Linezolid (Oral)

Discover the main uses for the antibacterial agent, Linezolid. Learn its side effects, drug interactions, precautions for use, and more.
Introduction Sentence
Oral Linezolid an antibiotic is suggested for the treatment of specific strains of skin and pneumococcal infections in pediatric and adult patients.

Overview

Oral Linezolid is a type of antibiotic used to treat a host of bacterial infections. It works by killing and preventing the spread of the underlying bacteria. As with other types of antibiotics on the market, viral infections are unresponsive to this drug. As a result, Linezolid is not indicated for the common cold or flu.

Linezolid is sold and marketed under the trade name Zyvox and is a prescription-only medicine. A complete doctor's assessment is needed to obtain a written order for this drug. When the prescription is filled at a pharmacy, it is dispensed as tablets or a mixed powder format.

Conditions Treated?

Pneumonia, Bone Infection, Diabetic Foot Infections, Enterococcus Faecium Infections

Type Of Medicine?

Antibacterial Agent, Oxazolidinone-Class Antibacterial

Side Effects

Linezolid may cause patients to experience unwanted side effects, including:

  • A high temperature
  • A nonstop headache
  • Agitation
  • An abnormal heartbeat
  • Appetite loss
  • Blisters on the mouth
  • Bloody stools or urine
  • Blurriness
  • Changes in stool color
  • Changes in the color of the teeth
  • Coughing, runny nose, ear congestion, and other cold or flu-like symptoms
  • Dehydration
  • Difficulty breathing
  • Excessive drowsiness
  • Feeling cold
  • Feeling confused
  • Feeling congested
  • Feeling dizzy, lightheaded, or faint
  • Feeling nauseous
  • Feeling sick all around
  • Glands that are tended or look and feel swollen
  • Hives
  • Insomnia
  • Itchiness
  • Lips that look blue
  • Marks on the skin
  • Mood swings
  • Pain and aches in the muscles and/or joints
  • Pain in the chest
  • Pain in the eyes
  • Pain in the stomach
  • Rashes
  • Red eyes
  • Seizures
  • Sensitive gums
  • Skin rashes and other irritations
  • Skin that bruises easily
  • Skin that looks pale
  • Skin that looks purplish
  • Skin that peels easily
  • Hoarseness or other voice changes
  • Throwing up, particularly coffee-ground like substances
  • Tingling or pins and needles sensation
  • Trouble passing stools with ease
  • Trouble urinating
  • Unexplained bleeding
  • Welts on the skin

In a lot of these cases, mild side effects generally subside with time and do not generally warrant a call to 911. However, patients are advised to read the precautions on the warning label and know when to call for medical help. If you have a severe reaction to this drug, for example, such as an allergic reaction, changes in vision, loss of consciousness, difficulty breathing, or a fast or abnormal heartbeat, do not hesitate to call 911.

Dosage

Linezolid tablets are supplied in 600 mg. The oral suspension contains 100 mg of linezolid for every 5 ml prescribed.

It should also be noted that this drug can be administered intravenously. For the purposes of this guide, however, the focus is placed Linezolid taken by mouth.

Linezolid, as with all prescription medicines, should be taken exactly as prescribed by your primary healthcare physician. The dosage amounts vary based on specific factors, including;

  • The age of the patient
  • The weight of the patient
  • The type of infection being treated
  • The medication strength
  • The times per day required
  • The timeline of treatment

All dosage amounts prescribed are tailored to the patient's individual needs. To lower the risk of side effects, you should never take more or less of the medicine, or for longer than it is prescribed. Even if you feel better, the full length of treatment should be administered to promote full recovery. Additionally, Linezolid should never be shared with other members of your household.

The dosage table outlined below reflects average doses and should never replace the prescription provided by a primary care physician.

Both the tablet or oral liquid suspension form of Linezolid is generally administered in the following amounts:

  • Children Less Than 12 Years Old''mg per kg (weight) | 2-3X Daily
  • Children Older than 12 Years Old: 400-600 mg | 2X Daily
  • Adults: 400-600 mg | 2X Daily

In most cases, the dose is spaced out every 12 hours.

The following dose charts detail average prescriptions by condition:
Nosocomial Pneumonia (Oral Tablet or Suspension Form of Linezolid)
The average dose amounts of Linezolid for this condition is:

  • Children Less Than 12 Years Old' 10 mg per kg (weight) | 3X Daily (Every 8 Hours) | for 10-14 Days
  • Children Older than 12 Years Old: 600 mg | 2X Daily (Every 12 Hours) | for 10-14 Days
  • Adults: 600 mg | 2X Daily (Every 12 Hours) | for 10-14 Days

Community-Acquired Pneumonia (Oral Tablet or Suspension Form of Linezolid)
The average dose amounts of Linezolid for this condition is:

  • Children Less Than 12 Years Old'10 mg per kg (weight) | 3X Daily (Every 8 Hours) | for 10-14 Days
  • Children Older than 12 Years Old: 600 mg | 2X Daily (Every 12 Hours) | for 10-14 Days
  • Adults: 600 mg | 2X Daily (Every 12 Hours) | for 10-14 Days

Complicated Skin and Skin Structure Infections (Oral Tablet or Suspension Form of Linezolid)
The average dose amounts of Linezolid for this condition is:

  • Children Less Than 12 Years Old ' 10 mg per kg (weight) | 3X Daily (Every 8 Hours) | for 10-14 Days
  • Children Older than 12 Years Old: 600 mg | 2X Daily (Every 12 Hours) | for 10-14 Days
  • Adults: 600 mg | 2X Daily (Every 12 Hours) | for 10-14 Days

Uncomplicated Skin and Skin Structure Infections (Oral Tablet or Suspension Form of Linezolid)
The average dose amounts of Linezolid for this condition is:

  • Children Less Than 5 Years Old '10 mg per kg (weight) | 3X Daily (Every 8 Hours) | for 10-14 Days
  • Children 5-11 Years Old '10 mg per kg (weight) | 2X Daily (Every 12 Hours) | for 10-14 Days
  • Children Older than 12 Years Old: 600 mg | 2X Daily (Every 12 Hours) | for 10-14 Days
  • Adults: 600 mg | 2X Daily (Every 12 Hours) | for 10-14 Days

Enterococcus Faecium Infections (Oral Tablet or Suspension Form of Linezolid)

  • Children Less Than 12 Years Old' 10 mg per kg (weight) | 3X Daily (Every 8 Hours) | for 14-28 Days
  • Children Older than 12 Years Old: 600 mg | 2X Daily (Every 12 Hours) | for 14-28 Days
  • Adults: 600 mg | 2X Daily (Every 12 Hours) | for 14-28 Days

Note: Linezolid is used as a second line of treatment for Enterococcus Faecium infections that are resistant to Vancomycin.

How to correctly use the oral suspension
If you were prescribed an oral suspension version of this drug, the best practices include:

  • Mixing the solution' To ensure the ingredients are thoroughly blended and evenly distributed, the rule of thumb is to rotate the bottle at least 5 times before each use. However, the oral suspension liquid should never be shaken.
  • Portion the dose with care' Use the included measuring cup dispensed by the pharmacy to measure the right dosage. It may be tempting to use a household spoon. However, these measurements are slightly off.
  • Pay attention to the expiration date' To ensure the medicine works effectively, verify that the œuse by date listed has not passed.
  • Follow the schedule' Doctors deliberately prescribe the medicine for use at different intervals to safeguard that there is a constant supply in the bloodstream. It's one of the most effective ways to counterattack the underlying bacteria. Therefore, patients should make every effort to stick to the medication schedule.

Missed Doses

Missing a dose of Linezolid can be an unnerving experience. However, you can catch up on the medication schedule by taking it as soon as you remember. If a 6-12-hour window has passed since your missed dose, however, do not double the dose. Skip the missed dose, and resume the normal schedule. If you have questions, consult your pharmacist of the healthcare provider.

Interactions

Numerous drug contraindications have been determined when Linezolid is prescribed in conjunction with the below list of medications. If both medicines are required by the patient, modified doses may be required for one or all medicines. A doctor can explain in further detail the best course of action for prescribing Linezolid together with:

  • Citalopram
  • Methadone
  • Tolcapone
  • Benzphetamine
  • Escitalopram
  • Atomoxetine
  • Fentanyl
  • Trimipramine
  • Oxycodone
  • Flesinoxan
  • Imipramine
  • Amoxapine
  • Mate
  • Nortriptyline
  • Lithium
  • Morphine Sulfate Liposome
  • Levodopa
  • Nefazodone
  • Repaglinide
  • Risperidone
  • Methyldopa
  • Maprotiline
  • Tyrosine
  • Guarana
  • Doxylamine
  • Glimepiride
  • Diethylpropion
  • Meperidine
  • Sumatriptan
  • Methamphetamine
  • Desvenlafaxine
  • Hydromorphone
  • Tramadol
  • Reserpine
  • Clomipramine
  • Phenylpropanolamine
  • Nefopam
  • Guanadrel
  • Zimeldine
  • Insulin
  • Carbamazepine
  • Metoclopramide
  • Norepinephrine
  • Brimonidine
  • Carbidopa
  • Rifampin
  • Altretamine
  • Tryptophan
  • Naratriptan
  • Hydroxytryptophan
  • Palonosetron
  • Safinamide
  • Phenelzine
  • Milnacipran
  • Cholera Vaccine, Live
  • Epinephrine
  • Dextroamphetamine
  • Phenylalanine
  • Dobutamine
  • Ziprasidone
  • Vortioxetine
  • Fluvoxamine
  • Lorcaserin
  • Tetrabenazine
  • Tolbutamide
  • Rizatriptan
  • Granisetron
  • Vilazodone
  • Linezolid
  • Entacapone
  • Clarithromycin
  • Nateglinide
  • Protriptyline
  • Ma Huang
  • Ginseng
  • Dopamine
  • Morphine
  • Levomethadyl
  • Amitriptyline
  • Dolasetron
  • Mazindol
  • Carbinoxamine
  • Amphetamine
  • Droperidol
  • Cyproheptadine
  • Difenoxin
  • Rasagiline
  • Lisdexamfetamine
  • Phenmetrazine
  • Oxymetazoline
  • Paroxetine
  • Acarbose
  • Bupropion
  • Diphenhydramine
  • Licorice
  • Mirtazapine
  • Procarbazine
  • Atropine
  • Doxepin
  • Kava
  • Tranylcypromine
  • Duloxetine
  • Zolmitriptan
  • Guanethidine
  • Dextromethorphan
  • Methylene Blue
  • Ethchlorvynol
  • Levomilnacipran
  • Almotriptan
  • Isocarboxazid
  • Buspirone
  • Frovatriptan
  • Trazodone
  • Phendimetrazine
  • Pseudoephedrine
  • Fluoxetine
  • Tapentadol
  • Hydrocodone
  • Dexmethylphenidate
  • Metformin
  • Sibutramine
  • Opicapone
  • Warfarin
  • Tolazamide
  • Phentermine
  • St John's Wort
  • Methylphenidate
  • Venlafaxine
  • Phenylephrine
  • Iobenguane I 123
  • Opipramol
  • Diphenoxylate
  • Eletriptan
  • Clovoxamine
  • Apraclonidine
  • Cyclobenzaprine
  • Sertraline
  • Desipramine
  • Selegiline
  • Reboxetine
  • Chlorpropamide
  • Glipizide
  • Glyburide
  • Buprenorphine
  • Femoxetine

Note: Some medicines when prescribed together with Linezolid carry an increased risk of side effects than others.

Food interactions
Certain foods should not be consumed while undergoing treatment with Linezolid, as adverse reactions have been known to occur. Some examples include bitter orange or avocado. If these foods are typically a part of your normal diet, doctor-approved substitutes should be used in the interim.

Interactions With Substances

Limit the use of alcohol or tobacco products while being treated with Linezolid. You should also tell your doctor if you regularly smoke or drink alcoholic products to determine the safety of continuing these activities while taking Linezolid.

Interactions with underlying medical conditions
Linezolid may cause some conditions to get worse. Moreover, the presence of the following pre-existing conditions could affect how well the drug works. Tell your doctor, therefore, if you have:

Warnings

Linezolid carries the risk of some side effects, which medical experts detail during consultations. Typically, a take-home leaflet is provided listing the main precautions when using this antibiotic. In addition, a warning insert is included at the time of filling the prescription.

Some of the main precautions include:

Hypersensitivities
In rare cases, Linezolid may cause an allergic response. If you have a history of any allergic reactions to any medicines, substance or products, discuss this at your appointment with your primary care physician. You should also note any known hypersensitivities to foods, dyes or animal products. Your primary care physician will complete a thorough assessment to determine if this drug is right for you.

Pregnancy and Nursing Mothers
Inadequate information is available on how Linezolid affects developing human fetuses. In studies completed with animals, contraindications have been found. As a result, this medicine should be used with caution in expecting mothers. Similarly, if the patient is nursing, extra precautions should be taken to lower the potential risk to newborns and infants.

Follow-up visits
Patients and parents of minors are advised to complete due diligence by monitoring if the original symptoms persist. If no improvements are observed after a few days of using Linezolid, consult your healthcare provider.

Generally, patients who are given Linezolid usually need to return to the prescribing physician for a follow-up visit to determine if the medicine is working as it should. Be sure to keep all follow-up appointments.

Stopping other medications
Your doctor may ask if you have used the following drugs in the past two weeks, as negative interactions may occur with Linezolid:

  • Antidepressants
  • Buspirone
  • Cold medications
  • Dobutamine
  • Dopamine
  • Epinephrine
  • Isocarboxazid, phenelzine
  • Marplan
  • Medicines for migraines
  • Meperidine
  • Nardil
  • Norepinephrine
  • Parnate

Check the full list of drug interactions described earlier. Additionally, create a rundown of all medications currently being used and hand this list to your medical provider.

As an extra precaution, do not use over-the-counter medicines, including vitamins, herbs, supplements, NSAIDs, or cold, allergy, or sinus medicines before checking with your doctor.

Lower immune function
As an antibiotic, Linezolid may decrease white blood cells and platelets causing patients to become susceptible to new infections. As your immune-fighting abilities are lowered, it's better to:

1. Stay away from others who are sick' avoid other members of the household, coworkers, or schoolmates who are sick by taking a leave of absence or setting up parameters to isolate parties.

2. Tell your doctor about new infections ' If you notice new symptoms or suspect an infection has been acquired, consult your doctor immediately. You should also contact your healthcare provider if you or your child experiences fluctuations in bodily temperature, coughing, muscle aches and pain, or trouble urinating. Other warning signs of a new infection or adverse reaction include bloody stools or urine, skin that bruises easily, or pinpoint marks on the skin.

Diarrhea
One of the possible side effects of using antibiotics such as Linezolid is diarrhea. This adverse reaction can transpire for up to 8 weeks after discontinuing the medicine. If you suspect diarrhea while taking Linezolid or after stopping the treatment, do not use antidiarrheal medicines before first consulting your doctor, as the problem may be exacerbated as a result.

Hypoglycemia warning
Linezolid may cause blood sugar levels to decrease. As a result, parents or adult patients should pay attention to the warning signs and make a plan of action to curb the effects if hypoglycemia happens.

Some of the main telltale signs of hypoglycemia include:

  • Lethargy
  • Drowsiness
  • A state of confusion
  • Feeling famished
  • Anxiety
  • Vision changes
  • A bad and nonstop headache

In most cases, hypoglycemia is triggered by going a long time without eating. Therefore, try planning a meal schedule for breakfast, lunch, and dinner, with healthy snacks in between to keep you full. If you suspect hypoglycemia or low blood sugar, the best practices are to eat or drink something sweet as soon as possible.

Lactic Acidosis
There is a risk of lactic acidosis, which is characterized by:

  • Syncope' fainting, dizziness, or lightheadedness
  • Lethargy
  • Feeling nauseous
  • Difficulty breathing

If you notice these symptoms, call 911 right away.
Serotonin syndrome
This condition is a common side effect of Linezolid' when it is used in conjunction with certain types of drugs. A few of the telltale signs of this condition include:

  • Anxiety or nervousness
  • Runny stools
  • Feeling confused
  • Spikes in temperature
  • Hyperactivity
  • Imbalances
  • Chills
  • Perspiration
  • Feeling shaky

If these symptoms are noticeable, seek medical help immediately.

Vision changes
In rare cases, Linezolid may cause patients to have difficulty seeing or reading. If you or your child experiences blurriness or other visionary changes, get in touch with your healthcare provider right away. Your doctor may refer you to an ophthalmologist for further review and treatment.

High blood pressure
Patients with hypertension should discuss this underlying condition with their healthcare provider before starting treatment with Linezolid. Additionally, medical researchers have concluded that consuming certain food products in conjunction with Linezolid increases the risk of developing hypertension'more commonly known as high blood pressure.

These include food products that contain excess amounts of tyramine. The most common examples are foods that have been smoked, fermented, or cured. In other words, you should avoid:

  • Beer
  • Pickles
  • Sauerkraut
  • Sausages
  • Smoked seafood or chicken
  • Soy sauce
  • Wines

Limiting drug-resistant bacteria
Medical professionals now know that when antibiotics are overprescribed to patients, drug resistance and the possible development of superbugs can occur. As a result, Linezolid is only recommended for the following types of bacterial infections which have demonstrated a response to the drug:

  • Nosocomial pneumonia
  • Community-acquired pneumonia
  • Complicated and uncomplicated skin and skin structure infections,
  • Enterococcus faecium infections

There are also some exclusions, which healthcare professionals have advanced knowledge of. To determine if the patient has a case of the above listed and susceptible conditions, lab tests are generally performed.

Storage

To store Linezolid, keep in the original container and place it at a room temperature. Do not store near to areas that are generally get hit with direct sunlight. To preserve the quality of the medicine, you should also keep Linezolid tablets and syrup away from heat or moisture.

The oral suspension liquid of Linezolid features supplementary storage instructions. For example, the bottle cap should be tightly sealed after each use. The solution should moreover be discarded after three weeks of picking it up at your local pharmacy. Any leftover beyond this date is generally invalid.

Do not discard unused portions of the medicine in a sink or toilet. Instead, consider returning it to a local pharmacy offering a drug takeback program.

For the safety of others around you, store this medicine in a high and/or locked area. In particular, Linezolid should be kept out of the reach of children and pets.

Summary

Linezolid is a type of antibiotic used to treat different types of bacterial infections in children and adults. It is predominantly used as a therapy for skin infections and certain strains of pneumonia. This medicine is available by prescription only and it is sold under the brand name Zyvox.

To lower the risk of drug resistance, lab tests are done to confirm that Linezolid is an appropriate treatment for the patient's underlying complaint. In most cases, the bacterial infections that are treated with Linezolid are known to respond to this treatment. Some examples include diabetic foot infections, nosocomial pneumonia, and complicated skin structure infections, just to name a few.

Linezolid may cause several side effects, ranging from mild to severe. Patients are generally informed of when to seek emergency medical help. Some examples include severe allergic reactions; changes in vision; lactic acidosis; seizures; or serotonin syndrome. A leaflet is provided with all prescriptions detailing the main precautions for use.

Patients who have been prescribed Linezolid should complete the full course of treatment, even if they feel better. Patients are also advised to list all current medications being taken, underlying conditions, and any past incidences of hypersensitivities. Moreover, Linezolid users should not eat foods that are rich in tyramine, including soy sauce, smoked meats, or other pickled or fermented products. Concomitant use could cause increases in blood pressure levels.

In general, Linezolid is well-tolerated by most patients, including children, adults, and seniors. If, however, you experience persistent side effects of the drug or the underlying condition shows no signs of improvement, consult your healthcare provider.