Keflex generic: Availability, cost, and more

In this article:

• Why was Keflex discontinued?
• What are the differences between brand-name and generic Keflex?
• Keflex (cephalexin) warnings and side effects
• How much does cephalexin cost without insurance?
• What are the off-label uses for cephalexin?

In this article

• Why was Keflex discontinued?
• What are the differences between brand-name and generic Keflex?
• Keflex (cephalexin) warnings and side effects
• How much does cephalexin cost without insurance?
• What are the off-label uses for cephalexin?

Keflex (cephalexin) is an antibiotic that treats many different types of infections in the body. It’s a first-generation cephalosporin antibiotic, which means it was one of the first drugs developed in this category. It was approved by the Food and Drug Administration in 1970, but as a brand-name drug, Keflex was gradually discontinued in its various forms and dosages. 

However, the generic version is still widely prescribed today and is approved for use in treating infections of the respiratory tract, bone, skin, ears, genitals, and urinary tract. Here’s what to know if you’re prescribed this popular antibiotic.

Why was Keflex discontinued? 

The specific reason for Keflex’s discontinuation wasn’t given, but the FDA determined that it wasn’t for any reasons related to the drug’s safety or efficacy. Most likely, a combination of marketing and manufacturing issues played a role, or it simply became more cost-effective to only produce the generic version of Keflex.

What are the differences between brand-name and generic Keflex?

Brand-name and generic drugs are the same in all the ways that matter. They contain the same active ingredients and are equally safe and effective. But generic drugs are usually cheaper than brand-name drugs and may be more affordable for consumers.

According to Katina Hope, MD, a family medicine physician with Village Medical, there were no notable differences between Keflex and cephalexin before the brand name was discontinued. “They had the same mechanism of action, contained the same active ingredient, had the same side effects, and were both used to treat a myriad of bacterial infections.”

“However, sometimes generic drugs differ from brand-name drugs in other ways,” says Erika Gray, Pharm.D., cofounder of Toolbox Genomics, including their inactive ingredients, color, or taste. This could affect how some consumers tolerate the generic version versus the brand-name, but not their overall effectiveness.  

Keflex (cephalexin) warnings and side effects
	Keflex (cephalexin)
Uses	Respiratory tract infections; bone, skin, ear, and genital infections; and urinary tract infections (UTI)
Standard dosage	Adults: 250 mg or 500 mg   Children under 15 and over 1 year of age: 25 to 100 mg
Common side effects	Nausea; vomiting; heartburn; gastritis; abdominal pain; genital itching; dizziness; headache
Contraindications	Do not take Keflex if you are allergic to cephalexin Use with caution if you are also taking blood thinners, metformin, or zinc, per Dr. Hope, because of the risk for drug interactions
Other considerations	Keflex can cause Clostridium difficile-associated diarrhea, a severe and potentially life-threatening illness Pregnant and nursing women should discuss the risks and benefits of taking cephalexin with their provider

How much does cephalexin cost without insurance?

Without insurance, a 28-capsule prescription for 500 milligrams of cephalexin could cost around $45. With a SingleCare coupon for cephalexin, that price could drop to just $10.

What are the off-label uses for cephalexin? 

Cephalexin has a long success rate in treating the infections it’s approved for, including middle ear infections, soft tissue infections, strep throat, and UTIs. It can also be used off-label for a few other purposes. 

Prophylactic use

Dr. Gray says cephalexin can be used as a prophylactic antibiotic in people with certain cardiac conditions having dental or respiratory tract procedures to prevent a bacterial infection of the heart valve. Although some people who are allergic to penicillin are also allergic to cephalosporin antibiotics, cephalexin can be a safe alternative for some people with a penicillin allergy.

Joint infections

Though not specifically listed as an approved use, Dr. Hope says cephalexin can be used to treat some types of joint infections. Research shows that cephalexin penetrates joint tissue well and could be used to treat joint infections caused by certain types of bacteria.

Dr. Gray says cephalexin can also be used to manage joint infections after joint replacement surgery, including when long-term use of antibiotics is needed because a second surgery to remove infected tissues isn’t feasible.

Diabetic foot ulcers

Foot ulcers and infections are common in people with diabetes. Dr. Hope says cephalexin can be used to treat these infections, especially when they are caused by common strains of Staphylococcus bacteria. 

Bottom line

Keflex is a cephalosporin antibiotic that effectively treats most respiratory tract, skin, bone, ear, genital, and urinary tract infections. Since its approval, Keflex has been discontinued in favor of the generic version of the drug, cephalexin, which is commonly prescribed. As with all antibiotics, Dr. Gray says it’s important to complete the full course of cephalexin prescribed to you to prevent antibiotic resistance.