Cipro, XR (ciprofloxacin) vs. Keflex (cephalexin) differences

What is Cipro? What is Keflex? Are they the same?

Cipro (ciprofloxacin) is a type of fluoroquinolone antibiotic that is used for the treatment of bacterial infections. Cipro stops the multiplication of bacteria by inhibiting the reproduction and repair of their genetic material (DNA). Other fluoroquinolones include levofloxacin (Levaquin), ofloxacin (Floxin), gatifloxacin (Tequin), norfloxacin (Noroxin), moxifloxacin (Avelox), and trovafloxacin (Trovan).

Keflex (cephalexin) belongs to a class of antibiotics called cephalosporins. They are similar to penicillin in action and side effects. They stop or slow the growth of bacterial cells by preventing bacteria from forming and multiplying in the cell wall that surrounds each cell (called cell wall synthesis), which can lead to the destruction of the cell wall. 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 that are susceptible to cephalexin include Staphylococcus aureus, Streptococcus pneumoniae, Haemophilus influenzae, E. coli, and several others.

What are the uses for Cipro and Keflex?

Cirpo uses

Doctors and other healthcare professionals prescribe Cipro and Cipro XR to treat bacterial infections, for example:

  • Skin infections
  • Lung or airway Infections, for example, TB (tuberculosis), pneumonic and septicemic plague due to Yersinia pestis (Y. pestis), lower respiratory tract infections, and chronic bronchitis)
  • Bone infections
  • Joint infections
  • Urinary tract infections (UTI) caused by certain bacteria such as E. coli.
  • Infectious diarrheas caused by E. coli, Campylobacter jejuni, and Shigella bacteria.
  • Anthrax patients with fever and low white blood cell counts, and intra-abdominal infections.
  • Typhoid fever
  • Cervical and urethral gonorrhea due to Neisseria gonorrhoeae
  • Chronic bacterial prostatitis
  • Acute uncomplicated cystitis

Are there infections that should not be treated with Cipro?

Because of serious side effects associate with fluoroquinolones they should not be used for treating certain infections unless there are no other alternatives, and include:

  • Uncomplicated urinary tract infections (UTI)
  • Acute bacterial exacerbation of chronic bronchitis
  • Acute bacterial sinusitis

Keflex uses

Cephalexin is used to treat infections caused by bacteria that are susceptible to the effects of cephalexin. Common infections treated with cephalexin include:

What are the differences in the side effects of Cipro vs. Keflex?

Cipro side effects

The most common side effects of Cipro and Cipro XR include:

Serious side effects adverse reactions of Cipro

Cipro and Cipro XR as well as other antibiotics in the fluoroquinolone class of antibiotics has been associated with tendonitis and even tendon rupture, particularly the Achilles tendon. Some doctors and other medical professionals recommend that their patients discontinue vigorous exercise while they are taking fluoroquinolone antibiotics.

Fluoroquinolones have neuromuscular blocking activity and can worsen muscle weakness in individuals with myasthenia gravis.

Anaphylaxis, or shock, is a rare allergic reaction to this drug. This allergic reaction is a medical emergency and you are experiencing these symptoms seek medical immediately. Symptoms of shock include:

Other possible serious side effects of Cipro and Cipro XR include:

Cipro, Cipro XR should be avoided in children and adolescents less than 18 years of age, as safe use in these patients has not been established.

Many antibiotics, including Cipro, Cipro XR, can alter the normal bacteria in the colon and encourage overgrowth of a bacterium responsible for the development of inflammation of the colon, (C. difficile or pseudomembranous colitis). Patients who develop signs and symptoms of pseudomembranous colitis, for example, diarrhea, fever, abdominal pain, and possibly shock after starting Cipro or Cipro XR should contact their doctor immediately.

Keflex side effects

The most common side effects of cephalexin include:

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

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

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What are the differences in the strengths and dosages of Cipro vs. Keflex?

Cipro dosage

  • For most infections the recommended oral dose for adults is 250-750 mg (immediate release tablets) every 12 hours or 500-1000 mg (extended release tablets) every 24 hours.
  • The usual intravenous dose is 200-400 mg every 8-12 hours.

Cipro doses are available in strengths as:

  • Tablets: 250, 500, and 750 mg.
  • Tablets extended release (XR): 500 and 1000 mg.
  • Microcapsules for suspension: 250 mg/5 ml, 500 mg/5 ml.
  • Injection or Injection concentrate: 200 mg/100 ml, 200 mg/20 mg, 400 mg/200 ml, 400 mg/40 ml.

Keflex dosage

  • The dose of cephalexin 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.

Keflex doses are available in strengths as:

  • Tablets of 250 and 500 mg.
  • Capsules: 250, 500, and 750 mg.
  • Powder for Suspension: 125 and 250 mg/5 ml.

What drugs interact with Cipro and Keflex?

Cipro drug interactions

  • Ciprofloxacin administered together with theophylline (Respbid, Slo-Bid, Theo-24, Theolair) can lead to elevated, toxic blood levels of theophylline. Theophylline is used to open airways in the treatment of asthma. Toxic levels of theophylline can lead to seizures, and disturbances in heart rhythm. If concurrent use of ciprofloxacin and theophylline cannot be avoided, frequent blood tests to monitor theophylline blood levels are recommended.
  • Ciprofloxacin increases the effect of tizanidine (Zanaflex) that is used to treat muscle spasticity. Therefore, the two drugs should not be combined.
  • Iron salts (for example, ferrous sulfate) may reduce the absorption of ciprofloxacin because of formation of a ciprofloxacin-iron complex that is not absorbable. Antacids also may reduce the absorption of ciprofloxacin. If patients are receiving iron salts or antacids and ciprofloxacin, the ciprofloxacin should be given two hours before or six hours after the iron salt or antacid.
  • Ciprofloxacin may increase the blood thinning effect of warfarin (Coumadin, Jantoven). The reason for this is unknown. Anticoagulant activity should be monitored after starting or stopping ciprofloxacin.
  • Sevelamer (Renagel) may reduce the absorption of ciprofloxacin and possibly reduce the effectiveness of ciprofloxacin. Milk and orange juice also may reduce the absorption of ciprofloxacin. Ciprofloxacin, as with iron and antacids, should be given two hours before or six hours after milk or orange juice.
  • Administration of ciprofloxacin with diabetic medications (for example glyburide [Micronase, Diabeta, Glynase, Prestab]) may lead to severe low blood glucose.
  • Ciprofloxacin may increase blood concentrations of sildenafil (Viagra) that is used for treating erectile dysfunction. This combination should be avoided if possible.
  • Patients taking Cipro, Cipro XR can develop sensitivity of the skin to direct sunlight (photosensitivity) and should avoid exposure to sunlight or use sunblock.
  • Fluoroquinolones worsen low blood glucose levels when combined with sulfonylureas, for example, glyburide (Micronase, Diabeta, Glynase, Prestab).

Keflex drug interactions

Cephalexin may reduce the effect of BCG and typhoid vaccines. Cephalexin should not be combined with BCG or typhoid vaccine unless there are no other options.

Is it safe to take Cipro or Keflex if I am pregnant or breastfeeding?

Cipro safety

Cephalexin is excreted in breast milk. Cephalexin should be used with caution or stopped when breastfeeding.

Keflex safety

Doctors suggest that should not use this antibiotic if you are pregnant or breastfeeding because they do not know if it is safe.

Summary

Cipro, generic name ciprofloxacin, and Keflex, generic name cephalexin, are antibiotics that belong to different drug classes. Cipro is a type of fluoroquinolone and Keflex is a type of penicillin. Cipro and Keflex can cause similar side effects like abdominal pain, diarrhea, nausea, vomiting, headache, and skin rashes.

Keflex has fewer serious side effects than Cipro, for example, anaphylaxis, a type of severe allergic reaction. Cipro and Keflex both can cause a serious infection with C. difficile, which causes severe, chronic diarrhea and may lead to pseudomembranous colitis. Cipro has many serious side effects, for example, Achilles tendon rupture, peripheral nerve pain, CNS problems, high blood sugar, abnormal heart rhythms, hepatitis, yellowing of the skin and eyes (jaundice), liver failure, acute kidney failure, cardiac arrest, and respiratory failure.

Cipro and Keflex are used to treat bacterial infections, for example, infections of the ears, skin, bone, urinary tract, and C. difficile (infectious diarrhea). Cipro also is used for the treatment of lower respiratory infections, sinusitis, chronic prostatitis, TB, typhoid fever, cystitis, the plague, anthrax poisoning, and bronchiectasis. Keflex also is used for the treatment of infections of the middle ear, tonsils (tonsillitis), bronchioles (bronchitis), laryngitis (larynx), and lungs (pneumonia).

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Medically Reviewed on 2/26/2018
References
REFERENCE: FDA Prescribing Information.
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