Drug & supplement interaction

Sage + Cephalexin

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

No Known Interaction

Medically reviewed by Dr. Brian Staiger, PharmD, BCPS · Updated July 2026 · Pair last verified Sep 13, 2026

The bottom line No known interaction

We found no known interaction between Sage 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

Sage 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 Sage 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.

Sage safety at a glance

Sage overall Use caution Generally safe as a food and short-term as tea, but concentrated extracts and the essential oil should be used cautiously.

Pregnancy Likely Unsafe When used orally. The constituent thujone can have menstrual stimulant and abortifacient effects. Read the full pregnancy detail

Breastfeeding Possibly Unsafe When used orally; sage is thought to reduce the supply of mother's milk. Read the full breastfeeding detail

Pregnancy & breastfeeding ratings are from Natural Medicines (Therapeutic Research Center) — the full detail is in the Special populations card below. Safety guidance is general; always confirm with your pharmacist or doctor for your situation.

Still wondering about combining Cephalexin and Sage? 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. Sage has documented interactions with 14 drug classes — the most serious being anticholinergic drugs (moderate), anticonvulsants (moderate) and antidiabetes drugs (moderate) — 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

Sage Does Interact With Other Medications

Sage has 1,296 moderate known drug interactions in our database — Cephalexin isn’t one of them. If you take anything else, check it against the full list below.

Moderate 1,296 No known interaction 1,534 (incl. Cephalexin)

Taking anything else?

Check Another of Your Medications Against Sage

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

What to actually watch for

No Interaction Found — But Data Suggests Sage 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.

Seizures Worth acting on Additional detail
Sage
“Orally, sage can cause dizziness or agitation. Thujone, a constituent of common sage (Salvia officinalis), is a neurotoxin and can cause seizures. Camphor and cineol, constituents of common sage and Spanish sage, can also cause neurotoxicity and seizures in high doses. Generalized tonic-clonic seizures have been reported in adults, children, and infants after ingestion of sage oil.”

Sage · Natural Medicines adverse-effect record, reported in epilepsy.
6 sources cited

10810. Akhondzadeh S, Noroozian M, Mohammadi M, et al. Salvia officinalis extract in the treatment of patients with mild to moderate Alzheimer's disease: a double blind, randomized and placebo-controlled trial. J Clin Pharm Ther 2003;28:53-9.

17177. Bommer S, Klein P, Suter A. First time proof of sage's tolerability and efficacy in menopausal women with hot flushes. Adv Ther 2011;28:490-500. PubMed

10812. Perry NB, Anderson RE, Brennan NJ, et al. Essential oils from dalmatian sage (Salvia officinalis l.): variations among individuals, plant parts, seasons, and sites. J Agric Food Chem 1999;47:2048-54..

12868. Burkhard PR, Burkhardt K, Haenggeli CA, Landis T. Plant-induced seizures: reappearance of an old problem. J Neurol 1999;246:667-70. PubMed

10334. Perry NS, Bollen C, Perry EK, Ballard C. Salvia for dementia therapy: review of pharmacological activity and pilot tolerability clinical trial. Pharmacol Biochem Behav 2003;75:651-9.. PubMed

72666. Halicioglu, O., Astarcioglu, G., Yaprak, I., and Aydinlioglu, H. Toxicity of Salvia officinalis in a newborn and a child: an alarming report. Pediatr.Neurol. 2011;45(4):259-260. PubMed
Cephalexin

Listed in the ADVERSE REACTIONS section of the FDA label for Cephalexin. Read the label on DailyMed ›
Anxiety or restlessness / Dizziness Additional detail

Sage

Recorded for Sage in the same Natural Medicines adverse-effect record shown under Seizures above.

Cephalexin

Listed in the ADVERSE REACTIONS section of the FDA label for Cephalexin. Read the label on DailyMed ›
Stomach pain / Diarrhea / Vomiting / Nausea Additional detail
Sage
“Orally, sage can cause nausea, vomiting, abdominal pain, and diarrhea.

Topically, sage extract sprayed into the mouth and throat can cause dryness or mild burning of the throat.”

Sage · Natural Medicines adverse-effect record, reported in diarrhea.
3 sources cited

10810. Akhondzadeh S, Noroozian M, Mohammadi M, et al. Salvia officinalis extract in the treatment of patients with mild to moderate Alzheimer's disease: a double blind, randomized and placebo-controlled trial. J Clin Pharm Ther 2003;28:53-9.

17177. Bommer S, Klein P, Suter A. First time proof of sage's tolerability and efficacy in menopausal women with hot flushes. Adv Ther 2011;28:490-500. PubMed

72619. Hubbert, M., Sievers, H., Lehnfeld, R., and Kehrl, W. Efficacy and tolerability of a spray with Salvia officinalis in the treatment of acute pharyngitis - a randomised, double-blind, placebo-controlled study with adaptive design and interim analysis. Eur
Cephalexin

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

Reported for Sage but not commonly for Cephalexin: a skin rash.

Effects for Cephalexin come from the ADVERSE REACTIONS section of its FDA label; effects for Sage 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.

Special populations

Sage in Pregnancy & Breastfeeding

Pregnancy Likely Unsafe

When used orally. The constituent thujone can have menstrual stimulant and abortifacient effects.

Lactation Possibly Unsafe

When used orally; sage is thought to reduce the supply of mother's milk.

DISCLAIMER: This tool is intended for informational purposes only, and should not be interpreted as specific medical advice. Patients should consult with a qualified healthcare provider before making decisions about therapies and/or health conditions.© 2026 Therapeutic Research Center

From our Q&A

Questions About Sage 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 Sage 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 Sage 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 Sage as Part of a Dietary Supplement Product? Check It for Interactions

We hold 718 real supplement products containing Sage, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Sage. Even though Sage 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 Sage 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 Sage

Top 25%

#260 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 Sage reference on this page ↓
Freshness: we automatically re-check this combination every week — this pair was last verified September 13, 2026. The Sage and Cephalexin records this page draws on were last updated July 11, 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 Dr. Brian Staiger, PharmD, BCPS.

Supplement

About Sage

What is Sage?

Sore throat and mouth irritation
Digestive upset
Excessive sweating
Memory and thinking
Menopause symptoms (hot flashes)
General antioxidant support

Sage is a common kitchen herb that is generally safe in food amounts and is traditionally used for sore throats, digestion, sweating, and memory. Some early research is encouraging for sore throat and menopausal hot flashes, but most uses are not well proven. Concentrated extracts and the essential oil should be used carefully because high doses contain a compound called thujone, which can be harmful.

Salvia officinalis · Lamiaceae · Leaves and essential oil · Tea, capsules, tablets, tincture/extract, essential oil, lozenges, mouth rinse/gargle

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

Sage: dosing

There is no single official or standardized dose of sage, and the right amount depends on the form and the product. Sage tea, gargles, capsules, and extracts all differ in strength.The best approach is to follow the directions on the product label and not exceed the recommended amount.

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

Read the full Sage 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 & Sage

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

0Major

1,296Moderate

0Minor

1,533No known interaction

1,296 Moderate 1,533 No interaction

Moderate

1,296 interactions

Showing 60 of 1,296 moderate interactions — see all 1,296 on the Sage page.

No interaction 1,533 drugs checked — show the list

We also checked Sage against these medications and found no known interaction in our sources. Open any page to confirm.

Showing the 60 most looked-up of 1,533 medications checked with no known interaction — see the full Sage list.

See the full Sage interactions page

See every supplement checked against Cephalexin, ranked by severity

Evidence & sources

Sage References

The 27 references that drive our Sage 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.

Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, OR: Eclectic Medical Publications, 1998.
Todorov S, Philianos S, Petkov V, et al. Experimental pharmacological study of three species from genus Salvia. Acta Physiol Pharmacol (Bulg) 1984;10:13-20.
Perry NS, Bollen C, Perry EK, Ballard C. Salvia for dementia therapy: review of pharmacological activity and pilot tolerability clinical trial. Pharmacol Biochem Behav 2003;75:651-9.. PubMed
Saller R, Buechi S, Meyrat R, Schmidhauser C. Combined herbal preparation for topical treatment of Herpes labialis. Forsch Komplementarmed Klass Naturheilkd 2001;8:373-82. PubMed
Akhondzadeh S, Noroozian M, Mohammadi M, et al. Salvia officinalis extract in the treatment of patients with mild to moderate Alzheimer's disease: a double blind, randomized and placebo-controlled trial. J Clin Pharm Ther 2003;28:53-9.
Perry NB, Anderson RE, Brennan NJ, et al. Essential oils from dalmatian sage (Salvia officinalis l.): variations among individuals, plant parts, seasons, and sites. J Agric Food Chem 1999;47:2048-54..
Foster BC, Vandenhoek S, Hana J, et al. In vitro inhibition of human cytochrome P450-mediated metabolism of marker substrates by natural products. Phytomedicine 2003;10:334-42.. PubMed
Burkhard PR, Burkhardt K, Haenggeli CA, Landis T. Plant-induced seizures: reappearance of an old problem. J Neurol 1999;246:667-70. PubMed
Bommer S, Klein P, Suter A. First time proof of sage's tolerability and efficacy in menopausal women with hot flushes. Adv Ther 2011;28:490-500. PubMed
Hellum BH, Nilsen OG. The in vitro inhibitory potential of trade herbal products on human CYP2D6-mediated metabolism and the influence of ethanol. Basic Clin Pharmacol Toxicol. 2007 Nov;101:350-8.
Orhan, I., Kartal, M., Kan, Y., and Sener, B. Activity of essential oils and individual components against acetyl- and butyrylcholinesterase. Z.Naturforsch.C. 2008;63(7-8):547-553.
Perry, N. S., Houghton, P. J., Theobald, A., Jenner, P., and Perry, E. K. In-vitro inhibition of human erythrocyte acetylcholinesterase by salvia lavandulaefolia essential oil and constituent terpenes. J Pharm Pharmacol 2000;52(7):895-902.
Perry, N. S., Houghton, P. J., Sampson, J., Theobald, A. E., Hart, S., Lis-Balchin, M., Hoult, J. R., Evans, P., Jenner, P., Milligan, S., and Perry, E. K. In-vitro activity of S. lavandulaefolia (Spanish sage) relevant to treatment of Alzheimer's diseas
Futrell, J. M. and Rietschel, R. L. Spice allergy evaluated by results of patch tests. Cutis 1993;52(5):288-290.
Kavvadias, D., Monschein, V., Sand, P., Riederer, P., and Schreier, P. Constituents of sage (Salvia officinalis) with in vitro affinity to human brain benzodiazepine receptor. Planta Med. 2003;69(2):113-117.
Savelev, S. U., Okello, E. J., and Perry, E. K. Butyryl- and acetyl-cholinesterase inhibitory activities in essential oils of Salvia species and their constituents. Phytother Res 2004;18(4):315-324.
Kennedy, D. O., Pace, S., Haskell, C., Okello, E. J., Milne, A., and Scholey, A. B. Effects of cholinesterase inhibiting sage (Salvia officinalis) on mood, anxiety and performance on a psychological stressor battery. Neuropsychopharmacology 2006;31(4):84 PubMed
Hubbert, M., Sievers, H., Lehnfeld, R., and Kehrl, W. Efficacy and tolerability of a spray with Salvia officinalis in the treatment of acute pharyngitis - a randomised, double-blind, placebo-controlled study with adaptive design and interim analysis. Eur
Lima, C. F., Fernandes-Ferreira, M., and Pereira-Wilson, C. Drinking of Salvia officinalis tea increases CCl(4)-induced hepatotoxicity in mice. Food Chem.Toxicol. 2007;45(3):456-464.
Hellum, B. H. and Nilsen, O. G. In vitro inhibition of CYP3A4 metabolism and P-glycoprotein-mediated transport by trade herbal products. Basic Clin Pharmacol Toxicol. 2008;102(5):466-475.
Mayer, E., Gescheidt-Shoshany, H., and Weltfriend, S. Allergic contact dermatitis caused by Salvia officinalis extract. Contact Dermatitis 2011;64(4):237-238. PubMed
Halicioglu, O., Astarcioglu, G., Yaprak, I., and Aydinlioglu, H. Toxicity of Salvia officinalis in a newborn and a child: an alarming report. Pediatr.Neurol. 2011;45(4):259-260. PubMed
Sertoli, A., Fabbri, P., Campolmi, P., and Panconesi, E. Allergic contact dermatitis to Salvia Officinalis, Inula Viscosa and Conyza Bonariensis. Contact Dermatitis 1978;4(5):314-315.
Vandecasteele K, Ost P, Oosterlinck W, et al. Evaluation of the efficacy and safety of Salvia officinalis in controlling hot flashes in prostate cancer patients treated with androgen deprivation. Phytother Res. 2012;26(2):208-13.
Kianbakht S, Dabaghian FH. Improved glycemic control and lipid profile in hyperlipidemic type 2 diabetic patients consuming Salvia officinalis L. leaf extract: a randomized placebo. Controlled clinical trial. Complement Ther Med. 2013;21(5):441-6. PubMed
Amini L, Mojab F, Jahanfar S, Sepidarkish M, Raoofi Z, Maleki-Hajiagha A. Efficacy of Salvia officinalis extract on the prevention of insulin resistance in euglycemic patients with polycystic ovary syndrome: A double-blinded placebo-controlled clinical tr
Behradmanesh S, Derees F, Rafieian-Kopaei M. Effect of Salvia officinalis on diabetic patients. J Renal Inj Prev. 2013;2(2):51-4.

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.

Related: nutrient depletion

Cephalexin Is Linked to Lower Levels of 7 Nutrients

Natural Medicines records Cephalexin as a medicine that can lower these. This is not an interaction with Sage — it is a separate effect of the medicine, and it is a reason some people are advised to supplement rather than to avoid one:

Read the full Cephalexin nutrient depletion report ›

Depletion records come from the licensed Natural Medicines database. Do not start a supplement on the strength of this page — ask your pharmacist or doctor whether it applies to you.

Pharmacist Counseling Corner

Taking Sage and Cephalexin Together: Common Questions

Is it safe to take Sage with Cephalexin?

We do not list a known interaction between Sage 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 Sage and Cephalexin have any of the same side effects?

Yes — our sources link each of them separately to 7 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 Sage and Cephalexin combination checked?

Interactions in our licensed database are recorded against drug classes. Cephalexin is filed under 7 classifications, and Sage has documented interactions with 14 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 Sage interact with any other medications?

Yes. Sage has 1,296 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 — Sage 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

Where next

Keep Exploring

Sage monograph Uses, safety profile, and every drug interaction in one place Cephalexin drug information The full plain-English guide to this medication Cephalexin supplement interactions Every supplement checked against Cephalexin, ranked by severity Supplement interaction checker Check any supplement or product against your medications Browse medications A–Z Every drug we’ve checked against herbs & supplements References The 27 citations behind this page Ask a pharmacist Free, personal answer from our licensed team

Still Have a Question About Cephalexin and Sage?

Our pharmacists answer your medication & supplement questions — free.

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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.