Linezolid

May be taken with or without food.

Hypersensitivity. Unless facilities are available for close observation and monitoring of blood pressure, avoid linezolid use in patients with uncontrolled hypertension, thyrotoxicosis, phaeochromocytoma, bipolar depression, acute confusional states, or schizoaffective disorder, and/or in patients taking directly and indirectly acting sympathomimetic agents (including adrenergic bronchodilators, pseudoephedrine, and phenylpropanolamine), vasopressive agents (e.g. epinephrine, norepinephrine), and dopaminergic drugs (e.g. dopamine, dobutamine). Unless patients are closely observed for signs and symptoms of serotonin syndrome, linezolid must not be given to those with carcinoid syndrome, and/or patients taking SSRIs, TCAs, serotonin 5-HT₁ receptor agonists (triptans), pethidine, bupropion, or buspirone. Concomitant use or within 2 weeks of discontinuing MAOIs.

Patient with a history of seizures; diabetes mellitus, liver cirrhosis. Not indicated for the treatment of Gram-negative infections and catheter-related systemic infections. If a concomitant Gram-negative pathogen is documented or suspected, specific Gram-negative treatment must be initiated immediately. Severe renal impairment (CrCl <30 mL/min), including those undergoing haemodialysis; severe hepatic impairment. Children. Pregnancy and lactation. Patient Counselling This drug may cause dizziness or visual impairment, if affected, do not drive or operate machinery. Monitoring Parameters Perform culture and sensitivity tests; consult local institutional recommendations before treatment initiation due to antibiotic resistance risks. Obtain CBC weekly; closely monitor blood counts in patients at risk of bleeding, with pre-existing myelosuppression or renal impairment, those receiving >2 weeks of therapy or concomitant agents that cause bone marrow suppression. Monitor blood pressure; serum Na levels regularly in patients taking diuretics, at risk of hyponatraemia and/or SIADH, and in the elderly. Perform visual function tests in patients on prolonged therapy or with vision changes. Closely monitor for signs and symptoms of serotonin syndrome and neuropathic adverse effects (e.g. peripheral neuropathy, optic neuritis); signs of bone marrow suppression in patients with renal impairment.

Significant: Myelosuppression, including anaemia, thrombocytopenia, pancytopenia, and leucopenia; peripheral neuropathy and optic neuropathy and neuritis, particularly in patients treated for >28 days; convulsions, lactic acidosis, hyponatraemia, syndrome of inappropriate antidiuretic hormone secretion (SIADH); symptomatic hypoglycaemia, particularly in patients with diabetes mellitus receiving insulin or oral hypoglycaemic agents; fungal or bacterial superinfection (prolonged use). Blood and lymphatic system disorders: Eosinophilia, sideroblastic anaemia. Cardiac disorders: Tachycardia. Ear and labyrinth disorders: Tinnitus. Eye disorders: Blurred vision, changes in visual acuity or colour vision, loss of vision. Gastrointestinal disorders: Diarrhoea, nausea, vomiting, abdominal pain, constipation, dyspepsia, abdominal distention, stomatitis, gastritis, pancreatitis, dry mouth, glossitis, tongue discolouration, taste perversion (metallic taste). Rarely, superficial tooth discolouration. General disorders and administration site conditions: Fever, localised pain, chills, fatigue, increased thirst, inj site pain. Immune system disorders: Anaphylaxis. Infections and infestations: Candidiasis, fungal infections. Investigations: Increased ALT, AST, alkaline phosphatase, total bilirubin, BUN, serum creatinine, lactate dehydrogenase, creatine kinase, serum lipase, amylase, and non-fasting glucose; decreased total protein, albumin, and Ca levels; increased or decreased K or bicarbonate levels. Nervous system disorders: Headache, dizziness, hypoaesthesia, paraesthesia. Psychiatric disorders: Insomnia. Renal and urinary disorders: Renal failure, polyuria. Reproductive system and breast disorders: Vaginitis, vulvovaginal disorder. Skin and subcutaneous tissue disorders: Rash, pruritus, dermatitis, diaphoresis, urticaria, bullous disorders (e.g. Stevens-Johnson syndrome, toxic epidermal necrolysis), angioedema, alopecia. Vascular disorders: Hypertension, TIA, phlebitis, thrombophlebitis.
Potentially Fatal: Clostridioides difficile-associated diarrhoea (CDAD), pseudomembranous colitis; serotonin syndrome.

May enhance the hypoglycaemic effect of antidiabetic agents. Plasma concentration may be decreased by rifampicin.

Other Antibiotics

J01XX08 - linezolid ; Belongs to the class of other antibacterials. Used in the systemic treatment of infections.