] and acts by inhibiting synthesis of the ] layer of the bacterial cell wall.<ref name="Fisher_2005">{{cite journal | vauthors = Fisher JF, Meroueh SO, Mobashery S | title = Bacterial resistance to beta-lactam antibiotics: compelling opportunism, compelling opportunity | journal = Chemical Reviews | volume = 105 | issue = 2 | pages = 395–424 | date = February 2005 | pmid = 15700950 | doi = 10.1021/cr030102i }}</ref> As cefalexin closely resembles d-alanyl-d-alanine, an amino acid ending on the peptidoglycan layer of the cell wall, it can irreversibly bind to the active site of ], which is essential for the synthesis of the cell wall.<ref name="Fisher_2005"/> It is most active against ], and has moderate activity against some ].<ref name=AHFS2014/> However, some bacterial cells have the enzyme ], which hydrolyzes the β-lactam ring, rendering the drug inactive. This contributes to ] towards cefalexin.<ref name="pmid20065329">{{cite journal | vauthors = Drawz SM, Bonomo RA | title = Three decades of beta-lactamase inhibitors | journal = Clinical Microbiology Reviews | volume = 23 | issue = 1 | pages = 160–201 | date = January 2010 | pmid = 20065329 | pmc = 2806661 | doi = 10.1128/CMR.00037-09 }}</ref>

===Pharmacokinetics===
Cefalexin is rapidly and almost completely absorbed from the ] with ].<ref name="Keflex-Label" /> Absorption is slightly reduced when it is taken with food and the medication can be taken without regard for meals.<ref name="Keflex-Label" /> Peak levels of cefalexin occur about 1&nbsp;hour after administration.<ref name="Keflex-Label" /> Maximal levels of cefalexin increase approximately linearly over a dose range of 250 to 1,000&nbsp;mg.<ref name="Keflex-Label" />

Like most other cephalosporins, cefalexin is not ] or otherwise inactivated in the body.<ref name="GraysonCosgrove2017">{{cite book| vauthors = Rafiei N | chapter = Cephalexin| veditors = Grayson M |title=Kucers' The Use of Antibiotics: A Clinical Review of Antibacterial, Antifungal, Antiparasitic, and Antiviral Drugs | edition = Seventh | chapter-url=https://books.google.com/books?id=3xE4DwAAQBAJ&pg=PA364|date=2 October 2017|publisher=CRC Press|isbn=978-1-4987-4796-7|pages=364–|access-date=13 July 2018|archive-date=28 August 2021|archive-url=https://web.archive.org/web/20210828023755/https://books.google.com/books?id=3xE4DwAAQBAJ&pg=PA364|url-status=live}}</ref><ref name="Skidmore-Roth2015">{{cite book | vauthors = Skidmore-Roth L |title=Mosby's Drug Guide for Nursing Students, with 2016 Update|url=https://books.google.com/books?id=g_BwCgAAQBAJ&pg=PA181|date=16 July 2015|publisher=Elsevier Health Sciences|isbn=978-0-323-17297-4|pages=181–|access-date=13 July 2018|archive-date=28 August 2021|archive-url=https://web.archive.org/web/20210828023811/https://books.google.com/books?id=g_BwCgAAQBAJ&pg=PA181|url-status=live}}</ref>

The ] of cefalexin is approximately 30 to 60&nbsp;minutes in people with normal renal function.<ref name="Skidmore-Roth2015" /><ref name="Keflex-Label" /> Therapeutic levels of cefalexin with oral administration are maintained for 6 to 8&nbsp;hours.<ref name="Keflex-Label">{{Cite web|url=https://www.medicines.org.uk/emc/product/9143/smpc|title=Cefalexin 500mg Tablets - Summary of Product Characteristics (SMPC) - (Emc)|access-date=5 March 2021|archive-date=19 April 2021|archive-url=https://web.archive.org/web/20210419094953/https://www.medicines.org.uk/emc/product/9143/smpc|url-status=live}}</ref> More than 90% of cefalexin is excreted unchanged in the urine within 8&nbsp;hours.<ref name="Keflex-Label" />

==Society and culture==
It is on the ].<ref name="WHO23rd" /> The World Health Organization classifies cefalexin as highly important for human medicine.<ref>{{cite book | vauthors=((World Health Organization)) | year=2019 | title=Critically important antimicrobials for human medicine | edition=6th revision | author-link = World Health Organization | publisher = World Health Organization | location = Geneva | hdl=10665/312266 | id=License: CC BY-NC-SA 3.0 IGO | isbn=9789241515528 | hdl-access=free }}</ref>

===Names===
Cefalexin is the ] (INN) and the ] (AAN), while cephalexin is the ] (BAN) and the United States Adopted Name (USAN).<ref>{{cite web | title=Cephalexin | website=ChemIDplus | url=https://chem.nlm.nih.gov/chemidplus/rn/15686-71-2 | access-date=25 September 2022 | archive-date=29 January 2022 | archive-url=https://web.archive.org/web/20220129041851/https://chem.nlm.nih.gov/chemidplus/rn/15686-71-2 | url-status=live }}</ref> Brand names for cefalexin include Keflex, Acfex, Cephalex, Ceporex, L-Xahl, Medoxine, Ospexin, Torlasporin, Bio-Cef, Panixine DisperDose, and Novo-Lexin.<ref>{{cite web | title=Cefalexin International | website=Drugs.com | date=3 February 2020 | url=https://www.drugs.com/international/cefalexin.html | access-date=8 February 2020 | archive-date=29 May 2016 | archive-url=https://web.archive.org/web/20160529145832/http://www.drugs.com/international/cefalexin.html | url-status=live }}</ref><ref>{{cite web |title=Cephalexin (Oral Route) Description and Brand Names |url=https://www.mayoclinic.org/drugs-supplements/cephalexin-oral-route/description/drg-20073325 |website=May Clinic |publisher=Mayo Foundation for Medical Education and Research |access-date=14 November 2022}}</ref>

== Veterinary uses ==
=== Dogs ===
According to Plumb's Veterinary Medication Guides, cefalexin can be used in treating skin, respiratory tract, and urinary tract infections. Specifically, it can treat ] in dogs.<ref>{{cite web | vauthors = Gollakner R |title=Cephalexin |url=https://vcahospitals.com/know-your-pet/cephalexin#:~:text=Cephalexin%20(brand%20names%20Rilexine%C2%AE,other%20types%20of%20skin%20infections. |website=VCA Animal Hospitals |publisher=Affiliate of Mars Inc. |access-date=14 November 2022}}</ref> The U.S. Food and Drug Administration (FDA) has approved it for use in humans and dogs but not for other species. Like other drugs approved for human use, cefalexin may be prescribed by veterinarians for animals in certain situations.<ref>{{cite web |title=Frequently Asked Questions about Animal Drugs |website=] |date=17 April 2024 |url=https://www.fda.gov/animal-veterinary/safety-health/frequently-asked-questions-about-animal-drugs#people |access-date=9 June 2024}}</ref>

Cefalexin (Lexylan) is indicated for the treatment of cattle, dogs, and cats in the European Union.<ref name="Lexylan PI">{{cite web | title=Lexylan Product information | website=Union Register of veterinary medicinal products | date=10 April 2024 | url=https://ec.europa.eu/health/documents/community-register/html/v308.htm | access-date=17 June 2024}}</ref>

== References ==
{{Reflist}}

{{Cell wall disruptive antibiotics}}
{{Portal bar | Medicine}}
{{Authority control}}


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