ModerateClass III antiarrhythmics (Vaughan Williams)×Oxazolidinone antibiotic
Updated · Methodology
Mechanism
Linezolid mildly prolongs QT, additively with amiodarone. Clinically significant arrhythmia is rare, but risk is higher with hypokalaemia, hypomagnesaemia, and bradycardia.
Symptoms
QT prolongation on ECG. Dizziness, syncope, palpitations. Rarely: polymorphic ventricular tachycardia (torsades de pointes). Risk is higher with hypokalaemia, hypomagnesaemia, bradycardia, and ischaemic heart disease.
Management
For short linezolid courses (10–14 days), check ECG before start and one week in. Keep potassium and magnesium in the upper half of the normal range. In atrial fibrillation with prior ventricular arrhythmia, alternatives: vancomycin or daptomycin.
Check the full regimen, not just this pair
Opens the checker with these two drugs prefilled. Add the rest of the regimen and recompute additive risks.
Summary of a multi-drug list →
Medicine list: everything you take in one place →
Sources
- FDA: Zyvox (linezolid) prescribing information (2018)– ; DailyMed setid 6e70e63b-bfd5-478d-a8ee-8ba22c9efabd