Drug interactions
Diphenoxylate-atropine + Linezolid
Severity: Major
Diphenoxylate-atropine and Linezolid: major interaction.
Last updated Sources: Health Canada product monograph
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Linezolid is a reversible nonselective MAO inhibitor, and diphenoxylate labeling warns against use with MAO inhibitors because of possible hypertensive crisis. Serotonergic or pressor reactions are theoretically possible given diphenoxylate's meperidine-like structure. Evidence is largely extrapolated from other MAO inhibitors.
What this interaction means in plain words
Diphenoxylate-atropine and Linezolid can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Diphenoxylate-atropine belongs to Gastrointestinal Tract; Linezolid belongs to Anti Bacterial.
Why it happens
MAO inhibition by linezolid may potentiate diphenoxylate effects, extrapolated from the MAO inhibitor class interaction.
What to do
Avoid the combination and use another antidiarrheal when linezolid is needed. If unavoidable, monitor blood pressure, temperature and mental status closely.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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References
Other interactions of Diphenoxylate-atropine
- Diphenoxylate-atropine + Isocarboxazid Contraindicated
- Diphenoxylate-atropine + Phenelzine Contraindicated
- Diphenoxylate-atropine + Tranylcypromine Contraindicated
- Alfentanil + Diphenoxylate-atropine Major
- Alvimopan + Diphenoxylate-atropine Major
- Amitriptyline + Diphenoxylate-atropine Major
Other interactions of Linezolid
- Amoxapine + Linezolid Contraindicated
- Atomoxetine + Linezolid Contraindicated
- Benzphetamine + Linezolid Contraindicated
- Brimonidine + Linezolid Contraindicated
- Bupropion-naltrexone + Linezolid Contraindicated
- Bupropion + Linezolid Contraindicated
Frequently asked questions
Can I take Diphenoxylate-atropine with Linezolid?
MediHelp rates the interaction as major. Diphenoxylate-atropine and Linezolid can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Linezolid is a reversible nonselective MAO inhibitor, and diphenoxylate labeling warns against use with MAO inhibitors because of possible hypertensive crisis. Serotonergic or pressor reactions are theoretically possible given diphenoxylate's meperidine-like structure. Evidence is largely extrapolated from other MAO inhibitors.
How serious is the interaction between Diphenoxylate-atropine and Linezolid?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid the combination and use another antidiarrheal when linezolid is needed. If unavoidable, monitor blood pressure, temperature and mental status closely.
What other medicines interact with Diphenoxylate-atropine?
MediHelp also lists interactions of Diphenoxylate-atropine with, for example, Isocarboxazid, Phenelzine, Tranylcypromine. The full list is on the Diphenoxylate-atropine page.
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