Antimicrobials
Linezolid

Linezolid

Restricted

Low
Excellent

Spectrum of Activity

Dosing

General Information

HEALTH CANADA APPROVED

  • Treatment of serious and life-threatening infections (pneumonia, skin and soft tissue, intra-abdominal, and bacteremia) due to gram positive organisms, including vancomycin-resistant Enterococcus (VRE) or methicillin-resistant Staphylococcus aureus (MRSA)
  • Myelosuppression
  • Uncontrolled hypertension, pheochromocytoma, carcinoid syndrome, or untreated hyperthyroidism; monitor for potential increases in BP
  • Is a weak reversible, nonselective monoamine oxidase inhibitor and may interact with any drug that acts as a serotonin reuptake inhibitor; including serotonin reuptake inhibitors (SSRIs) (eg citalopram, paroxetine), serotonin norepinephrine reuptake inhibitors (SNRIs) (eg duloxetine, venlafaxine), tricyclic antidepressants (eg amitriptyline) resulting in serotonin syndrome. List is not all inclusive. Avoid concurrent use whenever possible
  • Adrenergic agents (eg EPINEPHrine, norephinephrine) may increase pressor response
  • Other MAO inhibitors (eg methylene blue); may enhance serotonergic effect, resulting in serotonin syndrome. Avoid combination when possible

RECOMMENDED

  • Baseline complete blood count and differential; then weekly. (Predictable cytopenia after 2 weeks of therapy)
  • Lactic acidosis, peripheral neuropathy, optic neuropathy after 4 weeks of therapy
  • Visual testing for therapy greater than 3 months or if symptoms develop on therapy

Requires Special Authorization for PEI Pharmacare

HEALTH PEI has restricted the use of linezolid:

  • To empirically treat suspected VRE (based on travel, non-response, past microbiology)
  • To empirically treat suspected severe MRSA pneumonia until culture susceptibilities are known
  • To treat infections in patients who are truly allergic to vancomycin
  • OR at the opinion of the Medical Microbiologist or an Infectious Disease consultant

No dosage adjustment required when stepping down to PO

IM and subcutaneous administration; not recommended

Antimicrobial class: Antibiotic - Oxazolidinone

Pregnancy category: C

Average serum half life: 5 hours

Urine penetration: Therapeutic

Lung penetration: Therapeutic

CSF penetration: Therapeutic

pH: ~4.6