Linezolid

Restricted
Restricted

C. diff Risk

Low

Oral Bioavailability

Complete (100%)

Approximate Cost

$2.62 (PO)
$31.06 (IV)

Dosing

600 mg PO/IV q12h

No dose adjustment required in renal dysfunction including dialysis

600mg PO/IV q12h

General Information

Common Usage

Targeted or empiric therapy for gram positive infections including skin and soft tissue, and pneumonia when first line therapies are precluded by allergy, organism resistance or intolerance/adverse drug reaction.

Covers MRSA and VRE.

Drug Monitoring

CBC at least once/week

Visual testing for therapy >3 months or if symptoms develop on therapy.

Adverse Effects

  • Serotonin syndrome

  • Rash

  • Elevated liver enzymes

  • Lactic acidosis

  • Myelosuppression (usually with >2weeks therapy)- reversible

  • Peripheral/optic neuropathy with prolonged courses

Major Interactions

  • SSRI and other serotonergics/MAOIs - Increased risk of serotonin syndrome.

  • Pharmacist consult recommended to review drug interactions.

  • Rifampin decreases linezolid levels.

Tablet/Capsule Strengths

Special Authorization Required

Additional Information

IV Administration:

  • 600 mg premixed bags; infuse over 60 min
    • Premixed bags are not compatible with pumps used by Community IV Program

EH Prescribing Restrictions:
Pharmacist review (with ID consult if required)

See Systemic Antimicrobial Formulary Policy (PHA-305)) for full details.

NLPDP Status (PO):
Special Authorization required

Note
Costs for PO are based on Eastern Health Contract Pricing.
Costs are MARKEDLY higher (i.e. > $1000 for a 10 day course) in Community Setting.

Pharmacology

Antimicrobial class: Oxazolidinone

Pregnancy category: C

Average serum half life: 5 hours

CSF penetration: Therapeutic

Lung penetration: Therapeutic

Urine penetration: Therapeutic