linezolid (Rx)

Brand and Other Names:Zyvox

Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

injectable solution

  • 2mg/mL (100mL, 300mL infusion bags)

oral suspension

  • 100mg/5mL

tablet

  • 600mg

Vancomycin-Resistant Enterococcal Infections

600 mg PO/IV q12hr for 14-28 days

Complicated Skin & Skin Structure Infections

600 mg PO/IV q12hr for 10-14 days

Uncomplicated Skin & Skin Structure Infections

400-600 mg PO q12hr for 10-14 days

Community-Acquired Pneumonia (Including Concurrent Bacteremia)

600 mg PO/IV q12hr for 10-14 days

Nosocomial Pneumonia

600 mg PO/IV q12hr for 10-14 days

Methicillin-Resistant Staphylococcal Infections

600 mg PO/IV q12hr

Methicillin-Susceptible Staphylococcus Aureus

600 mg PO/IV q12hr for 10-14 days

Dosing Considerations

Monitor: CBC count qWeek

Dosage Forms & Strengths

injectable solution

  • 2mg/mL (100mL, 300mL infusion bags)

oral suspension

  • 100mg/5mL

tablet

  • 600mg

Complicated Skin & Skin Structure Infections

<12 years: 10 mg/kg PO/IV q8hr for 10-14 days  

≥12 years: 600 mg PO/IV q12hr for 10-14 days

Uncomplicated Skin & Skin Structure Infections

<5 years: 10 mg/kg PO q8hr for 10-14 days  

5-12 years: 10 mg/kg PO q12hr for 10-14 days

>12 years: 600 mg PO q12hr for 10-14 days

Pneumonia

<12 years: 10 mg/kg PO/IV q8hr for 10-14 days  

≥12 years: 600 mg PO/IV q12hr for 10-14 days

Vancomycin-Resistant Enterococcal Infections

<12 years: 10 mg/kg PO/IV q8hr for 14-28 days  

≥12 years: 600 mg PO/IV q12hr for 14-28 days

Dosing Considerations

Monitor: CBC count qWeek

Next:

Interactions

Interaction Checker

and linezolid

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            Contraindicated (50)

            • amoxapine

              linezolid and amoxapine both increase serotonin levels. Contraindicated.

            • apraclonidine

              apraclonidine, linezolid. Mechanism: unknown. Contraindicated. Contraindicated in mfr. prescribing info.

              linezolid, apraclonidine. Mechanism: unknown. Contraindicated. Contraindicated in mfr prescribing info.

            • armodafinil

              linezolid increases effects of armodafinil by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.

            • atomoxetine

              linezolid increases effects of atomoxetine by pharmacodynamic synergism. Contraindicated. The use of atomoxetine with monoamine oxidase inhibitors (MAOIs) is contraindicated. Risk of acute hypertensive episode.

            • benzphetamine

              linezolid increases effects of benzphetamine by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.

            • brimonidine

              linezolid, brimonidine. Mechanism: unknown. Contraindicated. Contraindicated in mfr prescribing info.

            • buspirone

              linezolid, buspirone. Mechanism: pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.

            • caffeine

              linezolid increases effects of caffeine by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.

            • carbamazepine

              carbamazepine increases toxicity of linezolid by unknown mechanism. Contraindicated. D/C MAO inhibitor 2 weeks before.

            • cyproheptadine

              linezolid, cyproheptadine. Other (see comment). Contraindicated. Comment: MAO inhibitors may prolong and intensify the anticholinergic effects of antihistamines. Cyproheptadine may diminish the serotonergic effect of MAO inhibitors.

            • desvenlafaxine

              linezolid and desvenlafaxine both increase serotonin levels. Contraindicated. Linezolid may increase serotonin as a result of MAO-A inhibition. If linezolid must be administered, discontinue serotonergic drug immediately and monitor for CNS toxicity. Serotonergic therapy may be resumed 24 hours after last linezolid dose or after 2 weeks of monitoring, whichever comes first

            • deutetrabenazine

              linezolid, deutetrabenazine. Either increases toxicity of the other by sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Contraindicated. Deutetrabenazine should not be used in combination with an MAOI, or within 14 days of discontinuing therapy with an MAOI. If linezolid must be used, discontinue deutetrabenazine and monitor for adverse effects. Deutetrabenazine may be resumed 24 hours after last linezolid dose or after 2 weeks of monitoring, whichever comes first.

            • dexfenfluramine

              linezolid increases effects of dexfenfluramine by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.

            • dexmethylphenidate

              linezolid increases effects of dexmethylphenidate by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.

            • dextroamphetamine

              linezolid increases effects of dextroamphetamine by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.

            • dextroamphetamine transdermal

              linezolid increases effects of dextroamphetamine transdermal by decreasing metabolism. Contraindicated. MAOIs slows amphetamine metabolism, increasing amphetamine?s effect on norepinephrine release and other monoamines from adrenergic nerve endings causing signs of hypertensive crisis. Do not administer dextroamphetamine during or within 14 days following MAOI administration.

            • diethylpropion

              linezolid increases effects of diethylpropion by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.

            • dobutamine

              linezolid increases effects of dobutamine by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.

            • dopamine

              linezolid increases effects of dopamine by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.

            • dosulepin

              linezolid and dosulepin both increase serotonin levels. Contraindicated.

            • ephedrine

              linezolid increases effects of ephedrine by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.

            • epinephrine

              linezolid increases effects of epinephrine by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.

            • fenfluramine

              linezolid increases effects of fenfluramine by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.

            • fluoxetine

              linezolid and fluoxetine both increase serotonin levels. Contraindicated. Linezolid may increase serotonin as a result of MAO-A inhibition. If linezolid must be administered, discontinue serotonergic drug immediately and monitor for CNS toxicity. Serotonergic therapy may be resumed 24 hours after last linezolid dose or after 5 weeks of monitoring, whichever comes first.

            • isometheptene

              linezolid, isometheptene. Either increases effects of the other by pharmacodynamic synergism. Contraindicated. Hypertension, V tach.

            • isoproterenol

              linezolid increases effects of isoproterenol by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.

            • lisdexamfetamine

              linezolid increases effects of lisdexamfetamine by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.

            • lofepramine

              linezolid and lofepramine both increase serotonin levels. Contraindicated.

            • meperidine

              linezolid increases toxicity of meperidine by unknown mechanism. Contraindicated.

            • methamphetamine

              linezolid increases effects of methamphetamine by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.

            • methylenedioxymethamphetamine

              linezolid increases effects of methylenedioxymethamphetamine by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.

            • methylphenidate

              linezolid increases effects of methylphenidate by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.

            • midodrine

              linezolid increases effects of midodrine by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.

            • modafinil

              linezolid increases effects of modafinil by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.

            • norepinephrine

              linezolid increases effects of norepinephrine by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.

            • ozanimod

              linezolid and ozanimod both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Contraindicated. Coadministration of ozanimod with MAO-B inhibitors may decrease exposure of the active metabolites of ozanimod, which may inhibit MAO. The potential for a clinical interaction with MAO inhibitors has not been studied; however, the increased risk of nonselective MAO inhibition may lead to a hypertensive crisis. Allow at least 14 days to elapse between discontinuing ozanimod and initiating with MAO inhibitors.

            • phendimetrazine

              linezolid increases effects of phendimetrazine by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.

            • phentermine

              linezolid increases effects of phentermine by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.

            • phenylephrine

              linezolid increases effects of phenylephrine by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.

            • phenylephrine PO

              linezolid increases effects of phenylephrine PO by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.

            • propylhexedrine

              linezolid increases effects of propylhexedrine by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.

            • pseudoephedrine

              linezolid increases effects of pseudoephedrine by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.

            • safinamide

              linezolid, safinamide. Either increases toxicity of the other by serotonin levels. Contraindicated. Coadministration increases risk of nonselective MAO inhibition, that may lead to hypertensive crisis. At least 14 days should elapse between discontinuating safinamide and initiating MAOIs.

            • serdexmethylphenidate/dexmethylphenidate

              linezolid increases effects of serdexmethylphenidate/dexmethylphenidate by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.

            • solriamfetol

              linezolid will increase the level or effect of solriamfetol by sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Contraindicated. Do no use solriamfetol during and/or within 14 days of discontinuing MAOI treatment. MAOIs irreversibly inhibit the enzyme monamine oxidase, an enzyme involved in the degradation of various monoamines, including dopamine and norepinephrine. Solriamfetol increases synaptic dopamine and norepinephrine.

            • tetrabenazine

              tetrabenazine, linezolid. Other (see comment). Contraindicated. Comment: Risk of acute hypertensive episode; separate by 14 d. Mechanism: MAOI causes accumulation of NE in neuron and tetrabenazine stimulates NE release.

            • tyramine

              linezolid increases effects of tyramine by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode. Tyramine containing foods include cheese, red wine, caviar, herring, canned figs, fermented meats, fava beans, yeast extracts, miso, avocado.

            • vortioxetine

              linezolid increases toxicity of vortioxetine by serum potassium. Contraindicated. Linezolid may increase serotonin as a result of MAO-A inhibition. If linezolid must be urgently administered, discontinue vortioxetine immediately and monitor for serotonin syndrome. Monitor for serotonin syndrome for 3 weeks or 24 hr after last linezolid dose, whichever comes first. Vortioxetine may be resumed 24 hr after last linezolid dose.

            • xylometazoline

              linezolid increases effects of xylometazoline by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.

            • yohimbine

              linezolid increases effects of yohimbine by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.

            Serious - Use Alternative (112)

            • 5-HTP

              linezolid and 5-HTP both increase serotonin levels. Avoid or Use Alternate Drug. Linezolid may increase serotonin as a result of MAO-A inhibition. If linezolid must be administered, discontinue serotonergic drug immediately and monitor for CNS toxicity. Serotonergic therapy may be resumed 24 hours after last linezolid dose or after 2 weeks of monitoring, whichever comes first.

            • albuterol

              linezolid increases effects of albuterol by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.

            • alfentanil

              linezolid increases toxicity of alfentanil by unknown mechanism. Avoid or Use Alternate Drug. Risk of hypotension, hyperpyrexia, somnolence, or death; separate by 14 d.

              alfentanil, linezolid. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.

            • almotriptan

              almotriptan and linezolid both increase serotonin levels. Avoid or Use Alternate Drug. Linezolid may increase serotonin as a result of MAO-A inhibition. If linezolid must be administered, discontinue serotonergic drug immediately and monitor for CNS toxicity. Serotonergic therapy may be resumed 24 hours after last linezolid dose or after 2 weeks of monitoring, whichever comes first.

              linezolid increases levels of almotriptan by decreasing metabolism. Contraindicated.

            • amitriptyline

              linezolid and amitriptyline both increase serotonin levels. Avoid or Use Alternate Drug. Linezolid may increase serotonin as a result of MAO-A inhibition. If linezolid must be administered, discontinue serotonergic drug immediately and monitor for CNS toxicity. Serotonergic therapy may be resumed 24 hours after last linezolid dose or after 2 weeks of monitoring, whichever comes first.

            • arformoterol

              linezolid increases effects of arformoterol by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.

            • BCG vaccine live

              linezolid decreases effects of BCG vaccine live by pharmacodynamic antagonism. Contraindicated. Wait until Abx Tx complete to administer live bacterial vaccine.

            • belladonna and opium

              linezolid increases toxicity of belladonna and opium by unknown mechanism. Avoid or Use Alternate Drug. Risk of hypotension, hyperpyrexia, somnolence, or death; separate by 14 d.

            • benzhydrocodone/acetaminophen

              linezolid increases toxicity of benzhydrocodone/acetaminophen by serotonin levels. Avoid or Use Alternate Drug. MAOI interactions with opioids may manifest as serotonin syndrome or opioid toxicity (eg, respiratory depression, coma). Opioids are not recommended for patients taking MAOIs or within 14 days of stopping MAOIs. If urgent opioid treatment needed, use test doses and frequent titration of small doses to treat pain while closely monitoring blood pressure and signs and symptoms of CNS and respiratory depression. If linezolid must be administered, discontinue serotonergic drug immediately and monitor for CNS toxicity. Serotonergic therapy may be resumed 24 hours after last linezolid dose or after 2 weeks of monitoring, whichever comes first.

            • buprenorphine

              linezolid increases toxicity of buprenorphine by unknown mechanism. Avoid or Use Alternate Drug. Risk of hypotension, hyperpyrexia, somnolence, or death; separate by 14 d.

            • buprenorphine buccal

              linezolid increases toxicity of buprenorphine buccal by unknown mechanism. Avoid or Use Alternate Drug. Risk of hypotension, hyperpyrexia, somnolence, or death; separate by 14 d.

            • bupropion

              bupropion, linezolid. serotonin levels. Avoid or Use Alternate Drug. Linezolid may increase serotonin as a result of MAO-A inhibition. If linezolid must be administered, discontinue serotonergic drug immediately and monitor for CNS toxicity. Serotonergic therapy may be resumed 24 hours after last linezolid dose or after 2 weeks of monitoring, whichever comes first.

            • buspirone

              linezolid and buspirone both increase serotonin levels. Avoid or Use Alternate Drug. Linezolid may increase serotonin as a result of MAO-A inhibition. If linezolid must be administered, discontinue serotonergic drug immediately and monitor for CNS toxicity. Serotonergic therapy may be resumed 24 hours after last linezolid dose or after 2 weeks of monitoring, whichever comes first.

            • butorphanol

              linezolid increases toxicity of butorphanol by unknown mechanism. Avoid or Use Alternate Drug. Risk of hypotension, hyperpyrexia, somnolence, or death; separate by 14 d.

            • cholera vaccine

              linezolid, cholera vaccine. pharmacodynamic antagonism. Avoid or Use Alternate Drug. Avoid coadministration of cholera vaccine with systemic antibiotics since these agents may be active against the vaccine strain. Do not administer cholera vaccine to patients who have received oral or parenteral antibiotics within 14 days prior to vaccination.

            • citalopram

              linezolid and citalopram both increase serotonin levels. Avoid or Use Alternate Drug. Linezolid may increase serotonin as a result of MAO-A inhibition. If linezolid must be administered, discontinue serotonergic drug immediately and monitor for CNS toxicity. Serotonergic therapy may be resumed 24 hours after last linezolid dose or after 2 weeks of monitoring, whichever comes first.

            • clomipramine

              linezolid and clomipramine both increase serotonin levels. Avoid or Use Alternate Drug. Linezolid may increase serotonin as a result of MAO-A inhibition. If linezolid must be administered, discontinue serotonergic drug immediately and monitor for CNS toxicity. Serotonergic therapy may be resumed 24 hours after last linezolid dose or after 2 weeks of monitoring, whichever comes first.

            • cocaine topical

              linezolid and cocaine topical both increase serotonin levels. Avoid or Use Alternate Drug. Linezolid may increase serotonin as a result of MAO-A inhibition. Cocaine inhibits presynaptic reuptake of serotonin. Monitor for CNS toxicity.

            • codeine

              linezolid increases toxicity of codeine by unknown mechanism. Avoid or Use Alternate Drug. Risk of hypotension, hyperpyrexia, somnolence, or death; separate by 14 d.

            • cyclobenzaprine

              linezolid and cyclobenzaprine both increase serotonin levels. Avoid or Use Alternate Drug. Linezolid may increase serotonin as a result of MAO-A inhibition. If linezolid must be administered, discontinue serotonergic drug immediately and monitor for CNS toxicity. Serotonergic therapy may be resumed 24 hours after last linezolid dose or after 2 weeks of monitoring, whichever comes first

            • deferiprone

              deferiprone, linezolid. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Avoid use of deferiprone with other drugs known to be associated with neutropenia or agranulocytosis; if an alternative is not possible, monitor absolute neutrophil count more frequently.

            • desipramine

              linezolid and desipramine both increase serotonin levels. Avoid or Use Alternate Drug. Linezolid may increase serotonin as a result of MAO-A inhibition. If linezolid must be administered, discontinue serotonergic drug immediately and monitor for CNS toxicity. Serotonergic therapy may be resumed 24 hours after last linezolid dose or after 2 weeks of monitoring, whichever comes first.

            • dexfenfluramine

              linezolid and dexfenfluramine both increase serotonin levels. Avoid or Use Alternate Drug. Linezolid may increase serotonin as a result of MAO-A inhibition. If linezolid must be administered, discontinue serotonergic drug immediately and monitor for CNS toxicity. Serotonergic therapy may be resumed 24 hours after last linezolid dose or after 2 weeks of monitoring, whichever comes first.

            • dextroamphetamine

              linezolid and dextroamphetamine both increase serotonin levels. Avoid or Use Alternate Drug. Linezolid may increase serotonin as a result of MAO-A inhibition. If linezolid must be administered, discontinue serotonergic drug immediately and monitor for CNS toxicity. Serotonergic therapy may be resumed 24 hours after last linezolid dose or after 2 weeks of monitoring, whichever comes first.

            • dextromethorphan

              linezolid and dextromethorphan both increase serotonin levels. Avoid or Use Alternate Drug. Linezolid may increase serotonin as a result of MAO-A inhibition. If linezolid must be administered, discontinue serotonergic drug immediately and monitor for CNS toxicity. Serotonergic therapy may be resumed 24 hours after last linezolid dose or after 2 weeks of monitoring, whichever comes first.

            • dextromoramide

              linezolid increases toxicity of dextromoramide by unknown mechanism. Avoid or Use Alternate Drug. Risk of hypotension, hyperpyrexia, somnolence, or death; separate by 14 d.

            • diamorphine

              linezolid increases toxicity of diamorphine by unknown mechanism. Avoid or Use Alternate Drug. Risk of hypotension, hyperpyrexia, somnolence, or death; separate by 14 d.

            • difenoxin hcl

              linezolid increases toxicity of difenoxin hcl by unknown mechanism. Avoid or Use Alternate Drug. Risk of hypotension, hyperpyrexia, somnolence, or death; separate by 14 d.

            • dihydroergotamine

              linezolid and dihydroergotamine both increase serotonin levels. Avoid or Use Alternate Drug. Linezolid may increase serotonin as a result of MAO-A inhibition. If linezolid must be administered, discontinue serotonergic drug immediately and monitor for CNS toxicity. Serotonergic therapy may be resumed 24 hours after last linezolid dose or after 2 weeks of monitoring, whichever comes first.

            • dihydroergotamine intranasal

              linezolid and dihydroergotamine intranasal both increase serotonin levels. Avoid or Use Alternate Drug. Linezolid may increase serotonin as a result of MAO-A inhibition. If linezolid must be administered, discontinue serotonergic drug immediately and monitor for CNS toxicity. Serotonergic therapy may be resumed 24 hours after last linezolid dose or after 2 weeks of monitoring, whichever comes first.

            • diphenoxylate hcl

              linezolid increases toxicity of diphenoxylate hcl by unknown mechanism. Avoid or Use Alternate Drug. Risk of hypotension, hyperpyrexia, somnolence, or death; separate by 14 d.

            • dipipanone

              linezolid increases toxicity of dipipanone by unknown mechanism. Avoid or Use Alternate Drug. Risk of hypotension, hyperpyrexia, somnolence, or death; separate by 14 d.

            • dopexamine

              linezolid increases effects of dopexamine by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.

            • doxapram

              doxapram increases effects of linezolid by pharmacodynamic synergism. Avoid or Use Alternate Drug. Additive pressor effect.

            • doxepin

              linezolid and doxepin both increase serotonin levels. Avoid or Use Alternate Drug. Linezolid may increase serotonin as a result of MAO-A inhibition. If linezolid must be administered, discontinue serotonergic drug immediately and monitor for CNS toxicity. Serotonergic therapy may be resumed 24 hours after last linezolid dose or after 2 weeks of monitoring, whichever comes first.

            • doxepin cream

              linezolid increases levels of doxepin cream by pharmacodynamic synergism. Contraindicated. D/C MAO inhibitor 2 weeks before.

            • duloxetine

              linezolid and duloxetine both increase serotonin levels. Avoid or Use Alternate Drug. Linezolid may increase serotonin as a result of MAO-A inhibition. If linezolid must be administered, discontinue serotonergic drug immediately and monitor for CNS toxicity. Serotonergic therapy may be resumed 24 hours after last linezolid dose or after 2 weeks of monitoring, whichever comes first.

            • eletriptan

              eletriptan and linezolid both increase serotonin levels. Avoid or Use Alternate Drug. Linezolid may increase serotonin as a result of MAO-A inhibition. If linezolid must be administered, discontinue serotonergic drug immediately and monitor for CNS toxicity. Serotonergic therapy may be resumed 24 hours after last linezolid dose or after 2 weeks of monitoring, whichever comes first.

              linezolid increases levels of eletriptan by decreasing metabolism. Contraindicated.

            • epinephrine racemic

              linezolid increases effects of epinephrine racemic by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.

            • ergotamine

              linezolid and ergotamine both increase serotonin levels. Avoid or Use Alternate Drug. Linezolid may increase serotonin as a result of MAO-A inhibition. If linezolid must be administered, discontinue serotonergic drug immediately and monitor for CNS toxicity. Serotonergic therapy may be resumed 24 hours after last linezolid dose or after 2 weeks of monitoring, whichever comes first.

            • escitalopram

              linezolid and escitalopram both increase serotonin levels. Avoid or Use Alternate Drug. Linezolid may increase serotonin as a result of MAO-A inhibition. If linezolid must be administered, discontinue serotonergic drug immediately and monitor for CNS toxicity. Serotonergic therapy may be resumed 24 hours after last linezolid dose or after 2 weeks of monitoring, whichever comes first.

            • fenfluramine

              linezolid and fenfluramine both increase serotonin levels. Avoid or Use Alternate Drug. Linezolid may increase serotonin as a result of MAO-A inhibition. If linezolid must be administered, discontinue serotonergic drug immediately and monitor for CNS toxicity. Serotonergic therapy may be resumed 24 hours after last linezolid dose or after 2 weeks of monitoring, whichever comes first.

            • fentanyl

              fentanyl, linezolid. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.

            • fentanyl intranasal

              fentanyl intranasal, linezolid. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.

            • fentanyl transdermal

              fentanyl transdermal, linezolid. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.

            • fentanyl transmucosal

              fentanyl transmucosal, linezolid. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.

            • fluvoxamine

              fluvoxamine and linezolid both increase serotonin levels. Avoid or Use Alternate Drug.

            • formoterol

              linezolid increases effects of formoterol by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.

            • frovatriptan

              frovatriptan and linezolid both increase serotonin levels. Avoid or Use Alternate Drug. Linezolid may increase serotonin as a result of MAO-A inhibition. If linezolid must be administered, discontinue serotonergic drug immediately and monitor for CNS toxicity. Serotonergic therapy may be resumed 24 hours after last linezolid dose or after 2 weeks of monitoring, whichever comes first.

              linezolid increases levels of frovatriptan by decreasing metabolism. Contraindicated.

            • hydrocodone

              linezolid increases toxicity of hydrocodone by serotonin levels. Avoid or Use Alternate Drug. MAOI interactions with opioids may manifest as serotonin syndrome or opioid toxicity (eg, respiratory depression, coma). Opioids are not recommended for patients taking MAOIs or within 14 days of stopping MAOIs. If urgent opioid treatment needed, use test doses and frequent titration of small doses to treat pain while closely monitoring blood pressure and signs and symptoms of CNS and respiratory depression. If linezolid must be administered, discontinue serotonergic drug immediately and monitor for CNS toxicity. Serotonergic therapy may be resumed 24 hours after last linezolid dose or after 2 weeks of monitoring, whichever comes first.

            • hydromorphone

              linezolid increases toxicity of hydromorphone by unknown mechanism. Avoid or Use Alternate Drug. Risk of hypotension, hyperpyrexia, somnolence, or death; separate by 14 d.

            • imipramine

              linezolid and imipramine both increase serotonin levels. Avoid or Use Alternate Drug. Linezolid may increase serotonin as a result of MAO-A inhibition. If linezolid must be administered, discontinue serotonergic drug immediately and monitor for CNS toxicity. Serotonergic therapy may be resumed 24 hours after last linezolid dose or after 2 weeks of monitoring, whichever comes first.

            • iobenguane I 131

              linezolid will decrease the level or effect of iobenguane I 131 by Other (see comment). Avoid or Use Alternate Drug. Based on the mechanism of action of iobenguane, drugs that reduce catecholamine uptake or that deplete catecholamine stores may interfere with iobenguane uptake into cells, and thus, reduce iobenguane efficacy. Discontinue interfering drugs for at least 5 half-lives before administration of either the dosimetry or an iobenguane dose. Do not administer these drugs until at least 7 days after each iobenguane dose.

            • isocarboxazid

              isocarboxazid and linezolid both increase serotonin levels. Avoid or Use Alternate Drug. Linezolid may increase serotonin as a result of MAO-A inhibition. If linezolid must be administered, discontinue serotonergic drug immediately and monitor for CNS toxicity. Serotonergic therapy may be resumed 24 hours after last linezolid dose or after 2 weeks of monitoring, whichever comes first.

            • isoniazid

              linezolid and isoniazid both increase serotonin levels. Avoid or Use Alternate Drug. Linezolid may increase serotonin as a result of MAO-A inhibition. If linezolid must be administered, discontinue serotonergic drug immediately and monitor for CNS toxicity. Serotonergic therapy may be resumed 24 hours after last linezolid dose or after 2 weeks of monitoring, whichever comes first.

            • L-tryptophan

              linezolid and L-tryptophan both increase serotonin levels. Avoid or Use Alternate Drug. Linezolid may increase serotonin as a result of MAO-A inhibition. If linezolid must be administered, discontinue serotonergic drug immediately and monitor for CNS toxicity. Serotonergic therapy may be resumed 24 hours after last linezolid dose or after 2 weeks of monitoring, whichever comes first.

            • levalbuterol

              linezolid increases effects of levalbuterol by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.

            • levodopa

              linezolid and levodopa both increase serotonin levels. Avoid or Use Alternate Drug. Linezolid may increase serotonin as a result of MAO-A inhibition. If linezolid must be administered, discontinue serotonergic drug immediately and monitor for CNS toxicity. Serotonergic therapy may be resumed 24 hours after last linezolid dose or after 2 weeks of monitoring, whichever comes first.

              linezolid, levodopa. Mechanism: pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of acute hypertensive episode.

            • levomilnacipran

              linezolid and levomilnacipran both increase serotonin levels. Avoid or Use Alternate Drug. Linezolid may increase serotonin as a result of MAO-A inhibition. If linezolid must be administered, discontinue serotonergic drug immediately and monitor for CNS toxicity. Serotonergic therapy may be resumed 24 hours after last linezolid dose or after 2 weeks of monitoring, whichever comes first.

            • levorphanol

              linezolid increases toxicity of levorphanol by unknown mechanism. Avoid or Use Alternate Drug. Risk of hypotension, hyperpyrexia, somnolence, or death; separate by 14 d.

            • lithium

              linezolid and lithium both increase serotonin levels. Avoid or Use Alternate Drug. Linezolid may increase serotonin as a result of MAO-A inhibition. If linezolid must be administered, discontinue serotonergic drug immediately and monitor for CNS toxicity. Serotonergic therapy may be resumed 24 hours after last linezolid dose or after 2 weeks of monitoring, whichever comes first.

            • lorcaserin

              linezolid and lorcaserin both increase serotonin levels. Avoid or Use Alternate Drug.

            • lsd

              linezolid and lsd both increase serotonin levels. Avoid or Use Alternate Drug. Linezolid may increase serotonin as a result of MAO-A inhibition. If linezolid must be administered, discontinue serotonergic drug immediately and monitor for CNS toxicity. Serotonergic therapy may be resumed 24 hours after last linezolid dose or after 2 weeks of monitoring, whichever comes first.

            • maprotiline

              linezolid and maprotiline both increase serotonin levels. Avoid or Use Alternate Drug. Linezolid may increase serotonin as a result of MAO-A inhibition. If linezolid must be administered, discontinue serotonergic drug immediately and monitor for CNS toxicity. Serotonergic therapy may be resumed 24 hours after last linezolid dose or after 2 weeks of monitoring, whichever comes first.

            • meperidine

              linezolid and meperidine both increase serotonin levels. Avoid or Use Alternate Drug. Linezolid may increase serotonin as a result of MAO-A inhibition. If linezolid must be administered, discontinue serotonergic drug immediately and monitor for CNS toxicity. Serotonergic therapy may be resumed 24 hours after last linezolid dose or after 2 weeks of monitoring, whichever comes first.

              meperidine, linezolid. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.

            • metaproterenol

              linezolid increases effects of metaproterenol by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.

            • methadone

              linezolid increases toxicity of methadone by unknown mechanism. Avoid or Use Alternate Drug. Risk of hypotension, hyperpyrexia, somnolence, or death; separate by 14 d.

            • methylene blue

              methylene blue and linezolid both increase serotonin levels. Avoid or Use Alternate Drug. Both drugs increase serotonin as a result of MAO-A inhibition. Avoid coadministration if possible. If coadministered, monitor for CNS toxicity.

            • metoclopramide intranasal

              metoclopramide intranasal increases toxicity of linezolid by Other (see comment). Avoid or Use Alternate Drug. Comment: Metoclopramide may enhance the hypertensive effect of monoamine oxidase inhibitors.

            • microbiota oral

              linezolid decreases effects of microbiota oral by pharmacodynamic antagonism. Avoid or Use Alternate Drug. Microbiota oral contains bacterial spores. Antibacterial agents may decrease efficacy if coadministered. Complete antibiotic regimens 2-4 days before initiating microbiota oral. .

            • milnacipran

              linezolid and milnacipran both increase serotonin levels. Avoid or Use Alternate Drug. Linezolid may increase serotonin as a result of MAO-A inhibition. If linezolid must be administered, discontinue serotonergic drug immediately and monitor for CNS toxicity. Serotonergic therapy may be resumed 24 hours after last linezolid dose or after 2 weeks of monitoring, whichever comes first.

            • mirtazapine

              linezolid and mirtazapine both increase serotonin levels. Avoid or Use Alternate Drug. Linezolid may increase serotonin as a result of MAO-A inhibition. If linezolid must be administered, discontinue serotonergic drug immediately and monitor for CNS toxicity. Serotonergic therapy may be resumed 24 hours after last linezolid dose or after 2 weeks of monitoring, whichever comes first.

            • morphine

              linezolid and morphine both increase serotonin levels. Avoid or Use Alternate Drug. Linezolid may increase serotonin as a result of MAO-A inhibition. If linezolid must be administered, discontinue serotonergic drug immediately and monitor for CNS toxicity. Serotonergic therapy may be resumed 24 hours after last linezolid dose or after 2 weeks of monitoring, whichever comes first.

              linezolid increases toxicity of morphine by unknown mechanism. Avoid or Use Alternate Drug. Risk of hypotension, hyperpyrexia, somnolence, or death; separate by 14 d.

            • nalbuphine

              linezolid increases toxicity of nalbuphine by unknown mechanism. Avoid or Use Alternate Drug. Risk of hypotension, hyperpyrexia, somnolence, or death; separate by 14 d.

            • naratriptan

              naratriptan and linezolid both increase serotonin levels. Avoid or Use Alternate Drug. Linezolid may increase serotonin as a result of MAO-A inhibition. If linezolid must be administered, discontinue serotonergic drug immediately and monitor for CNS toxicity. Serotonergic therapy may be resumed 24 hours after last linezolid dose or after 2 weeks of monitoring, whichever comes first.

              linezolid increases levels of naratriptan by decreasing metabolism. Contraindicated.

            • nefazodone

              linezolid and nefazodone both increase serotonin levels. Avoid or Use Alternate Drug. Linezolid may increase serotonin as a result of MAO-A inhibition. If linezolid must be administered, discontinue serotonergic drug immediately and monitor for CNS toxicity. Serotonergic therapy may be resumed 24 hours after last linezolid dose or after 2 weeks of monitoring, whichever comes first.

            • nortriptyline

              linezolid and nortriptyline both increase serotonin levels. Avoid or Use Alternate Drug. Linezolid may increase serotonin as a result of MAO-A inhibition. If linezolid must be administered, discontinue serotonergic drug immediately and monitor for CNS toxicity. Serotonergic therapy may be resumed 24 hours after last linezolid dose or after 2 weeks of monitoring, whichever comes first.

            • opium tincture

              linezolid increases toxicity of opium tincture by unknown mechanism. Avoid or Use Alternate Drug. Risk of hypotension, hyperpyrexia, somnolence, or death; separate by 14 d.

            • oxycodone

              linezolid increases toxicity of oxycodone by unknown mechanism. Avoid or Use Alternate Drug. Risk of hypotension, hyperpyrexia, somnolence, or death; separate by 14 d.

            • oxymorphone

              linezolid increases toxicity of oxymorphone by unknown mechanism. Avoid or Use Alternate Drug. Risk of hypotension, hyperpyrexia, somnolence, or death; separate by 14 d.

            • papaveretum

              linezolid increases toxicity of papaveretum by unknown mechanism. Avoid or Use Alternate Drug. Risk of hypotension, hyperpyrexia, somnolence, or death; separate by 14 d.

            • paroxetine

              linezolid and paroxetine both increase serotonin levels. Avoid or Use Alternate Drug. Linezolid may increase serotonin as a result of MAO-A inhibition. If linezolid must be administered, discontinue serotonergic drug immediately and monitor for CNS toxicity. Serotonergic therapy may be resumed 24 hours after last linezolid dose or after 2 weeks of monitoring, whichever comes first.

            • pentazocine

              linezolid and pentazocine both increase serotonin levels. Avoid or Use Alternate Drug. Linezolid may increase serotonin as a result of MAO-A inhibition. If linezolid must be administered, discontinue serotonergic drug immediately and monitor for CNS toxicity. Serotonergic therapy may be resumed 24 hours after last linezolid dose or after 2 weeks of monitoring, whichever comes first.

              linezolid increases toxicity of pentazocine by unknown mechanism. Avoid or Use Alternate Drug. Risk of hypotension, hyperpyrexia, somnolence, or death; separate by 14 d.

            • phenelzine

              linezolid and phenelzine both increase serotonin levels. Avoid or Use Alternate Drug. Linezolid may increase serotonin as a result of MAO-A inhibition. If linezolid must be administered, discontinue serotonergic drug immediately and monitor for CNS toxicity. Serotonergic therapy may be resumed 24 hours after last linezolid dose or after 2 weeks of monitoring, whichever comes first.

            • pirbuterol

              linezolid increases effects of pirbuterol by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.

            • procarbazine

              linezolid and procarbazine both increase serotonin levels. Avoid or Use Alternate Drug. Linezolid may increase serotonin as a result of MAO-A inhibition. If linezolid must be administered, discontinue serotonergic drug immediately and monitor for CNS toxicity. Serotonergic therapy may be resumed 24 hours after last linezolid dose or after 2 weeks of monitoring, whichever comes first.

            • protriptyline

              linezolid and protriptyline both increase serotonin levels. Avoid or Use Alternate Drug. Linezolid may increase serotonin as a result of MAO-A inhibition. If linezolid must be administered, discontinue serotonergic drug immediately and monitor for CNS toxicity. Serotonergic therapy may be resumed 24 hours after last linezolid dose or after 2 weeks of monitoring, whichever comes first.

            • rasagiline

              rasagiline and linezolid both increase serotonin levels. Avoid or Use Alternate Drug. Linezolid may increase serotonin as a result of MAO-A inhibition. If linezolid must be administered, discontinue serotonergic drug immediately and monitor for CNS toxicity. Serotonergic therapy may be resumed 24 hours after last linezolid dose or after 2 weeks of monitoring, whichever comes first.

            • remifentanil

              remifentanil, linezolid. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.

            • rizatriptan

              rizatriptan and linezolid both increase serotonin levels. Avoid or Use Alternate Drug. Linezolid may increase serotonin as a result of MAO-A inhibition. If linezolid must be administered, discontinue serotonergic drug immediately and monitor for CNS toxicity. Serotonergic therapy may be resumed 24 hours after last linezolid dose or after 2 weeks of monitoring, whichever comes first.

              linezolid increases levels of rizatriptan by decreasing metabolism. Contraindicated.

            • ropeginterferon alfa 2b

              ropeginterferon alfa 2b, linezolid. Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Myelosuppressive agents can produce additive myelosuppression. Avoid use and monitor patients receiving the combination for effects of excessive myelosuppression.

            • salmeterol

              linezolid increases effects of salmeterol by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.

            • SAMe

              linezolid and SAMe both increase serotonin levels. Avoid or Use Alternate Drug. Linezolid may increase serotonin as a result of MAO-A inhibition. If linezolid must be administered, discontinue serotonergic drug immediately and monitor for CNS toxicity. Serotonergic therapy may be resumed 24 hours after last linezolid dose or after 2 weeks of monitoring, whichever comes first.

            • selegiline

              selegiline and linezolid both increase serotonin levels. Avoid or Use Alternate Drug. Linezolid may increase serotonin as a result of MAO-A inhibition. If linezolid must be administered, discontinue serotonergic drug immediately and monitor for CNS toxicity. Serotonergic therapy may be resumed 24 hours after last linezolid dose or after 2 weeks of monitoring, whichever comes first.

            • selegiline transdermal

              selegiline transdermal and linezolid both increase serotonin levels. Avoid or Use Alternate Drug. Linezolid may increase serotonin as a result of MAO-A inhibition. If linezolid must be administered, discontinue serotonergic drug immediately and monitor for CNS toxicity. Serotonergic therapy may be resumed 24 hours after last linezolid dose or after 2 weeks of monitoring, whichever comes first.

            • sertraline

              linezolid and sertraline both increase serotonin levels. Avoid or Use Alternate Drug. Linezolid may increase serotonin as a result of MAO-A inhibition. If linezolid must be administered, discontinue serotonergic drug immediately and monitor for CNS toxicity. Serotonergic therapy may be resumed 24 hours after last linezolid dose or after 2 weeks of monitoring, whichever comes first.

            • St John's Wort

              linezolid and St John's Wort both increase serotonin levels. Avoid or Use Alternate Drug. Linezolid may increase serotonin as a result of MAO-A inhibition. If linezolid must be administered, discontinue serotonergic drug immediately and monitor for CNS toxicity. Serotonergic therapy may be resumed 24 hours after last linezolid dose or after 2 weeks of monitoring, whichever comes first.

            • sufentanil

              linezolid increases toxicity of sufentanil by unknown mechanism. Avoid or Use Alternate Drug. Risk of hypotension, hyperpyrexia, somnolence, or death; separate by 14 d.

              sufentanil, linezolid. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.

            • sufentanil SL

              sufentanil SL, linezolid. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.

              linezolid increases toxicity of sufentanil SL by serotonin levels. Avoid or Use Alternate Drug. MAOI interactions with opioids may manifest as serotonin syndrome or opioid toxicity (eg, respiratory depression, coma). Opioids are not recommended for patients taking MAOIs or within 14 days of stopping MAOIs. If urgent opioid treatment needed, use test doses and frequent titration of small doses to treat pain while closely monitoring blood pressure and signs and symptoms of CNS and respiratory depression. If linezolid must be administered, discontinue serotonergic drug immediately and monitor for CNS toxicity. Serotonergic therapy may be resumed 24 hours after last linezolid dose or after 2 weeks of monitoring, whichever comes first.

            • sumatriptan

              sumatriptan and linezolid both increase serotonin levels. Avoid or Use Alternate Drug. Linezolid may increase serotonin as a result of MAO-A inhibition. If linezolid must be administered, discontinue serotonergic drug immediately and monitor for CNS toxicity. Serotonergic therapy may be resumed 24 hours after last linezolid dose or after 2 weeks of monitoring, whichever comes first.

              linezolid increases levels of sumatriptan by decreasing metabolism. Contraindicated.

            • sumatriptan intranasal

              sumatriptan intranasal and linezolid both increase serotonin levels. Avoid or Use Alternate Drug. Linezolid may increase serotonin as a result of MAO-A inhibition. If linezolid must be administered, discontinue serotonergic drug immediately and monitor for CNS toxicity. Serotonergic therapy may be resumed 24 hours after last linezolid dose or after 2 weeks of monitoring, whichever comes first.

              linezolid increases levels of sumatriptan intranasal by decreasing metabolism. Contraindicated.

            • tapentadol

              linezolid increases toxicity of tapentadol by unknown mechanism. Avoid or Use Alternate Drug. Risk of hypotension, hyperpyrexia, somnolence, or death; separate by 14 d.

            • terbutaline

              linezolid increases effects of terbutaline by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.

            • tramadol

              linezolid and tramadol both increase serotonin levels. Avoid or Use Alternate Drug. Linezolid may increase serotonin as a result of MAO-A inhibition. If linezolid must be administered, discontinue serotonergic drug immediately and monitor for CNS toxicity. Serotonergic therapy may be resumed 24 hours after last linezolid dose or after 2 weeks of monitoring, whichever comes first.

              linezolid increases toxicity of tramadol by unknown mechanism. Avoid or Use Alternate Drug. Risk of hypotension, hyperpyrexia, somnolence, or death; separate by 14 d.

            • tranylcypromine

              linezolid and tranylcypromine both increase serotonin levels. Avoid or Use Alternate Drug. Linezolid may increase serotonin as a result of MAO-A inhibition. If linezolid must be administered, discontinue serotonergic drug immediately and monitor for CNS toxicity. Serotonergic therapy may be resumed 24 hours after last linezolid dose or after 2 weeks of monitoring, whichever comes first.

            • trazodone

              linezolid and trazodone both increase serotonin levels. Avoid or Use Alternate Drug. Linezolid may increase serotonin as a result of MAO-A inhibition. If linezolid must be administered, discontinue serotonergic drug immediately and monitor for CNS toxicity. Serotonergic therapy may be resumed 24 hours after last linezolid dose or after 2 weeks of monitoring, whichever comes first.

            • trimipramine

              linezolid and trimipramine both increase serotonin levels. Avoid or Use Alternate Drug. Linezolid may increase serotonin as a result of MAO-A inhibition. If linezolid must be administered, discontinue serotonergic drug immediately and monitor for CNS toxicity. Serotonergic therapy may be resumed 24 hours after last linezolid dose or after 2 weeks of monitoring, whichever comes first.

            • typhoid vaccine live

              linezolid decreases effects of typhoid vaccine live by pharmacodynamic antagonism. Contraindicated. Wait until Abx Tx complete to administer live bacterial vaccine.

            • valbenazine

              linezolid, valbenazine. Other (see comment). Avoid or Use Alternate Drug. Comment: Coadministration of valbenazine with MAOIs may increase monoamine neurotransmitter concentration in synapses, potentially increasing risk of serotonin syndrome or attenuating valbenazine effect.

            • venlafaxine

              linezolid and venlafaxine both increase serotonin levels. Avoid or Use Alternate Drug. Linezolid may increase serotonin as a result of MAO-A inhibition. If linezolid must be administered, discontinue serotonergic drug immediately and monitor for CNS toxicity. Serotonergic therapy may be resumed 24 hours after last linezolid dose or after 2 weeks of monitoring, whichever comes first.

            • vilazodone

              linezolid, vilazodone. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug. Linezolid may increase serotonin as a result of MAO-A inhibition. If linezolid must be administered, discontinue serotonergic drug immediately and monitor for CNS toxicity. Serotonergic therapy may be resumed 24 hours after last linezolid dose or after 2 weeks of monitoring, whichever comes first.

            • zolmitriptan

              zolmitriptan and linezolid both increase serotonin levels. Avoid or Use Alternate Drug. Linezolid may increase serotonin as a result of MAO-A inhibition. If linezolid must be administered, discontinue serotonergic drug immediately and monitor for CNS toxicity. Serotonergic therapy may be resumed 24 hours after last linezolid dose or after 2 weeks of monitoring, whichever comes first.

              linezolid increases levels of zolmitriptan by decreasing metabolism. Contraindicated.

            Monitor Closely (66)

            • acalabrutinib

              acalabrutinib, linezolid. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Coadministration may increase risk of myelosuppressive effects.

            • amifampridine

              linezolid increases toxicity of amifampridine by Other (see comment). Modify Therapy/Monitor Closely. Comment: Amifampridine can cause seizures. Coadministration with drugs that lower seizure threshold may increase this risk.

            • aripiprazole

              linezolid, aripiprazole. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).

            • asenapine

              linezolid, asenapine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).

            • bazedoxifene/conjugated estrogens

              linezolid will decrease the level or effect of bazedoxifene/conjugated estrogens by altering intestinal flora. Applies only to oral forms of hormone. Low risk of contraceptive failure. Use Caution/Monitor.

            • buprenorphine subdermal implant

              linezolid, buprenorphine subdermal implant. Either increases toxicity of the other by serotonin levels. Use Caution/Monitor. Concomitant use could result in life-threatening serotonin syndrome. If concomitant use is warranted, carefully observe the patient, particularly during treatment initiation, and during dose adjustment of the serotonergic drug. Discontinue buprenorphine if serotonin syndrome is suspected.

            • buprenorphine, long-acting injection

              linezolid, buprenorphine, long-acting injection. Either increases toxicity of the other by serotonin levels. Modify Therapy/Monitor Closely. Concomitant use could result in life-threatening serotonin syndrome or opioid toxicity (eg, respiratory depression, coma). Buprenorphine long-acting injection is not recommended for patients taking MAOIs or within 14 days of stopping such treatment.

            • carbamazepine

              carbamazepine decreases levels of linezolid by increasing metabolism. Use Caution/Monitor.

            • cariprazine

              linezolid, cariprazine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).

            • chlorpropamide

              linezolid increases effects of chlorpropamide by unknown mechanism. Use Caution/Monitor.

            • clozapine

              linezolid, clozapine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).

            • conjugated estrogens

              linezolid will decrease the level or effect of conjugated estrogens by altering intestinal flora. Applies only to oral forms of hormone. Low risk of contraceptive failure. Use Caution/Monitor.

            • desflurane

              linezolid increases levels of desflurane by pharmacodynamic synergism. Use Caution/Monitor.

            • difenoxin hcl

              difenoxin hcl, linezolid. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Risk of serotonin syndrome.

            • digoxin

              linezolid will increase the level or effect of digoxin by altering intestinal flora. Applies only to oral form of both agents. Use Caution/Monitor.

            • diphenoxylate hcl

              diphenoxylate hcl, linezolid. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Risk of serotonin syndrome.

            • estradiol

              linezolid will decrease the level or effect of estradiol by altering intestinal flora. Applies only to oral forms of hormone. Low risk of contraceptive failure. Use Caution/Monitor.

            • estrogens conjugated synthetic

              linezolid will decrease the level or effect of estrogens conjugated synthetic by altering intestinal flora. Applies only to oral forms of hormone. Low risk of contraceptive failure. Use Caution/Monitor.

            • estropipate

              linezolid will decrease the level or effect of estropipate by altering intestinal flora. Applies only to oral forms of hormone. Low risk of contraceptive failure. Use Caution/Monitor.

            • etomidate

              linezolid increases levels of etomidate by pharmacodynamic synergism. Use Caution/Monitor.

            • fluphenazine

              linezolid, fluphenazine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).

            • glimepiride

              linezolid increases effects of glimepiride by unknown mechanism. Use Caution/Monitor.

            • glipizide

              linezolid increases effects of glipizide by unknown mechanism. Use Caution/Monitor.

            • glyburide

              linezolid increases effects of glyburide by unknown mechanism. Use Caution/Monitor.

            • green tea

              green tea, linezolid. Other (see comment). Use Caution/Monitor. Comment: Avoid combination or excessive consumption of green tea. Combination may increase risk of cardiac arrhythmias or severe hypertension can occur due to caffeine component of green tea.

            • haloperidol

              linezolid, haloperidol. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).

            • hydralazine

              hydralazine, linezolid. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Risk of hypertension.

            • iloperidone

              linezolid, iloperidone. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).

            • insulin aspart

              linezolid increases effects of insulin aspart by unknown mechanism. Use Caution/Monitor.

            • insulin detemir

              linezolid increases effects of insulin detemir by unknown mechanism. Use Caution/Monitor.

            • insulin glargine

              linezolid increases effects of insulin glargine by unknown mechanism. Use Caution/Monitor.

            • insulin glulisine

              linezolid increases effects of insulin glulisine by unknown mechanism. Use Caution/Monitor.

            • insulin lispro

              linezolid increases effects of insulin lispro by unknown mechanism. Use Caution/Monitor.

            • insulin NPH

              linezolid increases effects of insulin NPH by unknown mechanism. Use Caution/Monitor.

            • insulin regular human

              linezolid increases effects of insulin regular human by unknown mechanism. Use Caution/Monitor.

            • ketamine

              linezolid increases levels of ketamine by pharmacodynamic synergism. Use Caution/Monitor.

            • lasmiditan

              linezolid increases effects of lasmiditan by serotonin levels. Use Caution/Monitor. Coadministration may increase risk of serotonin syndrome.

            • levodopa inhaled

              levodopa inhaled increases effects of linezolid by dopaminergic effects. Use Caution/Monitor. Coadministration of selective MAO-B inhibitors with levodopa may be associated with orthostatic hypotension.

            • lithium

              lithium, linezolid. Mechanism: unknown. Use Caution/Monitor. Risk of malignant hyperpyrexia. Interactions esp. expected w/non selective MAOIs.

            • loxapine

              linezolid, loxapine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).

            • loxapine inhaled

              linezolid, loxapine inhaled. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).

            • lurasidone

              linezolid, lurasidone. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).

            • mestranol

              linezolid will decrease the level or effect of mestranol by altering intestinal flora. Applies only to oral forms of hormone. Low risk of contraceptive failure. Use Caution/Monitor.

            • metformin

              linezolid will increase the level or effect of metformin by unspecified interaction mechanism. Use Caution/Monitor.

            • metrizamide

              linezolid, metrizamide. Mechanism: unspecified interaction mechanism. Use Caution/Monitor. Risk of seizure. D/C MAO inhibitor 24h before admin. of metrizamide.

            • molindone

              linezolid, molindone. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).

            • olanzapine

              linezolid, olanzapine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).

            • oliceridine

              linezolid, oliceridine. Either increases effects of the other by serotonin levels. Modify Therapy/Monitor Closely.

            • opium tincture

              opium tincture, linezolid. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Risk of serotonin syndrome.

            • paliperidone

              linezolid, paliperidone. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).

            • perphenazine

              linezolid, perphenazine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).

            • phenylephrine ophthalmic

              linezolid increases effects of phenylephrine ophthalmic by pharmacodynamic synergism. Use Caution/Monitor. Some systemic absorption of ophthalmic phenylephrine; reduce dose within 21 days of MAO inhibitors.

            • pimavanserin

              linezolid, pimavanserin. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).

            • pimozide

              linezolid, pimozide. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).

            • propofol

              linezolid increases levels of propofol by pharmacodynamic synergism. Use Caution/Monitor.

            • quetiapine

              linezolid, quetiapine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).

            • risperidone

              linezolid, risperidone. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).

            • sevoflurane

              linezolid increases levels of sevoflurane by pharmacodynamic synergism. Use Caution/Monitor.

            • sodium picosulfate/magnesium oxide/anhydrous citric acid

              linezolid decreases effects of sodium picosulfate/magnesium oxide/anhydrous citric acid by altering metabolism. Use Caution/Monitor. Coadministration with antibiotics decreases efficacy by altering colonic bacterial flora needed to convert sodium picosulfate to active drug.

            • tapentadol

              linezolid and tapentadol both increase serotonin levels. Modify Therapy/Monitor Closely.

            • thiothixene

              linezolid, thiothixene. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).

            • tolazamide

              linezolid increases effects of tolazamide by unknown mechanism. Use Caution/Monitor.

            • tolbutamide

              linezolid increases effects of tolbutamide by unknown mechanism. Use Caution/Monitor.

            • trifluoperazine

              linezolid, trifluoperazine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).

            • yohimbe

              yohimbe increases effects of linezolid by pharmacodynamic synergism. Use Caution/Monitor.

            • ziprasidone

              linezolid, ziprasidone. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).

            Minor (21)

            • amobarbital

              linezolid increases levels of amobarbital by decreasing metabolism. Minor/Significance Unknown. Theoretical interaction.

            • balsalazide

              linezolid will decrease the level or effect of balsalazide by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.

            • biotin

              linezolid will decrease the level or effect of biotin by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.

            • butabarbital

              linezolid increases levels of butabarbital by decreasing metabolism. Minor/Significance Unknown. Theoretical interaction.

            • butalbital

              linezolid increases levels of butalbital by decreasing metabolism. Minor/Significance Unknown. Theoretical interaction.

            • celandine

              celandine increases effects of linezolid by pharmacodynamic synergism. Minor/Significance Unknown. Based on animal studies.

            • cordyceps

              cordyceps increases effects of linezolid by pharmacodynamic synergism. Minor/Significance Unknown.

            • disulfiram

              disulfiram, linezolid. Mechanism: unknown. Minor/Significance Unknown. Risk of delirium (case report).

            • panax ginseng

              panax ginseng increases effects of linezolid by pharmacodynamic synergism. Minor/Significance Unknown.

            • pantothenic acid

              linezolid will decrease the level or effect of pantothenic acid by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.

            • pentobarbital

              linezolid increases levels of pentobarbital by decreasing metabolism. Minor/Significance Unknown. Theoretical interaction.

            • phenobarbital

              linezolid increases levels of phenobarbital by decreasing metabolism. Minor/Significance Unknown. Theoretical interaction.

            • pleurisy root

              pleurisy root decreases effects of linezolid by unspecified interaction mechanism. Minor/Significance Unknown. Theoretical interaction.

            • primidone

              linezolid increases levels of primidone by decreasing metabolism. Minor/Significance Unknown. Theoretical interaction.

            • pyridoxine

              linezolid will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.

            • pyridoxine (Antidote)

              linezolid will decrease the level or effect of pyridoxine (Antidote) by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.

            • secobarbital

              linezolid increases levels of secobarbital by decreasing metabolism. Minor/Significance Unknown. Theoretical interaction.

            • sulfadiazine

              linezolid increases levels of sulfadiazine by unspecified interaction mechanism. Minor/Significance Unknown.

            • sulfamethoxazole

              linezolid increases levels of sulfamethoxazole by unspecified interaction mechanism. Minor/Significance Unknown.

            • sulfisoxazole

              linezolid increases levels of sulfisoxazole by unspecified interaction mechanism. Minor/Significance Unknown.

            • thiamine

              linezolid will decrease the level or effect of thiamine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.

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            Adverse Effects

            >10%

            Pediatrics

            • Diarrhea (7.8-10.8%)

            1-10%

            Headache (5.7-8.8%)

            Diarrhea (8.2-8.3%)

            Nausea (5.1-6.6%)

            Vomiting (2-4.3%)

            Dizziness (1.8-2.6%)

            Rash (1.1-2.3%)

            Vaginal moniliasis (1.1-1.8%)

            Taste alteration (1-1.8%)

            Oral moniliasis (0.5-1.7%)

            Abnormal LFTs (0.4-1.6%)

            Fungal infection (0.3-1.5%)

            Localized abdominal pain (1.2-1.3%)

            Tongue discoloration (0.3-1.3%)

            Generalized abdominal pain (0.9-1.2%)

            Pediatrics

            • Vomiting (2.9-9.4%)
            • Headache (0.9-6.5%)
            • Anemia (5.6%)
            • Thrombocytopenia (4.7%)
            • Nausea (1.9-3.7%)
            • Generalized abdominal pain (0.9-2.4%)
            • Localized abdominal pain (0.5-2.4%)
            • Loose stools (1.6-2.3%)
            • Eosinophilia (0.4-1.9%)
            • Pruritus, other than application site (0.8-1.4%)
            • Vertigo (1.2%)

            <1%

            Lactic acidosis

            Myelosuppression

            Peripheral neuropathy

            Disorder of optic nerve

            Serotonin syndrome

            Postmarketing Reports

            Superficial tooth discoloration

            Superficial tongue discoloration

            Myelosuppression including anemia, leukopenia, pancytopenia, and thrombocytopenia

            Sideroblastic anemia

            Anaphylaxis

            Angioedema

            Bullous skin disorders including severe cutaneous adverse reactions (SCAR) such as toxic epidermal necrolysis and Stevens-Johnson syndrome

            Optic neuropathy

            Hypersensitivity vasculitis

            Hypoglycemia

            Hyponatremia and/or syndrome of inappropriate antidiuretic hormone secretion (SIADH)

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            Warnings

            Contraindications

            Hypersensitivity

            Within 14 days of taking MAO inhibitor

            Cautions

            Use caution in patients with pheochromocytoma, concurrent apraclonidine, brimonidine, uncontrolled hypertension, thyrotoxicosis, carcinoid syndrome, diabetes mellitus, or seizure disorders

            Phenylalanine can be harmful to patients with phenylketonuria (PKU); oral suspension contains phenylalanine, a component of aspartame; each 5 mL of the 100 mg/5 mL oral suspension contains 20 mg of phenylalanine; before prescribing oral suspension to patient with PKU, consider combined daily amount of phenylalanine from all sources, including oral suspension; the other formulations do not contain phenylalanine

            Not approved for gram-negative bacteria or for catheter-related infections; clinical study showed higher mortality rate with linezolid than with other antibiotics for these conditions

            Monitor for myelosuppression; consider discontinuation in patients who develop or have worsening myelosuppression

            Evaluate for clostridium difficile if diarrhea occurs

            Peripheral and optic neuropathy reported, especially in patients given extended courses of therapy >28 days

            May cause hypoglycemia; monitor blood glucose levels

            Lactic acidosis reported with use; immediately evaluate patients who develop recurrent unexplained acidosis with nausea and vomiting

            Superinfection may develop

            Hyponatremia

            • Postmarketing cases of hyponatremia and/or syndrome of inappropriate antidiuretic hormone secretion (SIADH) reported; in reported cases, the signs and symptoms included confusion, somnolence, generalized weakness, and in severe cases led to respiratory failure and even death
            • Monitor serum sodium levels regularly in the elderly, in patients taking diuretics, and in other patients at risk of hyponatremia and/or SIADH while taking drug
            • If signs and symptoms of hyponatremia and/or SIADH occur, discontinue therapy and institute appropriate supportive measures

            Serotonin syndrome

            • Avoid coadministration with serotonergic psychiatric drugs (eg, SSRIs, SNRIs, TCAs, MAOIs, bupropion, buspirone, serotonin 5-HT1 receptor agonists (triptans), and opioids, including meperidine) unless indicated for life-threatening or urgent infections (eg, vancomycin-resistant enterococcal infections, nosocomial pneumonia, complicated skin and skin structure infections such as methicillin-resistant S aureus), due to increased risk of serotonin syndrome; linezolid may increase serotonin CNS levels by MAO-A inhibition
            • If linezolid must be administered to a patient currently taking a serotonergic drug, stop serotonergic drug immediately and monitor for CNS toxicity; serotonergic therapy may be resumed 24 hours after last linezolid dose or after 2 weeks of monitoring (5 weeks if fluoxetine was taken), whichever comes first; serotonergic psychiatric medications should be stopped at least 2 weeks in advance of linezolid therapy; fluoxetine should be stopped at least 5 weeks in advance due to longer half-life
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            Pregnancy & Lactation

            Pregnancy

            Available data from published and postmarketing case reports with linezolid use in pregnant women have not identified a drug-associated risk of major birth defects, miscarriage, or adverse maternal or fetal outcomes

            Animal data

            • When administered during organogenesis, linezolid did not cause malformations in mice, rats, or rabbits at maternal exposure levels approximately 6.5 times (mice), equivalent to (rats), or 0.06 times (rabbits) the clinical therapeutic exposure, based on AUCs; however, embryo-fetal lethality was observed in mice at 6.5 times the estimated human exposure
            • When female rats were dosed during organogenesis through lactation, postnatal survival of pups was decreased at doses approximately equivalent to the estimated human exposure based on AUCs

            Infertility

            • Based on findings from studies in rats, drug may reversibly impair fertility in male patients

            Lactation

            Drug is present in breast milk; based on data from available published case reports, the daily dose that the infant would receive from breastmilk would be approximately 6% to 9% of the recommended therapeutic infant dose (10 mg/kg every 8 hours)

            There is no information on effects of linezolid on breastfed infant; however, diarrhea and vomiting were the most common adverse reactions reported in clinical trials in infants receiving linezolid therapeutically

            There is no information on effects of drug on milk production; consider developmental and health benefits of breastfeeding along with mother’s clinical need for drug and any potential adverse effects on breastfed child from drug or from underlying maternal condition

            Advise lactating women to monitor a breastfed infant for diarrhea and vomiting

            Pregnancy Categories

            A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

            B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

            C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

            D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

            X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

            NA: Information not available.

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            Pharmacology

            Mechanism of Action

            Binds to bacterial 23S rRNA of the 50S subunit to prevent protein translation; also elicits nonselective MAO inhibition

            Absorption

            Rapid and extensive

            Bioavailability: 100%

            Peak plasma time: 1-2 hr

            Distribution

            Protein bound: 31%

            Vd: 40-50 L

            Metabolism

            Hepatic via oxidation of the morpholine ring, resulting in 2 inactive metabolites (aminoethoxyacetic acid, hydroxyethyl glycine); does not involve CYP

            Elimination

            Half-life: 4-5 hr (adults); 1.5-3hr

            Clearance: Nonrenal (65% of total clearance)

            Excretion: Urine (80% of administered dose [30% unchanged, 50% metabolites]); feces (9% [metabolites])

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            Administration

            IV Incompatibilities

            Additive: Kanamycin, phenytoin, ceftriaxone, erythromycin lactobionate, TMP-SMX

            Syringe: Ampicillin

            Y-site: Ampho B, chlorpromazine, diazepam, pentamidine, phenytoin

            IV Compatibilities

            Additive: Aztreonam, cefazolin, ceftazidime, ciprofloxacin, gentamicin, levofloxacin, ofloxacin, piperacillin, tobramycin

            Y-site: Acyclovir, alfentanil, amikacin, aminophylline, ampicillin, aztreonam, bretylium, buprenorphine, butorphanol, Ca-gluconate, cefazolin, cefoperazone, cefotetan, cefoxitin, ceftazidime, ceftizoxime, ceftriaxone, cefuroxime, cimetidine, ciprofloxacin, cisatracurium, cisplatin, clindamycin, cyclophosphamide, cyclosporine, cytarabine, dexamethasone Na-phosphate, dexmetedomidine, digoxin, diphenhydramine, dobutamine, dopamine, doxorubicin, doxycycline, droperidol, enalaprilat, esmolol, etoposide PO4, famotidine, fenoldopam, fluconazole, fluorouracil, furosemide, ganciclovir, gemcitabine, gentamycin, granisetron, haloperidol, heparin, hydrocortisone sodium succinate, hydromorphone, hydroxyzine, ifosfamide, imipenem-cilastatin, labetalol, leucovorin, lidocaine, lorazepam, magnesium sulfate, mannitol, meperidine, meropenem, mesna, methotrexate, methylprednisolone, metoclopramide, metronidazole, midazolam, minocycline, mitoxantrone, morphine sulfate, nalbuphine, nicardipine, naloxone, nitroglycerin, ofloxacin, ondansetron, paclitaxel, pentobarbital, piperacillin, KCl, prochlorperazine, promethazine, propranolol, ranitidine, remifentanil, Na-bicarbonate, sufentanil, theophylline, ticarcillin, tobramycin, vancomycin, vecuronium, verapamil, vincristine, zidovudine

            IV Preparation

            Injection is supplied as a single-use, ready-to-use infusion bag; inspect for particulate matter and minute leaks in bag

            Infusion should be administered over 30-120 min

            Use reconstituted suspension within 21 days

            Storage

            Store at 25°C (77°F)

            Protect from light

            Keep infusion bags in overwrap until ready to use

            Protect infusion bags from freezing

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            Images

            BRAND FORM. UNIT PRICE PILL IMAGE
            Zyvox oral
            -
            100 mg/5 mL suspension
            Zyvox oral
            -
            600 mg tablet
            linezolid oral
            -
            600 mg tablet
            linezolid oral
            -
            600 mg tablet
            linezolid oral
            -
            600 mg tablet
            linezolid oral
            -
            600 mg tablet
            linezolid oral
            -
            100 mg/5 mL suspension
            linezolid oral
            -
            600 mg tablet
            linezolid oral
            -
            600 mg tablet
            linezolid oral
            -
            100 mg/5 mL suspension

            Copyright © 2010 First DataBank, Inc.

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            Patient Handout

            Patient Education
            linezolid oral

            LINEZOLID - ORAL

            (lin-AYZ-oh-lid)

            COMMON BRAND NAME(S): Zyvox

            USES: Linezolid is an antibiotic used to treat certain serious bacterial infections. It works by stopping the growth of bacteria.This antibiotic treats only bacterial infections. It will not work for viral infections (such as common cold, flu). Using any antibiotic when it is not needed can cause it to not work for future infections.Linezolid also belongs to a class of drugs known as MAO inhibitors. It can increase the levels of certain natural substances in the body (such as dopamine, norepinephrine, serotonin) which can increase the chance of certain side effects and food and drug interactions. See How to Use, Side Effects, and Drug Interactions sections for more details.

            HOW TO USE: Take this medication by mouth with or without food as directed by your doctor, usually every 12 hours. The dosage is based on your medical condition and response to treatment. For children, the dosage is also based on age and weight, and they may be directed to take this medication every 8 hours.To prevent a very serious high blood pressure reaction, it is very important that you follow a special diet recommended by your doctor or dietician to limit your intake of tyramine while you are taking this medicine. Avoid foods and beverages that are high in tyramine, including aged cheeses, dried/aged meats and sausages (such as salami, liverwurst), preserved fish (such as pickled herring), products that contain large amounts of yeast (such as bouillon cubes, powdered soup/gravy, homemade or sourdough bread), fermented foods (such as sauerkraut, kim chee), most soybean products (such as soy sauce, tofu), broad/fava beans, red wine, sherry, tap beers, and vermouth. Consult your doctor or dietician for more details and a complete list of other foods that contain tyramine which you should limit or avoid.For the best effect, take this antibiotic at evenly spaced times. To help you remember, take this medication at the same time(s) every day.Continue to take this medication until the full prescribed amount is finished, even if symptoms disappear after a few days. Stopping the medication too early may result in a return of the infection.Tell your doctor if your condition lasts or gets worse.

            SIDE EFFECTS: Diarrhea, headache, nausea, vomiting, or dizziness may occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly.Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.Tell your doctor right away if you have any serious side effects, including: deep/fast breathing, unusual drowsiness, nausea/vomiting that doesn't stop, numbness/tingling of the hands/feet, unusual tiredness, easy bruising/bleeding.Get medical help right away if you have any very serious side effects, including: muscle stiffness, increased sweating, vision changes (such as blurred vision, change in color vision, loss of vision), mental/mood changes (such as agitation, confusion), seizure.This medication may rarely cause a severe intestinal condition due to a bacteria called C. difficile. This condition may occur during treatment or weeks to months after treatment has stopped. Tell your doctor right away if you develop: diarrhea that doesn't stop, abdominal or stomach pain/cramping, blood/mucus in your stool.If you have these symptoms, do not use anti-diarrhea or opioid products because they may make symptoms worseUse of this medication for prolonged or repeated periods may result in oral thrush or a new yeast infection. Contact your doctor if you notice white patches in your mouth, a change in vaginal discharge, or other new symptoms.This medication may increase serotonin and rarely cause a very serious condition called serotonin syndrome/toxicity. The risk increases if you are also taking other drugs that increase serotonin, so tell your doctor or pharmacist of all the drugs you take. Get medical help right away if you develop some of the following symptoms: fast heartbeat, hallucinations, loss of coordination, severe dizziness, unexplained fever, severe nausea/vomiting/diarrhea, twitching muscles, unusual agitation/restlessness.This drug may rarely cause an attack of extremely high blood pressure (hypertensive crisis), which may be fatal. Many drug and food interactions can increase this risk (see How to Use and Drug Interactions sections). Get medical help right away if any of these serious side effects occur: severe headache, fast/slow/irregular/pounding heartbeat, chest pain, neck stiffness/soreness, severe nausea/vomiting, sweating/clammy skin (sometimes with fever), widened pupils, vision changes (such as double/blurred vision), sudden sensitivity to light (photophobia).A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

            PRECAUTIONS: Before taking linezolid, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: high blood pressure, blood/bone marrow problems (such as low red/white blood cells and platelets), kidney problems, liver problems, certain tumor conditions (such as pheochromocytoma, carcinoid syndrome), overactive thyroid, seizures.This drug may make you dizzy. Alcohol or marijuana (cannabis) can make you more dizzy. Do not drive, use machinery, or do anything that needs alertness until you can do it safely. Limit alcoholic beverages. Talk to your doctor if you are using marijuana (cannabis).If you have diabetes, linezolid may lower your blood sugar. Check your blood sugar regularly as directed and share the results with your doctor. Tell your doctor right away if you have symptoms of low blood sugar such as sudden sweating, shaking, fast heartbeat, hunger, blurred vision, dizziness, or tingling hands/feet. Your doctor may need to adjust your diabetes medication, exercise program, or diet.Linezolid may cause live bacterial vaccines (such as typhoid vaccine) to not work well. Tell your health care professional that you are using linezolid before having any immunizations/vaccinations.Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.This medication passes into breast milk and may have undesirable effects on a nursing infant. Consult your doctor before breast-feeding.

            DRUG INTERACTIONS: See also How to Use section.Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.Some products that may interact with this drug include: diet pills/appetite suppressants (such as diethylpropion), drugs for attention deficit disorder (such as atomoxetine, methylphenidate), apraclonidine, bupropion, buspirone, carbamazepine, cyclobenzaprine, deutetrabenazine, a certain combination product (dextromethorphan/quinidine), levodopa, maprotiline, methyldopa, metoclopramide, certain opioid pain relievers (such as fentanyl, meperidine, methadone, tapentadol), certain drugs for Parkinson's disease (such as entacapone, tolcapone), certain supplements (such as tryptophan, tyramine), tetrabenazine, tricyclic antidepressants (such as amitriptyline, doxepin), valbenazine.The risk of serotonin syndrome/toxicity increases if you are also taking other drugs that increase serotonin. Examples include street drugs such as MDMA/"ecstasy," St. John's wort, certain antidepressants (including mirtazapine, SSRIs such as fluoxetine/paroxetine, SNRIs such as duloxetine/venlafaxine), tramadol, certain "triptans" used to treat migraine headaches (such as rizatriptan, sumatriptan, zolmitriptan), among others. The risk of serotonin syndrome/toxicity may be more likely when you start or increase the dose of these drugs.Some products can interact with linezolid if you take them together, or even if you take them weeks before or after taking linezolid. Tell your doctor or pharmacist if you take anything in the list of products that may interact with this drug, or any of the products that increase serotonin, within 2 weeks before or after taking linezolid. Also tell them if you have taken fluoxetine within 5 weeks before starting linezolid. Ask your doctor how much time to wait between starting or stopping any of these drugs and starting linezolid.Taking other MAO inhibitors with this medication may cause a serious (possibly fatal) drug interaction. Do not take any other MAO inhibitors (isocarboxazid, metaxalone, methylene blue, moclobemide, phenelzine, procarbazine, rasagiline, safinamide, selegiline, tranylcypromine) during treatment with this medication. Most MAO inhibitors should also not be taken for two weeks before and after treatment with this medication. Ask your doctor when to start or stop taking this medication.Before using linezolid, report the use of drugs that may increase the risk of extremely high blood pressure (hypertensive crisis) when combined with linezolid, including herbal products (such as ephedra/ma huang), allergy and cold products (including decongestants such as phenylephrine/pseudoephedrine), and stimulants (such as amphetamines, ephedrine, epinephrine). Linezolid should not be used with any of these medications. Talk to your doctor or pharmacist for more details.

            OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center.

            NOTES: Do not share this medication with others.This medication has been prescribed for your current condition only. Do not use it later for another infection unless your doctor tells you to.Lab and/or medical tests (such as complete blood count, blood sodium levels) may be done while you are taking this medication. Eye tests should also be done if you take linezolid for 3 months or more, or if you have vision changes. Keep all medical and lab appointments.

            MISSED DOSE: If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.

            STORAGE: Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.

            Information last revised January 2023. Copyright(c) 2023 First Databank, Inc.

            IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.

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            Formulary

            FormularyPatient Discounts

            Adding plans allows you to compare formulary status to other drugs in the same class.

            To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

            Adding plans allows you to:

            • View the formulary and any restrictions for each plan.
            • Manage and view all your plans together – even plans in different states.
            • Compare formulary status to other drugs in the same class.
            • Access your plan list on any device – mobile or desktop.

            The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

            Tier Description
            1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
            2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
            3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
            4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            NC NOT COVERED – Drugs that are not covered by the plan.
            Code Definition
            PA Prior Authorization
            Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
            QL Quantity Limits
            Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
            ST Step Therapy
            Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
            OR Other Restrictions
            Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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            Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.