Drug interactions
Linezolid + Methylene blue
Severity: Contraindicated
Linezolid and Methylene blue: contraindicated interaction.
Last updated
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
Both drugs inhibit monoamine oxidase, and combining them can produce excess serotonergic activity, causing serotonin syndrome with agitation, hyperthermia, clonus and autonomic instability. Regulators have issued warnings about this combination.
What this interaction means in plain words
Linezolid and Methylene blue are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two.
Why it happens
Additive serotonergic effect through reversible MAO-A inhibition by both linezolid and methylene blue.
What to do
Avoid the combination; use an alternative antibiotic or alternative treatment for methemoglobinemia where possible. If methylene blue is urgently needed, stop linezolid and monitor closely for serotonin syndrome for at least 24 hours after the last dose of linezolid or until 2 weeks have passed.
What to ask your pharmacist
- Is there an alternative to one of these two medicines for me?
- If both are essential, who is monitoring me and how often?
- Which symptoms mean I should stop and seek help straight away?
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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 Linezolid with Methylene blue?
MediHelp rates the interaction as contraindicated. Linezolid and Methylene blue are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two. Both drugs inhibit monoamine oxidase, and combining them can produce excess serotonergic activity, causing serotonin syndrome with agitation, hyperthermia, clonus and autonomic instability. Regulators have issued warnings about this combination.
How serious is the interaction between Linezolid and Methylene blue?
MediHelp rates it contraindicated, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid the combination; use an alternative antibiotic or alternative treatment for methemoglobinemia where possible. If methylene blue is urgently needed, stop linezolid and monitor closely for serotonin syndrome for at least 24 hours after the last dose of linezolid or until 2 weeks have passed.
What other medicines interact with Linezolid?
MediHelp also lists interactions of Linezolid with, for example, Amoxapine, Atomoxetine, Benzphetamine. The full list is on the Linezolid page.
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