Linezolid (Lzd)

Therapeutic action

– Antibacterial (oxazolidinone) with bactericidal activity

Presentation

– 600 mg tablet
Also comes in 400 mg tablet and 100 mg/5 ml powder for oral suspension.

Dosage

– Child under 30 kg: 30 mg/kg/day in 3 divided doses
– Child over 30 kg and adult: 600 mg once daily
– Maximum dose: 600 mg daily

Weight
(kg)

Daily dose
(mg)

600 mg
tablet

100 mg per 5 ml
oral suspension

5

150

2.5 ml x 3

6

180

3 ml x 3

7

210

3.5 ml x 3

8

240

4 ml x 3

9

270

4.5 ml x 3

10

300

5 ml x 3

11

330

5.5 ml x 3

12

360

6 ml x 3

13

390

6.5 ml x 3

14

420

7 ml x 3

15

450

7.5 ml x 3

16

480

8 ml x 3

17

510

8.5 ml x 3

18

540

9 ml x 3

19

570

9.5 ml x 3

20

600

10 ml x 3

21

600

10 ml x 3

22

600

10 ml x 3

23

600

10 ml x 3

24

600

10 ml x 3

25

600

10 ml x 3

26

600

10 ml x 3

27

600

10 ml x 3

28

600

10 ml x 3

29

600

10 ml x 3


30-35

600

1 tab

36-45

600

1 tab

46-55

600

1 tab

56-70

600

1 tab

> 70

600

1 tab

Contra-indications, adverse effects, precautions

– Administer with caution to patients with blood disorders or hypertension.
– May cause:
• myelosuppression (decreased level of platelets after 10-14 days of treatment, decreased level of white blood cells, and anaemia), lactic acidosis;
• optic and peripheral neuropathy (can be irreversible), diarrhoea, nausea.
– For the management of adverse effects, see Appendix 10.
– Avoid or monitor combination with serotoninergic drugs such as tricyclic antidepressants (e.g. amitriptyline), selective serotonin reuptake inhibitors (e.g. fluoxetine, paroxetine), lithium, etc., as it may cause a serotonin syndrome.
– Administer concomitantly pyridoxine (vitamin B6) to prevent neurotoxic effects (child: 5 to 10 mg/day; adult: 50 mg/day).
Pregnancy: avoid (safety is not established), except if vital. To prevent neurotoxic effects, administer pyridoxine as above.
Breast-feeding: avoid (safety is not established), except if vital. To prevent neurotoxic effects, administer pyridoxine as above. Supplement the breast-fed infant with pyridoxine (5 mg/day).

Monitoring

– Symptomatic monitoring, visual acuity and colour discrimination before and during treatment; complete blood count weekly (first month), then monthly, and as needed based on symptoms

Patient instructions

– Take with or without food.

Remarks

Storage: no special temperature requirements