Drug interactions
Linezolid + Nalbuphine
Severity: Major
Linezolid and Nalbuphine: major 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
Linezolid is a reversible, non-selective MAO inhibitor, and combining it with opioids can lead to serotonin toxicity or exaggerated CNS and respiratory depression and blood pressure changes. Nalbuphine has little serotonergic activity, so the risk is probably lower than with agents such as meperidine or tramadol, but it is not eliminated.
What this interaction means in plain words
Linezolid and Nalbuphine 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 belongs to Anti Bacterial; Nalbuphine belongs to Musculoskeletal.
Why it happens
Linezolid's MAO inhibition may potentiate opioid CNS depressant and hemodynamic effects and possibly serotonergic toxicity; the mechanism for nalbuphine is not well established.
What to do
Prefer an alternative antibiotic or analgesic where possible. If both are required, use the lowest effective nalbuphine dose and monitor for agitation, hyperthermia, clonus, sedation and hypotension.
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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Other interactions of Nalbuphine
- Alvimopan + Nalbuphine Contraindicated
- Nalbuphine + Olanzapine / samidorphan Contraindicated
- Alprazolam + Nalbuphine Major
- Amobarbital + Nalbuphine Major
- Benzhydrocodone / acetaminophen + Nalbuphine Major
- Brexanolone + Nalbuphine 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 Linezolid with Nalbuphine?
MediHelp rates the interaction as major. Linezolid and Nalbuphine 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, non-selective MAO inhibitor, and combining it with opioids can lead to serotonin toxicity or exaggerated CNS and respiratory depression and blood pressure changes. Nalbuphine has little serotonergic activity, so the risk is probably lower than with agents such as meperidine or tramadol, but it is not eliminated.
How serious is the interaction between Linezolid and Nalbuphine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Prefer an alternative antibiotic or analgesic where possible. If both are required, use the lowest effective nalbuphine dose and monitor for agitation, hyperthermia, clonus, sedation and hypotension.
What other medicines interact with Nalbuphine?
MediHelp also lists interactions of Nalbuphine with, for example, Alvimopan, Olanzapine / samidorphan, Alprazolam. The full list is on the Nalbuphine page.
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