Precautions and Warnings With Linezolid

Specific Linezolid Warnings and Precautions

Some warnings and precautions to be aware of prior to taking linezolid include the following:
  • Antibiotics like linezolid can disrupt the normal bacteria in the digestive tract, allowing undesirable bacteria to overgrow. A serious problem known as pseudomembranous colitis may result and can occur while you are taking the drug or even two or more months later.
Make sure to watch for signs of this problem, which can become life threatening, such as bloody diarrhea or severe diarrhea. Mild, short-term diarrhea is a common side effect of many antibiotics and is usually not a cause for concern.
  • Linezolid oral liquid suspension contains phenylalanine, an amino acid. This is important for people with phenylketonuria, who must limit their intake of phenylalanine.
  • This drug may cause a potentially serious condition called lactic acidosis, which occurs when there is a buildup of lactic acid in the blood. Signs of lactic acidosis may include nausea, vomiting, rapid breathing, and stomach pain. If you have recurrent nausea and vomiting, or any other symptoms of lactic acidosis while taking this medication, contact your healthcare provider immediately. A blood test can be used to check for it.
  • Linezolid may cause a serious, potentially life-threatening reaction called serotonin syndrome when used in combination with medications that work on serotonin, or in people with a condition known as carcinoid syndrome. People with carcinoid syndrome or those who take serotonergic medications should be closely monitored for serotonin syndrome during linezolid treatment. Signs may include:
    • Confusion
    • Problems with coordination
    • An elevated body temperature
    • Hyperactive reflexes
    • Sweating
    • Shivering
    • Tremors.
(Click Drug Interactions With Linezolid for more information on medications that may lead to this reaction when used with linezolid.)
  • There have been cases of peripheral neuropathy (a problem with the nerves in the body) in people taking linezolid. Taking this medication for a longer period than recommended may increase the risk of this problem. Signs of peripheral neuropathy include numbness; tingling; or a burning sensation in the arms, hands, legs, or feet. Talk to your healthcare provider if you experience signs of peripheral neuropathy while taking linezolid.
  • There have been cases of optic neuropathy (a problem with the nerves of the eye) in people taking linezolid, sometimes leading to loss of vision. Taking this medication for a longer time than recommended may increase the risk for this problem. 
If you experience any changes in your vision, including decreased visual clarity, blurry vision, changes in color vision, or problems with your visual field, contact your healthcare provider immediately. Your vision will need to be monitored if you take linezolid for three months or longer, or experience any problems with your vision during treatment.
  • There have been reports of seizures in some people taking linezolid. Some of these people had a history of seizures or other risk factors for seizures. If you have a seizure while taking this drug, contact your healthcare provider right away.
  • Linezolid may cause a dangerous increase in blood pressure (hypertension) in people with uncontrolled hypertension, pheochromocytoma (a rare tumor of the adrenal gland), or thyrotoxicosis (elevated blood thyroid hormone levels). People with these conditions who take linezolid will need to be closely monitored.
  • This drug may cause a serious decrease in bone marrow activity that could result in low levels of platelets, red blood cells, and white blood cells. People who take it may need blood tests to check for this problem, especially those who take the medication for longer than two weeks, take other antibiotics, or who have risk factors for this problem.
  • In one study, people given linezolid to treat serious intravenous (IV) catheter-related blood infections had an increased risk for death compared to people who were given other antibiotics. Although it is not entirely clear why this increased risk was seen, it is thought to be due to the type of bacteria causing the infection. Linezolid is not approved to treat blood infections from IV catheter use or infections at IV catheter sites, and should not be used for these infections.
  • Linezolid can potentially interact with foods and beverages that contain high levels of tyramine, leading to dangerous increases in blood pressure. Therefore, people who are taking this medicine should avoid consuming large amounts of food that contain a lot of tyramine.
If you are on linezolid, limit your tyramine consumption to less than 100 mg at each meal. Most aged, fermented, pickled, and smoked foods contain large amounts of tyramine. Ask your healthcare provider for a list of foods and beverages that contain it.
  • This drug can potentially interact with several other medications (see Drug Interactions With Linezolid).
  • Linezolid is considered a pregnancy Category C medication. This means that it may not be safe for use during pregnancy, although the full risks are not known (see Zyvox and Pregnancy).
  • This medication passes through breast milk. Therefore, if you are breastfeeding or plan to start, discuss this with your healthcare provider prior to beginning treatment (see Zyvox and Breastfeeding).

Linezolid Drug Information

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