Linezolid

Linezolid
Brands

DEA Class; Rx

Common Brand Names; Zyvox

  • Antibiotics, Other; 
  • Oxazolidinones

Synthetic oxazolidinone antibiotic
Indicated for treatment of bacterial pneumonia, skin and skin structure infections, and for vancomycin-resistant enterococcal (VRE) infections, including infections due to susceptible organisms which are complicated by bacteremia
Inhibits MAO and may cause drug interactions with adrenergic and serotonergic drugs

Indicated for

  • Vancomycin-Resistant Enterococcal Infections
  • Complicated Skin & Skin Structure Infections
  • Uncomplicated Skin & Skin Structure Infections
  • Community-Acquired Pneumonia (Including Concurrent Bacteremia)
  • Nosocomial Pneumonia
  • Methicillin-Resistant Staphylococcal Infections
  • Methicillin-Susceptible Staphylococcus Aureus

Hypersensitivity

Within 14 days of taking MAO inhibitor

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

  • Diarrhea (7.8-10.8%)
  • 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%)

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

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

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)

Adults

1,200 mg/day PO or IV.

Geriatric

1,200 mg/day PO or IV.

Adolescents

1,200 mg/day PO or IV.

Children

12 years: 1,200 mg/day PO or IV.
1 to 11 years: 10 mg/kg/dose PO or IV every 8 hours (Max: 600 mg/dose).

Infants

10 mg/kg/dose PO or IV every 8 hours.

Neonates

10 mg/kg/dose PO or IV every 8 hours.

Linezolid

injectable solution

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

oral suspension

  • 100mg/5mL

tablet

  • 600mg
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