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linezolid

Pronunciation

Generic Name: linezolid (lin EZ oh lid)
Brand Name: Zyvox

What is linezolid?

Linezolid is an antibiotic that fights bacteria in the body.

Linezolid is used to treat different types of bacterial infections, such pneumonia, skin infections, and infections that are resistant to other antibiotics.

Linezolid may also be used for purposes not listed in this medication guide.

What is the most important information I should know about linezolid?

Do not use linezolid if you have used an MAO inhibitor such as furazolidone (Furoxone), isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam, Zelapar), or tranylcypromine (Parnate) in the last 14 days. A dangerous drug interaction could occur, leading to serious side effects.

Many drugs can interact with linezolid. Before using linezolid, tell your doctor about all other medications you use. You may need to stop using certain medicines before using linezolid (in some cases for up to 5 weeks before you start linezolid). During your treatment with linezolid, do not start or stop using any other medications unless your doctor tells you to.

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You should not use linezolid if you have untreated or uncontrolled high blood pressure, a carcinoid tumor, adrenal gland tumor, or a severely overactive thyroid.

If you take an antidepressant or psychiatric medication, call your doctor right away if you have signs of a serious drug interaction, including: confusion, memory problems, feeling hyperactive (mentally or physically), loss of coordination, muscle twitching, shivering, sweating, diarrhea, and/or fever.

Eating tyramine while you are using linezolid can raise your blood pressure to dangerous levels. Avoid foods that have a high level of tyramine, such as aged cheeses or meats, pickled or fermented meats, smoked or air-dried meats, sauerkraut, soy sauce, tap beer, red wine, or any meat, cheese, or other protein-based food that has been improperly stored.

What should I discuss with my healthcare provider before using linezolid?

Do not use linezolid if you have used an MAO inhibitor such as furazolidone (Furoxone), isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam, Zelapar), or tranylcypromine (Parnate) in the last 14 days. A dangerous drug interaction could occur, leading to serious side effects.

Many drugs can interact with linezolid. Before using linezolid, tell your doctor about all other medications you use. You may need to stop using certain medicines before using linezolid (in some cases for up to 5 weeks before you start linezolid). However, do not stop taking any of your medications without your doctor's advice.

  • meperidine (Demerol);

  • diet pills, stimulants, cold or allergy medicines, ADHD medication;

  • migraine or cluster headache medication such as almotriptan (Axert), frovatriptan (Frova), naratriptan (Amerge), rizatriptan (Maxalt), sumatriptan (Imitrex, Treximet), or zolmitriptan (Zomig);

  • medication to treat Parkinson's disease or restless leg syndrome, such as carbidopa or levodopa (Lodosyn, Parcopa, Sinemet), pramipexole (Mirapex), or ropinorole (Requip);

  • an "SSRI" antidepressant such as citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac, Sarafem, Symbyax), fluvoxamine (Luvox), paroxetine (Paxil), or sertraline (Zoloft);

  • an "SNRI" antidepressant such as venlafaxine (Effexor), desvenlafaxine (Pristiq), or duloxetine (Cymbalta);

  • a "tricyclic" antidepressant such as amitriptyline (Elavil, Vanatrip, Limbitrol), clomipramine (Anafranil), desipramine (Norpramin), doxepin (Sinequan), imipramine (Janimine, Tofranil), nortriptyline (Pamelor), protriptyline (Vivactil), or trimipramine (Surmontil); or

  • other medications used to treat depression, anxiety, and other psychiatric conditions, such as bupropion (Wellbutrin, Zyban, Aplenzin), buspirone (BuSpar), maprotiline (Ludiomil), mirtazapine (Remeron), nefazodone, trazodone (Desyrel, Oleptro), or vilazodone (Viibryd).

You should not use linezolid if you are allergic to it, or if you have:

  • untreated or uncontrolled high blood pressure;

  • a carcinoid tumor;

  • pheochromocytoma (adrenal gland tumor); or

  • a severe thyroid disorder.

To make sure you can safely use linezolid, tell your doctor if you have any of these other conditions:

  • a history of high blood pressure;

  • epilepsy or a history of seizures;

  • diabetes (and you use insulin or an oral diabetes medication);

  • a thyroid disorder;

  • kidney or liver disease; or

  • bone marrow suppression or a weak immune system.

It is not known whether linezolid passes into breast milk or if it could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

FDA pregnancy category C. It is not known whether linezolid is harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment.

The liquid form may contain phenylalanine. Talk to your doctor before using this form of linezolid if you have phenylketonuria (PKU).

How is linezolid used?

Use exactly as prescribed by your doctor. Do not use in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label.

Before taking the oral suspension (liquid), gently mix it by turning the bottle upside down 3 to 5 times. Do not shake. Measure the liquid with a special dose-measuring spoon or cup, not a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist for one.

Intravenous linezolid is injected into a vein through an IV. This medicine must be given slowly, and the IV infusion can take up to 2 hours to complete. You may be shown how to use an IV at home. Do not self-inject this medicine if you do not fully understand how to give the injection and properly dispose of used needles, IV tubing, and other items used to inject the medicine.

To be sure this medication is not causing harmful effects, your blood cells and blood pressure will need to be tested often. You may also need eye exams. Visit your doctor regularly.

Use this medication for the full prescribed length of time. Your symptoms may improve before the infection is completely cleared. Skipping doses may also increase your risk of further infection that is resistant to antibiotics. Linezolid will not treat a viral infection such as the common cold or flu.

Store all forms of linezolid at room temperature away from moisture, heat, and light. Do not freeze. Throw away any unused oral liquid that is more than 21 days old.

What happens if I miss a dose?

Use the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not use extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. Overdose may cause vomiting, tremors, or loss of balance or coordination.

What should I avoid while using linezolid?

Antibiotic medicines can cause diarrhea, which may be a sign of a new infection. If you have diarrhea that is watery or bloody, stop taking linezolid and call your doctor. Do not use anti-diarrhea medicine unless your doctor tells you to.

Eating tyramine while you are using linezolid can raise your blood pressure to dangerous levels. Avoid foods that have a high level of tyramine, such as:

  • aged cheeses or meats;

  • pickled or fermented meats, smoked or air-dried meats;

  • sauerkraut;

  • soy sauce;

  • tap beer (alcoholic and nonalcoholic);

  • red wine; or

  • any meat, cheese, or other protein-based food that has been improperly stored.

You should become very familiar with the list of foods you must avoid while you are using linezolid.

Linezolid side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

If you take an antidepressant or psychiatric medication, call your doctor right away if you have signs of a serious drug interaction, including: confusion, memory problems, feeling hyperactive (mentally or physically), loss of coordination, muscle twitching, shivering, sweating, diarrhea, and/or fever.

Some people develop lactic acidosis while using linezolid. Early symptoms may get worse over time and this condition can be fatal. Get emergency medical help if you have even mild symptoms such as: muscle pain or weakness, numb or cold feeling in your arms and legs, trouble breathing, stomach pain, nausea with vomiting, slow or uneven heart rate, dizziness, or feeling very weak or tired.

Call your doctor at once if you have any other serious side effects, such as:

  • fever, chills, body aches, flu symptoms, sores in your mouth and throat;

  • easy bruising or bleeding, pale skin, feeling light-headed or short of breath, rapid heart rate, trouble concentrating;

  • diarrhea that is watery or bloody;

  • blurred vision, trouble seeing color;

  • numbness, burning pain, or tingly feeling in your hands or feet;

  • seizure (convulsions); or

  • low blood sugar (headache, hunger, weakness, sweating, confusion, irritability, dizziness, fast heart rate, or feeling jittery).

Less serious side effects may include:

  • headache, dizziness, sleep problems (insomnia);

  • nausea, vomiting, constipation;

  • discolored tongue, unusual or unpleasant taste in the mouth;

  • vaginal itching or discharge; or

  • yeast infection in the mouth.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

Linezolid Dosing Information

Usual Adult Dose for Bacteremia:

Vancomycin-resistant Enterococcus faecium infections, including concurrent bacteremia: 600 mg IV or orally every 12 hours
Duration: 14 to 28 days

Usual Adult Dose for Pneumonia:

600 mg IV or orally every 12 hours
Duration: 10 to 14 days

Usual Adult Dose for Nosocomial Pneumonia:

600 mg IV or orally every 12 hours
Duration: 10 to 14 days

Usual Adult Dose for Skin and Structure Infection:

Complicated infections: 600 mg IV or orally every 12 hours
Duration: 10 to 14 days

Uncomplicated infections: 400 mg orally every 12 hours
Duration: 10 to 14 days

Usual Adult Dose for Bacterial Infection:

Vancomycin-resistant Enterococcus faecium infections: 600 mg IV or orally every 12 hours
Duration: 14 to 28 days

Usual Pediatric Dose for Bacteremia:

Vancomycin-resistant Enterococcus faecium infections, including concurrent bacteremia:
Less than 7 days, gestational age less than 34 weeks: 10 mg/kg IV or orally every 12 hours; may increase to every 8 hours based on clinical response
Less than 7 days, gestational age 34 weeks or more: 10 mg/kg IV or orally every 8 hours
7 days through 11 years: 10 mg/kg IV or orally every 8 hours
12 years or older: 600 mg IV or orally every 12 hours

Duration: 14 to 28 days

Usual Pediatric Dose for Pneumonia:

Less than 7 days, gestational age less than 34 weeks: 10 mg/kg IV or orally every 12 hours; may increase to every 8 hours based on clinical response
Less than 7 days, gestational age 34 weeks or more: 10 mg/kg IV or orally every 8 hours
7 days through 11 years: 10 mg/kg IV or orally every 8 hours
12 years or older: 600 mg IV or orally every 12 hours

Duration: 10 to 14 days

Usual Pediatric Dose for Nosocomial Pneumonia:

Less than 7 days, gestational age less than 34 weeks: 10 mg/kg IV or orally every 12 hours; may increase to every 8 hours based on clinical response
Less than 7 days, gestational age 34 weeks or more: 10 mg/kg IV or orally every 8 hours
7 days through 11 years: 10 mg/kg IV or orally every 8 hours
12 years or older: 600 mg IV or orally every 12 hours

Duration: 10 to 14 days

Usual Pediatric Dose for Skin and Structure Infection:

Complicated infections:
Less than 7 days, gestational age less than 34 weeks: 10 mg/kg IV or orally every 12 hours; may increase to every 8 hours based on clinical response
Less than 7 days, gestational age 34 weeks or more: 10 mg/kg IV or orally every 8 hours
7 days through 11 years: 10 mg/kg IV or orally every 8 hours
12 years or older: 600 mg IV or orally every 12 hours

Duration: 10 to 14 days

Uncomplicated infections:
Less than 7 days, gestational age less than 34 weeks: 10 mg/kg orally every 12 hours; may increase to every 8 hours based on clinical response
Less than 7 days, gestational age 34 weeks or more: 10 mg/kg orally every 8 hours
7 days through 4 years: 10 mg/kg orally every 8 hours
5 through 11 years: 10 mg/kg orally every 12 hours
12 years or older: 600 mg orally every 12 hours

Duration: 10 to 14 days

Usual Pediatric Dose for Bacterial Infection:

Vancomycin-resistant Enterococcus faecium infections:
Less than 7 days, gestational age less than 34 weeks: 10 mg/kg IV or orally every 12 hours; may increase to every 8 hours based on clinical response
Less than 7 days, gestational age 34 weeks or more: 10 mg/kg IV or orally every 8 hours
7 days through 11 years: 10 mg/kg IV or orally every 8 hours
12 years or older: 600 mg IV or orally every 12 hours

Duration: 14 to 28 days

What other drugs will affect linezolid?

During your treatment with linezolid, do not start or stop using any other medications unless your doctor tells you to.

There are many other drugs that can cause serious or life threatening medical problems if you take them together with linezolid. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor. Keep a list of all your medicines and show it to any healthcare provider who treats you.

Where can I get more information?

  • Your pharmacist can provide more information about linezolid.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 7.01. Revision Date: 2012-06-11, 4:25:10 PM.

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