Peripheral neuropathy linezolid

The principal toxicity of linezolid is hematologic—reversible and generally mild. Thrombocytopenia is the most common manifestation (seen in approximately 3% of treatment courses), particularly when the drug is administered for longer than 2 weeks. Anemia and neutropenia may also occur, most commonly in patients with a predisposition to or underlying bone marrow suppression. Cases of optic and peripheral neuropathy and lactic acidosis have been reported with prolonged courses of linezolid. These side effects are thought to be related to linezolid-induced inhibition of mitochondrial protein synthesis. 

Observational studies In a retrospective study in South Korea of linezolid in combination with other second-line drugs in 11 patients with intractable multidrug resistant tuberculosis, nine had serious adverse events [145 ]. Eight patients developed a peripheral neuropathy in the legs after a median of 4 months linezolid was withdrawn in these cases. Three patients developed an optic neuropathy, including two who had a peripheral neuropathy, after a median of 4 months. Two patients developed anemia requiring blood transfusion. 

A 12-year-old girl developed a peripheral neuropathy after taking linezolid for 4 months for chronic vertebral osteomyelitis, with reduced sensation with painful burning paresthesia in both legs there was... 

Linam WM, Wesselkamper K, Gerber MA. Peripheral neuropathy in an adolescent treated with linezolid. Pediatr Infect Dis J 2009 28(2) 149-51. 

Linezolid Myelosuppression monitor CBC once weekly if more than 2 weeks of therapy Peripheral and/or optic neuropathy has been reported with long-term therapy Mild MAO inhibitor evaluate for potential drug-drug or drug-food interactions... 

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