Linezolid (intravenous route)


    Brand Name

    US Brand Name

    Zyvox


    Description

    Linezolid injection is used to treat certain bacterial infections in many different parts of the body, including certain types of skin infections or pneumonia.

    Linezolid belongs to the family of medicines called antibiotics. It works by killing bacteria or preventing their growth. However, this medicine will not work for colds, flu, or other virus infections.

    This medicine is to be given only by or under the direct supervision of a doctor.

    This product is available in the following dosage forms:

    • Solution

    Before Using

    In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

    Allergies

    Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

    Pediatric

    Appropriate studies performed to date have not demonstrated pediatric-specific problems that would limit the usefulness of linezolid injection in children.

    Geriatric

    Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of linezolid injection in the elderly. However, elderly patients are more sensitive to the effects of this medicine than younger adults.

    Breastfeeding

    There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

    Drug Interactions

    Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are receiving this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

    Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

    • Almotriptan
    • Amitriptyline
    • Amoxapine
    • Amphetamine
    • Apraclonidine
    • Atomoxetine
    • Benzphetamine
    • Brimonidine
    • Bupropion
    • Buspirone
    • Carbamazepine
    • Carbidopa
    • Carbinoxamine
    • Citalopram
    • Clomipramine
    • Clovoxamine
    • Codeine
    • Cyclobenzaprine
    • Cyproheptadine
    • Desipramine
    • Desvenlafaxine
    • Deutetrabenazine
    • Dexmethylphenidate
    • Dextroamphetamine
    • Diethylpropion
    • Dihydrocodeine
    • Dobutamine
    • Dopamine
    • Doxepin
    • Doxylamine
    • Duloxetine
    • Eletriptan
    • Entacapone
    • Epinephrine
    • Escitalopram
    • Femoxetine
    • Fenfluramine
    • Flesinoxan
    • Fluoxetine
    • Fluvoxamine

    Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

    • Albuterol
    • Alfentanil
    • Atropine
    • Benzhydrocodone
    • Buprenorphine
    • Butalbital
    • Butorphanol
    • Cholera Vaccine, Live
    • Dextromethorphan
    • Difenoxin
    • Diphenhydramine
    • Diphenoxylate
    • Dolasetron
    • Droperidol
    • Ethchlorvynol
    • Fentanyl
    • Formoterol
    • Granisetron
    • Guarana
    • Hydrocodone
    • Hydromorphone
    • Iobenguane I 123
    • Iobenguane I 131
    • Kava
    • Lasmiditan
    • Levorphanol
    • Licorice
    • Lithium
    • Lorcaserin
    • Ma Huang
    • Mate
    • Metaxalone
    • Methadone
    • Metoclopramide
    • Midodrine
    • Nalbuphine
    • Norepinephrine
    • Oliceridine
    • Ondansetron
    • Oxycodone

    Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

    • Acarbose
    • Chlorpropamide
    • Clarithromycin
    • Ginseng
    • Glimepiride
    • Glipizide
    • Glyburide
    • Insulin
    • Insulin Aspart, Recombinant
    • Insulin Bovine
    • Insulin Degludec
    • Insulin Detemir
    • Insulin Glargine, Recombinant
    • Insulin Glulisine
    • Insulin Lispro, Recombinant
    • Metformin
    • Nateglinide
    • Repaglinide
    • Rifampin
    • Tolazamide
    • Tolbutamide

    Other Interactions

    Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

    Using this medicine with any of the following is usually not recommended, but may be unavoidable in some cases. If used together, your doctor may change the dose or how often you use this medicine, or give you special instructions about the use of food, alcohol, or tobacco.

    • Avocado
    • Bitter Orange

    Using this medicine with any of the following may cause an increased risk of certain side effects but may be unavoidable in some cases. If used together, your doctor may change the dose or how often you use this medicine, or give you special instructions about the use of food, alcohol, or tobacco.

    • Tyramine Containing Food

    Other Medical Problems

    The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

    • Blood problems or
    • Bone marrow depression or
    • Diabetes or
    • Hypertension (high blood pressure), history of or
    • Hypoglycemia (low blood sugar) or
    • Seizures, history of—Use with caution. May make these conditions worse.
    • Carcinoid syndrome or
    • Hypertension (high blood pressure), uncontrolled or
    • Pheochromocytoma or
    • Thyroid problems—Should not be used in patients with these conditions unless they are closely monitored by their doctor for hypertension and serotonin syndrome.
    • Infection at the catheter site—Should not be used in patients with this condition.
    • Infection, Gram-negative—Use is not indicated in patients with this condition.
    • Kidney disease, severe or
    • Liver disease, moderate to severe—Use with caution. May cause thrombocytopenia (low platelet count in the blood) in patients with these conditions.

    Proper Use

    A nurse or other trained health professional will give you or your child this medicine in a hospital. This medicine is given through an IV catheter placed in one of your veins. It must be given slowly, so the IV will have to remain in place for 30 to 120 minutes.

    Your doctor will give you or your child a few doses of this medicine until your condition improves, and then switch you to an oral medicine that works the same way. If you have any concerns about this, talk to your doctor.


    Precautions

    It is very important that your doctor check your or your child's progress while you are receiving this medicine, to see if the medicine is working properly. Blood and urine tests may be needed to check for any unwanted effects.

    If your or your child's symptoms do not improve within a few days or if they become worse, check with your doctor.

    You should not use this medicine if you or your child have used an MAO inhibitor (MAOI) including isocarboxazid, phenelzine, Eldepryl®, Marplan®, Nardil®, or Parnate® within the past 14 days. Also, do not use this medicine if you or your child are also using the following medicines: buspirone (Buspar®), dobutamine (Dobutrex®), dopamine (Intropin®), epinephrine (Adrenalin®), norepinephrine (Levophed®), cold medicines or decongestants (eg, phenylpropanolamine, pseudoephedrine, or Sudafed®), medicine to treat depression (eg, amitriptyline, bupropion, doxepin, fluoxetine, nortriptyline, paroxetine, Celexa®, Effexor®, Elavil®, Lexapro™, Paxil®, or Zoloft®), medicine to treat migraine headaches (eg, sumatriptan, zolmitriptan, Axert®, Imitrex®, or Zomig®), or narcotic pain medicines (eg, meperidine, Demerol®).

    Linezolid can lower the number of white blood cells in your blood temporarily, increasing the chance of getting an infection. It can also lower the number of platelets, which are necessary for proper blood clotting. If this occurs, there are certain precautions your doctor may ask you to take, especially when your blood count is low, to reduce the risk of infection or bleeding:

    • If you can, avoid people with infections. Check with your doctor immediately if you think you or your child are getting an infection or if you get a fever or chills, cough or hoarseness, lower back or side pain, or painful or difficult urination.
    • Check with your doctor immediately if you notice any unusual bleeding or bruising, black, tarry stools, blood in the urine or stools, or pinpoint red spots on your skin.

    This medicine may cause diarrhea, and in some cases it can be severe. It may occur 2 months or more after you stop using this medicine. Do not take any medicine to treat diarrhea without first checking with your doctor. If you have any questions or if mild diarrhea continues or gets worse, check with your doctor.

    You or your child may develop low blood sugar while using this medicine. You may feel weak, drowsy, confused, anxious, or very hungry. You may have trouble seeing or have a headache that won't go away. Ask your doctor what you should do if this happens. Some things that can lead to low blood sugar are exercising more than normal or waiting too long to eat.

    This medicine may cause a serious reaction called lactic acidosis (build-up of acid in the blood). Call your doctor right away if you or your child feel very tired, weak, or nauseated, if you vomit or have trouble breathing, or if you feel lightheaded or fainting.

    This medicine may cause serious condition called serotonin syndrome when taken with certain medicines, including medicines to treat depression (SSRIs) or opioid pain medicines. Check with your doctor first before taking any other medicines. Call your doctor right away if you or your child experience agitation, confusion, diarrhea, fever, overactive reflexes, poor coordination, restlessness, shivering, sweating, or trembling or shaking.

    Check with your doctor right away if blurred vision, difficulty in reading, or any other change in vision occurs during treatment with this medicine. Your eyes may need to be checked by an ophthalmologist (eye doctor).

    This medicine may cause rhabdomyolysis (severe muscle problem). Check with your doctor right away if you have dark-colored urine, fever, muscle cramps, spasms, pain, or stiffness, or unusual tiredness or weakness.

    When taken with certain foods or drinks, linezolid can cause an increase in blood pressure. To avoid this, do not eat large amounts of foods or drink beverages that have a high tyramine content (most common in foods that are aged, fermented, pickled, or smoked to increase their flavor, including aged cheeses, air-dried, fermented, or smoked fish, meat, or poultry, sauerkraut, soy sauce, red wine, or tap beer). If a list of these foods and beverages is not given to you, ask your doctor to provide one.

    Check with your doctor right away if you have agitation, coma, confusion, decreased urine output, depression, dizziness, headache, hostility, increased thirst, irritability, lethargy, muscle pain or cramps, muscle twitching, nausea or vomiting, rapid weight gain, seizures, stupor, swelling of the face, ankles, or hands, or unusual tiredness or weakness. These may be symptoms of hyponatremia (low sodium levels in the blood) or syndrome of inappropriate antidiuretic hormone (SIADH).

    This medicine may cause infertility in male patients. Talk with your doctor before using this medicine if you plan to have children.

    Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.


    Side Effects

    Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

    Check with your doctor or nurse immediately if any of the following side effects occur:

    More common

    • Chills
    • confusion
    • dizziness
    • fainting
    • fast heartbeat
    • fever
    • lightheadedness
    • pale skin
    • rapid, shallow breathing
    • rash
    • trouble breathing
    • unusual bleeding or bruising
    • unusual tiredness or weakness

    Less common

    • Black, tarry stools
    • bleeding gums
    • blood in the urine or stools
    • bluish lips or skin
    • body aches or pain
    • chest pain or tightness
    • congestion
    • constipation
    • cough
    • decreased urine
    • difficult or labored breathing
    • dry mouth
    • dryness or soreness of the throat
    • ear congestion
    • headache
    • hoarseness
    • increased thirst
    • irregular heartbeat
    • loss of appetite
    • loss of voice
    • mood changes
    • muscle pain or cramps
    • nausea or vomiting
    • not breathing
    • numbness or tingling in the hands, feet, or lips
    • painful or difficult urination
    • pinpoint red spots on the skin
    • seizures
    • severe stomach pain
    • sneezing
    • sores, ulcers, or white spots on the lips or in the mouth
    • stuffy or runny nose
    • swollen glands
    • tender, swollen glands in the neck
    • trouble with swallowing
    • voice changes
    • vomiting of blood or material that looks like coffee grounds

    Incidence not known

    • Agitation
    • blindness
    • blistering, peeling, or loosening of the skin
    • blurred vision
    • burning, numbness, tingling, or painful sensations
    • coma
    • dark urine
    • decreased appetite
    • decreased vision
    • depression
    • diarrhea
    • eye pain
    • general feeling of discomfort
    • high fever
    • hives
    • hostility
    • irritability
    • itching
    • joint or muscle pain
    • large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
    • lethargy
    • muscle pain, cramping, stiffness, or twitching
    • puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
    • rapid weight gain
    • red skin lesions, often with a purple center
    • red, irritated eyes
    • sleepiness or unusual drowsiness
    • stomach discomfort
    • stupor
    • swelling of the face, ankles, or hands
    • swollen glands
    • unexplained bleeding or bruising
    • unsteadiness or awkwardness
    • weakness in the arms, hands, legs, or feet

    Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

    Less common

    • Bad, unusual, or unpleasant (after) taste
    • change in taste
    • discoloration of the tongue
    • itching of the vagina or outside genitals
    • loose stools
    • pain during sexual intercourse
    • pain in the arms or legs
    • sore mouth or tongue
    • thick, white curd-like vaginal discharge without odor or with mild odor
    • trouble sleeping

    Incidence not known

    • Discoloration of the tooth

    Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

    Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.






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