Drug & supplement interaction

Grapefruit + Cephalexin

Cephalexin brand names: Keflex, Keftab, Cephalex, Lexin.

No Known Interaction
The bottom line No known interaction

We found no known interaction between Grapefruit and Cephalexin in our sources. Absence of a documented interaction is not the same as proven safety, and does not guarantee one does not exist. Do not start, stop, or change a medication or supplement based on this page; confirm with your pharmacist or doctor first. Additionally, although there is no interaction, the two are separately associated with some of the same side effects, which would make a new symptom harder to attribute to one or the other.

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Interaction report

Grapefruit and Cephalexin

We checked these two against our interaction database. Here is what we found.

No Known Interaction Found

We did not find a documented interaction between Cephalexin and Grapefruit in our sources. This does not guarantee that the combination is completely free of risk — there is often limited research on supplements and herbal products, especially around drug interactions.

If you decide to take both, the practical routine is simple: add one new thing at a time and note the date you started it. If the combination is going to disagree with you, it usually shows in the first days to a couple of weeks — and a start date turns “I’ve been feeling off” into something a pharmacist can actually work with. Do not stop a prescribed medicine on your own.

Always talk with your pharmacist or doctor before making changes to your medications or supplements, particularly if you take several medications or have an ongoing health condition.

Grapefruit safety at a glance

Grapefruit overall Use caution The fruit is safe to eat for most people, but it interacts with many medicines.
Pregnancy Use caution Eating grapefruit as food is generally fine, but concentrated supplements should be avoided unless approved by your doctor.
Breastfeeding Use caution Grapefruit as food is generally acceptable, but the safety of concentrated extracts is not well studied.

Safety guidance is general; always confirm with your pharmacist or doctor for your situation.

Still wondering about combining Cephalexin and Grapefruit? Ask Dr. Brian Staiger, PharmD, BCPS directly ›
How we checked

Why No Interaction Is Listed for Cephalexin

Interactions in our licensed database are recorded against drug classes, not just single drug names. Cephalexin is filed under 7 classifications — including organic anion transporter 3 (oat3) substrates, organic anion transporter 1 (oat1) substrates, antibiotic drugs. Grapefruit has documented interactions with 62 drug classes — the most serious being amiodarone (cordarone) (major), artemether (artenam, paluther) (major) and benzodiazepines (major) — and none of Cephalexin’s classifications are among them.

Classification data comes from our licensed Natural Medicines dataset. A medication can belong to classes beyond those recorded there, so this describes how the check was run — it is not a safety guarantee.

Keep it in perspective

Grapefruit Does Interact With Other Medications

Grapefruit has 776 major, 151 moderate, 63 minor known drug interactions in our database — Cephalexin isn’t one of them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Grapefruit

Covers the 2,830 medications we’ve checked against Grapefruit. Pick one to open its full report.

What to actually watch for

No Interaction Found — But Data Suggests Grapefruit and Cephalexin May Share Several of the Same Side Effects

This is not an interaction. Neither one changes how your body handles the other, and nothing here says they react together. What our sources do show is that each has separately been linked to the effects below — so taking both can make those effects more likely to turn up, and harder to pin on one or the other if they do. One of them is worth acting on rather than waiting out — marked below.

  • An allergic reaction Worth acting on Additional detail

    Grapefruit

    “Orally, grapefruit and grapefruit juice are generally well tolerated.

    Serious Adverse Effects (Rare):

    Orally: Allergic reactions in sensitive individuals have been reported. When large quantities are consumed, arrhythmias, mineralocorticoid excess, QT prolongation, and pseudohyperaldosteronism have been reported. There is also some concern for increased breast cancer risk with grapefruit consumption.”

    Grapefruit · Natural Medicines adverse-effect record, reported in arrhythmia.

    Cephalexin

    Listed in the ADVERSE REACTIONS section of the FDA label for Cephalexin. Read the label on DailyMed ›

  • Itching Additional detail

    Grapefruit

    “Orally, grapefruit can cause allergic sensitization characterized by eosinophilic gastroenteritis, urticaria, and generalized pruritus.”

    Grapefruit · Natural Medicines adverse-effect record, reported in pruritus.

    2 sources cited
    1. 53351. Kumar, A., Teuber, S. S., Naguwa, S., Prindiville, T., and Gershwin, M. E. Eosinophilic gastroenteritis and citrus-induced urticaria. Clin Rev Allergy Immunol 2006;30(1):61-70. PubMed
    2. 53360. Ferdman, R. M., Ong, P. Y., and Church, J. A. Pectin anaphylaxis and possible association with cashew allergy. Ann.Allergy Asthma Immunol. 2006;97(6):759-760. PubMed

    Cephalexin

    Listed in the ADVERSE REACTIONS section of the FDA label for Cephalexin. Read the label on DailyMed ›

Reported for Grapefruit but not commonly for Cephalexin: an irregular heartbeat, kidney stones and hives.

Effects for Cephalexin come from the ADVERSE REACTIONS section of its FDA label; effects for Grapefruit come from the Natural Medicines adverse-effect record, quoted above. Wording is matched across sources by our own clinical vocabulary, so treat this as a prompt to pay attention, not a diagnosis.

From our Q&A

Questions About Grapefruit or Cephalexin

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Grapefruit or Cephalexin, not necessarily both, but if one is close to what you were about to ask it will usually go further than a database entry can:

Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.

Everything else you take

See Every Supplement That Interacts With Cephalexin

This page covers Grapefruit only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Cephalexin page lists 61 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Asarabacca (major), Siberian Cocklebur (major), African Wild Potato (moderate) and Aristolochia (moderate).

By severity: 3 major · 47 moderate · 11 minor.

From our pharmacist’s overview on the Cephalexin page

“Cephalexin (Keflex) is one of the most commonly prescribed oral antibiotics, usually for skin and urinary infections, and its supplement list warrants genuine care rather than a quick skim. Three of the 61 ingredients on file rate major.”

Reviewed by 2 · Jul 18, 2026

Open the Cephalexin interaction page

One more smart check

Taking Grapefruit as Part of a Dietary Supplement Product? Check It for Interactions

We hold 1,144 real supplement products containing Grapefruit, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Grapefruit. Even though Grapefruit itself has no known interaction with Cephalexin, another ingredient on your label might. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Grapefruit and Cephalexin Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Grapefruit
Top 10%

#110 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Cephalexin
Top 5%

#69 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Where does our data come from?
  • Source: the Natural Medicines (TRC Healthcare) clinical database — the evidence-graded professional reference for herb & supplement interactions.
  • Citation library: 103,510 references behind our interaction content, 65,311 of them resolved to verified PubMed/DOI sources. See every Grapefruit reference on this page ↓
  • Freshness: we automatically re-check this combination every week — this pair was last verified September 13, 2026. The Grapefruit and Cephalexin records this page draws on were last updated July 10, 2026.
  • What “no known interaction” means: no documented interaction in the sources above — not a guarantee of safety. Supplements are studied far less than prescription drugs, so we say exactly what the evidence supports, and nothing more.
Data structure & sourcing designed and verified by .
Supplement

About Grapefruit

What is Grapefruit?

Grapefruit
  • Source of vitamin C
  • Digestive complaints
  • Antimicrobial (seed extract)
  • Weight management
  • Skin and cosmetic uses

Grapefruit is a nutritious citrus fruit rich in vitamin C and other nutrients, and it is generally safe to eat. However, grapefruit is famous for serious interactions with many prescription medicines, so anyone taking medication should check with a pharmacist or doctor before consuming it regularly.

Citrus paradisi · Rutaceae · Fruit, juice, peel, and seed extract · Fresh fruit, juice, seed extract (capsules or liquid), essential oil

An interaction check asks whether these two react with each other — it does not ask whether Grapefruit is a good idea for someone in your situation. Here is what our Grapefruit record says about it on its own.

Grapefruit: dosing

There is no official standardized dose for grapefruit as a supplement. Grapefruit is most often simply eaten as a fruit or consumed as juice as part of a normal diet.For grapefruit seed extract and other concentrated products, there is no well-established effective or safe dose.

From our Grapefruit monograph — the full record covers uses, side effects and every documented interaction.

Read the full Grapefruit monograph & all interactions
Medication

About Cephalexin

What Is Cephalexin Used For?

Brand names: Keflex, Keftab, Cephalex, Lexin

Cephalexin treats bacterial infections caused by susceptible strains of bacteria. It is used for respiratory tract infections, ear infections (otitis media), skin and skin structure infections, bone infections, and genitourinary tract infections — including acute prostatitis.

It works only against bacterial infections — not viruses like colds or flu. Your prescriber should use it only when a bacterial infection is confirmed or strongly suspected, to help prevent antibiotic resistance.

Most-Reported Side Effects for Cephalexin

From FAERS, the FDA’s public side-effect reporting system (0 reports, all brands). Reports are voluntary and are not proof the drug caused the effect.

Chronic kidney disease 2,157 reports
Renal failure 1,558 reports
Acute kidney injury 1,550 reports
Diarrhea 1,405 reports
Fatigue 1,303 reports
See full Cephalexin drug information
Keep checking

Other Drugs & Grapefruit

Browse every other medication we’ve checked against Grapefruit — both the ones with a known interaction and the ones without. Select any drug for the full detail.

776Major
151Moderate
63Minor
1,839No known interaction
Major

776 interactions

Showing 60 of 776 major interactions — see all 776 on the Grapefruit page.

Moderate

151 interactions

Showing 60 of 151 moderate interactions — see all 151 on the Grapefruit page.

Minor

63 interactions

Showing 60 of 63 minor interactions — see all 63 on the Grapefruit page.

No interaction 1,839 drugs checked — show the list
Evidence & sources

Grapefruit References

The 157 references that drive our Grapefruit monograph and interaction data, from the evidence-graded Natural Medicines (TRC Healthcare) database. Citations with a link open the study on PubMed or the publisher’s site.

  1. Penzak SR, Gubbins PO, Gurley BJ, et al. Grapefruit juice decreases the systemic availability of itraconazole capsules in healthy volunteers. Ther Drug Monit 1999;21:304-9. PubMed
  2. Ioannides-Demos LL, Christophidis N, et al. Dosing implications of a clinical interaction between grapefruit juice and cyclosporine and metabolite concentrations in patients with autoimmune diseases. J Rheumatol 1997;24:49-54.
  3. Josefsson M, Zackrisson AL, Ahlner J. Effect of grapefruit juice on the pharmacokinetics of amlodipine in healthy volunteers. Eur J Clin Pharmacol 1996;51:189-93. PubMed
  4. Garg SK, Kumar N, Bhargava VK, Prabhakar SK. Effect of grapefruit juice on carbamazepine bioavailability in patients with epilepsy. Clin Pharmacol Ther 1998;64:286-8. PubMed
  5. Weber A, Jager R, Borner A, et al. Can grapefruit juice influence ethinylestradiol bioavailability? Contraception 1996;53:41-7.
  6. Schubert W, Cullberg G, Edgar B, Hedner T. Inhibition of 17 beta-estradiol metabolism by grapefruit juice in ovariectomized women. Maturitas 1994;20:155-63.
  7. Kantola T, Kivisto KT, Neuvonen PJ, et al. Grapefruit juice greatly increases serum concentrations of lovastatin and lovastatin acid. Clin Pharmacol Ther 1998 63:397-402. PubMed
  8. Bailey DG, Spence JD, Munoz C, Arnold JM. Interaction of citrus juices with felodipine and nifedipine. Lancet 1991;337:268-9. PubMed
  9. Bailey DG, Arnold JM, Strong HA, et al. Effect of grapefruit juice and naringin on nisoldipine pharmacokinetics. Clin Pharmacol Ther 1993;54:589-94. PubMed
  10. Rau SE, Bend JR, Arnold MO, et al. Grapefruit juice-terfenadine single-dose interaction: magnitude, mechanism, and relevance. Clin Pharmacol Ther 1997 61:401-9. PubMed
  11. Offman EM, Freeman DJ, Dresser GK, et al. Cisapride interaction with grapefruit juice and red wine. Clin Pharmacol Ther 2000;67:110 (abstract PI-83).
  12. Bailey DG, Dresser GK, Kreeft JH, et al. Grapefruit juice-felodipine interaction: Effect of segments and an extract from unprocessed fruit. Clin Pharmacol Ther 2000;67:107 (abstract PI-71).
  13. Soldner A, Christians U, Susanto M, et al. Grapefruit juice activates P-glycoprotein-mediated drug transport. Pharm Res 1999;16:478-85. PubMed
  14. Zaidenstein R, Avni B, Dishi V, et al. Effect of grapefruit juice on the pharmacokinetics of losartan in healthy volunteers. Clin Pharmacol Ther 1998;65:(abstract PI-60). DOI
  15. Dresser GK, Bailey DG, Carruthers SG. Grapefruit juice-felodipine interaction in healthy seniors. Clin Pharmacol Ther 1998;65:(abstract PIII-63).

Medication overviews come from MedlinePlus (NIH); supplement label data from the NIH Dietary Supplement Label Database. Content is written and reviewed by licensed HelloPharmacist pharmacists — see our data sources and editorial standards.

Pharmacist Counseling Corner

Taking Grapefruit and Cephalexin Together: Common Questions

Is it safe to take Grapefruit with Cephalexin?
We do not list a known interaction between Grapefruit and Cephalexin. That does not guarantee the combination is risk-free, so confirm with your pharmacist or doctor — especially if you take other medications or have a health condition.
Do Grapefruit and Cephalexin have any of the same side effects?
Yes — our sources link each of them separately to 2 of the same effects. That is not an interaction: neither changes how your body handles the other. It does mean that if one of those effects turns up, it can be harder to tell which one is behind it. They are listed on this page with the source behind each.
How was the Grapefruit and Cephalexin combination checked?
Interactions in our licensed database are recorded against drug classes. Cephalexin is filed under 7 classifications, and Grapefruit has documented interactions with 62 drug classes — none of Cephalexin's classifications are among them. A medication can belong to classes beyond those recorded in our dataset, so this describes how the check was run rather than guaranteeing safety.
Does Grapefruit interact with any other medications?
Yes. Grapefruit has 990 documented drug interactions in our database — Cephalexin is simply not one of them. If you take anything else, it is worth checking each one; they are all listed on this page.
Does Cephalexin interact with any supplements?
Yes. Cephalexin has documented interactions with 61 supplements in our database — Grapefruit is not one of them. The Cephalexin interaction page linked on this page lists every one, ranked by severity.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Still Have a Question About Cephalexin and Grapefruit?

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.