Parenteral Manual

Linezolid (NON-FORMULARY)

Disclaimer: Official controlled document is the CHEO online copy. It is the responsibility of user to ensure that any paper copy version is the same as the online version before use.

Alternate Name(s): 
Zyvoxam
Classification: 
Antibiotic
Original Date: 
February 2008
Revised Date: 
September 2011
Indications: 
  • Treatment of vancomycin-resistant Enterococcus faecium (VREF) infections
  • Nosocomial & community acquired pneumonia,skin &  skin structure infections due to S.pneumonia, S.aureus (Methicillin susceptible & resistant strains), S.pyogenes, or S.agalactiae
  • Methicillin-resistant staphylococcal (MRSA) infections if failure or intolerance to vancomycin
Reconstitution and Stability: 
  • Available in 2 mg/mL single-dose premixed 300 mL bags
  • DO NOT further dilute
  • Store at room temperature
  • Keep infusion bags in overwrap until ready to use -protect from light
  • Solutions may exhibit a yellow colour than may intensify without adversely affecting potency
Compatibility: 

     - Solutions Compatible:  D5W, NS, ringer's lactate

    - Additives/Above Cassette Compatible:  cefazolin, ceftazidime, ciprofloxacin, gentamicin, tobramycin

    - Y-site Compatible:  acyclovir, amikacin, ampicillin, cefazolin, ceftazidime, ceftriaxone, cefuroxime ciprofloxacin, clindamycin, dexamethasome, dexmedetomidine, diphenhydramine, dobutamine, dopamine, fentanyl, furosemide, gentamicin, granisetron, heparin, hydromorphone, meropenem methylprednisolone sodium succinate, metronidazole, midazolam, morphine, potassium chloride, ranitidine, sodium bicarbonate, tobramycin, vancomycin

     - Incompatible:  amphoterin B, chlorpromazine, erythromycin, sulfamethoxazole/trimethoprim,

Administration: 

(For approved routes of administration by nursing personnel, refer to Policy for the Administration of Intravenous Medications.)

SC NO
IM NO
IV Direct          NO
IV Intermittent Infusion

YES
Usual dilution:  2 mg/mL
Infusion time:  30 - 120 minutes                               

IV Continuous Infusion NO

 

 

Dosage: 

(For neonatal dosages, refer to Neonatal IV Drug Manual.)

Pediatric:

  • 30 mg/kg/day  IV divided Q8H
  • Maximum: 1200 mg /day

Adolescent / adult:

  • 600 mg  IV Q12H
  • Maximum:  1200 mg/day
Potential hazards of parenteral administration: 
  • Myelosuppression (especially thrombocytopenia)
  • Hypertension
  • Nausea, diarrhea
  • Headache
Notes: 
  • Monitor CBC weekly
  • Reversible non-selective inhibitor of monamine oxidase
  • Avoid consuming foods/beverages with high tyramine content
  • Recommend to reduce doses of sympathomimetics, vasopressors, & dopaminergic agents prior to initiating linezolid
  • Patients on hemodialysis should receive linezolid after dialysis
References: 

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