Drug interactions
Linezolid + Remifentanil
Severity: Major
Linezolid and Remifentanil: 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 cause serotonin syndrome or excitatory reactions. Remifentanil has minimal serotonin reuptake inhibition, but caution is needed because of the severity of the reaction.
What this interaction means in plain words
Linezolid and Remifentanil 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; Remifentanil belongs to Musculoskeletal.
Why it happens
MAO inhibition by linezolid increases serotonergic and monoamine activity, adding to opioid effects.
What to do
Avoid the combination if an alternative antibiotic or analgesic is feasible. If it is necessary, monitor closely for serotonin toxicity and stop the serotonergic agents if signs appear.
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 Remifentanil
- Alvimopan + Remifentanil Contraindicated
- Isocarboxazid + Remifentanil Contraindicated
- Olanzapine / samidorphan + Remifentanil Contraindicated
- Phenelzine + Remifentanil Contraindicated
- Benzhydrocodone / acetaminophen + Remifentanil Major
- Brexanolone + Remifentanil 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 Remifentanil?
MediHelp rates the interaction as major. Linezolid and Remifentanil 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 cause serotonin syndrome or excitatory reactions. Remifentanil has minimal serotonin reuptake inhibition, but caution is needed because of the severity of the reaction.
How serious is the interaction between Linezolid and Remifentanil?
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 if an alternative antibiotic or analgesic is feasible. If it is necessary, monitor closely for serotonin toxicity and stop the serotonergic agents if signs appear.
What other medicines interact with Remifentanil?
MediHelp also lists interactions of Remifentanil with, for example, Alvimopan, Isocarboxazid, Olanzapine / samidorphan. The full list is on the Remifentanil page.
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