Oxazolidinone antibiotic
Linezolid
Brand names: Zyvox
Adult dose
Dose: 600mg IV/PO every 12h for 10–28 days (per indication)
Route: IV/PO
Frequency: BD
Clinical pearls
- MRSA, VRE, complicated SSTI, MDR-TB
- Restricted use — micro/AMR approval; FBC weekly
Contraindications
- Concurrent MAOI / SSRI / SNRI / TCA / triptan / pethidine (serotonin syndrome — avoid unless monitored)
- Uncontrolled hypertension
- Phaeochromocytoma
- Carcinoid
- Severe untreated thyroid disease
- Pregnancy/breastfeeding (relative)
Side effects
- Thrombocytopenia / cytopenias (limit course ≤28 days)
- Lactic acidosis
- Optic neuropathy / peripheral neuropathy (prolonged use)
- Serotonin syndrome with serotonergic drugs
- GI upset
Interactions
- Serotonergic drugs — major
- Tyramine-rich foods
- Sympathomimetics
- Adrenaline / dopamine (raised pressor effect)
Monitoring
- FBC weekly
- Lactate if symptoms
- Visual symptoms
- Mental state for serotonin syndrome
Reference: BNF; NICE CKS; UK AMR guidance; https://bnf.nice.org.uk/drugs/linezolid/. Verify against your local formulary and the latest BNF before prescribing.
Related
Curated clinical cross-links plus same-class fallbacks.
Calculators
- Centor / McIsaac Score for Strep Pharyngitis · Throat
- FeverPAIN Score for Strep Throat · Throat
- Jarisch-Herxheimer Reaction Severity Assessment · Treatment Reactions
- PID Severity (CDC Diagnostic Criteria) · Gynaecological Infections
- Gustilo-Anderson Classification (Open Fractures) · Fracture Classification
- DRIP Score for Drug-Resistant Pneumonia · Pneumonia
Pathways
- Infective Endocarditis · ESC 2023 Infective Endocarditis Guidelines; NICE NG41
- Eczema Herpeticum · BAD; NICE CKS
- Suspected Bacterial Meningitis (Adult) · NICE NG240 (2024); NICE NG143 (paeds)
- Clostridioides difficile Colitis · NICE NG199 (2021); IDSA/SHEA 2021
- Returning Traveller — Fever · NaTHNaC; PHE; ESCMID 2018
- Malaria — Diagnosis & Management · PHE 2016; WHO 2023