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What should I discuss with my healthcare provider before using linezolid (Zyvox)?

Do not use linezolid if you have used an MAO inhibitor such as furazolidone (Furoxone), isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam, Zelapar), or tranylcypromine (Parnate) in the last 14 days. A dangerous drug interaction could occur, leading to serious side effects.

Many drugs can interact with linezolid. Before using linezolid, tell your doctor about all other medications you use. You may need to stop using certain medicines before using linezolid (in some cases for up to 5 weeks before you start linezolid). However, do not stop taking any of your medications without your doctor's advice.

• meperidine (Demerol);
• diet pills, stimulants, cold or allergy medicines, ADHD medication;
• migraine or cluster headache medication such as almotriptan (Axert), frovatriptan (Frova), naratriptan (Amerge), rizatriptan (Maxalt), sumatriptan (Imitrex, Treximet), or zolmitriptan (Zomig);
• medication to treat Parkinson's disease or restless leg syndrome, such as carbidopa or levodopa (Lodosyn, Parcopa, Sinemet), pramipexole (Mirapex), or ropinorole (Requip);
• an "SSRI" antidepressant such as citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac, Sarafem, Symbyax), fluvoxamine (Luvox), paroxetine (Paxil), or sertraline (Zoloft);
• an "SNRI" antidepressant such as venlafaxine (Effexor), desvenlafaxine (Pristiq), or duloxetine (Cymbalta);
• a "tricyclic" antidepressant such as amitriptyline (Elavil, Vanatrip, Limbitrol), clomipramine (Anafranil), desipramine (Norpramin), doxepin (Sinequan), imipramine (Janimine, Tofranil), nortriptyline (Pamelor), protriptyline (Vivactil), or trimipramine (Surmontil); or
• other medications used to treat depression, anxiety, and other psychiatric conditions, such as bupropion (Wellbutrin, Zyban, Aplenzin), buspirone (BuSpar), maprotiline (Ludiomil), mirtazapine (Remeron), nefazodone, trazodone (Desyrel, Oleptro), or vilazodone (Viibryd).

You should not use linezolid if you are allergic to it, or if you have:

• untreated or uncontrolled high blood pressure;
• a carcinoid tumor;
• pheochromocytoma (adrenal gland tumor); or
• a severe thyroid disorder.

To make sure you can safely use linezolid, tell your doctor if you have any of these other conditions:

• a history of high blood pressure;
• epilepsy or a history of seizures;
• a thyroid disorder;
• kidney or liver disease; or
• bone marrow suppression or a weak immune system.

FDA pregnancy category C. It is not known whether linezolid is harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment.

It is not known whether linezolid passes into breast milk or if it could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

The liquid form may contain phenylalanine. Talk to your doctor before using this form of linezolid if you have phenylketonuria (PKU).

How is linezolid used (Zyvox)?

Use exactly as prescribed by your doctor. Do not use in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label.

Before taking the oral suspension (liquid), gently mix it by turning the bottle upside down 3 to 5 times. Do not shake. Measure the liquid with a special dose-measuring spoon or cup, not a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist for one.

Intravenous linezolid is injected into a vein through an IV. This medicine must be given slowly, and the IV infusion can take up to 2 hours to complete. You may be shown how to use an IV at home. Do not self-inject this medicine if you do not fully understand how to give the injection and properly dispose of used needles, IV tubing, and other items used to inject the medicine.

To be sure this medication is not causing harmful effects, your blood cells and blood pressure will need to be tested often. You may also need eye exams. Visit your doctor regularly.

Use this medication for the full prescribed length of time. Your symptoms may improve before the infection is completely cleared. Skipping doses may also increase your risk of further infection that is resistant to antibiotics. Linezolid will not treat a viral infection such as the common cold or flu.

Store all forms of linezolid at room temperature away from moisture, heat, and light. Do not freeze. Throw away any unused oral liquid that is more than 21 days old.

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