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Suprax (cefixime) vs. Keflex (cephalexin) Antibiotic Side Effects

Suprax (cefixime) vs. Keflex (cephalexin): What’s the difference?

What are Suprax and Keflex?

Suprax is a cephalosporin antibiotic used to treat middle ear infections (otitis media), tonsillitis, throat infections (pharyngitis), laryngitis, bronchitis, pneumonia, urinary tract infections (UTIs), gonorrhea, and acute bacterial bronchitis in patients with chronic obstructive pulmonary disease (COPD). Other cephalosporin antibiotics include cephalexin (Keflex), cefpodoxime (Vantin), cefaclor (Ceclor), cefuroxime (Zinacef), cefprozil (Cefzil), and injectable forms. Cephalosporins stop bacteria from multiplying by preventing bacteria from forming the walls that surround them that are necessary to protect bacteria from their environment and to keep the contents of the bacterial cell together. Bacteria cannot survive without a cell wall. Suprax is active against a wide variety of bacteria such as Streptococcus pneumoniae, Streptococcus pyogenes (the cause of strep throat), Staphylococcus aureus, Hemophilus influenzae, Moraxella catarrhalis, E. coli, Klebsiella, Proteus mirabilis, Shigella, Salmonella, and Neisseria gonorrhoeae.

Keflexis a cephalosporin antibiotic used to treat middle ear infections (otitis media), tonsillitis, throat infections, laryngitis, bronchitis, pneumonia, urinary tract infections (UTIs), skin infections, and bone infections. Cephalosporins stop or slow the growth of bacterial cells by preventing bacteria from forming the cell wall that surrounds each cell. The cell wall protects bacteria from the external environment and keeps the contents of the cell together, and without a cell wall, bacteria are not able to survive. Bacteria susceptible to Keflex include Staphylococcus aureus, Streptococcus pneumoniae, Haemophilus influenzae, E. coli, and others.


Bowel regularity means a bowel movement every day.
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What are the side effects of Suprax and Keflex?


Common side effects of Suprax include:

Other side effects include:


The most common side effects of Keflex are:

Individuals who are allergic to penicillin may also be allergic to Keflex. Serious but rare reactions include seizures, severe allergic reactions (anaphylaxis), and low platelet or red blood cell count.

Keflex, like almost all antibiotics, may cause mild or severe cases of pseudomembranous colitis, a mild to severe inflammation of the colon. Antibiotics, including Keflex, alter the types of bacteria in the colon and permit overgrowth of a bacterium called Clostridium difficile. Studies indicate that toxins produced by Clostridium difficile are a primary cause of pseudomembranous colitis.

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What is the dosage of Suprax vs. Keflex?


  • The recommended adult dose for otitis media, tonsillitis, pharyngitis, and urinary tract infections is 400 mg once daily or divided and given as 200 mg every 12 hours.
  • Pediatric patients (6 months and older) have a recommended dose of 8 mg/kg/day once daily or in two doses of 4/mg/kg every 12 hours.


  • The dose of Keflex for adults is 1 to 4 grams in divided doses.
  • The usual adult dose is 250 mg every 6 hours.
  • Some infections may be treated with 500 mg every 12 hours.
  • Children are treated with 25-100 mg/kg/day in divided doses.
  • The dosing interval may be every 6 or 12 hours depending on the type and seriousness of the infection.

What drugs interact with Suprax and Keflex?


Probenecid (Benemid) may increase the blood concentration of Suprax by decreasing the kidney's ability to remove Suprax. This interaction sometimes is used to enhance the effect of cephalosporins.

Combining Suprax with aminoglycosides — for example, tobramycin (Tobradex) — produces additive bacterial killing effects but also may increase the risk of harmful effects to the kidney.

Exenatide (Byetta) may delay or reduce the absorption of cephalosporins. Cephalosporins should be administered one hour before exenatide.

Suprax may cause a false positive urine ketone test.


Keflex may reduce the effect of the Bacille Calmette-Guérin (BCG) tuberculosis vaccine and typhoid vaccine. Keflex should not be combined with BCG or typhoid vaccines unless there are no other options.

Are Suprax and Keflex safe to use while pregnant or breastfeeding?


Safety in pregnancy has not been established for Suprax. There are no adequate studies in pregnant women; however, studies in animals suggest no important effects on the fetus.

Safety in nursing mothers has not been established. It is not known if Suprax is excreted in breast milk.


Keflex is excreted in breast milk. Stop Keflex use or use with caution when breastfeeding.


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