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linezolid


linezolid

Generic Name: linezolid (lin EZ oh lid)Brand Names: 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 other than those 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 isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam), or tranylcypromine (Parnate) within the past 14 days. Serious, life-threatening side effects can occur if you use linezolid before the MAO inhibitor has cleared from your body.

You also should not use linezolid if you are also using buspirone (BuSpar), meperidine (Demerol), a diet pill or other stimulant, pseudoephedrine (a decongestant), ADHD medication such as Adderall or Dexedrine, migraine or cluster headache medications ("triptans") such as Imitrex or Zomig and others, medication to treat Parkinson's disease or restless leg syndrome, or an antidepressant such as Celexa, Prozac, Paxil, Zoloft, and others.

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.

Before using linezolid, tell your doctor if you have high blood pressure, a seizure disorder, kidney or liver disease, bone marrow suppression, or a weak immune system.

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. Some people have developed a life-threatening condition called lactic acidosis while taking linezolid. Early signs of lactic acidosis generally get worse over time and this condition can be fatal. Get emergency medical help if you have even mild symptoms of lactic acidosis, 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.

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

Do not use linezolid if you have used an MAO inhibitor such as isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam), or tranylcypromine (Parnate) within the past 14 days. Serious, life-threatening side effects can occur if you use linezolid before the MAO inhibitor has cleared from your body.

You also should not use linezolid if you are also using any of these drugs:

  • buspirone (BuSpar);

  • meperidine (Demerol);

  • a diet pill that contains a stimulant;

  • cold or allergy medicines that contain a decongestant such as pseudoephedrine;

  • ADHD medication such as Adderall or Dexedrine;

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

  • an antidepressant such as amitriptyline (Elavil, Etrafon), citalopram (Celexa), doxepin (Sinequan), escitalopram (Lexapro), fluoxetine (Prozac, Sarafem, Symbyax), fluvoxamine (Luvox), imipramine (Janimine, Tofranil), paroxetine (Paxil), or sertraline (Zoloft), and others.

You should not use this medication if you are allergic to linezolid, or if you have:
  • untreated or uncontrolled high blood pressure;

  • a carcinoid tumor;

  • pheochromocytoma (adrenal gland tumor); or

  • a severe thyroid disorder.

If you have certain conditions, you may need a dose adjustment or special tests to safely use this medication. Before using linezolid, tell your doctor if you have:

  • high blood pressure;

  • epilepsy or other seizure disorder;

  • a thyroid disorder;

  • kidney or liver disease; or
  • bone marrow suppression or a weak immune system.

Some people have developed a life-threatening condition called lactic acidosis while taking linezolid. You may be more likely to develop lactic acidosis if you have liver or kidney disease, congestive heart failure, or if you drink large amounts of alcohol. Talk with your doctor about your individual risk. 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. 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.

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

How is linezolid used?

Use this medication exactly as it was prescribed for you. Do not use the medication in larger amounts, or use it for longer than recommended by your doctor. Follow the directions on your prescription label.

Linezolid can be taken with or without food.

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

To be sure linezolid is not causing harmful effects, your blood may need to be tested on a regular basis. Your vision may need to be checked if you use linezolid long-term. Do not miss any scheduled visits to your doctor.

Use this medication for the entire length of time prescribed by your doctor. Your symptoms may get better before the infection is completely treated. Linezolid will not treat a viral infection such as the common cold or flu. Store linezolid at room temperature away from moisture, heat, and light. Do not freeze the liquid forms of linezolid. 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. If it is almost time for your next dose, skip the missed dose and use the medicine at your next regularly scheduled time. Do not use extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention if you think you have used too much of this medicine. Overdose may cause weakness, tremors, vomiting, 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 has blood in it, call your doctor. Do not use any medicine to stop the diarrhea unless your doctor has told you to.

While you are using linezolid, avoid taking an "SSRI" antidepressant without telling your doctor. This includes citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac, Sarafem), fluvoxamine (Luvox), paroxetine (Paxil), or sertraline (Zoloft). Taking an SSRI antidepressant together with linezolid can cause symptoms such as anxiety, high fever, sweating, chills or goosebumps, memory problems, trouble concentrating, loss of coordination, or muscle spasms.

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. Call your doctor at once if you have a serious side effect such as:
  • pale skin, easy bruising or bleeding, unusual weakness;

  • fever, chills, body aches, flu symptoms;

  • diarrhea that is watery or bloody;

  • blurred vision, trouble seeing colors

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

  • seizure (convulsions); or

  • lactic acidosis - 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.

Less serious side effects may include:

  • headache, dizziness;

  • nausea, vomiting, constipation, stomach pain or upset;

  • sleep problems (insomnia);

  • mild rash or itching;

  • 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.

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 daysUncomplicated infections: 400 mg orally every 12 hoursDuration: 10 to 14 days

Usual Pediatric Dose for Bacteremia:

Vancomycin resistant Enterococcus faecium infections including concurrent bacteremia:6 days or less and gestational age 33 weeks or less: 10 mg/kg IV or orally every 12 hours; may increase to every 8 hours based on clinical response6 days or less and gestational age 34 weeks or more: 10 mg/kg IV or orally every 8 hours7 days to 11 years: 10 mg/kg IV or orally every 8 hours12 years or older: 600 mg IV or orally every 12 hoursDuration: 14 to 28 days

Usual Pediatric Dose for Pneumonia:

6 days or less and gestational age 33 weeks or less: 10 mg/kg IV or orally every 12 hours; may increase to every 8 hours based on clinical response6 days or less and gestational age 34 weeks or more: 10 mg/kg IV or orally every 8 hours7 days to 11 years: 10 mg/kg IV or orally every 8 hours12 years or older: 600 mg IV or orally every 12 hoursDuration: 10 to 14 days

Usual Pediatric Dose for Nosocomial Pneumonia:

6 days or less and gestational age 33 weeks or less: 10 mg/kg IV or orally every 12 hours; may increase to every 8 hours based on clinical response6 days or less and gestational age 34 weeks or more: 10 mg/kg IV or orally every 8 hours7 days to 11 years: 10 mg/kg IV or orally every 8 hours12 years or older: 600 mg IV or orally every 12 hoursDuration: 10 to 14 days

Usual Pediatric Dose for Skin and Structure Infection:

Complicated infections:6 days or less and gestational age 33 weeks or less: 10 mg/kg IV or orally every 12 hours; may increase to every 8 hours based on clinical response6 days or less and gestational age 34 weeks or more: 10 mg/kg IV or orally every 8 hours7 days to 11 years: 10 mg/kg IV or orally every 8 hours12 years or older: 600 mg IV or orally every 12 hoursDuration: 10 to 14 daysUncomplicated infections:6 days or less and gestational age 33 weeks or less: 10 mg/kg orally every 12 hours; may increase to every 8 hours based on clinical response6 days or less and gestational age 34 weeks or more: 10 mg/kg orally every 8 hours7 days to 4 years: 10 mg/kg orally every 8 hours5 to 11 years: 10 mg/kg orally every 12 hours12 to 18 years: 600 mg orally every 12 hoursDuration: 10 to 14 days

What other drugs will affect linezolid?

There may be other drugs that can interact with linezolid. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

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.
  • 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 1996-2006 Cerner Multum, Inc. Version: 4.03. Revision Date: 05/13/2009 3:06:03 PM.
  • linezolid Intravenous, Oral Advanced Consumer (Micromedex) - Includes Dosage Information
  • Linezolid Professional Patient Advice (Wolters Kluwer)
  • Linezolid MedFacts Consumer Leaflet (Wolters Kluwer)
  • Linezolid Detailed Consumer Information (PDR)
  • Zyvox Prescribing Information (FDA)
  • Zyvox Consumer Overview

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