Linezolid is an oxazolidinone antibiotic, prescribed for certain types of bacterial infections like pneumonia, complicated skin and soft tissue infections, and certain blood infections. This medication works by interfering with the synthesis of proteins and stops the growth of bacteria. It is effective only against bacteria referred to as gram positive bacteria. Its use should be restricted to severe and multi-resistant infections and it should not be used indiscriminately to prevent the development of resistance.
Linezolid is contraindicated in patients who are taking sympathomimetic drugs like pseudoephedrine, phenylpropanolamine, monoamine oxidase inhibitors (MAOIs) like phenelzine and isocarboxazid, which were used earlier for the treatment of depression or within 14 days of MAOIs administration . It should also not be used in patients with uncontrolled high blood pressure, tumor in adrenal gland which secretes adrenaline, overactive thyroid or previous allergic reaction to the drug.
Oral/IV- The recommended dose is 600mg twice daily for 10-21 days. The length of the treatment depends on the infection.
Linezolid comes as a tablet and a suspension to take by mouth, with or without food. Before taking the liquid suspension, gently mix by turning over the bottle three to four times without shaking. Linezolid also comes as a solution for injection to be administered by a healthcare provider into the vein.
• Linezolid has some ability to inhibit the enzyme MAO or monoamine oxidase. This enzyme plays a role in breaking down chemicals like adrenaline, dopamine and serotonin. Therefore, inhibition of the enzyme results in increased levels of these chemicals in the body. High adrenaline levels can cause increase in blood pressure, while high serotonin levels can result in a condition called serotonin syndrome. Symptoms of serotonin syndrome include confusion, seizures, high blood pressure, tremors, stomach cramps and muscle spasms. Therefore, linezolid should be avoided with other drugs that could have an additive effect. For the same reason, tyramine rich foods like cheese, bananas, yogurt, raisins, avocados and papaya products should be avoided when the patient is on linezolid.
• Caution should be exercised in patients with history of high blood pressure, overactive thyroid, kidney disease, eye problems, low blood cell counts, carcinoid tumors (tumors which secrete serotonin), prior allergies, children, during pregnancy and breastfeeding. It may cause dizziness, do not drive a car or operate machinery while taking this medication. Avoid alcohol consumption. Avoid long-term use of this medication; otherwise it may cause secondary infection. It may decrease platelet counts; avoid bruising or injury. Monitor complete blood counts regularly while taking this medication.
• Most Common :
Diarrhea, headache, nausea and vomiting.
• Blood : Anemia,decreased white blood cells and platelets
• CNS : Dizziness, difficulty in sleeping, loss of coordination, confusion and seizures.
• Miscellaneous : Rash, fever, fungal infections, itching, cough, loose stool, low blood sugar, vision problems and abdominal pain.
Do not use if the suspension contain particle matter, is cloudy or discolored or if the vial is broken or damaged.
Avoid excess dosage and contact the doctor immediately if there is any impairment in vision.
Linezolid should be avoided with
• Adrenergic drugs like epinephrine, methyl dopa, pseudoephedrine and phenylpropanolamine, anti-Parkinsonism drugs like levodopa/carbidopa as the combination may cause high blood pressure.
• Drugs used in the treatment of depression belonging to the group Selective Serotonin Reuptake Inhibitors (SSRIs)like citalopram, paroxetine, sertraline and fluoxetine. If given together, the patient may suffer from an adverse effect called serotonin syndrome.
• MAO inhibitors like isocarboxazid, selegiline, phenelzine and tranylcypromine, due to the chance of developing serotonin syndrome.
• Glaucoma medicines which are used as eye drops like apraclonidine and brimonidine, due to the risk of high blood pressure.
Store it at controlled room temperature (15° to 30°C). Discard any unused reconstituted suspension after 21 days.
Injection - Store it at controlled room temperature (15° to 30°C). Protect from heat , moisture and excess light.
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