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Compare Macrobid vs. Keflex

Head-to-head comparisons of medication uses, side effects, warnings, and more.

Key takeaways

Nitrofurantoin (Macrobid) and cephalexin (Keflex) are both antibiotics, but they belong to different classes and treat infections differently. Nitrofurantoin is a nitrofuran antibiotic primarily used to treat or prevent urinary tract infections (UTIs) by targeting bacteria in the urinary tract. Cephalexin, a cephalosporin antibiotic, treats a broader range of infections, including UTIs, respiratory tract infections, ear infections, and skin infections, by preventing bacteria from forming protective coverings. Nitrofurantoin is typically taken with food to improve absorption and reduce stomach upset, while cephalexin can be taken with or without food. Nitrofurantoin is not recommended for use in the last weeks of pregnancy, whereas cephalexin is generally considered safe during pregnancy. Both medications are available in generic forms, making them more affordable. However, nitrofurantoin is not suitable for people with severe kidney problems, while cephalexin may not be recommended for those with severe allergies to penicillin or other cephalosporin antibiotics.

  • Nitrofurantoin (Macrobid)
    Cephalexin
  • Nitrofurantoin (Macrobid)
    Cephalexin

  • Summary of Macrobid vs. Keflex

    Summary for Nitrofuran antibiotic
    Prescription only

    Nitrofurantoin (Macrobid) is an antibiotic used to treat or prevent a urinary tract infection (UTI). Some side effects include nausea, headache, and gas. It can also make your urine turn dark yellow or brown. Nitrofurantoin (Macrobid) doesn't have many interactions with other medications. There's a lower-cost generic version of nitrofurantoin (Macrobid) available.

    Summary for Cephalosporin antibiotic
    Prescription only

    Cephalexin is a common antibiotic that's used to treat many different bacterial infections including urinary tract infections (UTIs), ear infections, and sinus infections, to name a few. Cephalexin is a cephalosporin antibiotic that kills bacteria to fight the infection. It's safe to use in people over the age of 1, and it's typically taken by mouth 2 to 4 times per day. This medication is available as a lower-cost generic capsule, tablet, and suspension; the brand name Keflex is no longer available. Side effects can include nausea, vomiting, and diarrhea.

  • Indications of Macrobid vs. Keflex

    Indications for
    •Treatment or prevention of urinary tract infections
    Indications for
    •Respiratory tract infections
    •Ear infections
    •Skin infections
    •Bone infections
    •Urinary tract infections (UTIs)
    •Reproductive system infections

  • Pros and Cons of Macrobid vs. Keflex

    Pros and Const for Nitrofuran antibiotic
    Pros
    •Works well to treat and prevent UTIs
    •Available as both a capsule and a flavored oral suspension
    •Safe to take if you're allergic to other antibiotics like penicillin or sulfa medications (e.g., Bactrim, Septra (sulfamethoxazole / trimethoprim))
    Cons
    •Might need to take up to four times a day (depending on the formulation)
    •Can interact with certain types of antacids, travel vaccines, and lab tests
    •Can harm your lungs, liver, and nerves if taken for a long period of time
    Pros and Const for Cephalosporin antibiotic
    Pros
    •Treats several common types of bacterial infections
    •Can use for adults and children over the age of 1
    •Available as a liquid for people who have trouble swallowing pills
    •Available as a lower-cost generic
    Cons
    •Usually need to take a few times per day
    •Might not be able to take if you're allergic to penicillins or other cephalosporin antibiotics
    •Not recommended for the cold or flu (these are viral illnesses, not bacterial infections)

  • Common Side Effects of Macrobid vs. Keflex

    Common Side Effects for
    •Nausea (8%)
    •Headache (6%)
    •Gas (2%)
    Common Side Effects for
    •Diarrhea
    •Nausea
    •Vomiting
    •Indigestion
    •Stomach pain

  • Warnings of Macrobid vs. Keflex

    Common Side Effects for
    •Lung damage
    •Liver damage
    •Nerve damage (neuropathy)
    •Breakdown of red blood cells (hemolytic anemia)
    •Severe diarrhea
    Common Side Effects for
    •Allergic reactions
    •Diarrhea from Clostridioides difficile infection
    •Development of drug-resistant bacteria
    •Seizures
    •Higher risk of bleeding

  • Prices with our coupons for Macrobid vs. Keflex

    Learn more about Nitrofurantoin
    Learn more about Cephalexin

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