Pharmacy - LUHFT wide

 

What you need to know about monitoring for side effects

 

What is linezolid and what is it used for?

Linezolid is an antibiotic which is active against certain types of drug resistant bacteria, such as methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococci (VRE). Linezolid is used to treat serious bacterial infections including those of the skin, lungs or bone.

The main benefit of being prescribed this antibiotic is that it can be given to you as a tablet or liquid. This means that you do not need to have an intravenous drip and may be able to have your treatment at home.

How do I take linezolid?

The usual dose for an adult patient is one 600mg tablet every 12 hours e.g. at 8am and 8pm. Linezolid can be taken before, with or after food. A dose of 600mg once a day may be used for certain lung infections.

What should I do if I miss a dose?

Try not to miss a dose of linezolid as this can lead to bacterial resistance and treatment failure. However, if you do miss a dose, do not double up when the next dose is due. Take the next dose as soon as you remember and continue taking your tablets every 12 hours.

How long will I need to take linezolid for?

This depends on what infection we are treating, your blood results and how well you respond to treatment. Linezolid should be taken until the course is complete as determined by your doctor. Do not stop taking the medicine when you start to feel better, as stopping too soon may lead to surviving bacteria causing a relapse of the infection.

Doctors may use linezolid for longer courses or situations not listed in the original instructions (“off-label”). Your medical team will have considered this before they recommend prolonged treatment with linezolid and will discuss the risks and benefits of this to you before you begin treatment.

Whilst on linezolid, how will I be monitored?

Whilst taking linezolid you will need to attend for a review or have a telephone consultation weekly or fortnightly so that blood tests can be taken, assess your progress and ensure you are not experiencing any side effects. Blood tests can be arranged at the hospital or by your GP.

Please be aware you may need to visit the hospital on request of the medical team at any point during your treatment.

Why do I need regular blood tests?

Linezolid can reduce the production of blood cells, making you susceptible to infections and anaemia. Blood tests will show if you are developing any side effects. If you are being affected your treatment will be reviewed.

What side effects might I experience on linezolid?

Like all medicines, linezolid can cause side effects. Common side effects of linezolid could include:

  • Headaches
  • Dizziness
  • Metallic taste in the mouth
  • Diarrhoea
  • Nausea or vomiting or stomach upset
  • Skin rashes
  • Tongue discolouration

You may not suffer from any of these side effects but please inform your doctor or nurse if you do experience any of the above.

In rare cases, more serious side effects can occur; these are more likely in prolonged treatment courses. If you notice any of the following symptoms, please contact the hospital team immediately:

  • Changes to your eyesight, for example blurred vision, colour changes, difficulty in seeing detail or your field of vision becomes restricted.
  • Severe allergic reaction, for example widespread rash, swelling, difficulty breathing or fast heartbeat.
  • ‘Pins and needles’ or numbness in your hands and/or feet.
  • Unexplained bleeding or bruising or blood in your stools; which may be due to changes in the numbers of certain cells in the blood which may affect blood clotting or lead to anaemia.
  • Severe throbbing headache.
  • Severe or persistent diarrhoea. Recurrent nausea and/or vomiting, abdominal pain or increased breathing rate.
  • Feeling more anxious, agitated and restless. Increased heart rate and blood pressure, twitching, heavy sweating and confusion.

Can I take my current medication with linezolid?

It is important that you tell your doctor if you are taking any other medicines, including over the counter medications or herbal remedies, because linezolid can interfere with other treatment. It is particularly important to mention that you are taking antidepressant medication.

Please tell your doctor or pharmacist that you are taking linezolid before you start on any new medicines.

Do I need to change my diet whilst on linezolid?

Please avoid the following types of food (which naturally contain a substance called tyramine) whilst taking linezolid because they may increase your blood pressure:

Mature cheese e.g. Stilton, blue, cheddar, camembert cheese

Some fruits e.g. figs, grapes, prunes, raisins, oranges

Overripe fruits such as bananas and avocados

Yeast extracts e.g. Bovril, Vegemite, Oxo & Marmite

Sour cream & yoghurt

Fermented soya bean products e.g. soy sauce, miso soup

Broad beans, avocado

Fermented or air dried/cured/smoked meats e.g. salami, bacon, pepperoni

Peanuts

Liver, kidney, pickled herring or game

Beer and wine

More than 500g dark chocolate

Protein diet supplements

If you suffer from a throbbing headache after eating please inform the hospital team.

 

Where will I get further supplies of linezolid?

Your GP is not allowed to prescribe linezolid. If you need further supplies then this will be prescribed by your hospital doctors and dispensed by the hospital pharmacy. If you have not had blood tests, this may delay receiving further supplies.

Can I take linezolid during pregnancy or breastfeeding?

Linezolid is not usually given to pregnant or breastfeeding women.

Please tell your doctor if you are pregnant, trying to become pregnant or breastfeeding. They can help you to decide if linezolid is the best medicine for you.

Who can I tell about my side effects?

If you have any questions about linezolid please contact your pharmacist, doctor or nurse. Please report any side effects to the MHRA via the Yellow Card Scheme. Reports are confidential and help to improve the safety of medicines ( https://yellowcard.mhra.gov/uk/).

Disclaimer

This leaflet does not replace the patient information leaflet issued with your medicines, but you should read it in conjunction with them.

Feedback

Your feedback is important to us and helps us influence care in the future.

Following your discharge from hospital or attendance at your outpatient appointment you will receive a text asking if you would recommend our service to others. Please take the time to text back, you will not be charged for the text and can opt out at any point. Your co-operation is greatly appreciated.

Further information

OPAT specialist team: 0151 706 3125 or 07387 526057

This service is available Monday to Friday (not including Bank Holidays) between 8am and 4pm.

For emergencies outside these hours please attend your local Emergency Department (A&E) and let them know you are taking linezolid.

 

Pharmacy Departments

 

Royal Liverpool Hospital

Tel: 0151 706 2092

Text phone number: 18001 0151 706 2092

 

Aintree Hospital

Tel: 0151 525 5980

Text phone number: 18001 0151 525 5980

 

Broadgreen Hospital

Tel: 0151 282 6056

Text phone number: 18001 0151 282 6056

 

Author: Pharmacy

Review date: April 2028

PI 2196 V2