Linezolid

Pronunciation: lin-EZ-oh-lid.

Generic name
linezolid
Brand names
Zyvox (United States, United Kingdom, Australia, New Zealand), Zyvoxid (European Union), Zyvoxam (Canada)
Drug class
Oxazolidinone antibiotic
Form
Tablet, oral suspension, or solution for intravenous infusion
Route
Oral (tablet or oral suspension) or intravenous infusion
Legal status
Prescription-only

Availability and supply rules vary by country

Trade names by country: United States · United Kingdom · Canada · Australia · New Zealand

Australia: Zyvox (5) · Full directory

What linezolid is and how it works

Linezolid is a prescription-only antibiotic from the oxazolidinone class, used to treat serious bacterial infections caused by certain Gram-positive bacteria, including some infections that are resistant to other antibiotics. (1)

Take linezolid exactly as your prescriber directs, for the exact duration prescribed. Because of real risks that increase the longer it is taken -- including effects on blood cells, nerves, and a serious interaction with many common antidepressants and other serotonergic medicines -- your prescriber will want to know about every other medicine you take, and may arrange blood tests during treatment, especially if treatment continues beyond 2 weeks.

Mechanism of action: how linezolid works

Linezolid is a synthetic oxazolidinone antibacterial that inhibits bacterial protein synthesis by binding the 23S ribosomal RNA of the bacterial 50S ribosomal subunit, preventing formation of a functional 70S initiation complex -- a mechanism distinct from other protein-synthesis-inhibiting antibiotics, which helps limit cross-resistance. (1)

What linezolid is used for

Serious Gram-positive bacterial infections

Used for nosocomial (hospital-acquired) pneumonia, community-acquired pneumonia, complicated and uncomplicated skin/skin-structure infections, and infections caused by vancomycin-resistant Enterococcus faecium, in adults and children, when caused by susceptible Gram-positive bacteria. Not effective against Gram-negative bacteria -- if a Gram-negative infection is also present or suspected, a clinician will start additional or different antibiotic treatment for that. Not established for use beyond 28 days. (1) (2)

Before taking linezolid

Do not take / not appropriate for

  • Do not take linezolid if you are taking, or have taken within the last 2 weeks, a monoamine oxidase inhibitor (MAOI) medicine, such as phenelzine or isocarboxazid -- this combination is contraindicated because of the risk of a dangerous interaction. (all countries) (1) (2)
  • Do not take linezolid if you have had a serious allergic reaction to it or any of its ingredients. (all countries) (1)
  • In the United Kingdom, linezolid is also listed as contraindicated with serotonin-affecting medicines (such as SSRIs) unless the treating team has facilities to closely monitor for serotonin syndrome; in the United States, this combination is described as a serious warning requiring caution and monitoring rather than an outright contraindication. Either way, tell your prescriber about every antidepressant or other serotonin-affecting medicine you take before starting linezolid. (varies -- UK: contraindication unless closely monitored; US: warning requiring caution) (2) (1)

Tell your clinician about

  • Every other medicine and supplement you take, especially antidepressants (including SSRIs, SNRIs, and tricyclics), migraine medicines (triptans), certain opioid painkillers (such as pethidine/meperidine), buspirone, or any MAOI, because of the serotonin syndrome and blood-pressure interaction risks.
  • Any history of low blood cell counts, bone marrow problems, or bleeding disorders.
  • Any kidney or liver problems, particularly severe kidney impairment or moderate-to-severe liver impairment.
  • Any history of nerve problems, vision problems, or high blood pressure.
  • Diabetes and the diabetes medicines you take, since linezolid has been linked to low blood sugar in some people with diabetes.
  • Whether you eat large amounts of aged cheese, cured/fermented meats, tap beer, or drink red wine regularly, since very high-tyramine foods may need to be limited.
  • Pregnancy, plans for pregnancy, or breastfeeding.
(1) (2)

How to take linezolid

  • Take or receive linezolid exactly as prescribed, for the full length of treatment your prescriber sets, even if you feel better sooner.
  • It can usually be taken with or without food, as directed by your prescriber or pharmacist.
  • If you are switched between the intravenous (IV) and oral forms, this is a normal part of treatment your clinical team manages -- both forms work in the same way.
  • Attend any blood tests your prescriber schedules during treatment, particularly for courses longer than 2 weeks.
(1) (2)

Procedures and treatment changes

Tell the treating team before surgery, procedures, or any medicine change. Do not alter treatment without the responsible clinician. (1) (2) (3) (4) (5) (6)

Missed dose

Contact your prescriber or pharmacist for guidance if you miss a dose, rather than doubling a later dose, since your specific treatment schedule matters for how well the antibiotic works.

Overdose

Seek urgent medical attention if an overdose is suspected. Supportive care and general measures are used to manage overdose; contact your local poison-control service or emergency department for guidance. (1)

Side effects

Side effects and their urgency vary; report severe, persistent, or concerning symptoms.

Diarrhoea and nausea or vomiting.

What to notice: Diarrhoea and nausea or vomiting.

What to do: Discuss persistent or troublesome symptoms with the treating clinician or pharmacist. (1)

Headache.

What to notice: Headache.

What to do: Discuss persistent or troublesome symptoms with the treating clinician or pharmacist. (1)

Anaemia (low red blood cell count).

What to notice: Anaemia (low red blood cell count).

What to do: Discuss persistent or troublesome symptoms with the treating clinician or pharmacist. (1)

Changes in taste, and a discoloured (yellow, blue, or grey) tongue have also been reported with this class of medicine.

What to notice: Changes in taste, and a discoloured (yellow, blue, or grey) tongue have also been reported with this class of medicine.

What to do: Discuss persistent or troublesome symptoms with the treating clinician or pharmacist. (1)

Serious warnings

Signs of serotonin syndrome (from combining linezolid with antidepressants or other serotonin-affecting medicines) — emergency

Symptoms: High body temperature, agitation, confusion, muscle twitching or rigidity, rapid heart rate, and changes in blood pressure; fatal cases have been reported.

Action: Seek emergency medical help immediately. Tell your prescriber about every antidepressant or serotonin-affecting medicine you take before starting linezolid, since this combination needs careful clinical decision-making and close monitoring, or may need to be avoided. (1) (2)

Signs of low blood cell counts (myelosuppression) — high caution

Symptoms: Unusual bruising or bleeding, persistent sore throat or fever, or unusual tiredness -- risk increases with treatment beyond 2 weeks.

Action: Tell your prescriber promptly; blood counts are often checked weekly during treatment, and your clinical team will decide whether treatment needs to be adjusted if levels drop. (1)

Signs of nerve or vision problems (peripheral or optic neuropathy) — high caution

Symptoms: Numbness, tingling, or burning in the hands or feet; blurred vision, changes in colour vision, or eye pain -- reported mainly with treatment longer than 28 days and sometimes not fully reversible.

Action: Contact your prescriber promptly for any of these symptoms; an eye examination may be arranged, and your clinical team will assess whether treatment needs to continue. (1)

Signs of lactic acidosis — emergency

Symptoms: Repeated nausea or vomiting, unusual tiredness, or fast/deep breathing.

Action: Seek prompt medical attention; this needs urgent clinical evaluation. (1)

Severe or persistent diarrhoea (possible Clostridioides difficile-associated diarrhoea) — high caution

Symptoms: Watery or bloody diarrhoea, abdominal pain or cramping, that can occur during treatment or for some time after it ends.

Action: Contact your prescriber promptly; do not treat diarrhoea yourself with anti-diarrhoeal medicines without checking first, since a clinician needs to assess and manage this. (1)

Signs of low blood sugar (in people with diabetes) — high caution

Symptoms: Shakiness, sweating, confusion, or dizziness in a person taking insulin or other diabetes medicines.

Action: Tell your prescriber promptly; your diabetes medicine doses may need adjustment. (1)

Interactions

  • Monoamine oxidase inhibitor (MAOI) medicines must not be combined with linezolid, and at least 2 weeks should pass after stopping an MAOI before starting linezolid, or after stopping linezolid before starting an MAOI. (1)
  • Antidepressants and other serotonin-affecting medicines (SSRIs, SNRIs, tricyclic antidepressants, certain opioid painkillers such as pethidine/meperidine, triptans for migraine, and buspirone) carry a real risk of serotonin syndrome, including fatal cases, when combined with linezolid -- your prescriber will weigh this carefully and may choose to avoid the combination or monitor you closely. (1) (2)
  • Medicines that raise blood pressure (such as certain decongestants, vasopressors, or dopamine-type medicines) may have an enhanced effect when combined with linezolid -- your prescriber may use a lower starting dose of these if needed. (1)
  • Large amounts of tyramine-rich foods (aged cheeses, fermented or air-dried meats, soy sauce, tap beer, red wine) should generally be limited during treatment, since a significant blood-pressure rise can occur with high intakes. (1)
  • Rifampin (rifampicin) may reduce linezolid levels in the body; the clinical significance is not fully established, but your prescriber may take this into account. (1)

Pregnancy, breastfeeding, kidney/liver function, age

Pregnancy

Available published and postmarketing reports have not identified a linezolid-associated risk of major birth defects, miscarriage, or adverse pregnancy outcomes, but discuss the specific benefits and risks with your prescriber. (1) (2) (3) (4) (5) (6)

Breastfeeding

Linezolid passes into breast milk in small amounts. Watch a breastfed infant for diarrhoea or vomiting, and discuss the benefits and risks with your prescriber. (1) (2) (3) (4) (5) (6)

Children

Used from birth through 17 years for the approved indications, with dosing calculated by weight and age; preterm newborns under 7 days old may need a different dosing schedule set by their specialist. (1) (2) (3) (4) (5) (6)

Elderly

No overall difference in safety or effectiveness was seen between older adults (65 and older) and younger adults in clinical trials. (1) (2) (3) (4) (5) (6)

Hepatic Impairment

No dose adjustment is needed for mild-to-moderate liver impairment; severe liver impairment has not been specifically studied -- tell your prescriber about any liver problems. (1) (2) (3) (4) (5) (6)

Renal Impairment

No dose adjustment is generally needed based on kidney function, though the breakdown products of linezolid can build up with more severe kidney impairment; about 30% of a dose is removed during a 3-hour haemodialysis session -- tell your prescriber about any kidney problems or dialysis. (1) (2) (3) (4) (5) (6)

Monitoring

Before starting

  • Baseline full blood count
  • Review of all other medicines, especially antidepressants, MAOIs, and blood-pressure-affecting medicines
  • Assessment of kidney and liver function

During treatment

  • Weekly complete blood counts are generally recommended, especially for courses longer than 2 weeks or in those at higher risk of low blood counts.
  • Watching for any vision changes or numbness/tingling, especially with courses longer than 28 days.
  • Watching for symptoms of serotonin syndrome if any serotonergic medicine is also being taken.
  • Blood sugar monitoring in people with diabetes.
  • Watching for severe or persistent diarrhoea.
(1)

Storage

Store tablets and oral suspension at room temperature as directed on the product packaging. Oral suspension should generally not be refrigerated and is typically used within a limited number of days once mixed -- follow the pharmacy label. IV infusion bags are stored as directed by the dispensing pharmacy/hospital.

Study the drug class: Oxazolidinones

Professional information

Clinician-facing context only, sourced from the current US FDA prescribing information and UK SmPC; verify against the current full label before prescribing. No boxed warning is present on either label as of this review -- confirmed by direct, repeated checks rather than assumed.

United States

Indication: Nosocomial/community-acquired pneumonia, complicated/uncomplicated skin infections, VRE infections

Dose summary: Adults/adolescents (>=12y): 600 mg PO/IV q12h for most indications (400 mg q12h for uncomplicated skin infections), 10-28 days depending on indication. Pediatric (birth-11y): 10 mg/kg PO/IV q8h for most indications; age-banded dosing for uncomplicated skin infections. Preterm neonates <7 days: consider 10 mg/kg q12h.

Renal context: No dose adjustment needed; metabolites accumulate with more severe impairment; ~30% removed by 3-hour haemodialysis. (1)

United Kingdom

Indication: Community-acquired and nosocomial pneumonia due to susceptible Gram-positive bacteria

Dose summary: Adults: 600 mg orally or IV every 12 hours; maximum licensed treatment duration 28 days.

Renal context: Not detailed in the source reviewed for this dossier beyond the US label's general guidance. (2)

Mechanism of action

Hepatic guidance

No dose adjustment for mild-to-moderate hepatic impairment; severe hepatic impairment has not been studied and should prompt closer clinical judgement.

Overdose note

Limited specific overdose data are available; general supportive measures apply. Roughly 30% of a dose is removed by a 3-hour haemodialysis session, though this has not been studied specifically as an overdose treatment. (1)

Frequently asked questions

Why can't I take linezolid with my antidepressant?

Linezolid has weak monoamine-oxidase-inhibiting activity of its own, and combining it with antidepressants or other serotonin-affecting medicines (such as SSRIs, SNRIs, or certain migraine or pain medicines) carries a real risk of serotonin syndrome, a potentially fatal reaction. In the United Kingdom, this combination is generally listed as a contraindication unless close monitoring is available; in the United States, it is described as a serious warning requiring caution. Always tell your prescriber about every medicine you take before starting linezolid. (1) (2)

Why does linezolid sometimes require weekly blood tests?

Linezolid can reduce blood cell counts (myelosuppression), particularly with treatment beyond 2 weeks. Weekly full blood counts help your clinical team catch this early and decide whether treatment needs to be adjusted. (1)

Is linezolid (Zyvox) available in the US, UK, Europe, Canada, Australia, and New Zealand?

Yes, it is authorised and available in all of these regions, under the brand names Zyvox (US, UK, Australia, New Zealand), Zyvoxid (European Union), or Zyvoxam (Canada), and generically in several of these markets. (1) (2) (3) (4) (5) (6)

What is the mechanism of action of linezolid?

Linezolid is a synthetic oxazolidinone antibacterial that inhibits bacterial protein synthesis by binding the 23S ribosomal RNA of the bacterial 50S ribosomal subunit, preventing formation of a functional 70S initiation complex -- a mechanism distinct from other protein-synthesis-inhibiting antibiotics, which helps limit cross-resistance. (1)

What is the generic name of Linezolid?

The generic name is linezolid. It is sold under brand names including Zyvox (United States, United Kingdom, Australia, New Zealand), Zyvoxid (European Union), Zyvoxam (Canada). (1) (2)

What class of drug is linezolid?

Linezolid is classed as: Oxazolidinone antibiotic. (1) (2)

References

  1. ZYVOX (linezolid) injection, tablets, and oral suspension -- full prescribing informationU.S. Food and Drug Administration / DailyMed (NIH), full prescribing information, Pfizer · United States · accessed 2026-07-30 · source 1
  2. Zyvox 600 mg Film-Coated Tablets / 2 mg/ml Solution for Infusion / 100 mg/5 ml Granules for Oral Suspension -- Summary of Product Characteristicselectronic medicines compendium (emc), United Kingdom -- Pfizer Limited · United Kingdom · accessed 2026-07-30 · source 2
  3. Linezolid -- list of nationally authorised medicinal products (Zyvoxid and others) across EU member statesEuropean Medicines Agency (EMA) -- periodic safety update (PSUSA) listing of nationally authorised linezolid products · European Union · accessed 2026-07-30 · source 3
  4. ZYVOXAM (linezolid) solution for intravenous infusion, tablets, and powder for oral suspension -- Pfizer CanadaHealth Canada -- Pfizer Canada product information (Zyvoxam) and generic Health Canada product monographs · Canada · accessed 2026-07-30 · source 4
  5. ZYVOX linezolid 600 mg tablets / 600 mg per 300 mL and 400 mg per 200 mL infusion bags -- ARTG registrationTherapeutic Goods Administration (TGA), Australia · Australia · accessed 2026-07-30 · source 5
  6. Zyvox (linezolid) injection, tablets, and oral suspension -- New Zealand Data SheetMedsafe (New Zealand regulator) · New Zealand · accessed 2026-07-30 · source 6

Brand names by country

Single-ingredient linezolid names are shown separately by country. Product availability, strengths, and supply rules can change; combination products are not included here.

Priority countries

United States

  • Zyvox100 mg/5mL, 600 mg/300mL, 600 mg, 200 mg00mL · pharmacia & upjohn company llc

United Kingdom

  • Zyvox (2)MHRA licensed emc smpc confirmed · 600 mg tablet, 100 mg/5 mL granules for oral suspension, 2 mg/mL solution for infusion · Pfizer Limited

Canada

  • ZYVOXAM

Australia

  • Zyvox (5)TGA ARTG registered 2001-09-24 confirmed · 600 mg tablet, 600 mg/300 mL infusion bag, 400 mg/200 mL infusion bag · Pfizer Australia Pty Ltd

New Zealand

  • Zyvox (6)Medsafe data sheet confirmed · not fully extracted from source -- see evidence note · Pfizer New Zealand
View brands in additional countries.

European Union

Zyvoxid (3)

This page provides general reference information about linezolid and is not a substitute for advice from the prescriber managing your treatment. All dosing and treatment decisions should be made with your prescriber.

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