Zyvox: Potent Gram-Positive Antibiotic with Rapid Onset
| Product dosage: 600mg | |||
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| 60 | $6.06
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Synonyms | |||
Zyvox (linezolid) is a synthetic antibacterial agent of the oxazolidinone class, specifically designed to target resistant Gram-positive pathogens. It represents a critical therapeutic option for complicated skin and skin structure infections, hospital-acquired and community-acquired pneumonia, and vancomycin-resistant Enterococcus faecium infections. Its unique mechanism of action inhibits bacterial protein synthesis, providing a robust defense against multidrug-resistant organisms where other antibiotics may fail. This product card provides a comprehensive overview for healthcare professionals considering Zyvox in clinical practice.
Features
- Active ingredient: Linezolid 600 mg or 400 mg (tablets); 200 mg/100 mL (injection)
- Pharmacologic class: Oxazolidinone antibacterial
- Mechanism: Binds to the 50S ribosomal subunit, inhibiting protein synthesis
- Spectrum: Active against resistant Gram-positive bacteria including MRSA, VRE, and penicillin-resistant Streptococcus pneumoniae
- Bioavailability: Approximately 100% (oral formulation)
- Half-life: 4–5 hours
- Excretion: Primarily non-renal (metabolized to inactive metabolites)
Benefits
- Rapid bactericidal activity against susceptible Gram-positive organisms, reducing time to clinical improvement
- Excellent oral bioavailability allows for early transition from IV to oral therapy, facilitating outpatient treatment
- Effective against multidrug-resistant pathogens including methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococcus (VRE)
- No dosage adjustment required in patients with renal impairment
- Convenient twice-daily dosing regimen supports adherence
- Demonstrated efficacy in both hospital and community settings
Common use
Zyvox is indicated for the treatment of adults and pediatric patients with infections caused by susceptible strains of designated Gram-positive microorganisms. These include complicated skin and skin structure infections (including diabetic foot infections without osteomyelitis), nosocomial pneumonia, community-acquired pneumonia, and vancomycin-resistant Enterococcus faecium infections. It is particularly valuable in cases where resistance to other antimicrobial agents has been documented or suspected.
Dosage and direction
Adults: 600 mg orally or intravenously every 12 hours for 10-14 days (up to 28 days for specific indications).
Pediatric patients: 10 mg/kg orally or intravenously every 8 hours (neonates) or every 12 hours (children and adolescents).
Oral administration may be taken with or without food. The injection formulation should be administered over 30-120 minutes. Complete the full course of therapy even if symptoms improve earlier to prevent development of resistance.
Precautions
Monitor complete blood counts weekly during therapy due to potential myelosuppression (thrombocytopenia, anemia, neutropenia). Use with caution in patients with pre-existing myelosuppression, uncontrolled hypertension, pheochromocytoma, carcinoid syndrome, or seizure disorders. Peripheral and optic neuropathy have been reported, particularly with prolonged use beyond 28 days. Monitor visual function in patients taking Zyvox for extended periods. Serotonin syndrome has occurred when used with serotonergic drugs—observe for mental status changes, autonomic instability, and neuromuscular abnormalities.
Contraindications
Known hypersensitivity to linezolid or any component of the formulation. Concurrent use with monoamine oxidase inhibitors (MAOIs) or within two weeks of MAOI therapy. Should not be administered to patients taking serotonergic drugs (SSRIs, SNRIs, TCAs, triptans) unless closely monitored. Avoid in patients with uncontrolled hypertension, pheochromocytoma, thyrotoxicosis, and/or those taking sympathomimetic agents.
Possible side effect
Common adverse reactions (≥2%) include: diarrhea (4-11%), nausea (3-10%), headache (4-9%), vomiting (1-7%), insomnia (3-6%), constipation (2-6%), dizziness (2-5%), and rash (2-4%). Serious adverse reactions may include myelosuppression, peripheral neuropathy, optic neuropathy, lactic acidosis, serotonin syndrome, and Clostridium difficile-associated diarrhea. Laboratory abnormalities may include decreased hemoglobin, platelets, neutrophils, and increased liver transaminases.
Drug interaction
Significant interactions occur with:
- Adrenergic agents (pressor response potentiation)
- Serotonergic agents (risk of serotonin syndrome)
- MAO inhibitors (contraindicated)
- Foods high in tyramine (potential hypertensive crisis)
No significant interactions with cytochrome P450 enzymes. Use caution with drugs that affect platelet function or increase bleeding risk.
Missed dose
If a dose is missed, administer it as soon as possible. If it is almost time for the next dose, skip the missed dose and continue with the regular dosing schedule. Do not double the dose to make up for a missed dose. Maintain the twice-daily dosing interval to ensure consistent therapeutic levels.
Overdose
Symptoms may include nausea, vomiting, agitation, dizziness, or seizures. Management includes supportive care with maintenance of glomerular filtration and monitoring of hematologic parameters. Hemodialysis may accelerate elimination of both linezolid and its metabolites. There is no specific antidote for linezolid overdose.
Storage
Store tablets at 25°C (77°F); excursions permitted to 15-30°C (59-86°F). Keep in original container, protected from moisture and light. Intravenous solution should be stored at room temperature and protected from freezing. Keep out of reach of children. Do not use if solution is discolored or contains particulate matter.
Disclaimer
This information is intended for healthcare professionals only. Zyvox should be prescribed by qualified practitioners familiar with antibacterial therapy and microbial resistance patterns. The prescriber should review full prescribing information before administration. This summary does not include all possible uses, directions, precautions, or adverse effects.
Reviews
Clinical trials demonstrate Zyvox’s efficacy with clinical cure rates of 85-90% in complicated skin infections and 85-92% in pneumonia cases. Many infectious disease specialists note its value as a reserve antibiotic for resistant infections, though emphasize the importance of antimicrobial stewardship to preserve its effectiveness. Some clinicians report excellent outcomes in diabetic foot infections and osteomyelitis cases when combined with surgical debridement. The main limitations noted include cost considerations and the need for hematologic monitoring during extended therapy.