Linezolid Brand Name– Zyvox
What is Linezolid
Linezolid is a synthetic oxazolidinone antibiotic.
It is indicated for gram-positive infections and is approved for the 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.
The drug provides an alternative to vancomycin, particularly in inpatient settings. In April 2001, scientists reported that linezolid-resistant VRE organisms were being discovered in various institutions.
Inappropriate use of linezolid leading to an increase in resistant organisms is a concern, and treatment alternatives should be carefully considered prior to using linezolid in outpatient settings.
As of March 16, 2007, the FDA is evaluating preliminary results of an open-label, randomized trial comparing linezolid to vancomycin, oxacillin, and dicloxacillin for catheter-related bloodstream infections including catheter-site infections. It was reported that, for linezolid-treated patients, there was a higher chance of death than with any of the comparator agents and the chance of death was related to the type of organism causing the infection.
In the linezolid arm of the study, mortality was higher in patients infected with gram negative bacteria alone, in patients infected with both gram positive and gram negative bacteria, and in patients who had no observed infection when enrolled in the study. No difference in mortality was noted in linezolid-treated patients with only gram positive infections.
Linezolid is not approved for treating gram-negative infections, catheter-related bloodstream infections, or catheter-site infections.
Health care providers are also advised that linezolid is a non-selective inhibitor of monoamine oxidase (MAO), a property that has potential implications for medication safety and drug interactions.
Final FDA approval for linezolid use in adults was granted in April 2000; FDA-approval for use in pediatric patients was granted in December 2002.
Indications
- anthrax
- bacteremia
- bone and joint infections
- brain abscess
- cellulitis
- community-acquired pneumonia
- diabetic foot ulcer
- endocarditis
- Enterococcus faecalis
- Enterococcus faecium
- febrile neutropenia
- infectious arthritis
- meningitis
- nosocomial pneumonia
- orthopedic device-related infection
- osteomyelitis
- Pasteurella multocida
- pneumonia
- sepsis
- skin and skin structure infections
- Staphylococcus aureus (MRSA)
- Staphylococcus aureus (MSSA)
- Staphylococcus epidermidis
- Staphylococcus haemolyticus
- Streptococcus agalactiae (group B streptococci)
- Streptococcus pneumoniae
- Streptococcus pyogenes (group A beta-hemolytic streptococci)
- subdural empyema
- tuberculosis infection
- vancomycin-resistant enterococci (VRE)
- ventriculitis
- Viridans streptococci
Side Effects
- abdominal pain
- anaphylactic shock
- anaphylactoid reactions
- anemia
- angioedema
- blurred vision
- bullous rash
- candidiasis
- diarrhea
- dizziness
- dysgeusia
- elevated hepatic enzymes
- eosinophilia
- headache
- hypertension
- hypoglycemia
- lactic acidosis
- leukopenia
- nausea
- neuroleptic malignant syndrome-like symptoms
- optic neuritis
- pancytopenia
- peripheral neuropathy
- pruritus
- pseudomembranous colitis
- rash
- seizures
- serotonin syndrome
- sideroblastic anemia
- Stevens-Johnson syndrome
- superinfection
- thrombocytopenia
- tongue discoloration
- tooth discoloration
- toxic epidermal necrolysis
- vertigo
- visual impairment
- vomiting
Monitoring Parameters
- CBC with differential
- ophthalmologic exam
Contraindications
- alcoholism
- bone marrow suppression
- breast-feeding
- children
- colitis
- diabetes mellitus
- diarrhea
- geriatric
- GI disease
- hypertension
- hyperthyroidism
- hypoglycemia
- infants
- infertility
- inflammatory bowel disease
- MAOI therapy
- neonates
- optic neuritis
- phenylketonuria
- pheochromocytoma
- pregnancy
- premature neonates
- pseudomembranous colitis
- radiographic contrast administration
- seizure disorder
- seizures
- spinal anesthesia
- surgery
- thyrotoxicosis
- ulcerative colitis
Interactions
- Acebutolol
- Acetaminophen; Aspirin, ASA; Caffeine
- Acetaminophen; Butalbital; Caffeine
- Acetaminophen; Butalbital; Caffeine; Codeine
- Acetaminophen; Caffeine
- Acetaminophen; Caffeine; Dihydrocodeine
- Acetaminophen; Caffeine; Magnesium Salicylate; Phenyltoloxamine
- Acetaminophen; Caffeine; Phenyltoloxamine; Salicylamide
- Acetaminophen; Chlorpheniramine; Dextromethorphan; Phenylephrine
- Acetaminophen; Chlorpheniramine; Dextromethorphan; Pseudoephedrine
- Acetaminophen; Chlorpheniramine; Phenylephrine; Phenyltoloxamine
- Acetaminophen; Codeine
- Acetaminophen; Dextromethorphan
- Acetaminophen; Dextromethorphan; Doxylamine
- Acetaminophen; Dextromethorphan; Guaifenesin; Phenylephrine
- Acetaminophen; Dextromethorphan; Phenylephrine
- Acetaminophen; Dextromethorphan; Pseudoephedrine
- Acetaminophen; Dichloralphenazone; Isometheptene
- Acetaminophen; Guaifenesin; Phenylephrine
- Acetaminophen; Hydrocodone
- Acetaminophen; Oxycodone
- Acetaminophen; Pentazocine
- Acetaminophen; Pseudoephedrine
- Acetaminophen; Tramadol
- Acetohexamide
- Aclidinium; Formoterol
- Acrivastine; Pseudoephedrine
- Albiglutide
- Albuterol
- Albuterol; Ipratropium
- Alfentanil
- Alogliptin
- Alogliptin; Metformin
- Alogliptin; Pioglitazone
- Amitriptyline
- Amitriptyline; Chlordiazepoxide
- Amoxapine
- Amphetamines
- Arformoterol
- Armodafinil
- Articaine; Epinephrine
- Aspirin, ASA; Butalbital; Caffeine
- Aspirin, ASA; Butalbital; Caffeine; Codeine
- Aspirin, ASA; Caffeine; Dihydrocodeine
- Aspirin, ASA; Caffeine; Orphenadrine
- Aspirin, ASA; Carisoprodol; Codeine
- Aspirin, ASA; Oxycodone
- Atenolol
- Atenolol; Chlorthalidone
- Atomoxetine
- Atropine; Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
- Atropine; Difenoxin
- Atropine; Diphenoxylate
- Atropine; Hyoscyamine; Phenobarbital; Scopolamine
- Belladonna Alkaloids; Ergotamine; Phenobarbital
- Bendroflumethiazide; Nadolol
- Benzhydrocodone; Acetaminophen
- Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
- Beta-adrenergic blockers
- Beta-agonists
- Betaxolol
- Bisoprolol
- Bisoprolol; Hydrochlorothiazide, HCTZ
- Brimonidine
- Brimonidine; Brinzolamide
- Brimonidine; Timolol
- Bromocriptine
- Brompheniramine; Carbetapentane; Phenylephrine
- Brompheniramine; Dextromethorphan; Guaifenesin
- Brompheniramine; Dextromethorphan; Phenylephrine
- Brompheniramine; Guaifenesin; Hydrocodone
- Brompheniramine; Hydrocodone; Pseudoephedrine
- Brompheniramine; Pseudoephedrine
- Budesonide; Formoterol
- Buprenorphine
- Buprenorphine; Naloxone
- Bupropion
- Bupropion; Naltrexone
- Buspirone
- Caffeine
- Caffeine; Ergotamine
- Canagliflozin; Metformin
- Carbamazepine
- Carbetapentane; Chlorpheniramine
- Carbetapentane; Chlorpheniramine; Phenylephrine
- Carbetapentane; Diphenhydramine; Phenylephrine
- Carbetapentane; Guaifenesin
- Carbetapentane; Guaifenesin; Phenylephrine
- Carbetapentane; Phenylephrine
- Carbetapentane; Phenylephrine; Pyrilamine
- Carbetapentane; Pseudoephedrine
- Carbetapentane; Pyrilamine
- Carbidopa; Levodopa
- Carbidopa; Levodopa; Entacapone
- Carbinoxamine; Dextromethorphan; Pseudoephedrine
- Carbinoxamine; Hydrocodone; Phenylephrine
- Carbinoxamine; Hydrocodone; Pseudoephedrine
- Carbinoxamine; Phenylephrine
- Carbinoxamine; Pseudoephedrine
- Carteolol
- Carvedilol
- Cetirizine; Pseudoephedrine
- Chlophedianol; Dexchlorpheniramine; Pseudoephedrine
- Chlophedianol; Guaifenesin; Phenylephrine
- Chlorpheniramine; Codeine
- Chlorpheniramine; Dextromethorphan
- Chlorpheniramine; Dextromethorphan; Phenylephrine
- Chlorpheniramine; Dihydrocodeine; Phenylephrine
- Chlorpheniramine; Dihydrocodeine; Pseudoephedrine
- Chlorpheniramine; Guaifenesin; Hydrocodone; Pseudoephedrine
- Chlorpheniramine; Hydrocodone
- Chlorpheniramine; Hydrocodone; Phenylephrine
- Chlorpheniramine; Hydrocodone; Pseudoephedrine
- Chlorpheniramine; Phenylephrine
- Chlorpheniramine; Pseudoephedrine
- Chlorpropamide
- Citalopram
- Clomipramine
- Cocaine
- Codeine
- Codeine; Guaifenesin
- Codeine; Phenylephrine; Promethazine
- Codeine; Promethazine
- COMT inhibitors
- Cyclobenzaprine
- Dapagliflozin; Metformin
- Dapagliflozin; Saxagliptin
- Desipramine
- Desloratadine; Pseudoephedrine
- Desvenlafaxine
- Dexchlorpheniramine; Dextromethorphan; Pseudoephedrine
- Dexmethylphenidate
- Dextromethorphan
- Dextromethorphan; Diphenhydramine; Phenylephrine
- Dextromethorphan; Guaifenesin
- Dextromethorphan; Guaifenesin; Phenylephrine
- Dextromethorphan; Guaifenesin; Potassium Guaiacolsulfonate
- Dextromethorphan; Guaifenesin; Pseudoephedrine
- Dextromethorphan; Promethazine
- Dextromethorphan; Quinidine
- Dienogest; Estradiol valerate
- Diethylpropion
- Dihydrocodeine; Guaifenesin; Pseudoephedrine
- Dihydroergotamine
- Dipeptidyl Peptidase-4 Inhibitors
- Diphenhydramine; Hydrocodone; Phenylephrine
- Diphenhydramine; Phenylephrine
- Dobutamine
- Dolasetron
- Dopamine
- Dorzolamide; Timolol
- Doxepin
- Drospirenone
- Drospirenone; Estradiol
- Drospirenone; Ethinyl Estradiol
- Drospirenone; Ethinyl Estradiol; Levomefolate
- Droxidopa
- Dulaglutide
- Duloxetine
- Elagolix; Estradiol; Norethindrone acetate
- Empagliflozin; Linagliptin
- Empagliflozin; Linagliptin; Metformin
- Empagliflozin; Metformin
- Entacapone
- Ephedrine
- Epinephrine
- Ergoloid Mesylates
- Ergonovine
- Ergot alkaloids
- Ergotamine
- Ertugliflozin; Metformin
- Ertugliflozin; Sitagliptin
- Escitalopram
- Esmolol
- Estradiol; Levonorgestrel
- Estradiol; Norethindrone
- Estradiol; Norgestimate
- Ethanol
- Ethinyl Estradiol
- Ethinyl Estradiol; Desogestrel
- Ethinyl Estradiol; Ethynodiol Diacetate
- Ethinyl Estradiol; Etonogestrel
- Ethinyl Estradiol; Levonorgestrel
- Ethinyl Estradiol; Levonorgestrel; Ferrous bisglycinate
- Ethinyl Estradiol; Levonorgestrel; Folic Acid; Levomefolate
- Ethinyl Estradiol; Norelgestromin
- Ethinyl Estradiol; Norethindrone
- Ethinyl Estradiol; Norethindrone Acetate
- Ethinyl Estradiol; Norethindrone Acetate; Ferrous fumarate
- Ethinyl Estradiol; Norethindrone; Ferrous fumarate
- Ethinyl Estradiol; Norgestimate
- Ethinyl Estradiol; Norgestrel
- Exenatide
- Fenfluramine
- Fentanyl
- Fexofenadine; Pseudoephedrine
- Fluoxetine
- Fluoxetine; Olanzapine
- Fluticasone; Salmeterol
- Fluticasone; Umeclidinium; Vilanterol
- Fluticasone; Vilanterol
- Fluvoxamine
- food
- Formoterol
- Formoterol; Mometasone
- Fosphenytoin
- Ginseng, Panax ginseng
- Glimepiride
- Glimepiride; Pioglitazone
- Glimepiride; Rosiglitazone
- Glipizide
- Glipizide; Metformin
- Glyburide
- Glyburide; Metformin
- Glycopyrrolate; Formoterol
- Granisetron
- Green Tea
- Guaifenesin; Hydrocodone
- Guaifenesin; Hydrocodone; Pseudoephedrine
- Guaifenesin; Phenylephrine
- Guaifenesin; Pseudoephedrine
- Guanabenz
- Homatropine; Hydrocodone
- Hydrochlorothiazide, HCTZ; Methyldopa
- Hydrochlorothiazide, HCTZ; Metoprolol
- Hydrochlorothiazide, HCTZ; Propranolol
- Hydrocodone
- Hydrocodone; Ibuprofen
- Hydrocodone; Phenylephrine
- Hydrocodone; Potassium Guaiacolsulfonate
- Hydrocodone; Potassium Guaiacolsulfonate; Pseudoephedrine
- Hydrocodone; Pseudoephedrine
- Hydromorphone
- Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate; Sodium Biphosphate
- Ibuprofen; Oxycodone
- Ibuprofen; Pseudoephedrine
- Imipramine
- Incretin Mimetics
- Indacaterol
- Indacaterol; Glycopyrrolate
- Insulin Degludec; Liraglutide
- Insulin Glargine; Lixisenatide
- Insulins
- Iobenguane I 131
- Isoniazid, INH
- Isoniazid, INH; Pyrazinamide, PZA; Rifampin
- Isoniazid, INH; Rifampin
- Isoproterenol
- Labetalol
- Lasmiditan
- Leuprolide; Norethindrone
- Levalbuterol
- Levobetaxolol
- Levobunolol
- Levodopa
- Levomilnacipran
- Levonorgestrel
- Levorphanol
- Linagliptin
- Linagliptin; Metformin
- Liraglutide
- Lithium
- Lixisenatide
- Loratadine; Pseudoephedrine
- Lorcaserin
- Maprotiline
- Meglitinides
- Meperidine
- Meperidine; Promethazine
- Mestranol; Norethindrone
- Metaproterenol
- Metformin
- Metformin; Pioglitazone
- Metformin; Repaglinide
- Metformin; Rosiglitazone
- Metformin; Saxagliptin
- Metformin; Sitagliptin
- Methadone
- Methenamine; Sodium Acid Phosphate; Methylene Blue; Hyoscyamine
- Methyldopa
- Methylene Blue
- Methylergonovine
- Methylphenidate
- Methysergide
- Metoclopramide
- Metoprolol
- Midodrine
- Milnacipran
- Mirtazapine
- Modafinil
- Morphine
- Morphine; Naltrexone
- Nadolol
- Nalbuphine
- Naproxen; Pseudoephedrine
- Nateglinide
- Nebivolol
- Nebivolol; Valsartan
- Nefazodone
- Netupitant, Fosnetupitant; Palonosetron
- Norepinephrine
- Norethindrone
- Norgestrel
- Nortriptyline
- Olodaterol
- Ondansetron
- Oral Contraceptives
- Oxycodone
- Oxymorphone
- Ozanimod
- Palonosetron
- Paroxetine
- Penbutolol
- Pentazocine
- Pentazocine; Naloxone
- Pergolide
- Perphenazine; Amitriptyline
- Phendimetrazine
- Phenobarbital
- Phentermine
- Phentermine; Topiramate
- Phenylephrine
- Phenylephrine; Promethazine
- Phenytoin
- Pindolol
- Pioglitazone
- Pirbuterol
- Pramlintide
- Prilocaine; Epinephrine
- Primidone
- Procarbazine
- Propranolol
- Protriptyline
- Pseudoephedrine
- Racepinephrine
- Rasagiline
- Remifentanil
- Repaglinide
- Reserpine
- Rifampin
- Ritodrine
- Rosiglitazone
- Safinamide
- Salmeterol
- Saxagliptin
- Segesterone Acetate; Ethinyl Estradiol
- Semaglutide
- Serotonin-Receptor Agonists
- Sertraline
- Sibutramine
- Simvastatin; Sitagliptin
- Sitagliptin
- Sodium picosulfate; Magnesium oxide; Anhydrous citric acid
- St. John’s Wort, Hypericum perforatum
- Sufentanil
- Sulfonylureas
- Tapentadol
- Terbutaline
- Tetrahydrozoline
- Thiazolidinediones
- Timolol
- Tiotropium; Olodaterol
- Tolazamide
- Tolbutamide
- Tolcapone
- Tramadol
- Trazodone
- Trimipramine
- Umeclidinium; Vilanterol
- Valerian, Valeriana officinalis
- Venlafaxine
- Vilazodone
- Vortioxetine
- Yohimbine
