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Can Keflex Be Taken When Suffering From Elevated Liver Enzymes?

Posted on Thu, 4 Sep 2014

Question: Hi. I was on Lamisil for my toenail fungus for 7 weeks. I went on vacation to mexico and I came back with rash on my lower legs. My dermatologist thought the rash was from the heat in Mexico. I took my blood test and my liver enzymes are borderline elevated. I stopped the Lamisil and my doctor gave me Keflex for my rash. Is it okay to take the Keflex at this time with my liver enzymes elevated?

Answered by Dr. Johny Chacko (26 minutes later)

Brief Answer:
Cephalexin and liver enzymes

Detailed Answer:
Hello,

Welcome to healthcare magic.

I understand that you are concerned about taking oral Cephalexin ( Keflex).

I would personally not give Cephalexin if your liver enzymes are already raised due to another medicine. Renal and hepatic impairment ate contraindications to its use. However, you could discuss with your treating doctor about the same and whether he wishes to switch over to a topical medication for the rash. Or if he wishes to monitor your liver enzymes after the course of cephalexin is over

Hope this helps you.

Take care.

Regards,
Dr. Johny Chacko

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Johny Chacko (5 minutes later)

what topical cream would you recommend for red rash on lower legs caused as a side effect of Lamisil? Do you think the rash is from the Lamisil or the heat?Does coffee has interaction with Lamisil? I am trying to figure out what caused my liver enzymes to go up while on Lamisil? I never had alcohol.
How about now? Can I drink coffee with my liver enzymes elevated borderline?

Answered by Dr. Johny Chacko (7 minutes later)

Brief Answer:
Please upload a photograph

Detailed Answer:
Hello,

Cephalexin is an antibiotic. I am not sure if the rash on your leg is due to a side effect if Lamisil because cephalexin will not be prescribed for such a rash.

Please upload a clear photograph of the rash so that I can assess better.

Liver enzymes could get elevated due to Lamisil even if you do not consume alcohol. It is generally well tolerated by most patients, but in some it could cause mild liver problems which is reversible on stopping the drug. Please get a liver function test repeated after 2 weeks.

You can definitely have coffee even with the raised liver enzymes. There is no harm.

Please revert back with the picture.

Regards,
Dr. Johny Chacko

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Johny Chacko (3 minutes later)

how long does it take for my liver enzymes to go back to normal? I have stopped taking Lamisil for a week now.

Answered by Dr. Johny Chacko (2 hours later)

Brief Answer:
Rash unlikely to be side effect of Lamisil

Detailed Answer:
Hello,

I saw the picture that you have uploaded.

It does not look like a medicine induced allergy.

I would consider the possibility of pseudofolliculitis and a mild dermatitis.

Did you shave your legs ( reverse shaving). Were you exposed to any potential allergens like plants or any cosmetics/ insect repellants, etc while on your trip?

You could apply a topical antibiotic like 2% Mupirocin twice a day for about 10 days.

It usually takes 2-4 weeks for the liver function test to come back to normal after stopping the medicine.

You could repeat it after 2 more weeks.

It is not a fasting sample.

Regards,
Dr. Johny Chacko

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Johny Chacko (6 hours later)

Yes I got one or two itchy bug bites on my leg. But I never shaved. Then after 1 or 2 days this big rash appeared first on my right leg and then after 1 or 2 days on my right lower leg as well.
Anyways, do you think I should stop taking Keflex? I have been on it for 4 days now( 500mg four times a day). And do the cream?

Answered by Dr. Johny Chacko (13 hours later)

Brief Answer:
Insect bite reaction

Detailed Answer:
Hello,

From your history of bug bites, I would definitely consider an insect bite reaction.

If you have already taken Keflex for 4 days, you could take it for 1 more day and stop it. ( It is usually a 5 day course)

Apply a cream containing 1% hydrocortisone twice a day instead of the antibiotic for about 10 days for the rash to subside.

Repeat the liver test as I mentioned earlier.

Hope this helps you.

Take care.

Regards,
Dr. Johny Chacko

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Johny Chacko (42 minutes later)

Thank you. I have one more question. What can I do about my toenail fungus now that I stopped Lamisil?

Answered by Dr. Johny Chacko (1 hour later)

Brief Answer:
onychomycosis

Detailed Answer:
Hello,

You could use topical Amorolfine. Please do discuss with your dermatologist as it is a prescription medicine.

Wishing you good health,
Dr. Johny Chacko

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Johny Chacko (8 minutes later)

Is it as effective as Lamisil? for how long do you use that?

Answered by Dr. Johny Chacko (4 hours later)

Brief Answer:
Onychomycosis

Detailed Answer:
Hello,

It is not as effective as oral Lamisil. The other option is oral Itraconazole which is also ruled out in your case due to raised liver enzymes.
Hence, the only resort as of now is topical medications.

Amorolfine comes as a nail lacquer which you need to apply once a week for about 3-4 months.

It gives a good response in case of single nail involvement. But you have to be regular in its usage.

Hope this clarifies your query.

Regards,
Dr. Johny Chacko

Note: Hope the answers resolves your concerns, however for further guidance of skin related queries consult our Dermatologist.Click here to book a consultation

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar