Trade Names:Zyvox- Tablets 400 mg (sodium content is 1.95 mg per 400 mg tablet [0.1 mEq/tablet])- Tablets 600 mg (sodium content is 2.92 mg per 600 mg tablet [0.1 mEq/tablet])- Powder for oral suspension 100 mg per 5 mL (sodium content is 8.52 mg per 5 mL [0.4 mEq per 5 mL])- Injection 2 mg/mL (sodium content is 0.38 mg/mL [5 mEq per 300 mL bag, 3.3 mEq per 200 mL bag, 1.7 mEq per 100 mL bag])Zyvoxam (Canada)Zyvoxam IV (Canada)
Prevents the formation of a functional 70S initiation complex, which is essential to the bacterial translation process.
Rapidly and extensively absorbed. T max is 1 to 2 h. Absolute bioavailability is about 100% (no dose adjustment needed from IV to oral). Food does not affect absorption; however, T max is delayed from 1.5 to 2.2 h and C max is decreased 17% when high-fat food is given.
Readily distributed to well-perfused tissues; 31% protein bound. Vd at steady state is 40 to 50 L.
Primarily metabolized by oxidation of the morpholine ring. Metabolites are aminoethoxyacetic acid (A) and hydroxyethyl glycine (B) metabolite.
About 65% nonrenal Cl. Approximately 30% of dose appears in urine (40% as metabolite B, 10% as metabolite A). Renal Cl is 40 mL/min.
Treatment of vancomycin-resistant Enterococcus faecium infections; treatment of nosocomial pneumonia, complicated and uncomplicated skin and skin structure infections, and community-acquired pneumonia caused by susceptible strains of specific organisms.
No dosage adjustment is necessary when switching from IV to PO. Administer IV infusion over a period of 30 to 120 min.Vancomycin-Resistant E. faecium Infections, Including Concomitant BacteremiaAdults and children 12 yr of age and older
PO or IV 600 mg every 12 h for 14 to 28 days.Children (birth through 11 yr of age)
PO or IV 10 mg/kg every 8 h for 14 to 28 days. Most preterm neonates younger than 7 days of age should start with 10 mg/kg every 12 h. A dose of 10 mg/kg every 8 h may be considered in neonates with a suboptimal response.Nosocomial Pneumonia, Complicated Skin and Skin Structure Infections, Community-Acquired Pneumonia, Including Concomitant BacteremiaAdults and children 12 yr of age and older
PO or IV 600 mg every 12 h for 10 to 14 days.Children (birth through 11 yr of age)
PO or IV 10 mg/kg every 8 h for 10 to 14 days. Most preterm neonates less than 7 days of age should start with 10 mg/kg every 12 h. A dose of 10 mg/kg every 8 h may be considered in neonates with a suboptimal response.Uncomplicated Skin and Skin Structure InfectionsAdults
PO 400 mg every 12 h for 10 to 14 days.Children 12 to 18 yr of age
PO 600 mg every 12 h for 10 to 14 days.Children 5 to 11 yr of age
PO 10 mg/kg every 12 h for 10 to 14 days.Children younger than 5 yr of age
PO 10 mg/kg every 8 h for 10 to 14 days. Most preterm neonates younger than 7 days of age should start with 10 mg/kg every 12 h. A dose of 10 mg/kg every 8 h may be considered in neonates with a suboptimal response.Methicillin-Resistant Staphylococcus aureusAdults
600 mg every 12 h.
Store tablets and reconstituted suspension at controlled room temperature (59° to 86°F). Protect from light. Keep bottles tightly closed. Discard any unused suspension after 21 days.Injection
Store IV infusion bags at controlled room temperature (59° to 86°F). Protect infusion bags from freezing and light.
Effects may be enhanced by linezolid.Serotonergic agents (eg, fluoxetine)
Possible increased risk of serotonin syndrome.
None well documented.
Headache (7%); insomnia, convulsions (3%); dizziness (2%); vertigo (1%); neuropathy (postmarketing).
Rash (7%); skin disorder (2%).
Diarrhea (11%); vomiting (9%); nausea (6%); generalized and localized abdominal pain, GI bleeding, loose stools, constipation, altered taste (2%); tongue discoloration, oral moniliasis (1%).
Vaginal moniliasis (2%).
Anemia (6%); thrombocytopenia (5%); thrombocythemia (3%); eosinophilia (1%); leukopenia, pancytopenia (postmarketing).
Abnormal LFTs (1%).
Hypokalemia (3%); generalized edema (2%); lactic acidosis (postmarketing).
Upper respiratory tract infection (4%); pneumonia, dyspnea (3%); cough, apnea (2%).
Fever (14%); sepsis (8%); trauma, injection site reactions (3%); fungal infections, localized pain (2%).
Category C .
See dosing recommendations.
Because myelosuppression has been reported, monitor CBC weekly in patients receiving linezolid.
Consider pseudomembranous colitis in patients who develop diarrhea.
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