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Anafranil and Zyvox (Linezolid Tablets)

Determining the interaction of Anafranil and Zyvox (Linezolid Tablets) and the possibility of their joint administration.

Check result:

Anafranil <> Zyvox (Linezolid Tablets)

Relevance: 24.12.2022 Reviewer: Shkutko P.M., M.D., in

In the database of official manuals used in the service creation an interaction registered by statistical results of studies was found, which can either lead to negative consequences for the patient health or strengthen a mutual positive effect. A doctor should be consulted to address the issue of joint drug administration.

Consumer:

If you are currently being treated with clomiPRAMINE, let your doctor know before you receive linezolid. Combining these medications can increase the risk of a rare but serious condition called the serotonin syndrome, which may include symptoms such as confusion, hallucination, seizure, extreme changes in blood pressure, increased heart rate, fever, excessive sweating, shivering or shaking, blurred vision, muscle spasm or stiffness, tremor, incoordination, stomach cramp, nausea, vomiting, and diarrhea. Severe cases may result in coma and even death. Depending on your condition, your doctor may want you to discontinue clomiPRAMINE before you start treatment with linezolid, or prescribe an alternative medication. Otherwise, you will need to be closely monitored by your doctor during treatment. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Professional:

CONTRAINDICATED: Coadministration of linezolid with serotonergic agents may potentiate the risk of serotonin syndrome, which is a rare but serious and potentially fatal condition thought to result from hyperstimulation of brainstem 5-HT1A and 2A receptors. Linezolid is a reversible, nonselective monoamine oxidase inhibitor (MAOI). As such, it can enhance serotonergic effects by inhibiting serotonin metabolism. Rare cases of serotonin syndrome have been reported in association with linezolid use, most often in combination with serotonin reuptake inhibitors. Symptoms of the serotonin syndrome may include mental status changes such as irritability, altered consciousness, confusion, hallucination, and coma; autonomic dysfunction such as tachycardia, hyperthermia, diaphoresis, shivering, blood pressure lability, and mydriasis; neuromuscular abnormalities such as hyperreflexia, myoclonus, tremor, rigidity, and ataxia; and gastrointestinal symptoms such as abdominal cramping, nausea, vomiting, and diarrhea.

MANAGEMENT: Concomitant use of linezolid and serotonergic agents should be avoided unless no alternatives exist and close monitoring for the development of serotonin syndrome can be provided. In general, most serotonergic psychiatric drugs should be stopped 1 to 2 weeks (i.e., 4 to 5 half-lives) prior to treatment with an MAOI, while others such as fluoxetine may require discontinuation up to 5 weeks in advance due to its prolonged half-life. Treatment with serotonergic medications may be resumed 24 hours after the last dose of linezolid. In emergency situations that may necessitate urgent treatment with linezolid (e.g., vancomycin-resistant Enterococcus faecium (VRE) infections; nosocomial pneumonia and complicated skin and skin structure infections, including cases caused by methicillin-resistant Staphylococcus aureus), the availability of alternative interventions should be considered and the benefit of linezolid treatment should be weighed against the risk of serotonin toxicity. If the decision is made to administer linezolid to a patient receiving a serotonergic drug, the serotonergic drug must be immediately stopped, and the patient closely monitored for emergent symptoms of CNS toxicity for two weeks (five weeks if fluoxetine was taken; three weeks if vortioxetine was taken) or until 24 hours after the last dose of linezolid, whichever comes first. Patients and/or their caregivers should be advised to seek medical attention if potential symptoms of serotonin syndrome develop.

References

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"Product Information. Zyvox (linezolid)" Pharmacia and Upjohn, Kalamazoo, MI.
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DeBellis RJ, Schaefer OP, Liquori M, Volturo GA "Linezolid-associated serotonin syndrome after concomitant treatment with citalopram and mirtazepine in a critically ill bone marrow transplant recipient." J Intensive Care Med 20 (2005): 351-3
Jones SL, Athan E, O'Brien D "Serotonin syndrome due to co-administration of linezolid and venlafaxine." J Antimicrob Chemother 54 (2004): 289-90
Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
Steinberg M, Morin AK "Mild serotonin syndrome associated with concurrent linezolid and fluoxetine." Am J Health Syst Pharm 64 (2007): 59-62
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Packer S, Berman SA "Serotonin syndrome precipitated by the monoamine oxidase inhibitor linezolid." Am J Psychiatry 164 (2007): 346-7
Bernard L, Stern R, Lew D, Hoffmeyer P "Serotonin syndrome after concomitant treatment with linezolid and citalopram." Clin Infect Dis 36 (2003): 1197
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FDA. U.S. Food and Drug Administration "FDA Drug Safety Communication: Serious CNS reactions possible when linezolid (Ayvox) is given to patients taking certain psychiatric medications. Available from: URL: http://www.fda.gov/Drugs/DrugSafety/ucm265305.htm#table." ([2011 July 26]):
Tahir N "Serotonin syndrome as a consequence of drug-resistant infections: an interaction between linezolid and citalopram." J Am Med Dir Assoc 5 (2004): 111-3
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Anafranil

Generic Name: clomipramine

Brand name: Anafranil

Synonyms: n.a.

What is Anafranil?

Zyvox (Linezolid Tablets)

Generic Name: linezolid

Brand name: Zyvox

Synonyms: Zyvox

What is Zyvox (Linezolid Tablets)?

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In the course of checking the drug compatibility and interactions, data from the following reference sources was used: Drugs.com, Rxlist.com, Webmd.com, Medscape.com.

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