Linezolid Injection

Brand Name(s): Zyvox®; also available generically

WHY is this medicine prescribed?

Linezolid injection is used to treat infections, including pneumonia, and infections of the skin. Linezolid is in a class of antibacterials called oxazolidinones. It works by stopping the growth of bacteria.

Antibiotics such as linezolid injection will not kill viruses that can cause colds, flu, or other infections. Using antibiotics when they are not needed increases your risk of getting an infection later that resists antibiotic treatment.

HOW should this medicine be used?

Linezolid injection comes as a solution (liquid) to be infused into a vein. It is usually given as an intravenous infusion over 30 minutes to two hours twice a day (every 12 hours) for 10 to 28 days. Children 11 years of age and younger usually receive linezolid injection two to three times a day (every 8 to 12 hours) for 10 to 28 days. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Use linezolid injection exactly as directed. Do not use more or less of it or use it more often than prescribed by your doctor.

Linezolid infusions are usually given by a doctor or nurse. Your doctor may decide that you or a friend or relative can give the infusions. Your doctor will train the person who will be administering the medication and will test him to be sure he can give the infusion correctly. Be sure that you and the person who will be giving the infusions know the correct dose, how to give the medication, and how often to give the medication. Be sure that you and the person who will be giving the infusion read the manufacturer's information for the patient that comes with this medication before you use it for the first time at home.

Continue to use linezolid injection until you finish the prescription, even if you feel better. Do not skip doses or stop using linezolid injection without talking to your doctor. If you stop using linezolid injection too soon or if you skip doses, your infection may not be completely treated and the bacteria may become resistant to antibiotics.

Are there OTHER USES for this medicine?

Linezolid injection is also sometimes used to treat certain infections of the brain or spinal cord. Talk to your doctor about the risks of using this medication for your condition.

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

What SPECIAL PRECAUTIONS should I follow?

Before using linezolid injection,

• tell your doctor and pharmacist if you are allergic to linezolid, any other medications, or any of the ingredients in linezolid injection. Ask your pharmacist for a list of the ingredients .
• tell your doctor if you are taking following medications or have stopped taking them within the past two weeks: isocarboxazid (Marplan) phenelzine (Nardil). rasagiline(Azilect), selegiline (Eldepryl, Emsam, Zelapar), and tranylcypromine (Parnate). Your doctor will probably tell you not to use linezolid injection if you are taking one or more of these medications, or have taken them within the past two weeks.
• tell your doctor if you have a chronic (long-lasting) infection, or if you have or have ever had diabetes, carcinoid syndrome (a condition in which a tumor secretes serotonin), high blood pressure, hyperthyroidism (an overactive thyroid), immune suppression (problems with your immune system), pheochromocytoma (a tumor of the adrenal gland), seizures, or kidney disease.
• tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: epinephrine (EpiPen); meperidine (Demerol); medications for migraine such as almotriptan (Axert), eletriptan (Relpax), frovatriptan (Frova), naratriptan (Amerge), rizatriptan (Maxalt), sumatriptan (Imitrex, in Treximet), and zolmitriptan (Zomig); phenylpropanolamine (no longer available in the US); and pseudoephedrine (Sudafed; in many cold or decongestant medications). Also tell your doctor if you are taking the following medications or have stopped taking them within the past two weeks: bupropion (Aplenzin, Wellbutrin, Zyban, others); buspirone; selective serotonin reuptake inhibitors (SSRIs) such as citalopram (Celexa), escitalopram (Lexapro), fluvoxamine (Luvox), paroxetine (Brisdelle, Paxil, Pexeva), sertraline (Zoloft), and vilazodone (Vilbyrd); serotonin norepinephrine reuptake inhibitors (SNRIs) such as desvenlafaxine (Khedezla, Pristiq), duloxetine (Cymbalta), levomilnacipran (Fetzima), and venlafaxine (Effexor); and tricyclic antidepressants such as amitriptyline, amoxapine, clomipramine (Anafranil), desipramine (Norpramin), doxepin (Silenor), imipramine (Tofranil), nortriptyline (Pamelor), protriptyline (Vivactil), and trimipramine (Surmontil). Also tell your doctor if you are taking fluoxetine (Prozac, Sarafem, Selfemra, in Symbyax), or have stopped taking it within the past 5 weeks. Your doctor may need to change the doses of your medications or monitor you carefully for side effects. Many other medications may also interact with linezolid injection, so be sure to tell your doctor about all the medications you are taking, even those that do not appear on this list.
• tell your doctor if you are pregnant, plan to become pregnant, or are breastfeeding. If you become pregnant while using linezolid injection, call your doctor.
• if you are having surgery, including dental surgery, tell the doctor or dentist that you are using linezolid injection.

What SPECIAL DIETARY instructions should I follow?

Avoid eating or drinking large amounts of foods and beverages containing tyramine while using linezolid injection. Foods and beverages that have been pickled, smoked, or fermented usually contain tyramine. These foods and beverages include alcoholic beverages, especially beer, Chianti, and other red wines; alcohol-free beer; cheeses (especially strong, aged, or processed varieties); sauerkraut; yogurt; raisins; bananas; sour cream; pickled herring; liver (especially chicken liver); dried meats and sausage (including hard salami and pepperoni); canned figs; avocados; soy sauce; turkey; yeast extracts; papaya products (including certain meat tenderizers); fava beans; and broad bean pods.

What should I do IF I FORGET to take a dose?

Infuse the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not infuse a double dose to make up for a missed one.

What SIDE EFFECTS can this medicine cause?

Linezolid injection may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

• diarrhea
• headache
• nausea
• vomiting
• stomach pain
• change in the ways things taste
• rash
• itching
• dizziness
• white patches in the mouth
• irritation, burning, or itching of the vagina
• change in color of the tongue or teeth

• hives, rash, itching, difficulty breathing or swallowing, swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs, hoarseness
• blistering or peeling skin
• repeated nausea and vomiting; fast breathing; confusion; feeling tired
• pain, numbness, or weakness in hands, feet, or other parts of the body
• severe diarrhea (watery or bloody stools) that may occur with or without fever and stomach cramps (may occur up to 2 months or more after your treatment)
• unusual bleeding or bruising
• changes in color vision, blurred vision, or other changes in vision
• seizures

Linezolid injection may cause other side effects. Call your doctor if you have any unusual problems while using this medication.

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online (http://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088).

What should I do in case of OVERDOSE?

In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at https://www.poisonhelp.org/help. If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911.

What OTHER INFORMATION should I know?

Keep all appointments with your doctor and the laboratory. Your doctor may order certain blood tests to check your body's response to linezolid injection.

Do not let anyone else use your medication. Your prescription is probably not refillable. If you still have symptoms of infection after you finish treatment with linezolid injection, call your doctor.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.

This report on medications is for your information only, and is not considered individual patient advice. Because of the changing nature of drug information, please consult your physician or pharmacist about specific clinical use.

The American Society of Health-System Pharmacists, Inc. represents that the information provided hereunder was formulated with a reasonable standard of care, and in conformity with professional standards in the field. The American Society of Health-System Pharmacists, Inc. makes no representations or warranties, express or implied, including, but not limited to, any implied warranty of merchantability and/or fitness for a particular purpose, with respect to such information and specifically disclaims all such warranties. Users are advised that decisions regarding drug therapy are complex medical decisions requiring the independent, informed decision of an appropriate health care professional, and the information is provided for informational purposes only. The entire monograph for a drug should be reviewed for a thorough understanding of the drug's actions, uses and side effects. The American Society of Health-System Pharmacists, Inc. does not endorse or recommend the use of any drug. The information is not a substitute for medical care.

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