Antimicrobial Use Guidelines (AMUG) version 21 - UW Health

with linezolid should be considered in patients who develop or have worsening myelosuppression. Peripheralneuropathies have been reported with prolonged use. See IV-to-PO conversion policy (Appendix F) or on uconnectSee guidelines for use on uconnect.Drug InteractionsSerotonin syndrome has been reported with concurrent use of linezolid and other serotonergic dugs, including:• Bupropion • Methadone• Buspirone • Metoclopramide• Dextromethorphan • Norepinephrine reuptake inhibitors• Flesinoxan • Norepinephrine-serotonin reuptake inhibitors• Hydroxytryptophan • Risperidone• Levodopa • Tapentadol• Lithium • Tramadol• Maprotiline • Tricyclic antidepressants• MeperidineThe following medications are metabolized by monoamine oxidases and may have their serum levels increased bylinezolid, potentially resulting in toxicity:• Albuterol/levalbuterol• Mazindol*• Amphetamines*• Methylphenidate*/dexmethylphenidate*• Clenbuterol• Norepinephrine• Cyclobenzaprine• Phendimetrizine*• Cyproheptadine• Phentermine*• Diethylpropion*• Phenylpropanolamine*• Diphenhydramine• Phenmetrazine*• Dobutamine• Pirbuterol• Dopamine• Salmeterol• Entacapone• Terbutaline• Epinephrine• Tetrabenazine*• Formoterol/arformoterol • Triptans• Other MAOIs** -- Medication is contraindicated to give with linezolidThe following miscellaneous drug interactions are associated with linezolid:• Carbamazepine – decreases linezolid serum levels• Phenobarbital – decreases linezolid serum levels• Phenytoin – decreases linezolid serum levels• Rifampin – decreases linezolid serum levels• Altretamine – linezolid increases the risk of severe orthostatic hypotension• Morphine – linezolid increases hypotension and exaggerates CNS and respiratory depression• Oxycodone – linezolid increases CNS depression• Droperidol – prolongs QTc interval; additive effects with linezolid (MAOI effect can generate arrhythmias)• Levomethadyl – prolongs QTc interval; additive effects with linezolid (MAOI effect can generate arrhythmias)The following drugs are contraindicated to administer with linezolid:• Apraclonidine – potentiates the MAOI activity of linezolid (and other MAOIs)• Brimonidine – concurrent administration may result in hypertensive urgency/emergency• Guanadrel – concurrent administration may result in decreased antihypertensive effect of guanadrel orhypertensive emergency• Guanethedine – concurrent administration may result in decreased antihypertensive effect of guanethidine orhypertensive emergency