Cephalexin ®
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Reviewed on December 19, 2025. by
Dr Alexandra Cristina Cowell
Writer & Clinical Content Reviewer
Next review due on
December 19, 2028.
Dr Alexandra Cristina Cowell

Last updated on Dec 19, 2025.

Antibiotic tablets for severe paronychia.

Cephalexin is a first-line treatment for severe or persistent cases of paronychia. It’s usually prescribed when topical treatments and warm water soaks haven’t worked, or the infection is particularly bad.

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Cephalexin Cephalexin

What is Cephalexin?

Cephalexin is an oral antibiotic that’s used to treat paronychia. Paronychia is an infection of the skin around your fingernail – and cephalexin targets and kills the bacteria causing the infection. This should stop the infection spreading and getting worse, and eventually clear it up.

How does Cephalexin work?

Cephalexin is a type of beta-lactam antibiotic. This means it binds to specific proteins involved in maintaining the bacterial cell wall’s strength and rigidity. This causes the structure of the bacteria’s cell wall to deteriorate so that the cells expire, clearing the infection.[1]

How do Cephalexin doses work?

Cephalexin tablets come in two doses: 250 mg and 500 mg. For paronychia, you’ll usually take one 250 mg tablet every six hours, or one 500 mg tablet every 12 hours.

What is Cephalexin’s active ingredient?

Cephalexin is a generic medication. This means it’s named after its active ingredient: cephalexin. It’s a type of cephalosporin and beta-lactam antibiotic that interferes with the cell walls of bacteria, killing them off and clearing up infections.[1]

Treated trusted source:

  1. Herman, T.F. Hashmi, M.F. (2023). Cephalexin. StatPearls. Treasure Island (FL): StatPearls Publishing.
Dr Alexandra Cristina Cowell
This page was medically reviewed by Dr Alexandra Cristina Cowell on December 19, 2025. Next review due on December 19, 2028.

How we source info.

When we present you with stats, data, opinion or a consensus, we’ll tell you where this came from. And we’ll only present data as clinically reliable if it’s come from a reputable source, such as a state or government-funded health body, a peer-reviewed medical journal, or a recognised analytics or data body. Read more in our editorial policy.

Cephalexin Cephalexin

How to take Cephalexin

You should always follow your prescriber’s instructions when taking Cephalexin. Usually, to treat paronychia infections, you’ll take one 250 mg Cephalexin tablet every six hours, or one 500 mg tablet every 12 hours. Swallow your tablet whole with a drink of water. You can take it with or without food, but taking it alongside a meal or a snack can help reduce the risk of side effects like nausea.

Dr Alexandra Cristina Cowell
This page was medically reviewed by Dr Alexandra Cristina Cowell on December 19, 2025. Next review due on December 19, 2028.

How we source info.

When we present you with stats, data, opinion or a consensus, we’ll tell you where this came from. And we’ll only present data as clinically reliable if it’s come from a reputable source, such as a state or government-funded health body, a peer-reviewed medical journal, or a recognised analytics or data body. Read more in our editorial policy.

Cephalexin Cephalexin

Cephalexin isn’t suitable for everyone, and there are some things that you need to be aware of when taking it.

Here’s all the official info on it. If anything is unclear, let our clinician know, and they can talk with you about it.

Cephalexin Cephalexin

Cephalexin: FAQ

Have something specific you want to know? Search our info below, or ask our experts a question if you can’t find what you’re looking for.

Are there any alternatives to Cephalexin for paronychia?

Answer:
Yes, there are a few different options depending on the severity, persistence and cause of your paronychia infection. If you’re looking to manage inflammation and redness caused by the infection, a topical corticosteroid cream like hydrocortisone can be a helpful option.

For bacterial paronychia infections, warm water soaks and topical antibiotics like Mupirocin are usually the first-line treatment. But if your paronychia hasn’t responded to these, and Cephalexin isn’t right for you, other oral antibiotics like Dicloxacillin and Clindamycin could be effective alternatives.

If your paronychia is caused by fungus and not bacteria, topical antifungals like Ketoconazole and Clotrimazole can kill off the fungus responsible and treat the infection.

How effective is Cephalexin at treating paronychia?

Answer:
Cephalexin is a first-line treatment for paronychia infections when topical treatment hasn’t worked, or in more severe infections. This means that it’s shown to be very effective at treating severe or persistent paronychia infections, as it’s one of the first treatments prescribed.

Research suggests that cephalexin has a cure rate of 90% or higher when it comes to treating staphylococcal and streptococcal infections, which are the types of bacterial infection that typically cause paronychia.[1]

Do I need a prescription for Cephalexin?

Answer:
Yes, because it’s an antibiotic. Taking antibiotics when you don’t need them (for example if your infection is caused by fungus instead of bacteria) can contribute to antibiotic resistance, which means they might not be as effective as they should be when we need to use them. A healthcare professional will need to check to make sure Cephalexin is the right treatment for your infection before you use it.

How long does it take Cephalexin to treat paronychia?

Answer:
Your infection should start to clear up after two or three days of taking Cephalexin for paronychia.[2] But it’s really important to finish your course of Cephalexin, even if your infection appears to have cleared up. This reduces the risk of your infection coming back.

What should I do if I make a mistake when taking Cephalexin?

Answer:
If you miss a dose of Cephalexin, you can take your missed tablet as soon as you remember. But if it’s almost time for your next dose, skip the one you missed and carry on as normal from your upcoming pill. Never double up your dose to make up for a forgotten one.

If you do take more Cephalexin than you should, get medical attention right away. Symptoms of Cephalexin overdose can include nausea, vomiting, stomach ache, and blood in your urine.

Does Cephalexin cause side effects?

Answer:
Like any medicine you take, Cephalexin has some risk of side effects. Stop taking Cephalexin right away and get medical attention if you experience:

  • Sudden breathlessness or wheezing

  • Swelling of your eyelids, face, or lips

  • A rash or swelling, especially across your entire body

  • Blistering or peeling of the skin

  • Severe diarrhea

  • A scaly, widespread rash with bumps under the skin and blisters

  • Fever


Other Cephalexin side effects that have been reported include:

  • Diarrhea

  • Nausea

  • Vomiting

  • Indigestion

  • Stomach ache

  • Itching

  • Rash with joint pain and stiffness

  • Swollen lymph nodes

  • Cloudy urine

  • Fainting

  • Agitation

  • Fatigue

  • Headaches

  • Confusion

  • Dizziness

  • Thrush

  • Nervousness

  • Sleep disturbances


This isn’t a complete list of all of the possible side effects associated with Cephalexin. For more information, speak to your prescribing clinician, or take a look at the package insert that comes with your medicine.

Can I get Cephalexin through private health insurance?

Answer:
If you’ve been prescribed Cephalexin by a doctor for a paronychia infection, you can usually get it through your health insurance. But it’s always best to check your insurer’s formulary to see what medicines they cover. If they don’t offer Cephalexin, they may offer a similar alternative.

Your insurer may also only cover part of the cost of Cephalexin, or only provide coverage if you obtain it through a specific healthcare provider. If you can’t get Cephalexin through your health insurance, you should still be able to get it through an online pharmacy service (as long as it’s the right treatment for you).

Treated trusted source:

  1. Derrick, C.W. Reilly, K. (1983). The role of cephalexin in the treatment of skin and soft-tissue infections. Postgrad Medical Journal. 59(5). pp. 43-46.
  2. NHS. (2023). How and when to take cefalexin.

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