Linezolid

Linezolid is a oxazolidinone antibiotic (reserve antibiotic) medicine available in Bangladesh under many brand names. Below are its uses, side effects and precautions — and every brand with its current price.

Linezolid is prescribed by specialists for serious infections caused by sensitive resistant bacteria, including:

• Hospital- and community-acquired pneumonia caused by certain resistant bacteria
• Complicated skin and soft-tissue infections, including some MRSA infections
• Infections caused by resistant Gram-positive bacteria (such as VRE) when other options are unsuitable

It is reserved for situations where standard antibiotics will not work. Treatment is started and supervised by a doctor, usually a specialist.

Linezolid can cause side effects, and longer courses carry more risk:

• Common: diarrhoea, nausea, headache and a metallic taste
• Less common: thrush (oral or vaginal), dizziness and rash
• Serious (seek urgent help): easy bruising or bleeding, unusual tiredness or paleness (low blood counts); blurred vision or colour-vision changes; numbness or tingling in hands or feet; or agitation, fever and shivering (a sign of serotonin toxicity)

Blood counts may be checked during longer treatment. Report any visual changes, numbness or bleeding promptly.

Linezolid is a reserve antibiotic — it should only be used when prescribed by specialists for serious resistant infections. Never self-medicate, share it, or take leftover medicine for another illness.

• Complete the full course exactly as prescribed but do not take it for longer than instructed; both misuse and over-long use are harmful.
• Antibiotic resistance is a serious and growing crisis in Bangladesh, and reserve antibiotics like linezolid must be protected by careful, correct use.
• Blood counts can fall with longer courses, so regular blood tests may be needed.
• Tell your doctor about antidepressants (serotonin drugs) and tyramine-rich foods, and report numbness, tingling or vision changes.

Linezolid acts as a mild MAO inhibitor, so it has important interactions. Tell your doctor about everything you take. It can interact with:

• Antidepressants (SSRIs, SNRIs, tricyclics) and other serotonin drugs — risk of dangerous serotonin syndrome
• Pseudoephedrine and other decongestants, and some blood-pressure medicines — blood pressure may rise sharply
• Foods and drinks rich in tyramine (mature cheese, soy sauce, fermented or pickled foods, draught beer)
• Other medicines that lower blood counts

Do not start any new medicine, including over-the-counter cold remedies, without checking with your doctor.

Do not take Linezolid unless your specialist has specifically assessed you, and avoid it if you:

• Are allergic to linezolid
• Take or recently took an MAOI antidepressant, or take other serotonin drugs that your doctor has not reviewed
• Have uncontrolled high blood pressure, certain heart or thyroid conditions, or a phaeochromocytoma

Caution is needed with uncontrolled blood pressure and serotonin drugs. Always share your full medical and medicine history before starting.

There is limited safety information on linezolid in pregnancy, so it is used only if clearly necessary and when a specialist decides the benefit outweighs the risk.

It may pass into breast milk, so breastfeeding is generally not advised during treatment unless your doctor judges it essential. If you are pregnant, think you might be, are planning a pregnancy or are breastfeeding, tell your doctor before taking Linezolid so the safest possible plan can be made for you and your baby.

Store Linezolid in a cool, dry place below 30°C, away from light and moisture.

• Keep tablets in their original pack, protected from light.
• Any oral suspension should be stored as directed on the label and used within the stated period.
• Keep all medicines out of the reach of children.
• Do not use after the expiry date; return unused medicine to a pharmacy for safe disposal.