Last update May 11, 2019

Linezolid

Likely Compatibility

Fairly safe. Mild or unlikely adverse effects. Compatible under certain circumstances. Follow-up recommended. Read Commentary.

An antibacterial oxazolidinone, indicated in the treatment of skin, soft tissue and lung infections by Gram-positive bacteria, including methicillin-resistant Staphylococcus aureus and vancomycin.
Oral or intravenous administration every 12 hours.
Its use is authorized in small infants and neonates.

It is excreted in breastmilk in moderate amounts which could be significant (Lim 2017, Rowe 2014, Sagirli 2009), but it is less than one tenth of the dose used in neonates and infants.

Possible side effects are not serious or frequent.

Several experts believe that the use of this medication is probably compatible during breastfeeding (Briggs 2017, Hale 2017 p563).

Be aware of false negative results of bacterial cultures obtained from febrile infants whose mothers are on antibiotics, as well as the possibility of gastroenteritis due to altered intestinal flora (Briggs 2017, Ito 1993).

Alternatives

  • Clindamycin (Safe product and/or breastfeeding is the best option.)
  • Doxycycline (Fairly safe. Mild or unlikely adverse effects. Compatible under certain circumstances. Follow-up recommended. Read Commentary.)
  • Minocycline (Fairly safe. Mild or unlikely adverse effects. Compatible under certain circumstances. Follow-up recommended. Read Commentary.)
  • Trimethoprim-Sulfamethoxazole (TMP-SMX; TMP-SMZ) (Safe product and/or breastfeeding is the best option.)
  • Vancomycin (Safe product and/or breastfeeding is the best option.)

Suggestions made at e-lactancia are done by APILAM team of health professionals, and are based on updated scientific publications. It is not intended to replace the relationship you have with your doctor but to compound it. The pharmaceutical industry contraindicates breastfeeding, mistakenly and without scientific reasons, in most of the drug data sheets.

Jose Maria Paricio, Founder & President of APILAM/e-Lactancia

Your contribution is essential for this service to continue to exist. We need the generosity of people like you who believe in the benefits of breastfeeding.

Thank you for helping to protect and promote breastfeeding.

José María Paricio, founder of e-lactancia.

Other names

Linezolid in other languages or writings:

Group

Linezolid belongs to this group or family:

Tradenames

Main tradenames from several countries containing Linezolid in its composition:

Pharmacokinetics

Variable Value Unit
Oral Bioavail. 100 %
Molecular weight 337 daltons
Protein Binding 31 %
VD 0.7 l/Kg
pKa 14.45 -
Tmax 1 - 2 hours
5 -7 hours
Theoretical Dose 0.53 - 2.8 mg/Kg/d
Relative Dose 2.6 - 14 %
Ped.Relat.Dose 1.7 - 9.3 %

References

  1. Algharably EA, Kreutz R, Gundert-Remy U. Infant Exposure to Antituberculosis Drugs via Breast Milk and Assessment of Potential Adverse Effects in Breastfed Infants: Critical Review of Data. Pharmaceutics. 2023 Apr 13;15(4). pii: 1228. Abstract Full text (link to original source)
  2. van Wattum JJ, Leferink TM, Wilffert B, Ter Horst PGJ. Antibiotics and lactation: An overview of relative infant doses and a systematic assessment of clinical studies. Basic Clin Pharmacol Toxicol. 2019 Jan;124(1):5-17. Abstract
  3. AEMPS-Accordpharma. Linezolid. Ficha técnica. 2018 Full text (in our servers)
  4. Lim FH, Lovering AM, Currie A, Jenkins DR. Linezolid and lactation: measurement of drug levels in breast milk and the nursing infant. J Antimicrob Chemother. 2017 Abstract
  5. Rowe HE, Felkins K, Cooper SD, Hale TW. Transfer of linezolid into breast milk. J Hum Lact. 2014 Abstract
  6. Mitrano JA, Spooner LM, Belliveau P. Excretion of antimicrobials used to treat methicillin-resistant Staphylococcus aureus infections during lactation: safety in breastfeeding infants. Pharmacotherapy. 2009 Sep;29(9):1103-9. Abstract
  7. Sagirli O, Onal A, Toker S, Oztunç A. Determination of linezolid in human breast milk by high-performance liquid chromatography with ultraviolet detection. J AOAC Int. 2009 Abstract
  8. Pfizer. Linezolid. Drug Summary. 2008 Full text (in our servers)
  9. Ito S, Blajchman A, Stephenson M, Eliopoulos C, Koren G. Prospective follow-up of adverse reactions in breast-fed infants exposed to maternal medication. Am J Obstet Gynecol. 1993 May;168(5):1393-9. Abstract

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