buspar-dividose and Linezolid Interactions

Interactions between buspar-dividose(busPIRone) and Linezolid (linezolid)

busPIRone and linezolid (Major Drug-Drug)

CONTRAINDICATED: Concomitant use of linezolid and serotonergic agents may potentiate the risk of serotonin syndrome, which is a rare but serious and potentially fatal condition thought to result from hyperstimulation of brainstem 5-HT1A and 2A receptors. Linezolid is a reversible, nonselective monoamine oxidase inhibitor (MAOI) and can enhance serotonergic effects by inhibiting serotonin metabolism. Rare cases of serotonin syndrome have been reported in association with linezolid, most often in combination with serotonin reuptake inhibitors.

MANAGEMENT: Unless patients can be closely monitored for the development of serotonin syndrome, linezolid should not be administered in combination with serotonin reuptake inhibitors, tricyclic antidepressants, 5-HT1 receptor agonists (i.e., triptans), meperidine, or buspirone. Signs and symptoms of serotonin syndrome may include mental status changes such as irritability, altered consciousness, confusion, hallucinations, and coma; autonomic dysfunction such as tachycardia, hyperthermia, diaphoresis, shivering, blood pressure lability, and mydriasis; neuromuscular abnormalities such as hyperreflexia, myoclonus, tremor, and ataxia; and gastrointestinal symptoms such as abdominal cramping, nausea, vomiting, and diarrhea. The potential risk of serotonin syndrome should be considered even when administering serotonergic agents and linezolid sequentially, as some agents may demonstrate a prolonged elimination half-life. For example, a 5-week washout period is recommended following use of fluoxetine before administering a monoamine oxidase inhibitor or another serotonergic agent. If serotonin syndrome develops or is suspected during the course of therapy, all serotonergic agents should be discontinued immediately and supportive care rendered as necessary. Moderately ill patients may also benefit from the administration of a serotonin antagonist (e.g., cyproheptadine, chlorpromazine). Severe cases should be managed under consultation with a toxicologist and may require sedation, neuromuscular paralysis, intubation, and mechanical ventilation in addition to the other measures.