Rilexine (Cephalexin) Chewable Tablets for Dogs

Warnings

Oral systemic antibiotics should not be administered in patients with septicemia, shock, or other grave illnesses, as absorption of the medication from the GI tract may be significantly delayed or diminished. Parenteral routes (preferably IV) should be used for these cases.

Because RILEXINE usually has minimal toxicity associated with its use, monitoring for efficacy is usually all that is required.

Precautions

RILEXINE is contraindicated in patients with a history of hypersensitivity to it and other cephalosporins. Because there may be cross-reactivity, RILEXINE should be used cautiously in patients that are documented hypersensitive to other beta-lactam antibiotics (eg. penicillins, cephamycins, carbapenems). Use of cephalosporins in patients that are documented to be hypersensitive to penicillin-class antibiotics is controversial.

RILEXINE has been shown to cross the placenta and safe use during pregnancy has not been firmly established. There have been no documented teratogenic problems (related to, or causing developmental malformations) associated with these drugs. Small amounts of RILEXINE may be distributed into maternal milk; it could potentially affect gut flora in newborns. It should be used with caution in nursing patients.

Food and Drug Interactions

The following drug interactions have either been reported or are theoretical in animals receiving RILEXINE and may be of significance in veterinary patients. Unless otherwise noted, use together is not necessarily contraindicated, but the potential risks should be weighed, and additional monitoring performed when appropriate.

• AMINOGLYCOSIDES AND OTHER NEPHROTOXIC DRUGS - Concurrent use of parenteral aminoglycosides or other nephrotoxic drugs (eg, amphotericin B, furosemide) with RILEXINE is somewhat controversial. RILEXINE could cause additive nephrotoxicity when used with these drugs, but this interaction has only been well documented with cephaloridine (no longer marketed). In vitro studies have demonstrated that RILEXINE can have synergistic or additive activity against certain bacteria when used with aminoglycosides.
• CHOLESTYRAMINE - RILEXINE absorption may be reduced.
• ESTROGENS (eg, estriol) - RILEXINE disruption of GI flora may alter enterohepatic recirculation, which may decrease estrogen effectiveness.
• METFORMIN - Metformin levels may be increased.
• METOCLOPRAMIDE -Metoclopramide given IV may increase RILEXINE peak concentration and AUC when given prior to oral RILEXINE.
• OMEPRAZOLE - Omeprazole may reduce peak RILEXINE concentration and AUC and may delay oral absorption in adult dogs; however, time above MIC was not altered.
• PROBENECID - May competitively block the tubular secretion of RILEXINE, thereby increasing serum levels and serum half-lives.
• WARFARIN - May increase risk for bleeding.
• ZINC (ORAL): RILEXINE absorption may be reduced.

Human Warnings

Not for use in humans.

There are no specific precautions required when handling this medication unless you are allergic to it. Wash your hands after handling any medication.

Possible Side Effects

When given orally, RILEXINE may cause GI effects (eg. salivation, vomiting, diarrhea, anorexia). Administration with a small meal may help alleviate these effects. Because RILEXINE may also alter the gut microbiome, antibiotic-associated diarrhea or proliferation of resistant bacteria in the colon can occur.

RILEXINE has reportedly caused:

• Lethargy
• Pruritus (severe itching of the skin)
• Salivation
• Tachypnea (abnormally rapid breathing)
• Excitability in dogs
• Emesis and fever in cats.

Rarely, RILEXINE has been implicated in causing serious skin reactions (eg. erythema multiforme, toxic epidermal necrolysis, cutaneous vasculitis, and pemphigus foliaceus) in small animals.

Hypersensitivity reactions unrelated to dosage can occur with these agents and can manifest as a rash, fever, eosinophilia, lymphadenopathy, interstitial nephritis, or anaphylaxis. Although apparently uncommon, the true incidence of these effects is not known.

Nephrotoxicity can occur (rare) during therapy with RILEXINE, but patients that have renal dysfunction, are receiving other nephrotoxic drugs, or are geriatric may be more susceptible.

High doses or very prolonged use has been associated with neurotoxicity, neutropenia, agranulocytosis, thrombocytopenia, hepatitis, positive Coombs test, interstitial nephritis, and tubular necrosis. Longer prothrombin times have also been noted. Except for tubular necrosis and neurotoxicity, these effects have an immunologic component.

Contact your veterinarian if you believe your pet is experiencing side effects.

Product Administration

Oral

Product Form

Chewable tablet

Ingredients

Cephalexin

Storage

Manufacturer

Virbac

Prescribing Info/Brochures

• https://us.virbac.com/home/our-product/pagecontent/product-selector/rilexine-cephalexin-chewable.html
• https://prod-npim-media-static.s3.amazonaws.com/media/guides/cephalexin.pdf?X-Amz-Algorithm=AWS4-HMAC-SHA256&X-Amz-Credential=AKIAT6YUBUSOGBKN7377%2F20220414%2Fus-east-2%2Fs3%2Faws4_request&X-Amz-Date=20220414T013330Z&X-Amz-Expires=604800&X-Amz-SignedHeaders=host&X-Amz-Signature=6fa177ff09ab88ad3b52677fb5f013531e9ef140903dd438037af18f7d7ac23f