Cephalexin interactions

Conditions

Conditions in which Cephalexin needs care, as documented in this source.

• Colitis

  Major

  Clostridioides difficile-associated diarrhea (CDAD), formerly pseudomembranous colitis, has been reported with almost all antibacterial drugs and may range from mild diarrhea to fatal colitis. The most common culprits include clindamycin and lincomycin. Antibacterial therapy alters the normal flora of the colon, leading to overgrowth of C difficile, whose toxins A and B contribute to CDAD development. Morbidity and mortality are increased with hypertoxin-producing strains of C difficile; these infections can be resistant to antimicrobial therapy and may require colectomy. CDAD must be considered in all patients who present with diarrhea after antibacterial use. Since CDAD has been reported to occur more than 2 months after antibacterial use, careful medical history is necessary. Therapy with broad-spectrum antibacterials and other agents with significant antibacterial activity should be administered cautiously in patients with history of gastrointestinal disease, particularly colitis; pseudomembranous colitis (generally characterized by severe, persistent diarrhea and severe abdominal cramps, and sometimes associated with the passage of blood and mucus), if it occurs, may be more severe in these patients and may be associated with flares in underlying disease activity. Antibacterial drugs not directed against C difficile may need to be stopped if CDAD is suspected or confirmed. Appropriate fluid and electrolyte management, protein supplementation, antibacterial treatment of C difficile, and surgical evaluation should be started as clinically indicated.

  31 sources

  1. "Product Information. Omnipen (ampicillin)." Wyeth-Ayerst Laboratories (2002):
  2. "Product Information. Ceftin (cefuroxime)." Glaxo Wellcome (2002):
  3. "Product Information. Zinacef (cefuroxime)." Glaxo Wellcome (2002):
  4. "Product Information. Cleocin (clindamycin)." Pharmacia and Upjohn (2002):
  5. "Product Information. Macrobid (nitrofurantoin)." Procter and Gamble Pharmaceuticals (2002):
  6. "Product Information. Macrodantin (nitrofurantoin)." Procter and Gamble Pharmaceuticals (2002):
  7. "Product Information. Amoxil (amoxicillin)." SmithKline Beecham (2001):
  8. "Product Information. Merrem (meropenem)." Astra-Zeneca Pharmaceuticals (2001):

  Show all 31 sourcesShow fewer sources

  9. "Product Information. Coly-Mycin M Parenteral (colistimethate)." Parke-Davis (2001):
  10. "Product Information. Lincocin (lincomycin)." Pharmacia and Upjohn (2001):
  11. "Product Information. Cubicin (daptomycin)." Cubist Pharmaceuticals Inc (2003):
  12. "Product Information. Xifaxan (rifaximin)." Salix Pharmaceuticals (2004):
  13. "Product Information. Doribax (doripenem)." Ortho McNeil Pharmaceutical (2007):
  14. "Product Information. Penicillin G Procaine (procaine penicillin)." Monarch Pharmaceuticals Inc (2009):
  15. "Product Information. Vibativ (telavancin)." Theravance Inc (2009):
  16. "Product Information. Teflaro (ceftaroline)." Forest Pharmaceuticals (2010):
  17. "Product Information. Penicillin G Sodium (penicillin G sodium)." Sandoz Inc (2022):
  18. "Product Information. Dalvance (dalbavancin)." Durata Therapeutics, Inc. (2014):
  19. "Product Information. Orbactiv (oritavancin)." The Medicines Company (2014):
  20. "Product Information. Bicillin C-R (benzathine penicillin-procaine penicillin)." A-S Medication Solutions (2017):
  21. "Product Information. Baxdela (delafloxacin)." Melinta Therapeutics, Inc. (2017):
  22. "Product Information. Polymyxin B Sulfate (polymyxin B sulfate)." AuroMedics Pharma LLC (2022):
  23. "Product Information. Zemdri (plazomicin)." Achaogen (2018):
  24. "Product Information. Seysara (sarecycline)." Allergan Inc (2018):
  25. "Product Information. Nuzyra (omadacycline)." Paratek Pharmaceuticals, Inc. (2018):
  26. "Product Information. Aemcolo (rifamycin)." Aries Pharmaceuticals, Inc. (2018):
  27. "Product Information. Fetroja (cefiderocol)." Shionogi USA Inc (2019):
  28. "Product Information. Biaxin (clarithromycin)." AbbVie US LLC (2019):
  29. "Product Information. Zithromax (azithromycin)." Pfizer U.S. Pharmaceuticals Group (2021):
  30. "Product Information. E.E.S.-400 Filmtab (erythromycin)." Arbor Pharmaceuticals (2018):
  31. "Product Information. Priftin (rifapentine)." sanofi-aventis (2020):

• Diseases requiring dialysis

  Moderate

  Most cephalosporin antibiotics are removed by hemodialysis. Doses should either be scheduled for administration after dialysis or supplemental doses be given after dialysis. Cefonicid, cefixime, and ceftriaxone are not significantly removed by hemodialysis.

  24 sources

  1. "Product Information. Ceclor (cefaclor)." Lilly, Eli and Company (2002):
  2. "Product Information. Duricef (cefadroxil)." Bristol-Myers Squibb (2002):
  3. "Product Information. Ancef (cefazolin)." SmithKline Beecham (2002):
  4. "Product Information. Suprax (cefixime)." Lupin Pharmaceuticals Inc (2002):
  5. "Product Information. Monocid (cefonicid)." SmithKline Beecham (2002):
  6. "Product Information. Cefobid (cefoperazone)." Roerig Division (2002):
  7. "Product Information. Claforan (cefotaxime)." Hoechst Marion Roussel (2002):
  8. "Product Information. Cefotan (cefotetan)." Stuart Pharmaceuticals (2002):

  Show all 24 sourcesShow fewer sources

  9. "Product Information. Mefoxin (cefoxitin)." Merck & Co., Inc (2002):
  10. "Product Information. Vantin (cefpodoxime)." Pharmacia and Upjohn (2002):
  11. "Product Information. Cefzil (cefprozil)." Bristol-Myers Squibb (2002):
  12. "Product Information. Tazicef (ceftazidime)." SmithKline Beecham (2002):
  13. "Product Information. Cefizox (ceftizoxime)." Fujisawa (2002):
  14. "Product Information. Rocephin (ceftriaxone)." Roche Laboratories (2002):
  15. "Product Information. Keflex (cephalexin)." Dista Products Company (2002):
  16. "Product Information. Velosef (cephradine)." Apothecon Inc (2002):
  17. "Product Information. Keflin (cephalothin)." Lilly, Eli and Company (2002):
  18. "Product Information. Cefadyl (cephapirin)." Apothecon Inc (2002):
  19. "Product Information. Lorabid (loracarbef)." Lilly, Eli and Company (2002):
  20. "Product Information. Mandol (cefamandole)." Lilly, Eli and Company (2001):
  21. "Product Information. Cedax (ceftibuten)." Schering-Plough (2001):
  22. "Product Information. Maxipime (cefepime)." Bristol-Myers Squibb (2001):
  23. "Product Information. Omnicef (cefdinir)." Parke-Davis (2001):
  24. "Product Information. Spectracef (cefditoren)." TAP Pharmaceuticals Inc (2001):

• Epilepsy

  Moderate

  Cephalosporins have been implicated in triggering seizures. Nonconvulsive status epilepticus (NCSE), encephalopathy, coma, asterixis, neuromuscular excitability, and myoclonia have been reported with cephalosporins particularly in patients with a history of epilepsy and/or when recommended dosages of cephalosporins were exceeded due to renal impairment. Adjust dosing based on creatinine clearance. Anticonvulsant therapy should be continued in patients with known seizure disorders. If CNS adverse reactions including seizures occur, patients should undergo a neurological evaluation to determine whether treatment should be discontinued.

  19 sources

  1. "Product Information. Vantin (cefpodoxime)." Pharmacia and Upjohn
  2. "Product Information. Ceclor (cefaclor)." Lilly, Eli and Company (2002):
  3. "Product Information. Duricef (cefadroxil)." Bristol-Myers Squibb (2002):
  4. "Product Information. Ancef (cefazolin)." SmithKline Beecham (2002):
  5. "Product Information. Kefzol (cefazolin)." Lilly, Eli and Company (2002):
  6. "Product Information. Suprax (cefixime)." Lupin Pharmaceuticals Inc (2002):
  7. "Product Information. Claforan (cefotaxime)." Hoechst Marion Roussel (2002):
  8. "Product Information. Cefotan (cefotetan)." Stuart Pharmaceuticals (2002):

  Show all 19 sourcesShow fewer sources

  9. "Product Information. Mefoxin (cefoxitin)." Merck & Co., Inc (2002):
  10. "Product Information. Cefzil (cefprozil)." Bristol-Myers Squibb (2002):
  11. "Product Information. Fortaz (ceftazidime)." Glaxo Wellcome (2002):
  12. "Product Information. Cefizox (ceftizoxime)." Fujisawa (2002):
  13. "Product Information. Keflex (cephalexin)." Dista Products Company (2002):
  14. "Product Information. Cedax (ceftibuten)." Schering-Plough (2001):
  15. "Product Information. Maxipime (cefepime)." Bristol-Myers Squibb (2001):
  16. "Product Information. Omnicef (cefdinir)." Parke-Davis (2001):
  17. "Product Information. Ceclor CD (cefaclor)." Dura Pharmaceuticals (2001):
  18. "Product Information. Spectracef (cefditoren)." TAP Pharmaceuticals Inc (2001):
  19. "Product Information. Fetroja (cefiderocol)." Shionogi USA Inc (2019):

• Kidney Diseases

  Moderate

  Most beta-lactam antibiotics are eliminated by the kidney as unchanged drug and, in some cases, also as metabolites. The serum concentrations of beta-lactam antibiotics and their metabolites may be increased and the half-lives prolonged in patients with impaired renal function. Dosage adjustments may be necessary and modifications should be based on the degree of renal impairment as well as severity of infection in accordance with the individual product package labeling. Renal function tests should be performed periodically during prolonged and/or high-dose therapy, since nephrotoxicity and alterations in renal function have occasionally been associated with the use of these drugs.

  67 sources

  1. Bergan T "Pharmacokinetic comparison of oral bacampicillin and parenteral ampicillin." Antimicrob Agents Chemother 13 (1978): 971-4
  2. Ehrnebo M, Nilsson SO, Boreus LO "Pharmacokinetics of ampicillin and its prodrugs bacampicillin and pivampicillin in man." J Pharmacokinet Biopharm 7 (1979): 429-51
  3. Humbert G, Spyker DA, Fillastre JP, Leroy A "Pharmacokinetics of amoxicillin: dosage nomogram for patients with impaired renal function." Antimicrob Agents Chemother 15 (1979): 28-33
  4. Bloch R, Szwed JJ, Sloan RS, Luft FC "Pharmacokinetics of cefaclor in normal subjects and patients with chronic renal failure." Antimicrob Agents Chemother 12 (1977): 730-2
  5. Santoro J, Agarwal BN, Martinelli R, et al. "Pharmacology of cefaclor in normal volunteers and patients with renal failure." Antimicrob Agents Chemother 13 (1978): 951-4
  6. Spyker DA, Thomas BL, Sande MA, Bolton WK "Pharmacokinetics of cefaclor and caphalexin: dosage nomograms for impaired renal function." Antimicrob Agents Chemother 14 (1978): 172-7
  7. Gartenberg G, Meyers BR, Hirschman SZ, Srulevitch E "Pharmacokinetics of cefaclor in patients with stable renal impairment, and patients undergoing haemodialysis." J Antimicrob Chemother 5 (1979): 465-70
  8. Fillastre JP, Leroy A, Humbert G, Godin M "Cefaclor pharmacokinetics and renal impairment." J Antimicrob Chemother 6 (1980): 155-6

  Show all 67 sourcesShow fewer sources

  9. Berman SJ, Boughton WH, Sugihara JG, et al. "Pharmacokinetics of cefaclor in patients with end stage renal disease and during hemodialysis." Antimicrob Agents Chemother 14 (1978): 281-3
  10. Spyker DA, Gober LL, Scheld WM, et al. "Pharmacokinetics of cefaclor in renal failure: effects of multiple doses and hemodialysis." Antimicrob Agents Chemother 21 (1982): 278-81
  11. Pommer W, Krause PH, Berg PA, et al. "Acute interstitial nephritis and non-oliguric renal failure after cefaclor treatment." Klin Wochenschr 64 (1986): 290-3
  12. Guay DR, Meatherall RC, Harding GK, Brown GR "Pharmacokinetics of cefixime (CL 284,635; FK 027) in healthy subjects and patients with renal insufficiency." Antimicrob Agents Chemother 30 (1986): 485-90
  13. Dhib M, Moulin B, Leroy A, et al. "Relationship between renal function and disposition of oral cefixime." Eur J Clin Pharmacol 41 (1991): 579-83
  14. Shyu WC, Pittman KA, Wilber RB, et al. "Pharmacokinetics of cefprozil in healthy subjects and patients with renal impairment." J Clin Pharmacol 31 (1991): 362-71
  15. Humbert G, Leroy A, Fillastre JP, Godin M "Pharmacokinetics of cefadroxil in normal subjects and in patients with renal insufficiency." Chemotherapy 25 (1979): 189-95
  16. Leroy A, Humbert G, Godin M, Fillastre JP "Pharmacokinetics of cefadroxil in patients with impaired renal function." J Antimicrob Chemother 10 (1982): 39-46
  17. Kabins SA, Kelner B, Walton E, Goldstein E "Cephalexin therapy as related to renal function." Am J Med Sci 259 (1970): 133-42
  18. Kunin CM, Finkelberg Z "Oral cephalexin and ampicillin: antimicrobial activity, recovery in urine, and persistence in blood of uremic patients." Ann Intern Med 72 (1970): 349-56
  19. Yamasaku F, Tsuchida R, Usuda Y "A study of the kinetics of cephalosporins in renal impairment." Postgrad Med J Suppl (1970): 57-9
  20. Bailey RR, Gower PE, Dash CH "The effect of impairment of renal function and haemodialysis on serum and urine levels of cephalexin." Postgrad Med J 46 (1970): 60-4
  21. Regamey C, Humair L "Pharmacokinetics of cephalexin in renal insufficiency." Postgrad Med J 47 Supp) (1971): 69-77
  22. Reisberg BE, Mandelbaum JM "Cephalexin: absorption and excretion as related to renal function and hemodialysis." Infect Immun 3 (1971): 540-3
  23. Kirby WM, de Maine JB, Serrill WS "Pharmacokinetics of the cephalosporins in healthy volunteers and uremic patients." Postgrad Med J 47 Suppl (1971): 41-6
  24. Brogard JM, Pinget M, Dorner M, Lavillaureix J "Determination of cefalexin pharmacokinetics and dosage adjustments in relation to renal function." J Clin Pharmacol 15 (1975): 666-73
  25. Chow M, Quintiliani R, Cunha BA, et al. "Pharmacokinetics of high-dose oral cephalosporins." J Clin Pharmacol 19 (1979): 185-94
  26. Finkelstein ER, Quintiliani R, Nightingale CH "Pharmacokinetics of oral cephalosporins." J Pediatr 93 (1978): 902
  27. Andriole VT "Pharmacokinetics of cephalosporins in patients with normal or reduced renal function." J Infect Dis 137 (1978): s88-99
  28. Hori R, Okumura K, Nihira H, et al. "A new dosing regimen in renal insufficiency: application to cephalexin." Clin Pharmacol Ther 38 (1985): 290-5
  29. St Peter JV, Borin MT, Hughes GS, et al. "Disposition of cefpodoxime proxetil in healthy volunteers and patients with impaired renal function." Antimicrob Agents Chemother 36 (1992): 126-31
  30. Gibaldi M, Perrier D "Drug distribution and renal failure." J Clin Pharmacol 12 (1972): 201-4
  31. Hoffman TA, Cestero R, Bullock WE "Pharmacodynamics of carbenicillin in hepatic and renal failure." Ann Intern Med 73 (1970): 173-8
  32. Latos DL, Bryan CS, Stone WJ "Carbenicillin therapy in patients with normal and impaired renal function." Clin Pharmacol Ther 17 (1975): 692-700
  33. Arancibia A, Droguett MT, Fuentes G, et al. "Pharmacokinetics of amoxicillin in subjects with normal and impaired renal function." Int J Clin Pharmacol Ther Toxicol 20 (1982): 447-53
  34. Sjovall J, Westerlund D, Alvan G "Renal excretion of intravenously infused amoxycillin and ampicillin." Br J Clin Pharmacol 19 (1985): 191-201
  35. Jackson EA, McLeod DC "Pharmacokinetics and dosing of antimicrobial agents in renal impairment, part I." Am J Hosp Pharm 31 (1974): 36-52
  36. Bailey RR, Eastwood JB, Vaughan RB "The pharmacokinetics of an oral form of carbenicillin in patients with renal failure." Postgrad Med J 48 (1972): 422-5
  37. Nelson JD, Reimold EW "Carbenicillin pharmacokinetics in an anephric patient." Lancet 1 (1973): 486-7
  38. Nakano H, Sasaki K, Mizoguchi M, Ishibe T, Nihira H "Absorption and excretion of carbenicillin indanyl sodium in patients with reduced kidney function." Chemotherapy 23 (1977): 299-308
  39. Hoffler D, Koeppe P, Corcilius M, Przyklink A "Cefpodoxime proxetil in patients with endstage renal failure on hemodialysis." Infection 18 (1990): 157-62
  40. Yamasaku F, Tsuchida R, Usada Y "A study of the kinetics of cephalosporins in renal impairment." Postgrad Med J Suppl (1970): 57-9
  41. Standiford HC, Jordan MC, Kirby WM "Clinical pharmacology of carbenicillin compared with other penicillins." J Infect Dis 122 (1970): s9-13
  42. Andriole VT "Pharmacokinetics of cephalosporins in patients with normal or reduced renal function." J Infect Dis 137 (1978): s88-97
  43. Schwinghammer TL, Norden CW, Gill E "Pharmacokinetics of cephradine administered intravenously and orally to young and elderly subjects." J Clin Pharmacol 30 (1990): 893-9
  44. Solomon AE, Briggs JD "The administration of cephradine to patients in renal failure." Br J Clin Pharmacol 2 (1975): 443-8
  45. Neu HC "The pharmacokinetics of bacampicillin." Rev Infect Dis 3 (1981): 110-6
  46. Braga PC, Fraschini F, Ceccarelli G, Scaglione F, Scarpazza G "Clinical pharmacokinetic evaluation of bacampicillin." Clin Ther 4 (1981): 32-42
  47. DeSante KA, Zeckel ML "Pharmacokinetic profile of loracarbef." Am J Med 92 (1992): s16-9
  48. "Product Information. Polymox (amoxicillin)." Bristol-Myers Squibb, Princeton, NJ.
  49. "Product Information. Spectrobid (bacampicillin)." Roerig Division (2002):
  50. "Product Information. Geocillin (carbenicillin)." Roerig Division (2002):
  51. "Product Information. Ceclor (cefaclor)." Lilly, Eli and Company (2002):
  52. "Product Information. Duricef (cefadroxil)." Bristol-Myers Squibb (2002):
  53. "Product Information. Suprax (cefixime)." Lupin Pharmaceuticals Inc (2002):
  54. "Product Information. Vantin (cefpodoxime)." Pharmacia and Upjohn (2002):
  55. "Product Information. Cefzil (cefprozil)." Bristol-Myers Squibb (2002):
  56. "Product Information. Keflex (cephalexin)." Dista Products Company (2002):
  57. "Product Information. Velosef (cephradine)." Apothecon Inc (2002):
  58. "Product Information. Lorabid (loracarbef)." Lilly, Eli and Company (2002):
  59. Therasse DG, Farlow DS, Davidson RL, et al. "Effect of renal dysfunction on the pharmacokinetics of loracarbef." Clin Pharmacol Ther 54 (1993): 311-6
  60. Granero L, Gimeno MJ, Torresmolina F, Chesajimenez J, Peris JE "Studies on the renal excretion mechanisms of cefadroxil." Drug Metab Dispos 22 (1994): 447-50
  61. Hyslop DL "Cefaclor safety profile: a ten-year review." Clin Ther 11 Suppl A (1988): 83-94
  62. "Product Information. Amoxil (amoxicillin)." SmithKline Beecham (2001):
  63. "Product Information. Cedax (ceftibuten)." Schering-Plough (2001):
  64. Nix DE, Symonds WT, Hyatt JM, et al. "Comparative pharmacokinetics of oral ceftibuten, cefixime, cefaclor, and cefuroxime axetil in healthy volunteers." Pharmacotherapy 17 (1997): 121-5
  65. "Product Information. Omnicef (cefdinir)." Parke-Davis (2001):
  66. Guay DRP "Ceftibuten: A new expanded-spectrum oral cephalosporin." Ann Pharmacother 31 (1997): 1022-33
  67. "Product Information. Spectracef (cefditoren)." TAP Pharmaceuticals Inc (2001):

• Liver Diseases

  Moderate

  Cases of hepatitis have been reported with the use of certain cephalosporins. Transient rise in AST, ALT, and alkaline phosphatase levels have also been observed. Caution and monitoring is recommended when these agents are prescribed to patients with hepatic disorders.

  20 sources

  1. "Product Information. Vantin (cefpodoxime)." Pharmacia and Upjohn
  2. "Product Information. Ceclor (cefaclor)." Lilly, Eli and Company (2002):
  3. "Product Information. Duricef (cefadroxil)." Bristol-Myers Squibb (2002):
  4. "Product Information. Ancef (cefazolin)." SmithKline Beecham (2002):
  5. "Product Information. Kefzol (cefazolin)." Lilly, Eli and Company (2002):
  6. "Product Information. Suprax (cefixime)." Lupin Pharmaceuticals Inc (2002):
  7. "Product Information. Claforan (cefotaxime)." Hoechst Marion Roussel (2002):
  8. "Product Information. Cefotan (cefotetan)." Stuart Pharmaceuticals (2002):

  Show all 20 sourcesShow fewer sources

  9. "Product Information. Mefoxin (cefoxitin)." Merck & Co., Inc (2002):
  10. "Product Information. Cefzil (cefprozil)." Bristol-Myers Squibb (2002):
  11. "Product Information. Fortaz (ceftazidime)." Glaxo Wellcome (2002):
  12. "Product Information. Cefizox (ceftizoxime)." Fujisawa (2002):
  13. "Product Information. Ceftin (cefuroxime)." Glaxo Wellcome (2002):
  14. "Product Information. Zinacef (cefuroxime)." Glaxo Wellcome (2002):
  15. "Product Information. Keflex (cephalexin)." Dista Products Company (2002):
  16. "Product Information. Cedax (ceftibuten)." Schering-Plough (2001):
  17. "Product Information. Maxipime (cefepime)." Bristol-Myers Squibb (2001):
  18. "Product Information. Omnicef (cefdinir)." Parke-Davis (2001):
  19. "Product Information. Ceclor CD (cefaclor)." Dura Pharmaceuticals (2001):
  20. "Product Information. Spectracef (cefditoren)." TAP Pharmaceuticals Inc (2001):