Linezolid Intravenous for Adults

Who can administer

May be administered by registered competent doctor or nurse/midwife

See monitoring requirements
Consider intravenous to oral switch as soon as possible as excellent oral bioavailability (approx.100%) - use same dose orally as intravenously
Red-light antimicrobial: requires pre-authorisation by Microbiology or ID prior to use 24 hours / 7 days a week
There are numerous important interactions - check current BNF (and also see under 'Monitoring')

Linezolid 600mg per 300ml solution for infusion

Already in solution

Not required - product ready for infusion

Intermittent intravenous infusion

Usual dose

Renal impairment

eGFR less than 30ml/minute/1.73m2 - no dose adjustment required but use with caution as metabolites may accumulate
Monitor FBC closely if eGFR <10ml/minute/1.73m2 (ref 1)
If being used in patients on haemodialysis- should be given after dialysis session

Hepatic impairment

No dose adjustment is required. However, there are limited clinical data and it is recommended that linezolid should be used in such patients only when the anticipated benefit is considered to outweigh the theoretical risk

Monitor FBC (including haemoglobin, platelets, and total and differential leucocyte counts) weekly in all patients (risk of haematopoeitic disorders)
Monitor blood pressure closely in uncontrolled hypertension, phaeochromocytoma, carcinoid, thyrotoxicosis, bipolar depression, schizoaffective disorder, acute confusional state or in patients taking SSRIs, tricyclic antidepressants, triptans, sympathomimetic agents, vasopressive agents, dopaminergic agents, pethidine or buspirone
Monitor for signs and symptoms of serotonin syndrome if used with serotonergic agents
Monitor for signs of metabolic acidosis

Linezolid should not be used in patients taking any drug which inhibits Monoamine oxidases A or B (e.g. phenelzine, selegiline, moclobemide, isocarboxazid) or within two weeks of having taken such drugs
The safety and efficacy of linezolid when administered for periods longer than 28 days have not been established. Severe peripheral or optic neuropathy may occur rarely, especially if linezolid is used for longer than 28 days
High-tech prescription needed if patient being discharged on oral form

Store below 25⁰C

Fresesius Kabi SPC July 2018

Zyvox SPC May 2021

Oxazolidinone antimicrobial