CriticalSSRI×Oxazolidinone antibiotic
Updated · Methodology
Mechanism
Linezolid is a reversible monoamine oxidase (MAO) inhibitor. Fluvoxamine (SSRI) raises synaptic serotonin. Co-administration: serotonin syndrome, fatal cases reported (FDA safety alert).
Symptoms
Serotonin syndrome: agitation, confusion, tremor, myoclonus, hyperreflexia. Autonomic features: sweating, tachycardia, fever.
Management
The AEMPS label for fluvoxamine lists the combination with linezolid as contraindicated. The combination is not prescribed. Stop fluvoxamine at least 2 weeks before 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: Fluvoxamina (nº registro 63277), sección 4.3 (2024)– AEMPS, CIMA, nº registro 63277, sección 4.3