Question:
How can Keflex affect blood sugar level?
Keflex is the brand name for cephalexin, an antibiotic. Keflex itself is not usually a major direct cause of high blood sugar, but the infection being treated can raise blood sugar because illness increases stress hormones.
Blood sugar can also go lower than usual if you are eating less, vomiting, feverish, or taking diabetes medicine while sick. If you take metformin, ask your doctor or pharmacist about monitoring because cephalexin may increase metformin levels in some cases.
Check your glucose more often during infection and antibiotic treatment, and call your doctor if readings are repeatedly too high, too low, or you feel unwell.
Answer by Dr. Albana Greca, MD, MMedSc
Hello,
Keflex, also called cephalexin, is commonly used for bacterial infections such as skin infections, urinary tract infections, throat infections, and some respiratory infections. In people with diabetes, blood sugar changes during antibiotic treatment are often caused by the illness itself, not only by the antibiotic.
When your body fights an infection, it releases stress hormones that can make the liver release more glucose and make insulin work less effectively. This can raise blood sugar, especially if you already have diabetes or insulin resistance.
This is why a person may notice higher readings during a urinary infection, skin infection, fever, pain, or inflammation, even before starting Keflex.
Helpful page: why isn’t my blood sugar going down?
Low blood sugar is also possible during illness if you are eating less than usual, skipping meals, vomiting, drinking less, or taking insulin or diabetes pills that can lower glucose.
Some cephalexin labels also advise monitoring for hypoglycemia when cephalexin is used with metformin. This does not mean everyone will have low blood sugar, but it is a reason to monitor more carefully.
Helpful page: is my blood sugar too high or too low?
Some cephalexin oral suspensions may contain sucrose or other ingredients. If you use the liquid form, ask your pharmacist whether it contains sugar and whether it matters for your diabetes plan.
Cephalexin can also cause a false-positive urine glucose result with some older urine sugar tests. This means urine glucose may look positive even when blood glucose is not truly high. Blood glucose testing is more reliable for diabetes decisions.
Helpful resource: can blood sugar be normal but sugar high in urine?
Helpful resource: blood sugar levels by time of day.
Call your doctor if your blood sugar is repeatedly above your target, repeatedly below 70 mg/dL, or if infection symptoms are not improving after starting the antibiotic.
Also call if you have diarrhea, rash, swelling, breathing trouble, severe stomach pain, vomiting, signs of dehydration, or symptoms of low blood sugar.
Seek urgent care if high blood sugar occurs with vomiting, confusion, severe weakness, dehydration, deep or rapid breathing, chest pain, fruity-smelling breath, or moderate to large ketones. Also seek urgent care for allergic reaction symptoms such as facial swelling, throat tightness, wheezing, or trouble breathing.
Keflex is often necessary to treat infection. In diabetes, the safer approach is not to avoid antibiotics, but to monitor glucose more closely during illness and follow a written sick-day plan from your doctor.
Educational safety note: This answer is for general diabetes education only. It does not replace personal medical advice, diagnosis, or treatment. Do not start, stop, or change Keflex, metformin, insulin, or diabetes medicine without speaking with your healthcare provider.
Keflex is not usually a major direct cause of high blood sugar. The infection being treated is often the bigger reason blood sugar rises.
Low blood sugar can happen during illness if you eat less, vomit, or take glucose-lowering medicines. People taking metformin should ask their clinician whether extra monitoring is needed.
Do not stop Keflex without medical advice. Call your doctor if readings become very high, very low, or you feel worse.
Last reviewed: July 2026.
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