Linzolid 600 mg/300 ml Infusion

Oxazolidinone antibiotic, reserved for serious infections caused by resistant Gram-positive bacteria:

• Pneumonia (community- or hospital-acquired) including MRSA
• Complicated skin and soft-tissue infections, diabetic foot infections
• Vancomycin-resistant Enterococcus (VRE) infections
• Multidrug-resistant tuberculosis (specialist regimens)

Adults and adolescents 12 years and over: 600 mg every 12 hours by mouth or IV, usually for 10–14 days (up to 28 days).

Children under 12 years: 10 mg/kg every 8 hours (maximum 600 mg per dose).

MDR-TB: 600 mg once daily (sometimes reduced to 300 mg) as part of a combination — specialist only.

• Tablets with or without food.
• Courses longer than 28 days increase the risk of nerve and blood side effects.

• Allergy to linezolid
• Use of MAO inhibitors (or within 2 weeks)
• Uncontrolled high blood pressure, phaeochromocytoma, carcinoid, thyrotoxicosis — unless closely monitored
• With serotonergic drugs (SSRIs, tricyclics, triptans, pethidine, buspirone) unless monitored for serotonin syndrome
• With sympathomimetics (pseudoephedrine, phenylpropanolamine, adrenaline, dopamine) unless monitored

Common: diarrhoea, nausea, headache, taste changes, vaginal or oral thrush, raised liver enzymes.

Serious: bone marrow suppression (low platelets, anaemia, low white cells — especially after 2 weeks), peripheral and optic neuropathy (numbness, vision changes — with long courses), lactic acidosis, serotonin syndrome, low blood sugar in diabetics, seizures, C. difficile colitis.

• Weekly full blood count during treatment.
• Report vision changes or numbness/tingling; eye checks if treatment lasts over 28 days.
• Avoid large amounts of tyramine-rich foods (aged cheese, cured/smoked meats, soy sauce, draught beer, red wine) — risk of sudden high blood pressure.
• Diabetics on insulin/tablets: watch for low sugar.

Use in pregnancy only if clearly needed. Avoid breastfeeding during treatment.

• MAO inhibitors (contraindicated)
• SSRIs, SNRIs, tricyclics, tramadol, pethidine, triptans (serotonin syndrome)
• Pseudoephedrine, adrenaline, dopamine (high blood pressure)
• Rifampicin (lowers levels)
• Insulin and diabetes tablets (low sugar)

Vomiting, tremor, unsteadiness. Supportive care; haemodialysis partly removes it.

Store below 30°C. IV bags: keep in the overwrap until use; do not freeze.