Antimicrobials
Linezolid

Linezolid

Restricted

Low
Excellent
IV: $$ PO: $$$

General Information

Complicated infections, including Vancomycin-resistant Enterococcus faecium (VRE)

Limited Use Product

362

  • Methicillin-resistant Staphylococcus species (MRSA, MRSE) infections* in patients who are intolerant or have failed vancomycin therapy, or have contraindications to venous access
  • LU Authorization Period: 1 year

363

  • Vancomycin resistant Enterococcus species (VRE) infections* in patients switching from IV linezolid
  • LU Authorization Period: 1 year

364

  • Step-down therapy for the treatment of methicillin-resistant Staphylococcus species or vancomycin resistant Enterococcus species (VRE) infections* after parenteral therapy or hospital/ emergency department discharge.

    • *Infections must be documented and culture proven. Not approved for colonization (e.g. nares, urine, etc). Maximum 28 days supply
  • LU Authorization Period: 1 year

  • Thrombocytopenia (usually with >2 weeks therapy) - reversible
  • Peripheral/optic neuropathy with prolonged courses
  • Serotonin syndrome
  • Rash
  • Elevated liver enzymes
  • Lactic acidosis
  • CBC (weekly), particularly in patients at increased risk for bleeding, patients with pre-existing thrombocytopenia or myelosuppression, patients with chronic infection who have received or who are on concomitant antibiotics, or concomitant medications that decrease platelet count or function or produce bone marrow suppression, and inpatients requiring >2 weeks of therapy
  • Number and type of stools/day for diarrhea
  • Visual function in patients requiring ≥3 months of therapy or in patients reporting new visual symptoms
  • With or Without Food
  • Avoid foods or beverages with high tyramine content (stong cheeses, smoked/cured meat, homebrewed beers etc)

Check for drug interactions prior to use

  • Usual duration of therapy is 10-14 days
  • For VRE, treatment duration is 14-28 days
  • Rare reports of serotonin syndrome when co-administered with SSRIs, TCAs, meperidine and other medications

    • Contact Pharmacy for further drug interaction information
  • Monitor CBC weekly, and visual function if used for >3 mos