Linezolid Dextromethorphan

Others Buspirone, chlorpheniramine, dextromethorphan, linezolid, lithium, selegiline, tryptophan, St. John s wort... 

Clinically important, potentially hazardous interactions with desvenlafaxine, dextromethorphan, dihydroergotamine, ephedra, ergot, fluoxetine, fluvoxamine, isocarboxazid, linezolid, lithium, MAO inhibitors, meperidine, methysergide, naratriptan, nefazodone, paroxetine, phenelzine, rizatriptan, sertraline, sumatriptan, tranylcypromine, tryptophan, venlafaxine, verapamil, zolmitriptan, zuclopenthixol... 

There is no important pharmacokinetic interaction between linezolid and dextromethorphan, but one case of concurrent use resulted in the serotonin syndrome. 

In a study in 14 healthy subjects, two 20-mg doses of dextromethorphan given 4 hours apart, before and during the use of linezolid 600 mg every 12 hours, had no effect on linezolid pharmacokinetics. The AUC and maximum level of the dextromethorphan metabolite, dextrorphan was decreased by 30%, but this was not considered sufficient to warrant any dosing alterations. There was no evidence of the serotonin syndrome, as measured by changes in body temperature, alertness and mental performance. However, the manufacturers describe one case where the concurrent use of linezolid and dextromethorphan resulted in the serotonin syndrome. Linezolid has mild reversible MAOI activity, and the serotonin syndrome has been described when dextromethorphan was taken by patients also taking antidepressant MAOIs, see MAOIs or RIMAs + Dextromethorphan , p.l 134. If the concurrent use of linezolid and dextromethorphan is considered necessary, it would seem prudent to monitor for symptoms of the serotonin syndrome , (p.9). 

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