Zyvox

Zyvox Prescribing Information

Zyvox is a brand name for the medication linezolid. It is an antibiotic used to treat various bacterial infections. Linezolid belongs to a class of antibiotics known as oxazolidinones and is often reserved for the treatment of serious infections that do not respond to other antibiotics.

Uses of Zyvox

Some common uses of Zyvox include the treatment of:

• Skin and Soft Tissue Infections: Antibiotic can be used to treat skin infections, including those caused by methicillin-resistant Staphylococcus aureus (MRSA) and other resistant bacteria.
• Pneumonia: It may be used for the treatment of pneumonia, including ventilator-associated pneumonia caused by specific bacteria.
• Bloodstream Infections: Zyvox is sometimes used to treat bloodstream infections, such as bacteremia.
• Certain Resistant Bacterial Infections: Medicine is effective against various drug-resistant bacteria, making it a valuable option when other antibiotics fail.
• Infective Endocarditis: It can be used in the treatment of infective endocarditis, a serious heart valve infection.
• Other Severe Infections: In some cases, Zyvox may be used to treat severe infections caused by susceptible bacteria when other antibiotics are not suitable.

Dosage

The following are general guidelines for Zyvox dosages:

Skin and Soft Tissue Infections:

• Zyvox is typically prescribed at a dosage of 600 mg every 12 hours (twice daily) for 10 to 14 days.

Pneumonia:

• The usual dosage for pneumonia is 600 mg every 12 hours for 10 to 14 days.

Complicated Skin and Soft Tissue Infections (including diabetic foot infections):

• A higher dosage of 600 mg every 12 hours may be used for 14 to 28 days.

Vancomycin-Resistant Enterococcus faecium Infections:

• The recommended dosage is 600 mg every 12 hours for 14 to 28 days.

Methicillin-Resistant Staphylococcus aureus (MRSA) Infections:

• For MRSA infections, the standard dosage is 600 mg every 12 hours for 10 to 14 days.

Pediatric Dosage:

Zyvox can also be used in children, and the dosage is usually calculated based on the child's weight. The recommended dosage for children is typically 10 mg/kg (up to 600 mg) every 8 hours.

Side Effects of Zyvox

Zyvox is an antibiotic medication used to treat various bacterial infections, but like all medications, it can potentially cause side effects. Common side effects may include:

• Nausea and Vomiting: Some individuals may experience nausea and vomiting while taking Zyvox. Taking the medication with food can help alleviate these symptoms.
• Diarrhea: Diarrhea is another common side effect.
• Headache: Headaches can occur in some people taking Zyvox.
• Insomnia or Sleep Disturbances: Some individuals may experience difficulty sleeping or other sleep disturbances while on Zyvox.
• Dizziness: Dizziness or lightheadedness may occur in a few cases.
• Taste Alterations: Some people report changes in taste, such as a metallic taste in the mouth.
• Peripheral Neuropathy: Drug has been associated with peripheral neuropathy, which can cause tingling, numbness, or pain in the extremities (hands and feet).
• Hypertension (High Blood Pressure): Linezolid may increase blood pressure in some individuals. Regular monitoring of blood pressure is important during treatment.
• Serotonin Syndrome: In rare cases, Zyvox can interact with other medications or substances (e.g., certain antidepressants) and lead to serotonin syndrome, a potentially serious condition characterized by symptoms like agitation, hallucinations, rapid heartbeat, fever, muscle stiffness, and tremors.
• Hematologic Effects: Zyvox can affect blood cell counts, leading to low levels of red blood cells (anemia), white blood cells (leukopenia), or platelets (thrombocytopenia). Regular blood tests may be necessary to monitor these levels.
• Allergic Reactions: Although rare, severe allergic reactions to Zyvox can occur. Seek immediate medical attention if you experience symptoms like rash, itching, swelling, severe dizziness, or difficulty breathing.

Interaction with other drugs

Zyvox can interact with various medications and substances, potentially leading to adverse effects or reduced drug efficacy. Here are some notable drug interactions:

• Serotonin Syndrome: Antibiotic has the potential to interact with drugs that increase serotonin levels, such as selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), and certain migraine medications. This interaction can lead to serotonin syndrome, a severe and potentially life-threatening condition. Symptoms of serotonin syndrome include agitation, hallucinations, rapid heartbeat, fever, muscle stiffness, tremors, and in severe cases, seizures. Avoid concurrent use of Zyvox and these medications.
• MAO Inhibitors: Linezolid is an MAO (monoamine oxidase) inhibitor and should not be used with other MAO inhibitors, such as phenelzine, selegiline, and tranylcypromine. Combining Zyvox with these drugs can lead to a dangerous increase in blood pressure.
• Sympathomimetic Agents: Medications that have sympathomimetic effects, such as some cold and allergy medications and certain bronchodilators (e.g., pseudoephedrine), should be used cautiously. The combination may lead to an increased risk of high blood pressure.
• Hypertensive Medications: Medicament has been associated with an increase in blood pressure. If you are taking medications to control blood pressure, your doctor may need to adjust your dosages while you are on Zyvox.
• Blood-Thinning Medications: Medicine may interact with anticoagulant medications like warfarin, potentially increasing the risk of bleeding. Frequent monitoring of blood clotting parameters may be necessary if these drugs are used together.
• Cyclobenzaprine: There have been reports of interactions between Linezolid and cyclobenzaprine, a muscle relaxant, leading to serotonin syndrome and increased blood pressure. Avoid concurrent use if possible.
• Adrenergic and Serotonergic Agents: Drugs that affect adrenergic or serotonergic neurotransmission, such as tricyclic antidepressants, meperidine, and buspirone, may interact with Zyvox and increase the risk of serotonin syndrome or other adverse effects.
• Dextromethorphan: Over-the-counter cough and cold medications containing dextromethorphan should be used cautiously with Zyvox due to the potential for serotonin syndrome.
• Herbal Supplements: Some herbal supplements, such as St. John's Wort, can increase serotonin levels and should be avoided while taking Zyvox.
• Alcohol: Avoid excessive alcohol consumption while on Zyvox, as it can increase the risk of side effects and may interact with the medication.

What to avoid while on Zyvox

While taking Zyvox, it's essential to be aware of certain foods, beverages, and medications that should be avoided or used with caution to prevent potential interactions and side effects. Here are some things to avoid or be cautious:

• Tyramine-Rich Foods: One of the most critical considerations while on Zyvox is avoiding foods that are high in tyramine. Tyramine is a naturally occurring compound found in some foods and beverages that can interact with Linezolid and lead to a sudden increase in blood pressure, known as a hypertensive crisis. Foods to avoid or limit include aged cheeses, aged or cured meats (such as pepperoni, salami, and some sausages), fermented or aged products like soy sauce and certain wines, and overripe or spoiled foods. Avoiding these foods can help reduce the risk of a hypertensive crisis.
• Alcohol: Drinking alcohol while on Zyvox can increase the risk of side effects like dizziness, drowsiness, and impaired coordination. It's advisable to avoid alcohol or consume it in moderation.
• Caffeine: High doses of caffeine may increase blood pressure and heart rate, which could potentially interact with Zyvox's hypertensive effects. While moderate caffeine consumption from sources like coffee or tea is usually safe, it's a good idea to limit excessive caffeine intake.
• Medications That Increase Serotonin: Avoid medications that increase serotonin levels, such as certain antidepressants (e.g., SSRIs and SNRIs), migraine medications (e.g., triptans), and other drugs that affect serotonin, as combining them with Zyvox can lead to serotonin syndrome.
• MAO Inhibitors: Do not use Zyvox with other monoamine oxidase inhibitors (MAOIs) or medications with MAOI properties, as this combination can lead to dangerous increases in blood pressure.
• Sympathomimetic Drugs: Be cautious with sympathomimetic agents, including some cold and allergy medications and bronchodilators, as they may increase blood pressure when used with Zyvox.
• Herbal Supplements: Some herbal supplements, such as St. John's Wort, may interact with Zyvox.
• Dextromethorphan: Over-the-counter cough and cold medications containing dextromethorphan should be used cautiously with Zyvox due to the potential for serotonin syndrome.
• Certain Pain Medications: Opioid pain medications, such as tramadol, may interact with Zyvox and increase the risk of serotonin syndrome.

Contraindications of Zyvox

Zyvox has certain contraindications, which are medical conditions or circumstances under which the use of the medication is not recommended due to the potential risks and adverse effects. Here are some common contraindications:

• Hypersensitivity: Medicament should not be used in individuals with a known hypersensitivity or allergy to linezolid or any of its components. Allergic reactions to Linezolid can be severe and potentially life-threatening.
• Concurrent Use with MAO Inhibitors: Antibiotic is a monoamine oxidase inhibitor (MAOI), and its use is contraindicated with other MAOIs or drugs with MAOI properties. Combining tablets with another MAOI can lead to a hypertensive crisis, a dangerous increase in blood pressure.
• Serotonergic Medications: The use of Zyvox is contraindicated with drugs that increase serotonin levels, such as selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), and certain migraine medications. This combination can lead to serotonin syndrome, a potentially life-threatening condition.
• Pheochromocytoma and Uncontrolled Hypertension: Zyvox can increase blood pressure. Therefore, it is contraindicated in individuals with conditions such as pheochromocytoma (a tumor of the adrenal gland that can raise blood pressure) and uncontrolled hypertension (high blood pressure).
• Thyroid Dysfunction: Linezolid should be used with caution in individuals with thyroid dysfunction, particularly if they are not receiving appropriate thyroid hormone replacement therapy.
• Serotonin Syndrome: Remedy is contraindicated in individuals who are already experiencing serotonin syndrome, a potentially life-threatening condition characterized by symptoms such as agitation, hallucinations, rapid heartbeat, fever, muscle stiffness, and tremors.
• Co-administration with Certain Medications: Avoid concurrent use of Zyvox with medications known to interact with it in a way that increases the risk of serotonin syndrome or hypertensive crises. This includes certain pain medications (e.g., tramadol), sympathomimetic agents, and medications that affect adrenergic or serotonergic neurotransmission.
• Pediatric Patients with Congenital Long QT Syndrome: Zyvox is not recommended for use in pediatric patients (less than 18 years old) with congenital long QT syndrome, a heart rhythm disorder.
• Elderly Patients with Psychiatric Conditions: Use this drug with caution in elderly patients with psychiatric conditions, as they may be at increased risk of experiencing delirium or other neuropsychiatric events.

Pregnancy and Zyvox

Zyvox is classified as a pregnancy category C medication by the U.S. Food and Drug Administration (FDA). This means that there are potential risks associated with its use during pregnancy, and the decision to use Linezolid during pregnancy should be made carefully, weighing the potential benefits against the risks.

Here are some key considerations regarding Zyvox and pregnancy:

• Risks to the Fetus: Studies in animals have shown that Zyvox can have adverse effects on fetal development, including skeletal and other abnormalities. However, there is limited data on the use tablets in pregnant women. The potential risks to the human fetus are not well-established.
• Potential Benefits: In some cases, the benefits of treating a severe or life-threatening bacterial infection with Linezolid during pregnancy may outweigh the potential risks.
• Breastfeeding: Zyvox is known to pass into breast milk.