Linezolid

Linezolid is a prescription medication used to treat infections, including pneumonia, and certain blood and skin infections. Linezolid belongs to a group of antibiotics called oxazolidinones. It works by preventing bacteria from making proteins, which inhibits bacterial growth.

This medication comes in capsule, liquid, and an injectable (IV) form. The capsule and liquid forms can be taken with or without food.

Common side effects of linezolid include diarrhea, headache, nausea, and vomiting.

Linezolid is a prescription medication used to treat infections, including pneumonia, and certain blood and skin infections. 

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

Linezolid may be found in some form under the following brand names:

• Zyvox

Serious side effects have been reported with linezolid. See the “Drug Precautions” section.

Common side effects of linezolid include the following:

• diarrhea
• headache
• nausea
• vomiting
• stomach pain
• difficulty falling asleep or staying asleep
• dizziness
• white patches in the mouth
• change in color of the tongue

• an allergic reaction with the following signs and symptoms:
  • hives
  • rash
  • itching
  • difficulty breathing or swallowing
  • swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs
• hoarseness
• blisters or peeling skin
• fever
• loss of coordination
• overactive reflexes
• confusion, forgetfulness, or difficulty thinking
• severe diarrhea (watery or bloody stools) that may occur with or without fever and stomach cramps (may occur months or more after your treatment)
• unusual bleeding or bruising
• cough, chills, sore throat, and other signs of infection
• changes in color vision, blurred vision, or other changes in vision
• seizures

This is not a complete list of linezolid side effects. Ask your doctor or pharmacist for more information.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

Tell your doctor about all the medicines you take including prescription and non-prescription medicines, vitamins, and herbal supplements. Especially tell your doctor if you take:

• antidepressant medications such as:
  • buspirone (Buspar)
  • selective serotonin reuptake inhibitors (SSRIs) such as citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac, Sarafem, Symbyax), fluvoxamine (Luvox), paroxetine (Paxil), sertraline (Zoloft), and vilazodone (Viibyrd)
  • serotonin norepinephrine reuptake inhibitors (SNRIs) such as desvenlafaxine (Pristiq), duloxetine (Cymbalta), and venlafaxine (Effexor);
  • tricyclic antidepressants such as amitriptyline (Elavil), amoxapine (Asendin), clomipramine (Anafranil), desipramine (Norpramin), doxepin (Adapin, Sinequan), imipramine (Tofranil), nortriptyline (Aventyl, Pamelor), protriptyline (Vivactil), and trimipramine (Surmontil)
• monoamine oxidase (MAO) inhibitors such as isocarboxazid (Marplan) phenelzine (Nardil). rasagiline (Azilect), selegiline (Eldepryl), and tranylcypromine (Parnate)
• medications for migraine such as almotriptan (Axert), eletriptan (Relpax), frovatriptan (Frova), naratriptan (Amerge), rizatriptan (Maxalt), sumatriptan (Imitrex), and zolmitriptan (Zomig)
• meperidine (Demerol)
• pseudoephedrine (Sudafed; in many cold or decongestant medications)
• amphetamine (in Adderall)
• carbamazepine
• dextroamphetamine (Adderall,Dexedrine, DextroStat)
• dexmethylphenidate (Focalin)
• lisdexamfetamine (Vyvanase)
• methamphetamine (Desoxyn)
• methylphenidate (Concerta, Metadate, Methylin, Ritalin)
• other antibiotics
• phenobarbital
• phenytoin (Dilantin, Phenytek)
• rifampin (Rifadin, Rimactance, in Rifamate in Rifater)

This is not a complete list of linezolid drug interactions. Ask your doctor or pharmacist for more information.

Serious side effects have been reported with linezolid including the following:

• serotonin syndrome. This is a potentially life-threatening condition that has occurred in some people who have received linezolid. Your risk for developing this condition is increased if you take certain medicines that affect serotonin levels, or if you have a condition known as carcinoid syndrome. Symptoms of serotonin syndrome, which can occur within minutes to hours, may include

• agitation or restlessness
• confusion
• diarrhea
• fast heart beat and high blood pressure
• hallucinations (seeing or hearing things that are not real)
• increased body temperature
• heavy sweating (without activity)
• shivering
• tremor
• loss of coordination
• nausea
• overactive reflexes
• rapid changes in blood pressure
• vomiting

Linezolid increases your risk of:

• seizures
• vision loss
• psuedomembranous colitis
• lactic acidosis (a buildup of lactic acid in the blood). Signs of lactic acidosis inlcude
  • nausea
  • vomiting
  • stomach pain
  • fast breathing

Linezolid oral liquid contains phenylalanine. If you have phenylketonuria, the amount of phenylalanine you consume must be limited. Talk to your doctor about the other linezolid formulations available.

Do not take linezolid if you:

• have a known allergy to any of its ingredients
• are taking medicines that can increase your blood pressure, or if your high blood pressure is uncontrolled
• are taking a MAO inhibitor (see "Drug Interactions")
• are taking certain antidepressants

Medicines can interact with certain foods. In some cases, this may be harmful and your doctor may advise you to avoid certain foods. In the case of linezolid you should avoid eating or drinking large amounts of foods and beverages containing tyramine.

Tyramine is a naturally occurring compound found in some cheeses and other foods that may cause dangerously high blood pressure in people taking monoamine oxidase inhibitors (MAOIs) like linezolid.

You should avoid eating very large amounts of foods containing high amounts of tyramine such as:

• cheese (particularly strong or aged varieties)
• sour cream
• Chianti wine
• sherry
• beer (including non-alcoholic beer)
• liqueurs
• pickled herring
• anchovies
• caviar
• liver
• canned figs
• raisins
• bananas
• avocados (particularly if overripe)
• chocolate
• soy sauce
• sauerkraut
• the pods of broad beans (fava beans)
• yeast extracts
• yogurt
• meat extracts
• meat prepared with tenderizers
• dry sausage

Some of the signs and symptoms of dangerously high blood pressure (hypertensive crisis) are:

• severe headache
• vision problems
• confusion
• stupor (mental numbness)
• coma
• seizures
• chest pain
• unexplained nausea or vomiting
• stroke-like symptoms (sudden numbness or weakness - especially on one side of the body)

Get emergency medical help if you experience these symptoms.

Tell your doctor about all of your medical conditions including if you have:

• carcinoid syndrome (a condition in which a tumor secretes serotonin)
• a long-lasting infection, or if you are currently being treated with other antibiotics
• high blood pressure (hypertension)
• hyperthyroidism (over-active thyroid)
• problems with your immune system
• a tumor of the adrenal gland (pheochromocytoma)
• a history of seizures
• kidney disease
• phenylketonuria (linezolid oral liquid contains phenylalanine)
• allergies to medications (especially linezolid or any of its ingredients)

Tell your doctor if you are pregnant or breastfeeding.

Tell your doctor about all the medicines you take including prescription and non-prescription medicines, vitamins, and herbal supplements.

Tell your doctor if you are pregnant or plan to become pregnant.

The FDA categorizes medications based on safety for use during pregnancy. Five categories - A, B, C, D, and X, are used to classify the possible risks to an unborn baby when a medication is taken during pregnancy.

Linezolid falls into category C. In animal studies, pregnant animals were given this medication and had some babies born with problems. No well-controlled studies have been done in humans. Therefore, this medication may be used if the potential benefits to the mother outweigh the potential risks to the unborn child.

It is not known if linezolid crosses into human milk. Because many medications can cross into human milk and because of the possibility for serious adverse reactions in nursing infants with use of this medication, a choice should be made whether to stop nursing or stop the use of this medication. Your doctor and you will decide if the benefits outweigh the risk of using linezolid.

Linezolid comes as a capsule, an oral liquid, and in an IV injection form. The capsules and oral liquid can be taken with or without food. It is usually taken twice daily (every 12 hours) for 10 to 28 days. Children 11 years of age and younger usually take linezolid two to three times a day (every 8 to 12 hours) for 10 to 28 days. The length of treatment depends on the type and severity of your infection.

Linezolid oral liquid

• Gently mix the oral liquid by turning the bottle over three to five times. Do not shake linezolid liquid.
• For accuracy, measure the oral liquid with an oral syringe or a measuring spoon or medicine cup. Do not use a regular household spoon to measure.
• Throw away any unused oral liquid after 21 days.

Take linezolid exactly as prescribed. Do not skip linezolid doses. If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and resume your regular dosing.

Do not stop taking linezolid before your doctor recommends, even if you are feeling better.

Linezolid injection

For adults, linezolid injection is infused into a vein twice daily for 10 to 28 days. The infusion usually lasts between 30 minutes and 2 hours. Children 11 years of age and younger usually receive Linezolid injections 2 to 3 times daily, for 10 to 28 days.

Injections are usually given by a healthcare professional in a medical facility, however, your doctor may decide that you can be taught to give yourself your injections.

The dose your doctor recommends will depend on your age, weight, and the type and severity of your infection.

• Adults - The usual recommended dose of linezolid in adults is 600 mg every 12 hours. For some infections, including certain skin or soft tissue infections, the recommended dose in adults is 400 mg every 12 hours.
• Children (11 years of age and younger) - The usual dose of linezolid in children is based on weight.
• Children (12 years of age and older) - The usual recommended dose is 600 mg every 12 hours.

If you take too much linezolid, call your local Poison Control Center or seek emergency medical attention right away.

If linezolid is administered by a healthcare provider in a medical setting, it is unlikely that an overdose will occur. However, if overdose is suspected, seek emergency medical attention.

• Store at room temperature (25°C or 77°F).
• Protect from light.
• Keep bottles tightly closed to protect from moisture.
• It is recommended that the infusion bags be kept in the overwrap until ready to use.
• Protect infusion bags from freezing.
• Keep this and all medicines out of the reach of children.