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Drug interactions

Linezolid + Protriptyline

Severity: Major

Linezolid and Protriptyline: 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 inhibits MAO, and protriptyline, a tricyclic antidepressant, inhibits serotonin and norepinephrine reuptake. Combined use raises the risk of serotonin syndrome and possibly hypertensive reactions.

What this interaction means in plain words

Linezolid and Protriptyline 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.

Evidence level: Moderate

Why it happens

Additive serotonergic and noradrenergic effects from MAO inhibition plus monoamine reuptake inhibition.

What to do

Avoid the combination and use an alternative antibiotic. If linezolid is required, stop protriptyline and monitor for serotonin toxicity, resuming it 24 hours after the last linezolid dose or after 2 weeks if no earlier.

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?

Bring a full list of your medicines, including over-the-counter products, supplements and herbal remedies, to every pharmacy visit.

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Frequently asked questions

Can I take Linezolid with Protriptyline?

MediHelp rates the interaction as major. Linezolid and Protriptyline 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 inhibits MAO, and protriptyline, a tricyclic antidepressant, inhibits serotonin and norepinephrine reuptake. Combined use raises the risk of serotonin syndrome and possibly hypertensive reactions.

How serious is the interaction between Linezolid and Protriptyline?

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 an alternative antibiotic. If linezolid is required, stop protriptyline and monitor for serotonin toxicity, resuming it 24 hours after the last linezolid dose or after 2 weeks if no earlier.

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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