CriticalSNRI×Oxazolidinone antibiotic
Updated · Methodology
Mechanism
Linezolid is a reversible monoamine oxidase (MAO) inhibitor. Duloxetine (SNRI) raises synaptic serotonin and norepinephrine. Co-administration: serotonin syndrome (FDA safety alert 2011, fatal cases reported).
Symptoms
Serotonin syndrome: agitation, confusion, tremor, myoclonus, hyperreflexia. Autonomic features: sweating, tachycardia, hypertension, fever. First signs appear within hours of co-administration.
Management
The AEMPS label for duloxetine says linezolid must not be given to patients on duloxetine. The combination is not prescribed. Stop duloxetine at least 5 days before starting linezolid. For urgent antibiotic therapy: vancomycin, daptomycin, or ceftaroline by susceptibility.
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
- AEMPS: Ficha técnica: Duloxetina (nº registro 86282), sección 4.5 (2026)– AEMPS, CIMA, nº registro 86282, sección 4.5