Zolidon 600 IV Infusion

Linezolid is a synthetic antibiotic belonging to the oxazolidinone class. It is active against many Gram-positive aerobic bacteria, certain Gram-positive anaerobes, and some Gram-negative organisms.

It works by selectively blocking bacterial protein synthesis through binding to the 23S ribosomal RNA of the 50S ribosomal subunit. This action prevents formation of the functional 70S initiation complex, which is essential for bacterial protein production. Linezolid generally acts as a bacteriostatic agent against enterococci and staphylococci, while showing bactericidal activity against most streptococcal strains.

Dosage and Administration

Administration

• Tablets may be taken with or without food.
• Intravenous (IV) infusion should be administered over 30–120 minutes.

Recommended Dosages

Neonates (<7 days old)

• Premature infants (<34 weeks gestational age) should generally receive 10 mg/kg every 12 hours initially.
• If response is inadequate, dosing may be increased to every 8 hours.
• By 7 days of age, all neonates should receive 10 mg/kg every 8 hours.

No dosage adjustment is required when switching between IV and oral formulations.

Hepatic Impairment

• No dose adjustment is needed in mild-to-moderate liver impairment.
• Use in severe hepatic impairment has not been adequately studied.

Drug Interactions

With Medicines
Linezolid is a reversible, non-selective monoamine oxidase inhibitor (MAOI) and may interact with:

• Selective serotonin reuptake inhibitors (SSRIs)
• Tricyclic antidepressants
• Triptans
• Buspirone
• Meperidine
• Dopaminergic agents
• Vasopressors and sympathomimetics

These combinations may increase the risk of serotonin syndrome or excessive blood pressure elevation.

With Food
Patients should avoid consuming large amounts of tyramine-rich foods and beverages during treatment.

Contraindications

Zolidon should not be used in patients with:

• Hypersensitivity to linezolid or any component of the formulation
• Current use of MAO inhibitors (or within 14 days of discontinuation)
• Uncontrolled hypertension
• Pheochromocytoma
• Thyrotoxicosis
• Carcinoid syndrome
• Concurrent use of certain sympathomimetic, serotonergic, vasopressor, or dopaminergic medications

Side Effects

Most side effects are mild to moderate.

Common adverse effects include:

• Diarrhea
• Headache
• Nausea

Other reported reactions:

• Oral or vaginal fungal infections
• High blood pressure
• Indigestion
• Localized abdominal discomfort
• Itching
• Tongue discoloration

Pregnancy and Lactation

Pregnancy
Available evidence has not demonstrated a clear risk of major birth defects or pregnancy loss. However, linezolid should only be used during pregnancy when the potential benefit outweighs possible risks.

Breastfeeding
Linezolid passes into breast milk. Breastfeeding mothers should monitor infants for symptoms such as diarrhea or vomiting while receiving treatment.

Precautions and Warnings

• Monitor complete blood counts weekly, especially during prolonged treatment (>2 weeks), in patients with bone marrow suppression, or those receiving myelosuppressive drugs.
• Prompt eye examination is recommended if visual disturbances occur, including blurred vision, changes in color perception, or reduced visual acuity.
• Not approved for catheter-related bloodstream or catheter-site infections.
• Clostridioides difficile–associated diarrhea (CDAD) may occur during or even months after therapy.
• Use cautiously in patients with hypertension, thyroid disorders, or those receiving agents that affect blood pressure.
• Recurrent nausea, vomiting, metabolic acidosis, or low bicarbonate levels require immediate evaluation.
• Blood glucose should be monitored, as hypoglycemia may occur and may necessitate adjustment of antidiabetic medications.

Overdose

No confirmed overdose cases have been reported. Management is supportive and symptomatic. Approximately 30% of the drug can be removed by hemodialysis over three hours. Data regarding removal by peritoneal dialysis or hemoperfusion are unavailable.

Reconstitution and Administration

Oral Suspension

1. Loosen the powder by shaking the bottle.
2. Add 75 mL of previously boiled and cooled water in two portions.
3. Shake thoroughly after each addition until a uniform suspension is formed.

Important Notes

• Shake well before each use.
• Keep the bottle tightly closed.
• Store in a cool, dry place.
• Use within 21 days after reconstitution.

IV Infusion

• Supplied as a ready-to-use single-use infusion bottle.
• Infuse over 30–120 minutes.
• Do not add other medications to the solution.
• Protect from freezing.
• A yellow coloration may develop over time without affecting potency.

Therapeutic Class

Oxazolidinone Antibiotic

Storage

Zolidon formulations should be stored at room temperature (15°C-30°C), away from light and moisture. All medicines should be kept away from children.