ANSPOR
Clinical safety rating: caution
Comprehensive clinical and safety monograph for ANSPOR (ANSPOR).
Cephalexin is a first-generation cephalosporin antibiotic that inhibits bacterial cell wall synthesis by binding to penicillin-binding proteins (PBPs), leading to cell lysis and death.
| Metabolism | Cephalexin is not extensively metabolized; it is primarily excreted unchanged in the urine. Minor hepatic metabolism may occur. |
| Excretion | Primarily renal (90–95%) as unchanged drug via glomerular filtration and tubular secretion; biliary excretion negligible (<1%) |
| Half-life | 1.5–2 hours in adults with normal renal function; prolonged to 20–30 hours in severe renal impairment (CrCl <10 mL/min) |
| Protein binding | 10–20% bound to serum albumin |
| Volume of Distribution | 0.13–0.22 L/kg; indicates distribution primarily into extracellular fluid |
| Bioavailability | Oral: 75–90% (well absorbed); IM: 100% |
| Onset of Action | Oral: 30–60 minutes; IM: 15–30 minutes |
| Duration of Action | 6–8 hours for susceptible organisms; requires twice-daily dosing due to short half-life |
| Molecular Weight | 349.41 |
250-500 mg orally every 6 hours for 10-14 days; maximum 4 g/day.
| Dosage form | FOR SUSPENSION |
| Renal impairment | CrCl 10-50 mL/min: 250 mg every 12-24 hours. CrCl <10 mL/min: 250 mg every 24-48 hours. |
| Liver impairment | No specific adjustment recommended; monitor for adverse effects in severe impairment. |
| Pediatric use | 12.5-25 mg/kg orally every 6 hours; maximum 50 mg/kg/day. |
| Geriatric use | Start at lower end of dosing range; monitor renal function and adjust based on CrCl. |
| 1st trimester | Generally considered safe; limited human data, but animal studies have not shown fetal risk. Avoid unless clearly needed. |
| 2nd trimester | Safe for use; no known teratogenic effects. |
| 3rd trimester | Safe; no known adverse fetal or neonatal effects. |
Clinical note
Comprehensive clinical and safety monograph for ANSPOR (ANSPOR).
| Placental transfer | Crosses placenta; concentrations in cord blood are approximately 10-20% of maternal serum levels. |
| Breastfeeding | Anspor (cefradine) is excreted into breast milk in small amounts. It is generally considered compatible with breastfeeding due to low transfer, but monitor infant for potential gastrointestinal disturbances or allergic reactions. |
| Lactation Rating |
■ FDA Black Box Warning
No FDA boxed warning exists for cephalexin.
| Serious Effects |
Hypersensitivity to cefradine or other cephalosporinsSevere immediate hypersensitivity reaction to penicillins (cross-allergenicity)
| Precautions | Hypersensitivity reactions including anaphylaxis., Clostridioides difficile-associated diarrhea (CDAD)., Dosage adjustment required in renal impairment., Seizures with high doses or renal failure., Potential for superinfection with prolonged use. |
| Food/Dietary | Iron-fortified infant formula and iron supplements may reduce absorption; take at least 2 hours apart. No other significant food interactions. Avoid alcohol. |
Loading safety data…
| L2 (Limited data - likely compatible) |
| Teratogenic Risk | Cefradine (ANSPOR) is classified as FDA Pregnancy Category B. Animal studies have not demonstrated fetal risk, and adequate well-controlled studies in pregnant women are lacking. No evidence of teratogenicity; however, caution is advised. First trimester: no known risk; second and third trimesters: no known fetal adverse effects. |
| Fetal Monitoring | No specific monitoring required beyond routine maternal care. Monitor for signs of hypersensitivity or superinfection in mother. No fetal monitoring indicated. |
| Fertility Effects | No reported adverse effects on fertility in animal studies or human data. No known impact on spermatogenesis or oogenesis. |
| Clinical Pearls |
| ANSPOR (cefdinir) is a third-generation oral cephalosporin with activity against Gram-positive and Gram-negative bacteria. It is stable in the presence of some beta-lactamases. Dose adjustment required for CrCl <30 mL/min. Avoid use in patients with immediate hypersensitivity to penicillins due to cross-reactivity (approx 10%). Administer with iron supplements or iron-fortified infant formula at least 2 hours apart to reduce chelation. Suspension should be refrigerated and discarded after 10 days. |
| Patient Advice | Take exactly as prescribed, even if you feel better. · Complete the full course of therapy. · If using suspension, shake well before each dose. Refrigerate and discard after 10 days. · Avoid alcohol while taking this medication. · Notify your doctor if you experience diarrhea, rash, or signs of allergic reaction. · Take iron supplements or iron-fortified infant formula at least 2 hours apart from ANSPOR. |