Classifications: antibiotic, oxazolidinone; Therapeutic: antibiotic
Pregnancy Category: C
400 mg, 600 mg tablets; 100 mg/5 mL suspension; 200 mg, 400 mg, 600 mg injection
Synthetic antibiotic that binds to a site on the bacterial 23S ribosomal RNA of the bacteria which prevents the bacterial
RNA translation process, thus preventing the bacteria from further growth.
Bacteriostatic against enterococci and staphylococci, and bactericidal against streptococci. Is bacteriocidal against gram-positive, gram-negative, and anaerobic bacteria.
Treatment of vancomycin-resistant Enterococcus faecium (VREF), nosocomial pneumonia, complicated and uncomplicated skin and skin structure infections, community-acquired pneumonia
due to susceptible gram-positive organisms.
Hypersensitivity to linezolid, pregnancy (category C), lactation.
Lactation, history of thrombocytopenia, thrombocytopenia; patients on MAOI, or serotonin reuptake inhibitors, or adrenergic agents, active alcoholism, anemia, bleeding, bone marrow suppression,
cardiac arrhythmias, cardiac disease, cerebrovascular disease, chemotherapy, coagulopathy, colitis, diarrhea, hypertension,
hyperthyroidism, leukopenia, MI, radiographic contrast administration, spinal anesthesia, surgery, hypertension; phenylketonuria;
Route & Dosage
|Vancomycin-Resistant Enterococcus faecium
Adult/Adolescent (>12 y): PO/IV 600 mg q12h x 1428 d
Child (211 y): PO/IV 10 mg/kg q8h x 1428 d
Nosocomial or Community-Acquired Pneumonia, Complicated Skin Infections
Adult/Adolescent (>12 y): PO/IV 600 mg q12h x 1014 d
Child (511 y): PO/IV 10 mg/kg q8h x 1014 d
Uncomplicated Skin Infections
Adult: PO 400 mg q12h x 1014 d
Adolescent: PO 600 mg q12h x 1014 d
Child: PO <5 y, 10 mg/kg q8h x 1014 d; 511 y, 10 mg/kg q12h x 1014 d
Note: No dosage adjustment is necessary when switching from IV to oral administration. Oral
- Reconstitute suspension by adding 123 mL distilled water in two portions; after adding first half, shake to wet all of the
powder, then add second half of water and shake vigorously to produce a uniform suspension with a concentration of 100 mg/5
- Before each use, mix suspension by inverting bottle 35 times, but DO NOT SHAKE. Discard unused suspension after 21 d.
PREPARE: Intermittent: IV solution is supplied in a single-use, ready-to-use infusion bag. Remove from protective wrap immediately prior to use.
Check for minute leaks by firmly squeezing bag. Discard if leaks are detected.
ADMINISTER: Intermittent: Do not use infusion bag in a series connection. Give over 30120 min. If IV line is used to infuse other drugs, flush
before and after with D5W, NS, or LR.
INCOMPATIBILITIES Solution/additive: Ceftriaxone, erythromycin, trimethoprim-sulfamethoxazole. Y-site: Amphotericin B, ceftriaxone, chlorpromazine, diazepam, pentamidine, phenytoin.
- Store at 25° C (77° F) preferred; 15°30° C (59°86° F) permitted. Protect from light
and keep bottles tightly closed.
Adverse Effects (≥1%)Body as a Whole:
Diarrhea, nausea, vomiting, constipation
, taste alteration, abnormal LFTs, tongue discoloration. Hematologic:
Thrombocytopenia, leukopenia. CNS:
, dizziness. Skin:
InteractionsDrug: mao inhibitors
may cause hypertensive crisis; pseudoephedrine
may cause elevated BP; may cause serotonin
syndrome with selective serotonin reuptake inhibitors
Tyramine-containing food may cause elevated BP. Herbal: Ginseng, ephedra, ma huang
may lead to elevated BP, headache, nervousness.
Rapidly or extensively absorbed, 100% bioavailable. Peak:
12 h PO. Distribution:
31% protein bound. Metabolism:
By oxidation. Elimination:
Primarily in urine. Half-Life:
Assessment & Drug Effects
- Monitor for signs and symptoms in individuals with a history of seizure activity or conditions that make them prone to seizures.
If a seizure occurs, discontinue the drug and report to the physician immediately.
- Monitor for S&S of: Bleeding; hypertension; or pseudomembranous colitis that begins with diarrhea.
- Lab tests: C&S before initiating therapy and during therapy as indicated; drug may be started pending results. Monitor complete
blood count, including platelet count and Hgb & Hct, in those at risk for bleeding or with >2 wk of linezolid therapy.
Patient & Family Education
- Report any of the following to physician promptly: Onset of diarrhea; easy bruising or bleeding of any type; or S&S of superinfection
(see Appendix F), S&S of seizure activity.
- Avoid foods and beverages high in tyramine (e.g., aged, fermented, pickled, or smoked foods, and beverages). Limit tyramine
intake to <100 mg per meal (see Information for Patients provided by the manufacturer).
- Do not take OTC cold remedies or decongestants without consulting physician.
- Note for phenylketonurics: Each 5 mL oral suspension contains 20 mg phenylalanine.