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Zyvox, Zyvoxam (CA)
Pharmacologic class: Oxazolidinone
Therapeutic class: Anti-infective
Pregnancy risk category C
Selectively binds to bacterial 23S ribosomal RNA of 50S subunit, preventing formation of essential component of bacterial protein synthesis. Bacteriostatic or bactericidal against gram-positive and some gram-negative bacteria.
Injection: 2 mg/ml
Powder for oral suspension: 100 mg/5 ml
Tablets: 400 mg, 600 mg
⊘Indications and dosages
➣ Vancomycin-resistant Enterococcus faecium infections
Adults and children ages 12 and older: 600 mg P.O. or I.V. infusion q 12 hours for 14 to 28 days
Children from birth to age 11: 10 mg/kg I.V. q 8 hours for 14 to 28 days
➣ Nosocomial pneumonia; community-acquired pneumonia; complicated skin and skin-structure infections
Adults and children ages 12 and older: 600 mg P.O. or I.V. infusion q 12 hours for 10 to 14 days
Children from birth to age 11: 10 mg/kg P.O. or I.V. q 8 hours for 10 to 14 days
➣ Uncomplicated skin and soft-tissue infections
Adults: 400 mg P.O. q 12 hours for 10 to 14 days
Adolescents: 600 mg P.O. or I.V. q 12 hours for 10 to 14 days
Children ages 5 to 11: 10 mg/kg P.O. or I.V. q 12 hours for 10 to 14 days
Children younger than age 5: 10 mg/kg P.O. or I.V. q 8 hours for 10 to 14 days
• Hypersensitivity to drug or its components
Use cautiously in:
• hepatic dysfunction, hypertension, hyperthyroidism, pheochromocytoma, bone marrow depression, pseudomembranous colitis
• phenylketonuria (oral suspension only)
• pregnant or breastfeeding patients.
• Give oral drug with or without food.
• For I.V. injection, use single-use, ready-to-use infusion bag. Check for particulate matter before giving. Infuse over 30 minutes to 2 hours.
• For I.V. infusion, mix with dextrose 5% in water, normal saline solution, or lactated Ringer's injection.
• Flush I.V. line before and after administering, to avoid incompatibilities.
CNS: anxiety, confusion, difficulty speaking, dizziness, hallucinations, lethargy, paresthesia, light-headedness, fatigue, drowsiness, headache, seizures
GI: nausea, vomiting, diarrhea, gastritis, anorexia, dry mouth, pseudomembranous colitis
Skin: rash, photosensitivity, diaphoresis
Other: fever, fungal infections
Drug-drug.Antiplatelet drugs (such as aspirin, dipyridamole, nonsteroidal anti-inflammatory drugs): increased bleeding risk
MAO inhibitors, pseudoephedrine: increased risk of hypertension and associated adverse effects
Serotonergics: serotonin syndrome
Drug-diagnostic tests.Prothrombin time: altered
Drug-food.Tyramine-containing foods and beverages (such as beer; Chianti and certain other red wines; aged cheese; bananas; aged, cured, or spoiled meats; salted herring and other dried fish; avocado; bean curd; red plums; soy sauce; spinach; tofu, tomatoes; yeast): hypertension
• Monitor neurologic status. Institute safety measures as needed to prevent injury.
• Check I.V. site for infiltration.
☞ Watch for bleeding and signs and symptoms of other adverse reactions (especially pseudomembranous colitis).
• Monitor CBC, coagulation studies, and culture and sensitivity tests.
• Tell patient he may take with or without food, but should avoid foods containing tyramine.
☞ Tell patient to promptly report bleeding or severe diarrhea.
• Instruct patient to minimize adverse GI effects by eating small, frequent servings of healthy food.
• Caution patient to avoid driving and other hazardous activities until he knows how drug affects concentration and alertness.
• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs, tests, and foods mentioned above.