Venlafaxine Linezolid

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... 

Clinically important, potentially hazardous interactions with citalopram, fluoxetine, fluvoxamine, ginkgo biloba, linezolid, lopinavir, nefazodone, paroxetine, sertraline, venlafaxine... 

The serotonin syndrome has been reported in patients taking linezolid with an SSRI or venlafaxine. The serotonin syndrome is also predicted to occur if linezolid is given with tricyclic antidepressants. 

Venlafaxine. An 85-year-old man taking venlafaxine 150 mg daily was prescribed ciprofloxacin, rifampicin and linezolid 600 mg twice daily for a hip prosthesis infection. After 20 days he was found to be confused and disorientated, and 4 days later he was also drowsy, and suffering myoclonic jerks. Linezolid and venlafaxine were stopped and the symptoms resolved over 2 days. However, another case report describes a 7-year-old boy treated with venlafaxine and methylphenidate who was prescribed linezolid for osteomyelitis. He was given all three drugs (doses not stated) for several days without any alterations in vital signs or evidence of the serotonin syndrome. ... 

Not fully understood. Linezolid has weak MAOI effects, and the serotonin syndrome is known to occur when MAOIs are given with SSRIs , (p.l 142), tricyclics , (p.ll49) and venlafaxine , (p.ll56). In the case of the patient taking linezolid with amitriptyline and paroxetine, it is possible that an interaction between amitriptyline and paroxetine contributed to the development of the serotonin syndrome. Consider also Tricyclic and related antidepressants + SSRIs , p.l241. 

Information on the reaction between linezolid and the SSRIs, tricyclics, mirtazapine or venlafaxine appears to be limited, but what is known suggests that the interaction is probably rare. The manufacturers of linezolid say that patients taking SSRIs and tricyclic antidepressants should have their blood pressure monitored and be closely observed if given linezolid. They say that if this is not possible, concurrent use should be avoided. If linezolid is used with a drug with serotonergic actions it would seem prudent to monitor for symptoms of the serotonin syndrome, which may take several weeks to manifest. See The serotonin syndrome , (p.9), for further details. 

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