Zyvox (Linezolid) 400mg & 600mg Tablets, 2mg/ml intravenous solution, 100mg/5ml oral powder for reconstitution

Manufacturer:  Pharmacia/Upjohn

Indication(s): Treatment of adult patients with infection caused by susceptible strains of bacteria.  Linezolid is effective against many aerobic gram-positive organisms including Enterococcus faecium (vancomycin-resistant strains), Staphylococcus aureus (including methicillin-resistant strains), Streptococcus agalactiae, Streptococcus pneumoniae (penicillin-susceptible strains), and Streptococcus pyogenes. Linezolid also shows in vitro activity against Enterococcus faecalis (including vancomycin-resistant strains), Enterococcus faecium (vancomycin-susceptible strains), Staphylococcus epidermidis (including methicillin-resistant strains), Staphylococcus haemolyticus, Streptococcus pneumoniae (penicillin-resistant strains), Viridans group streptococci, and Pasteurella multocida. Linezolid is approved for the treatment of vancomycin-resistant Enterococcus faecium infections, nosocomial pneumonia, complicated and uncomplicated skin and skin structure infections, and community-acquired pneumonia.

Administration:  400-600mg every twelve hours for 14 days.

Pharmacology:  Linezolid is a synthetic derivative of the oxazolidinone class.  The mechanism of action of linezolid involves binding to the 23S ribosomal RNA of the 50S subunit, thereby preventing the formation of a functional 70S initiation complex. This prevents bacterial translation and replication. Linezolid also exhibits reversible, nonselective inhibition of monoamine oxidase.  

WebRx Editorial Notes:  Zyvox may be taken with or without food.  Zyvox may contribute to hypertensive crisis when the patient consumes tyramine-containing foods while using the medication.  Foods high in tyramine include  those that may have undergone protein changes by aging, fermentation,  pickling or smoking to improve flavor such as  wine, cheese, fermented or air-dried meats, sauerkraut, or chocolate.  Common nasal decongestants such as pseudoephedrine or phenylpropanolamine and the SSRI class of anti-depressants may also be problematic when taking Zyvox.  The most common side effects include diarrhea, headache, and nausea but may also include oral moniliasis, vaginal moniliasis, hypertension, dyspepsia, localized abdominal pain, pruritis, and tongue discoloration.

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