Can You Drink Alcohol With Cephalexin?

It’s tough when a urinary tract infection disrupts your routine. It seems like those ultra-uncomfortable, ice-pick-painful symptoms find you at the worst possible moments — moments when you’re stressed and stretched thin.

When you finally carve out an hour for urgent care, the doctor asks you a few quick questions. She collects a urine sample before calling in a prescription.

When you pick up the pills, you see an unfamiliar name on the label: cephalexin. How is this drug going to affect your plans? You find yourself thinking about the upcoming weekend. What about your second date at that pop-up bar? Can you drink alcohol with cephalexin?  

Cephalexin Uses, Side Effects, and Contraindications

Cephalexin belongs to a class of medications known as cephalosporin antibiotics, which work by destroying bacteria in the body. It is available under the brand names Daxbia, Keflex, Biocef, and Keftab, among others. Let’s explore this drug’s purpose, primary side effects, and interactions with other substances.

What Is Cephalexin Prescribed For?

Doctors prescribe cephalexin for bacterial infections, including pneumonia, upper respiratory infections (URIs), and urinary tract infections (UTIs). It’s also used when bacteria take up residence in the skin, ears, genitals, and bones. We may have received a cephalexin prescription after contracting certain strains of staph (Staphylococcus aureus) or strep (Streptococcus pyogenes).

It comes in one of three forms: a tablet, a capsule, or a liquid suspension. We’ll need to take it as prescribed; usually, that’s once every six to 12 hours. We’ll want to continue taking this medication until we run out of it, even if our symptoms resolve within the first few days. Quitting earlier may place us at risk of a rebound infection.

Contrary to popular belief, antibiotics like cephalexin don’t work on viral illnesses like the common cold or the flu. Using these drugs unnecessarily can increase antibiotic resistance, which makes these medications less effective over time.

Side Effects of Cephalexin

Fortunately, most of us will probably tolerate cephalexin very well. The most common side effect is diarrhea, followed by headache, nausea, and unusual vaginal discharge. In some cases, we might feel fatigued, confused, or agitated. If you have any of these symptoms for more than two days (or if they are particularly severe), reach out to your care team.

In rare cases, some people experience flu-like symptoms, including chills, stomach pain, dizziness, and fever. If you experience an allergic or severe skin reaction — characterized by itching, a rash, blisters, peeling of the skin, difficulty breathing, bloody stools, hallucinations, or swollen lymph nodes — seek emergency medical attention.

It is worth noting that those of us with diabetes may get false positive tests for sugar in our urine while taking this drug. We should talk to our doctor about this if it occurs; ideally, they’ll let us know what to expect before we fill the script.

Contraindications: What Can You Not Take With Cephalexin?

Cephalexin won’t work for everyone. We should not take this drug if we have a penicillin allergy, which may make us more likely to experience adverse effects. We’ll also want to tell our healthcare provider about any medications, vitamins, and supplements we’re currently taking, as this drug tends to interact with metformin and probenecid.

• Metformin. This drug is especially important to those of us with diabetes because it controls the level of sugar in our blood. Taking cephalexin while on this medication can increase the amount of metformin in our blood by decreasing the amount processed by our kidneys. Liquid cephalexin might also contain sugar. For these reasons (among others), we should always tell our doctor whether we are diabetic.
• Probenecid. Used to treat chronic gout and gout-related arthritis, probenecid alters the amount of uric acid in our blood. Taking this drug alongside cephalexin dramatically increases our cephalexin exposure. In some patients, that’s ideal — in others, it’s a serious detriment. Let your doctor know if you’re taking metformin, probenecid, or any other prescription drug.

When asking, “What can you not take with cephalexin?”, we want to remember that this drug can seriously interact with supplements. We should avoid taking any zinc while on this medication. Zinc interferes with the absorption of cephalexin, reducing its concentration in the bloodstream and rendering it less effective. Pro tip: Check your multivitamin for zinc or bring it to your doctor’s appointment before starting cephalexin.

If this antibiotic interacts with popular prescription drugs and over-the-counter vitamins, will drinking alcohol affect its efficacy?

Can You Drink on Cephalexin?

Some cephalosporin antibiotics react strongly with alcohol. For example, mixing cefotetan or cefoperazone with a few after-work cocktails can result in gastrointestinal or cardiac distress. Symptoms include irregular heartbeat, blood pressure changes, severe nausea, and vomiting. However, this isn’t the case for all antibiotics. So, can you drink on cephalexin?

Technically, it’s safe to drink on cephalexin. We won’t experience the host of uncomfortable (or life-threatening) symptoms we might usually associate with antibiotics and alcohol. However, that doesn’t mean it’s a good idea to imbibe while taking this medication.

Potential Interactions Between Cephalexin and Alcohol

Cephalexin and alcohol interact in three key ways. If we drink on cephalexin, we may deal with worse side effects, a weakened immune system, and a longer recovery time. Here’s how it works:

• Alcohol may intensify cephalexin’s side effects. Drinking while on cephalexin can worsen the discomfort associated with this drug. Side effects like indigestion, nausea, and other gastrointestinal issues may be heightened when we add alcohol to the equation.
• Drinking suppresses our immune system. Any time we drink, we channel our inner Meryl Streep from The Devil Wears Prada. We dump our coat and bag on our liver’s desk and tell it to drop whatever it’s doing to process that glass of wine. As we can imagine, that’s bad for our health — especially when our liver is doing its best to work through antibiotics, toxins, and all the other stuff that comes with being sick.
• Alcohol may prolong our illness. Drinking can aggravate the issues that inspired us to seek medical attention in the first place, especially if we’re suffering from UTIs. The continued consumption of alcohol with cephalexin can create a cycle of symptoms.

So while it’s not necessarily dangerous to mix cephalexin and alcohol, it is certainly not beneficial.

How Long After Taking Cephalexin Can You Drink Alcohol?

If we want to avoid the interactions outlined above, we’ll probably want to abstain. Most of us will be on this medication for a maximum of 10 days, which isn’t long in the grand scheme of things. Consider framing this time as a break from hangovers while you focus on getting well. Plan to wait at least eight hours after your last dose of cephalexin to drink again.

Alcohol and UTIs

While drinking doesn’t directly cause UTIs, heavy drinking creates a perfect environment where these nasty infections can thrive.

Alcohol is a diuretic, which means it increases our urinary frequency. The more we use the bathroom, the more likely we are to become dehydrated, especially if we’re under the influence. The resulting dehydration can worsen our UTI symptoms, weaken our immune system, and make it more difficult for our body to overcome an existing infection, even if we’re already taking medication. Sound familiar?

Furthermore, alcohol is pretty acidic. This makes it especially irritating for the delicate tissue lining the inside of our bladder (which is already going through a lot!). Even when we’re healthy, heavy alcohol exposure and its associated inflammation can lead to a form of bladder discomfort known as cystitis. Unfortunately, the symptoms of alcohol-induced cystitis and UTIs are almost indistinguishable, making future diagnosis difficult.

All this is to say: if we’re taking cephalexin for a UTI or any other infection, we may want to rethink those drinks.

Alcohol-Free Options While on a Cephalexin Regimen

We can still enjoy ourselves while bouncing back from bacterial infections. Below are a few boozeless beverages for those of us avoiding alcohol on cephalexin.

• Water, water, everywhere. This is always our #1 recommendation, especially while taking antibiotics. But it doesn’t have to be boring! Sure, you could break out the Brita, but consider treating yourself to sparkling water, aguas frescas, or other restorative favorites.

• Herbal tea, anyone? Caffeine-free herbal teas like chamomile and peppermint can be especially soothing when we’re ill. Widely available variants like lemon ginger, lavender stress relief, and honey chai offer us the opportunity to combine mindfulness with hydration. If you’ve got a UTI, opt for green tea, which may have antimicrobial benefits.

• Fruit juice (diluted, please!). Whether you’re a fan of fresh-squeezed OJ or just need to work through that carton of cranberry juice in the refrigerator door, juices can be a vitamin-rich alcohol alternative. Watering them down lowers their calorie content and sugar concentration, making them balanced options during an illness. Note: Steer clear of grapefruit juice, which can make antibiotics less effective.

• Try non-alcoholic beer, wine, or liquor. If you’re missing the real thing, try the virgin version. Alcohol-free alternatives have gained serious momentum since the COVID-19 pandemic. You can grab these at your local grocery store or special order them online.

• Cheers to healthy mocktails. Make your favorite craft cocktail, minus the booze, whenever you want to feel fancy on cephalexin. Need a little inspiration? Consider these refreshing recipes from the Reframe team.

We hope these spirit-free sips bring you joy in the days ahead. Remember to check with a healthcare professional before altering your diet, especially if you’ve been prescribed a new medication.

In-App Inspiration 

If you’re struggling to take a break from drinking, you’re not alone. It can be difficult to stay substance-free for the days or weeks it takes to battle an infection. If you need help staying on track, consider seeking support from Reframe during your course of cephalexin.

Reframe is a habit-cessation app powered by neuroscience. Our team includes recovery experts, academics, psychologists, and more. The proof is in our data — we’ve helped millions of people change their drinking habits for the better. To learn more, visit the App Store or Google Play today.