Indications |
Oral Uncomplicated skin and skin structure infections Adult: 400 mg every 12 hr for 10-14 days. Child: Preterm neonates (<34 wk gestational age): 10 mg/kg every 12 hr; may increase to 10 mg/kg every 8 hr if response is suboptimal. By day 7 of life, all neonates should receive 10 mg/kg every 8 hr. Infant (excluding preterm neonates <1 wk) and children <5 yr: 10 mg/kg every 8 hr for 10-14 days. Children 5-11 yr: 10 mg/kg every 12 hr for 10-14 days; 12-18 yr: 600 mg every 12 hr for 10-14 days. Intravenous Complicated skin and skin structure infections Adult: 600 mg 12 hrly for 10-14 days, as an infusion over 30-120 minutes. Similar doses can also be given via oral route. Child: Preterm neonates (<34 wk gestational age): 10 mg/kg every 12 hr; may increase to 10 mg/kg every 8 hr if response is suboptimal. By day 7 of life, all neonates should receive 10 mg/kg every 8 hr. Infant (excluding preterm neonates <1 wk) and children ≤11 yr: 10 mg/kg every 8 hr for 10-14 days.
Intravenous Community-acquired pneumonia Adult: 600 mg 12 hrly for 10-14 days, as an infusion over 30-120 minutes. Similar doses can also be given via oral route. Child: Preterm neonates (<34 wk gestational age): 10 mg/kg every 12 hr; may increase to 10 mg/kg every 8 hr if response is suboptimal. By day 7 of life, all neonates should receive 10 mg/kg every 8 hr. Infant (excluding preterm neonates <1 wk) and children ≤11 yr: 10 mg/kg every 8 hr for 10-14 days.
Intravenous Nosocomial pneumonia Adult: 600 mg 12 hrly for 10-14 days, as an infusion over 30-120 minutes. Similar doses can also be given via oral route. Child: Preterm neonates (<34 wk gestational age): 10 mg/kg every 12 hr; may increase to 10 mg/kg every 8 hr if response is suboptimal. By day 7 of life, all neonates should receive 10 mg/kg every 8 hr. Infant (excluding preterm neonates <1 wk) and children ≤11 yr: 10 mg/kg every 8 hr for 10-14 days.
Intravenous Vancomycin-resistant enterococci infections Adult: 600 mg every 12 hr. Treatment duration for vancomycin-resistant enterococci: 14-28 day. Similar doses can also be given via oral route. Child: For VRE infections: Preterm neonates (<34 wk gestational age): 10 mg/kg every 12 hr; may increase to 10 mg/kg every 8 hr if response is suboptimal. By day 7 of life, all neonates should receive 10 mg/kg every 8 hr. Infant (excluding preterm neonates <1 wk) and children ≤11 yr: 10 mg/kg every 8 hr for 14-28 days. Intravenous Methicillin-resistant Staphylococcus aureus infections Adult: 600 mg every 12 hr. Treatment duration for vancomycin-resistant enterococci: 14-28 day. Similar doses can also be given via oral route. Child: For VRE infections: Preterm neonates (<34 wk gestational age): 10 mg/kg every 12 hr; may increase to 10 mg/kg every 8 hr if response is suboptimal. By day 7 of life, all neonates should receive 10 mg/kg every 8 hr. Infant (excluding preterm neonates <1 wk) and children ≤11 yr: 10 mg/kg every 8 hr for 14-28 days. Reconstitution: To reconstitute granules for oral suspension, add 123 ml in 2 equal aliquots and shake well to make 150 ml suspension. |
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Contraindications |
Hypersensitivity. | ||||||||||||
Warnings / Precautions |
Preexisting myelosuppression, renal impairment (CrCl < 30ml/min), uncontrolled hypertension, phaeochromocytoma, carcinoid syndrome, untreated hyperthyroidism, chronic infection, history of seizures, bipolar depression, schizophrenia or acute confusional states. Pregnancy and lactation. Monitor complete blood counts weekly. Give after haemodialysis. Not known if linezolid or metabolites removed during peritoneal dialysis. | ||||||||||||
Adverse Reactions |
Diarrhoea (antibiotic associated colitis reported), headache, nausea, vomiting, constipation, abnormal liver function tests, fever, vaginal and oral candidiasis, skin rash, pruritus, dizziness, insomnia, anaemia, tongue discoloration, taste disturbance, lactic acidosis, optic and peripheral neuropathy (particularly if used ≥ 28 days). Potentially Fatal: Reversible myelosuppression including anaemia, leukopenia, pancytopenia and thrombocytopenia (particularly if using > 10-14 days), transient ischaemic attacks, renal failure, Stevens-Johnson syndrome. |
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Drug Interactions |
Use with caution with serotonergic, vasopressor or dopaminergic agents to reduce the incidence of serotonin syndrome. Adrenergic drugs Eg. dopamine, epinephrine, phenylpropanolamine and pseudoephedrine may cause hypertension. Concurrent use with tramadol may increase risk of seizures. Potentially Fatal: MAOI; avoid concurrent use or use within 2 wk of stopping another MAOI to reduce risk of hypertensive crisis. See Below for More linezolid Drug Interactions |
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Lab Interactions |
May alter blood counts. | ||||||||||||
Food Interactions |
Beverages and foods high in tyramine content may cause hypertensive crisis. Avoid dietary tyramine ≥100 mg per meal. | ||||||||||||
Mechanism of Actions |
Linezolid is an bacteriostatic oxazolidinone, inhibiting ribosomal protein synthesis. It is active against gram-positive bacteria including vancomycin-resistant enterococci and MRSA. It has limited in-vitro activity against gram-negative bacteria. Absorption: Oral bioavaiability: Approx 100%. Rapidly absorbed after oral admin. Peak plasma concentrations after 1-2 hrs, although delayed if administered with high fat meal. Distribution: Plasma protein binking: Approx 31%. Readily distributed into well perfused tissues; bone, fat, lungs, muscle, skin blister fluids and CSF. Animal studies have shown Linezolid in milk but not known if distributed into human milk. Therapeutic concentrations not achieved or maintained in CNS fluid. Volume of distribution at steady state: 40-50 L. Metabolism: Oxidised to 2 main inactive metabolites. Excretion: Approx 65% of dose eliminated via non renal route. Renal clearance low. Elimination half life: 4.6-7hr (oral). |
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Administration |
May be taken with or without food. |
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Storage Conditions |
Intravenous: Infusion: Store at 25°C. Protect from light. Oral: Store at 25°C. Reconstituted oral suspension should be used within 21 days of constitution. Protect from light. | ||||||||||||
ATC Classification |
J01XX08 - linezolid ; Belongs to the class of other antibacterials. Used in the systemic treatment of infections. | ||||||||||||
Storage |
Intravenous: Infusion: Store at 25°C. Protect from light. Oral: Store at 25°C. Reconstituted oral suspension should be used within 21 days of constitution. Protect from light. | ||||||||||||
Available As |
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Linezolid
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Linezolid Containing Brands
Linezolid is used in following diseases
Drug - Drug Interactions of Linezolid
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