The Basics
What is Cephalexin?
Used to treat certain infections caused by bacteria such as pneumonia and other respiratory tract infections; and infections of the bone, skin, ears, , genital, and urinary tract.
Brand names for Cephalexin
Keflex
How Cephalexin is classified
Anti-Infective Agents, Antibacterial Agents, Cephalosporins
Cephalexin During Pregnancy
Cephalexin pregnancy category
Category BNote that the FDA has deprecated the use of pregnancy categories, so for some medications, this information isn’t available. We still think it’s useful to list historical info, however, given what a common proxy this has been in the past.
What we know about taking Cephalexin while pregnant
There are no adequate and well-controlled studies in pregnant women. Because animal reproduction studies are not always predictive of human response, this drug should be used during pregnancy only if clearly needed. Reproduction studies have been performed on mice and rats using oral doses of cephalexin monohydrate 0.6 and 1.5 times the maximum daily human dose (66 mg/kg/day) based upon body surface area basis, and have revealed no evidence of impaired fertility or harm to the fetus.
Taking Cephalexin While Breastfeeding
What are recommendations for lactation if you're taking Cephalexin?
Limited information indicates that maternal cephalexin produces low levels in milk that are usually not expected to cause adverse effects in breastfed infants. Cephalexin is an alternative for the treatment of mastitis.[1][2] Occasionally disruption of the infant’s gastrointestinal flora, resulting in diarrhea or thrush have been reported with cephalosporins, but these effects have not been adequately evaluated. A rare case of a severe allergic reaction occurred in an infant previously exposed to intravenous cefazolin whose mother began taking cephalexin whie breastfeeding. Cephalexin is acceptable in nursing mothers.
Maternal / infant drug levels
Limited information indicates that maternal cephalexin produces low levels in milk that are usually not expected to cause adverse effects in breastfed infants. Cephalexin is an alternative for the treatment of mastitis.[1][2] Occasionally disruption of the infant’s gastrointestinal flora, resulting in diarrhea or thrush have been reported with cephalosporins, but these effects have not been adequately evaluated. A rare case of a severe allergic reaction occurred in an infant previously exposed to intravenous cefazolin whose mother began taking cephalexin whie breastfeeding. Cephalexin is acceptable in nursing mothers.
Possible effects of Cephalexin on milk supply
Relevant published information was not found as of the revision date.
Possible alternatives to Cephalexin
(Mastitis) Dicloxacillin; (Methicillin-resistant Staph. aureus) Doxycycline, Linezolid, Minocycline, Trimethoprim-Sulfamethoxazole, Vancomycin.
List of References
Lactation sources: Drugs and Lactation Database (LactMed) [Internet]. Bethesda (MD): National Library of Medicine (US); 2006-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK501922/1. Amir LH. ABM clinical protocol #4: Mastitis, revised March 2014. Breastfeed Med. 2014;9:239-43. PMID: 24911394
2. Berens PD. Breast pain: Engorgement, nipple pain, and mastitis. Clin Obstet Gynecol. 2016;58:902-14. PMID: 26512442
3. Kafetzis DA, Siafas CA, Georgakopoulos PA et al. Passage of cephalosporins and amoxicillin into the breast milk. Acta Paediatr Scand. 1981;70:285-8. PMID: 7246123
4. Matsuda S. Transfer of antibiotics into maternal milk. Biol Res Pregnancy. 1984;5:57-60. PMID: 6743732
5. Ilett KF, Hackett LP, Ingle B et al. Transfer of probenecid and cephalexin into breast milk. Ann Pharmacother. 2006;40:986-9. PMID: 16551765
6. Ito S, Blajchman A, Stephenson M et al. Prospective follow-up of adverse reactions in breast-fed infants exposed to maternal medication. Am J Obstet Gynecol. 1993;168:1393-9. PMID: 8498418
7. Benyamini L, Merlob P, Stahl B et al. The safety of amoxicillin/clavulanic acid and cefuroxime during lactation. Ther Drug Monit. 2005;27:499-502. PMID: 16044108
8. Chu YN, Lee MS, Yang SC et al. Toxic epidermal necrolysis in an infant induced by drug intake through breast milk. Dermatologica Sinica. 2019;37:86-9. DOI: doi:10.4103/ds.ds_12_18
Disclaimer: This material is provided for educational purposes only and is not intended for medical advice, diagnosis, or treatment. Consult your healthcare provider with any questions.
