CriticalSelective serotonin reuptake inhibitors (SSRIs)×Oxazolidinone antibiotic
Updated · Methodology
Mechanism
Escitalopram (SSRI) raises synaptic serotonin. Linezolid reversibly inhibits MAO. Co-administration sharply amplifies serotonergic transmission. The FDA boxed warning applies to all SSRIs paired with linezolid.
Symptoms
Serotonin syndrome: agitation, confusion, tremor, myoclonus, hyperreflexia, dilated pupils. Autonomic features: profuse sweating, tachycardia, hypertension, fever above 38.5 °C. Severe cases progress to seizures, rhabdomyolysis, disseminated intravascular coagulation, and death. First signs appear within hours of concurrent dosing.
Management
The combination is not prescribed. Stop escitalopram at least 2 weeks before linezolid. If urgent antibiotic therapy is needed, use vancomycin, daptomycin, or ceftaroline based on 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
- FDA: Zyvox (linezolid) prescribing information (2018)– ; DailyMed setid 6e70e63b-bfd5-478d-a8ee-8ba22c9efabd
- AEMPS: Ficha técnica: Escitalopram (nº registro 71430), sección 4.5 (2021)– AEMPS, CIMA, nº registro 71430, revisión 03/2021, sección 4.5
- AEMPS: Ficha técnica: Linezolid (nº registro 81569), sección 4.5 (2026)– AEMPS, CIMA, nº registro 81569, revisión 05/2026, sección 4.5