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Zyvox (linezolid) Disease Interactions

There are 7 disease interactions with Zyvox (linezolid):

Linezolid (Includes Zyvox) ↔ Bone Marrow Suppression

Severe Potential Hazard, Moderate plausibility

Applies to: Thrombocytopathy, Bone Marrow Depression/Low Blood Counts

Reversible myelosuppression, including anemia, leukopenia, pancytopenia and thrombocytopenia, has been reported during postmarketing use of linezolid, although a causal relationship has not been established. Thrombocytopenia was also reported in phase 3 comparator-controlled trials at dosages up to and including 600 mg every 12 hours for up to 28 days, and bleeding events were identified in thrombocytopenic patients in a compassionate use program for linezolid. Therapy with linezolid should be administered cautiously in patients with preexisting blood dyscrasias and in patients receiving concomitant medications that may produce myelosuppression. Complete blood counts should be monitored weekly, particularly if linezolid is administered for longer than 2 weeks. Discontinuation of therapy should be considered in patients who develop or have worsening myelosuppression.

References

  1. Arellano FM "Linezolid and reversible myelosuppression." JAMA 286 (2001): 1973-4; discussion 1974
  2. Clemett D, Markham A "Linezolid." Drugs 59 (2000): 815-27
  3. Green SL, Maddox JC, Huttenbach ED "Linezolid and reversible myelosuppression." JAMA 285 (2001): 1291
View all 6 references

Antibiotics (Includes Zyvox) ↔ Colitis

Moderate Potential Hazard, Moderate plausibility

Applies to: Colitis/Enteritis (Noninfectious)

Pseudomembranous colitis has been reported with most antibacterial agents and may range in severity from mild to life-threatening, with an onset of up to two months following cessation of therapy. Antibiotic therapy can alter the normal flora of the colon and permit overgrowth of Clostridium difficile, whose toxin is believed to be a primary cause of antibiotic-associated colitis. The colitis is usually characterized by severe, persistent diarrhea and severe abdominal cramps, and may be associated with the passage of blood and mucus. The most common culprits are clindamycin, lincomycin, the aminopenicillins (amoxicillin, ampicillin), and the cephalosporins. Therapy with broad-spectrum antibiotics and other agents with significant antibacterial activity should be administered cautiously in patients with a history of gastrointestinal diseases, particularly colitis. There is some evidence that pseudomembranous colitis, if it occurs, may run a more severe course in these patients and that it may be associated with flares in their underlying disease activity. The offending antibiotic(s) should be discontinued if significant diarrhea occurs during therapy. Stool cultures for Clostridium difficile and stool assay for C. difficile toxin may be helpful diagnostically. A large bowel endoscopy may be considered to establish a definitive diagnosis in cases of severe diarrhea.

References

  1. Moriarty HJ, Scobie BA "Pseudomembranous colitis in a patient on rifampicin and ethambutol." N Z Med J 04/23/80 (1980): 294-5
  2. Thomas E, Mehta JB "Pseudomembranous colitis due to oxacillin therapy." South Med J 77 (1984): 532-3
  3. Harmon T, Burkhart G, Applebaum H "Perforated pseudomembranous colitis in the breast-fed infant." J Pediatr Surg 27 (1992): 744-6
View all 47 references

Linezolid (Includes Zyvox) ↔ Carcinoid Syndrome

Moderate Potential Hazard, Moderate plausibility

Applies to: Carcinoid Syndrome

Linezolid is a weak, reversible, nonselective monoamine oxidase inhibitor (MAOI). Nonspecific MAOIs inhibit the breakdown of pressor amines, including serotonin, and may exacerbate symptoms of the carcinoid syndrome. While adverse effects related to MAOI activity have not been reported with linezolid, the potential for excessive serotonergic effects should be considered. Therapy with linezolid should be administered cautiously in patients with carcinoid syndrome and in patients receiving serotonergic agents. Clinical data are not available concerning the use of linezolid in these populations.

References

  1. "Product Information. Zyvox (linezolid)" Pharmacia and Upjohn, Kalamazoo, MI.

Linezolid (Includes Zyvox) ↔ Hemodialysis

Moderate Potential Hazard, High plausibility

Applies to: hemodialysis

Linezolid is partially removed by hemodialysis and should be administered after dialysis.

References

  1. "Product Information. Zyvox (linezolid)" Pharmacia and Upjohn, Kalamazoo, MI.

Linezolid (Includes Zyvox) ↔ Liver Disease

Moderate Potential Hazard, Moderate plausibility

Applies to: Liver Disease

Linezolid is primarily metabolized by the liver. The pharmacokinetics of linezolid are not altered in patients with mild to moderate hepatic impairment (Child-Pugh class A or B) and, therefore, no dosage adjustments are necessary. Pharmacokinetic data are not available for patients with severe hepatic impairment. Therapy with linezolid should be administered cautiously in such patients.

References

  1. "Product Information. Zyvox (linezolid)" Pharmacia and Upjohn, Kalamazoo, MI.

Linezolid (Includes Zyvox) ↔ Maoi Activity

Moderate Potential Hazard, Moderate plausibility

Applies to: Cerebral Vascular Disorder, Cardiovascular Disease, Pheochromocytoma, Hyperthyroidism

Linezolid is a weak, reversible, nonselective monoamine oxidase inhibitor (MAOI). Nonspecific MAOIs inhibit the breakdown of pressor amines, the accumulation of which can precipitate hypertensive crises. Intracranial hemorrhage and death have been reported with MAOI antidepressants. While adverse effects related to MAOI activity have not been reported with linezolid, the potential for severe hypertension should be considered. Therapy with linezolid should be administered cautiously in patients with cerebro- or cardiovascular disease, pheochromocytoma, or untreated hyperthyroidism. Clinical data are not available concerning the use of linezolid in this population. As a precaution, patients should have their blood pressure monitored during therapy and observed for signs and symptoms of a hypertensive reaction (e.g., occipital headache which may radiate frontally; palpitation; neck stiffness or soreness; nausea or vomiting; perspiration associated with fever or cold, clammy skin; mydriasis; photophobia; constricting chest pain).

References

  1. Clemett D, Markham A "Linezolid." Drugs 59 (2000): 815-27
  2. "Product Information. Zyvox (linezolid)" Pharmacia and Upjohn, Kalamazoo, MI.

Linezolid (Includes Zyvox) ↔ Renal Dysfunction

Moderate Potential Hazard, Moderate plausibility

Applies to: Renal Dysfunction

Linezolid is primarily metabolized by the liver and subsequently eliminated by the kidney. The pharmacokinetics of the parent drug are not altered in patients with impaired renal function and, therefore, no dosage adjustments are necessary. However, accumulation of the two primary metabolites may occur in such patients, the amount of which increases with the degree of renal impairment. The clinical significance of metabolite accumulation has not been determined. Therapy with linezolid should be administered cautiously in patients with renal impairment and only if benefits outweigh the potential risks.

References

  1. "Product Information. Zyvox (linezolid)" Pharmacia and Upjohn, Kalamazoo, MI.

You should also know about...

Zyvox (linezolid) drug Interactions

There are 916 drug interactions with Zyvox (linezolid)

Zyvox (linezolid) alcohol/food Interactions

There is 1 alcohol/food interaction with Zyvox (linezolid)

Drug Interaction Classification

The classifications below are a general guideline only. It is difficult to determine the relevance of a particular drug interaction to any individual given the large number of variables.

Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.

Do not stop taking any medications without consulting your healthcare provider.

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