Infectious Disease Compendium

Linezolid (Zyvox®)

Dosing

CrCl Formula

CrCl > 80: 600 mg po or iv q 12 h.

CrCl 80-50:

CrCl 50-10:

CrCl < 10:

Hemodialysis:

Peritoneal dialysis:

Obesity dosing

Important side effects

Cytopenias and cannot have a high tyrosine diet (smoked sausage and red wines, usually not an issue in my hospital); optic and peripheral neuropathy (rare but not reversible).

Rare: rhabdomyolysis.

Important drug interactions

Citalopram, clovoxamine, dopamine, epinephrine, escitalopram, femoxetine, flesinoxan, fluoxetine, fluvoxamine, nefazodone, paroxetine, phenylpropanolamine, pseudoephedrine, sertraline, trazodone, venlafaxine, zimeldine. They get a serotonin syndrome)PubMed) (altered MS, agitation, fevers) with concomitant SSRI's but in most patients the drug can be continued without stopping the SSRI as long as they are watched closely (PubMed).

Rants and Screeds

Waaaaayyyyyyyy expensive ($1500 American dollars for a 10 day course), but, hey, someone needs to pay for that pizza at lunch conference.

Pearls

You want to really be irritated? Some Staphylococci require linezolid for growth (CDC).

Treatment of choice

Use for

Gram positives for the most part. MRSA and VRE if you can't use Vancomycin; Clostridium difficile is susceptible in the test tube. Cellulitis, Mycobacterium infection, Pneumonia.

Don't use for

Class

Oxazolidinone.