Linezolid (Lzd)

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    Update: October 2022

     

    Forms and strengths

    • 600 mg tablet (breakable and non-breakable)
    • 150 mg dispersible tablet 
    • 100 mg/5 ml, granules for oral suspension

    Dosage

    • Child under 15 kg: 15 mg/kg once daily
    • Child 15 to 45 kg: 10 to 12 mg/kg once daily
    • Patient 46 kg and over: 600 mg once daily
    • Maximum dose: 600 mg daily 

     

    Note: in the BPaLM therapeutic regimen for patients 15 years and over, the dose of linezolid is 600 mg once daily for 16 weeks then 300 mg once daily up to the end of treatment.

     

    Weight

    (kg)

    Daily dose

    (mg)

    600 mg

    tablet

    150 mg

    dispersible tablet

    100 mg per 5 ml

    oral suspension
    5 75 – – 3 ml
    6 90 – – 4 ml
    7 105 – – 5 ml
    8-9 120-135 – – 6 ml
    10-15 150-180 – 1 tab –
    16-23 160-276 – 1½ tab –
    24-29 240-348 – 2 tab –

     
    30-35 300 – 2 tab –
    36-45 450 – 3 tab –
    46-55 600 1 tab – –
    56-70 600 1 tab – –
    > 70 600 1 tab – –

     

    • Alternatively, for children 5 to 6 kg, if oral suspension is not available: one half of a 150 mg dispersible tablet (75 mg) once daily.
    • If 150 mg dispersible tablets are not available, 600 mg tablets can be crushed and suspended in 10 ml of water or fruit juice to obtain a solution of 60 mg of linezolid per ml, administered as follows:

     

    Weight

    (mg)

    Daily dose

    (mg)

    600 mg tablet in 10 ml

    (60 mg/ml)
    5 75 1.25 ml
    6 90 1.5 ml
    7-9 105-135 2 ml
    10-15 150-180 2.5 ml

     

    Contra-indications, adverse effects, precautions

    • Administer with caution to patients with haematological disorders or hypertension.
    • May cause:
      • anaemia, neutropenia and/or thrombocytopenia;
      • lactic acidosis;
      • peripheral neuropathy (can be irreversible); rarely, optic neuritis;
      • abdominal pain, diarrhoea, nausea;
      • hypersensitivity reactions.
    • For the management of adverse effects, see Appendix 17.
    • Avoid or monitor combination with serotonergic drugs such as tricyclic antidepressants (e.g. amitriptyline) or selective serotonin reuptake inhibitors (e.g. fluoxetine, paroxetine): risk of serotonin syndrome.
    • Administer concomitantly pyridoxine (vitamin B6); child: 1 to 2 mg/kg (usual range: 10 to 50 mg) once daily; adult: 100 mg once daily.
    • Pregnancy: use if the benefits outweigh the risks. Administer pyridoxine to the mother (as above).
    • Breastfeeding: avoid breastfeeding during treatment (safety not established).

    Monitoring

    • Symptomatic monitoring.
    • Full blood count.
    • Visual acuity and colour discrimination.

    Patient instructions

    • Take with or without food.

    Storage

     
    –  
     
    – 
    Below 25 °C

    Once reconstituted, the oral suspension may be kept at room temperature for 21 days, protected from light.

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