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Key takeaways
Cephalexin, a broad-spectrum antibiotic approved for treating various infections, may not suit everyone due to potential side effects or allergies.
Alternatives to cephalexin include antibiotics such as amoxicillin, ampicillin, azithromycin, and fluoroquinolones, each tailored for specific infections and patient needs.
Due to the potential for serious side effects like allergic reactions, anemia, liver damage, and antibiotic resistance, your healthcare provider should carefully prescribe cephalexin and its alternatives, monitoring for side effects.
Natural remedies like honey, garlic, and oregano provide antimicrobial benefits against bacterial infections, though their effectiveness and safety require further research.
Cephalexin is a broad spectrum first generation cephalosporin antibiotic. The generic name for this medication is cephalexin, and the brand name is Keflex. It is administered by mouth and available in tablets, capsules, or oral suspension. The United States Food and Drug Administration (FDA) approves the use of cephalexin for the management of a variety of bacterial infections. Such infections include skin infections, kidney infections, ear infections, soft tissue infections, upper respiratory infections, and bone infections. Cephalexin is approved for use in both adults and children as young as 1 month. The antibiotic should not be used if there is a known allergy to other cephalosporins or a penicillin allergy. It is safe for prescribing to those who may be pregnant and breastfeeding. Both adults and pediatric patients can also take cephalexin.
Although cephalexin has many indications for use against infectious diseases, there are some side effects associated with the use of this antibiotic. Life-threatening reactions seen with use of cephalexin include hypersensitivity reaction, anaphylaxis, Stevens-Johnson syndrome, toxic epidermal necrolysis, erythema multiforme, anemia, nephritis, low red/white blood cells and platelets, low neutrophils in the blood, jaundice, and C. difficile-associated diarrhea. More common and less serious side effects seen are diarrhea, nausea, vomiting, recurring indigestion, gastritis, and abdominal pain.
RELATED: Antibiotics 101: What are they and why do we need them?
What can I take in place of cephalexin?
Not all medications work for everyone. Luckily there are several different antibiotic options available to treat bacterial infections if cephalexin does not provide the results desired or if unwanted side effects occur with use of this medication.
Compare cephalexin alternatives |
|||
|---|---|---|---|
| Drug name | Uses | Dosage | Savings options |
| Keflex
(cephalexin) |
|
1,000-4,000 mg per day by mouth divided every 6-12 hours | Keflex coupons |
| Amoxil, Moxatag
(amoxicillin) |
|
1,000-4,000 mg per day by mouth divided every 8-12 hours | Amoxicillin coupons |
| Augmentin
(amoxicillin clavulanate) |
|
1,000-4,000 mg per day by mouth divided every 8-12 hours | Augmentin coupons |
| Ampi
(ampicillin) |
|
14,000 mg maximum per day in injectable form divided every 4 hours | Ampicillin coupons |
| Unasyn
(ampicillin/sulbactam) |
|
12,000 mg maximum per day in injectable form divided every 6 hours | Unasyn coupons |
| Zithromax
(azithromycin) |
|
250-500 mg by mouth daily | Zithromax coupons |
| Cipro
(ciprofloxacin) |
|
200-750 mg by mouth every 12 hours
200-400 mg by injectable form every 12 hours |
Cipro coupons |
| Vibramycin
(doxycycline hyclate) |
|
For most conditions 100 mg capsule by mouth or intravenously twice a day | Doxycycline hyclate coupons |
| Ery-Tab
(erythromycin) |
|
1,000-4,000 mg by mouth per day divided every 6-12 hours | Erythromycin coupons |
| Primaxin
(imipenem/cilastatin) |
|
4,000 mg maximum per day in injectable form divided every 6 hours | Primaxin coupons |
| Levaquin
(levofloxacin) |
|
250-750 mg by mouth or injectable form once daily | Levofloxacin coupons |
| Solodyn
(minocycline) |
|
For most conditions 100 mg capsule or tablet by mouth twice a day | Minocycline coupons |
| Zosyn
(piperacillin/tazobactam) |
|
3.375-4.5 g by injectable form every 6 hours | Zosyn coupons |
| Bactrim
(sulfamethoxazole/trimethoprim) |
|
160 mg of trimethoprim by mouth or injectable form every 12 hours | Bactrim coupons |
| Sumycin
(tetracycline) |
|
For most conditions 125-250 mg capsule by mouth four times a day
*Syphilis: 500 mg capsule by mouth four times a day |
Tetracycline coupons |
Other alternatives to cephalexin
- Cefazolin (ancef)
- Avycaz (ceftazidime/ avibactam)
- Azactam (aztreonam)
- Bactocill (oxacillin)
- Biaxin (clarithromycin)
- Bicillin C-R (penicillin G benzathine/ penicillin G procaine)
- Bicillin L-A (penicillin G benzathine)
- Cayston (aztreonam inhaled)
- Ceclor (cefaclor)
- Spectracef (cefditoren pivoxil)
- Cefotan (cefotetan)
- Ceftin (cefuroxime axetil)
- Claforan (cefotaxime)
- Vantin (cefpodoxime proxetil)
- Cefzil (cefprozil)
- Dynapen (dicloxacillin)
- Duricef (cefadroxil)
- Fetroja (cefiderocol)
- Fortaz (ceftazidime sodium)
- Ivanz (ertapenem)
- Kefzol (cefazolin)
- Maxipime (cefepime)
- Mefoxin (cefoxitin)
- Merrem (meropenem)
- Nallpen (nafcillin)
- Omnicef (cefdinir)
- Pfizerpen (penicillin G sodium)
- Recarbrio (imipenem/ cilastatin/ relebactam)
- Rocephin (ceftriaxone)
- Suprax (cefixime)
- Tazicef (ceftazidime sodium)
- Teflaro (ceftaroline fosamil)
- Truxcillin VK (penicillin V potassium)
- Vabomere (meropenem/ vaborbactam)
- Vantin (cefpodoxime proxetil)
- Zerbaxa (ceftolozane/ tazobactam)
- Zinacef (cefuroxime sodium)
- Zosyn (piperacillin )
Top 5 cephalexin alternatives
The following are some of the most common alternatives to cephalexin.
1. Augmentin
Augmentin (amoxicillin clavulanate) is a combination antibiotic that includes amoxicillin (a penicillin antibiotic) and clavulanate potassium (a beta-lactamase inhibitor). If there is no known penicillin allergy, this medication can serve as an alternative to cephalexin. Augmentin is capable of treating a variety of bacterial infections such as Streptococcus (Strep) or Staphylococcus (Staph) aureus infections that impair the lungs, skin, ears, respiratory and urinary tract. Common side effects with its use are diarrhea, nausea, rash, itching, vomiting, black hairy tongue, and candidiasis. People with kidney disease, liver disease, or jaundice should avoid using Augmentin. It should also be avoided while breastfeeding as it can pass to the breast milk. Augmentin can also make birth control less effective so an alternative for birth control will need to be discussed with your healthcare provider. This antibiotic is safe to take in infants as young as 3 months and with adults as well.
2. Bactrim
Bactrim is a sulfonamide that contains both antibiotics sulfamethoxazole and trimethoprim. The generic name is sulfamethoxazole/trimethoprim, and Bactrim or Bactrim DS are the brand names. This medication can treat a variety of conditions such as ear infections, Pneumocystis jiroveci pneumonia, traveler’s diarrhea, bronchitis, and urinary tract infections. Bactrim is only advised when there is certainty that the correct bacteria is being treated and first line options have shown to be ineffective. This helps to eliminate antibiotic resistance. Complications seen with use of Bactim are liver damage, low red/white blood cells and platelets, kidney damage, meningitis, seizures, lupus erythematosus, and anemia. It is available as a tablet, oral suspension, and injectables but cannot be used while pregnant or breastfeeding. Bactrim can be used in pediatric cases as young as 2 months and adults.
3. Cipro
Cipro is a fluoroquinolone antibiotic and can be used as an alternative when cephalexin is not an option. Cipro is the brand name, and ciprofloxacin is the generic name of this antimicrobial medication. It can be used for a variety of infections including gastrointestinal infections, kidney infections, bone infections, and more serious infections such as anthrax, typhoid fever, and the plague. There are some serious side effects associated with the use of Cipro that sometimes may not be reversible. This is usually why this antibiotic is not a first line therapy. These serious reactions include anaphylaxis, severe allergic reaction (hives), severe vasculitis, superinfection, seizures, psychosis, depression, suicidality, liver damage, peripheral neuropathy, and tendon rupture. It can be prescribed as a tablet, oral suspension, or injectable form for both adults and pediatric patients. The extended-release options are for adults only.
4. Doxycycline
Doxycycline is a second generation tetracycline antibiotic that can be used in place of cephalexin when needed. Doxycycline is the generic name as there are several brand names available (Acticlate, Adoxa CK, Adoxa Pak, Adoxa TT, Alodox, Avidoxy, Doryx, Mondoxyne NL, Monodox, Morgidox, Okebo, Oracea, Oraxyl, Periostat Targadox, Vibramycin calcium, Vibramycin Hyclate, Vibramycin monohydrate, Vibra-Tabs). Indications for its use include gastro-intestional diseases, urinary tract infections, respiratory infections, sexual transmitted infections, and bacterial skin infections—acne is the most common. Some reactions when using this antibiotic include nausea, vomiting, diarrhea, vaginal itching and discharge, headache, abdominal pain, candidiasis, skin/tissue hyperpigmentation, and permanent/temporary tooth discoloration. Doxycycline cannot be used while pregnant or breastfeeding. It should be cautioned while using birth control, antacids, laxatives, or vitamin supplements. Dosage includes 100 mg given orally or intravenously twice a day.
5. Erythromycin
Erythromycin is a macrolide antibiotic which is also available as a cephalexin alternative. There are many brand names (E.E.S. Granules, EryPed, Ery-Tab, and Erythrocin) for the generic erythromycin antibiotic. Erythromycin has been approved to treat a variety of bacterial infections such as respiratory tract infections, skin infections, chlamydia infections, pelvic inflammatory disease, and syphilis. Side effects associated with its use includes nausea, vomiting, abdominal pain, diarrhea, jaundice, anorexia, and rash. More serious adverse effects include liver damage, hearing loss, and seizures. It does provide an antibiotic option for those who are pregnant or breastfeeding. Erythromycin is given orally in either a capsule, tablet, or oral suspension. It should also be closely monitored in patients with known heart disease, liver disease, and those with low potassium and magnesium blood levels.
Natural alternatives to cephalexin
With the rise of antibiotic resistance in bacteria, holistic remedies are being looked at as alternatives to fight against bacterial infections. There are naturally occurring compounds that are shown to slow or even kill the spread of bacteria, viruses, and parasites that are also found over-the-counter. Examples include honey, garlic, oregano, thyme, myrrh extract, echinacea, goldenseal, and turmeric.
Raw honey has been around for centuries. There has been research that shows it is effective for healing wounds and drawing out infection. Honey can be used directly to the infected site or ingested. Apple cider vinegar is another natural remedy known for its antimicrobial properties. Research shows that it may fight against minor Candida albicans, Escherichia coli, and Staphylococcus aureus infections. Because natural antibiotics have not been fully studied, it is best to discuss using these alternatives with your healthcare provider. They may want to monitor the bacterial infection closely to ensure it is healing properly with these alternatives.
RELATED: Why you should take probiotics with antibiotics
How to switch to a cephalexin alternative
Abruptly stopping antibiotics—such as cephalexin—without proper guidance from your healthcare provider may cause the infection to return or cause the symptoms to get worse. Before you discontinue your cephalexin, get proper medical advice and instructions from your physician. Another antibiotic will likely need to be substituted. If this is the case, SingleCare coupons may help with purchasing your new antibiotic at a lower cost.