Drug interactions
Linezolid + St john's wort
Severity: Major
Linezolid and St john's wort: 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
St John's wort has serotonergic effects and linezolid inhibits MAO. Combined use can precipitate serotonin syndrome.
What this interaction means in plain words
Linezolid and St john's wort 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.
Why it happens
Additive serotonergic effect from MAO inhibition and inhibition of serotonin reuptake by St John's wort.
What to do
Stop St John's wort before and during linezolid therapy. Monitor for signs of serotonin toxicity if exposure has occurred.
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 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 St john's wort?
MediHelp rates the interaction as major. Linezolid and St john's wort 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. St John's wort has serotonergic effects and linezolid inhibits MAO. Combined use can precipitate serotonin syndrome.
How serious is the interaction between Linezolid and St john's wort?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Stop St John's wort before and during linezolid therapy. Monitor for signs of serotonin toxicity if exposure has occurred.
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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