Linezolid
Prescription ·Exploratory record · not publication-reviewed ·Updated July 13, 2026
Linezolid is a synthetic oxazolidinone antibiotic used to treat serious infections caused by resistant gram-positive bacteria, including methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococcus (VRE). It has excellent oral bioavailability that approaches that of the intravenous form, allowing seamless IV-to-oral transition. Because it is a reversible, nonselective monoamine oxidase (MAO) inhibitor, it carries clinically important serotonergic and tyramine-related interaction risks.
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What the research says.
A quick, data-only summary. The full evidence, dosing, and sources are below.
Linezolid is a synthetic oxazolidinone antibiotic used to treat serious infections caused by resistant gram-positive bacteria, including methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococcus (VRE). NutriStack rates the supporting evidence as strong. Common adult dosing is 600 mg orally or intravenously every 12 hours for most adult infections; 400 mg every 12 hours for uncomplicated skin and soft-tissue infections. Typical course is 10 to 14 days, or up to 28 days for VRE infections., though a prescriber sets the actual dose. This profile indexes 3 sources.
- Diarrhea, nausea, and vomiting
- Headache
- Reversible myelosuppression including thrombocytopenia and anemia, especially with courses longer than 14 days
- Known hypersensitivity to linezolid or any product component1,2
- Concurrent use with or within 2 weeks of monoamine oxidase inhibitors (for example phenelzine, isocarboxazid)2
The bottom line
Evidence rating strong. Most-documented uses: nosocomial and community-acquired pneumonia caused by susceptible gram-positive organisms, complicated and uncomplicated skin and soft-tissue infections including mrsa, vancomycin-resistant enterococcus faecium infections. 3 sources indexed (2006–2020), with 0 interaction records on file.
How it works, mechanistically.
Core mechanism
Linezolid inhibits bacterial protein synthesis by binding to the 23S ribosomal RNA of the 50S subunit near its interface with the 30S subunit. This binding prevents formation of the functional 70S initiation complex, blocking translation at an early step that is distinct from other protein-synthesis inhibitors, which limits cross-resistance. The drug is generally bacteriostatic against staphylococci and enterococci and bactericidal against most streptococci. Separately, linezolid is a weak, reversible, nonselective inhibitor of monoamine oxidase, which underlies its serotonergic and tyramine interaction profile.1,2
Dosing & protocol.
Oral linezolid is rapidly and almost completely absorbed (bioavailability approximately 100 percent) and can be taken with or without food. A high-fat meal slightly delays the time to peak concentration but does not meaningfully reduce overall absorption, so dose timing relative to meals is not critical. Patients should avoid large quantities of tyramine-rich foods because of the MAO-inhibitory activity.3
Full safety detail.
Side effects
- Diarrhea, nausea, and vomiting
- Headache
- Reversible myelosuppression including thrombocytopenia and anemia, especially with courses longer than 14 days
- Peripheral and optic neuropathy with prolonged use
- Lactic acidosis
- Serotonin syndrome when combined with serotonergic agents
- Clostridioides difficile-associated diarrhea
- Hypoglycemia in patients on insulin or oral hypoglycemics
Contraindications
- Known hypersensitivity to linezolid or any product component1,2
- Concurrent use with or within 2 weeks of monoamine oxidase inhibitors (for example phenelzine, isocarboxazid)2
- Uncontrolled hypertension, pheochromocytoma, or carcinoid syndrome unless closely monitored
- Concurrent use with serotonergic agents such as SSRIs, SNRIs, TCAs, triptans, or meperidine unless benefit outweighs risk and the patient is monitored2
- Concurrent use with sympathomimetic, vasopressive, or dopaminergic agents unless closely monitored2
Sources, by evidence tier.
Numbered references. Citations throughout the page link here.
Randomized controlled trials
1- 1Linezolid in Methicillin-Resistant Staphylococcus aureus Nosocomial Pneumonia: A Randomized, Controlled StudyWunderink RG, Niederman MS, Kollef MH, et al. · Clinical Infectious Diseases · 2012
Linezolid achieved a higher clinical cure rate than vancomycin in patients with MRSA nosocomial pneumonia while maintaining a comparable safety profile.
Reviews & position papers
1- 2Serotonin Toxicity Associated with the Use of Linezolid: A Review of Postmarketing DataLawrence KR, Adra M, Gillman PK · Clinical Infectious Diseases · 2006
Coadministration of linezolid with serotonergic agents, particularly SSRIs, was associated with reports of serotonin syndrome, supporting cautious or avoided concurrent use.
Reference material
1- 3Zyvox (linezolid) US Prescribing InformationPfizer Inc. · FDA Label · 2020
Oral linezolid is approximately 100 percent bioavailable, so oral and intravenous doses are interchangeable without dose adjustment.
Common questions.
Quick answers about Linezolid, drawn from the data on this page.
What is Linezolid?
Linezolid is a synthetic oxazolidinone antibiotic used to treat serious infections caused by resistant gram-positive bacteria, including methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococcus (VRE). It has excellent oral bioavailability that approaches that of the intravenous form, allowing seamless IV-to-oral transition. Because it is a reversible, nonselective monoamine oxidase (MAO) inhibitor, it carries clinically important serotonergic and tyramine-related interaction risks.
What is Linezolid used for?
Commonly cited benefits of Linezolid include: Nosocomial and community-acquired pneumonia caused by susceptible gram-positive organisms; Complicated and uncomplicated skin and soft-tissue infections including MRSA; Vancomycin-resistant Enterococcus faecium infections; Used in some multidrug-resistant tuberculosis regimens. NutriStack rates the overall evidence as strong.
What is a typical dose of Linezolid?
A typical adult dose of Linezolid is 600 mg orally or intravenously every 12 hours for most adult infections; 400 mg every 12 hours for uncomplicated skin and soft-tissue infections. Typical course is 10 to 14 days, or up to 28 days for VRE infections.. The commonly recommended form is Oral tablet, oral suspension, or intravenous infusion; oral and IV doses are equivalent due to near-complete bioavailability. These are general ranges, not personalized advice; confirm the right dose with a clinician.
What are the side effects of Linezolid?
Reported side effects include diarrhea, nausea, and vomiting, headache, reversible myelosuppression including thrombocytopenia and anemia, especially with courses longer than 14 days, peripheral and optic neuropathy with prolonged use, lactic acidosis, serotonin syndrome when combined with serotonergic agents. This is educational information; check with a healthcare professional before use.
How strong is the evidence for Linezolid?
NutriStack rates this as Strong, meaning multiple high-quality meta-analyses or systematic reviews converge on the same finding. Full tier criteria are at https://nutristackapp.com/methodology/evidence-tiers.
Use this with your stack
Linezolid in NutriStack.
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