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Serotonin Reuptake Inhibitors/Linezolid

This information is generalized and not intended as specific medical advice. Consult your healthcare professional before taking or discontinuing any drug or commencing any course of treatment.

Medical warning:

Severe. These medicines may interact and cause very harmful effects and are usually not taken together. Contact your healthcare professional (e.g. doctor or pharmacist) for more information.

How the interaction occurs:

Both of these medicines can increase the level of serotonin in your body.

What might happen:

High serotonin levels may cause changes in body temperature, blood pressure and behavior, leading to a medical condition called Serotonin Syndrome. Serotonin Syndrome may be life threatening.

What you should do about this interaction:

Make sure your healthcare professionals (e.g. doctor or pharmacist) know that you are taking these medicines together.If you experience muscle twitching, tremors, shivering or stiffness, fever, heavy sweating, heart palpitations, restlessness, confusion, agitation, trouble with coordination, or severe diarrhea contact your doctor right away.Your healthcare professionals may already be aware of this interaction and may be monitoring you for it. Do not start, stop, or change the dosage of any medicine before checking with them first.

References:

1.USFood and Drug Administration. FDA Drug Safety Communication: Serious CNS reactions possible when linezolid (Zyvox) is given to patients taking certain psychiatric medications. available at: http://www.fda.gov/Drugs/DrugSafety/ucm265305.htm July 26, 2011.
2.Prozac (fluoxetine hydrochloride) US prescribing information. Eli Lilly and Company January, 2013.
3.Zoloft (sertraline) US prescribing information. Pfizer Inc. December, 2012.
4.Effexor (venlafaxine hydrochloride) US prescribing information. Wyeth Pharmaceuticals December, 2012.
5.Luvox (fluvoxamine maleate) US prescribing information. ANI Pharmaceuticals November, 2012.
6.Serzone (nefazodone hydrochloride) US prescribing information. Bristol-Myers Squibb Company January, 2005.
7.Pexeva (paroxetine mesylate) US prescribing information. Noven Therapeutics, LLC December, 2012.
8.Bernard L, Stern R, Lew D, Hoffmeyer P. Serotonin syndrome after concomitant treatment with linezolid and citalopram. Clin Infect Dis 2003 May 1;36(9):1197.
9.Wigen CL, Goetz MB. Serotonin syndrome and linezolid. Clin Infect Dis 2002 Jun 15;34(12):1651-2.
10.Hachem RY, Hicks K, Huen A, Raad I. Myelosuppression and serotonin syndrome associated with concurrent use of linezolid and selective serotonin reuptake inhibitors in bone marrow transplant recipients. Clin Infect Dis 2003 Jul 1;37(1):e8-11.
11.Lexapro (escitalopram oxalate) US prescribing information. Forest Pharmaceuticals Inc. December, 2012.
12.Celexa (citalopram hydrobromide) US prescribing information. Forest Laboratories Inc. December, 2012.
13.Cymbalta (duloxetine hydrochloride) US prescribing information. Eli Lilly and Company October, 2012.
14.Tahir N. Serotonin syndrome as a consequence of drug-resistant infections: an interaction between linezolid and citalopram. J Am Med Dir Assoc 2004 Mar-Apr;5(2):111-3.
15.Bergeron L, Boule M, Perreault S. Serotonin toxicity associated with concomitant use of linezolid. Ann Pharmacother 2005 May;39(5):956-61.
16.Thomas CR, Rosenberg M, Blythe V, Meyer WJ 3rd. Serotonin syndrome and linezolid. J Am Acad Child Adolesc Psychiatry 2004 Jul;43(7):790.
17.Morales N, Vermette H. Serotonin syndrome associated with linezolid treatment after discontinuation of fluoxetine. Psychosomatics 2005 May-Jun;46(3):274-5.
18.Lavery S, Ravi H, McDaniel WW, Pushkin YR. Linezolid and serotonin syndrome. Psychosomatics 2001 Sep-Oct;42(5):432-4.
19.Jones SL, Athan E, O'Brien D. Serotonin syndrome due to co-administration of linezolid and venlafaxine. J Antimicrob Chemother 2004 Jul; 54(1):289-90.
20.Clark DB, Andrus MR, Byrd DC. Drug interactions between linezolid and selective serotonin reuptake inhibitors: case report involving sertraline and review of the literature. Pharmacotherapy 2006 Feb;26(2):269-76.
21.Boyer EW, Shannon M. The serotonin syndrome. N Engl J Med 2005 Mar 17; 352(11):1112-20.
22.Priligy (dapoxetine hydrochloride) Australian prescribing information. Ortho-McNeil Pharmaceutical March 19, 2013.
23.Brintellix (vortioxetine) US prescribing information. Takeda Pharmaceuticals America, Inc. September, 2013.

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