UMEM Educational Pearls

Category: Pharmacology & Therapeutics

Title: On your radar: methadone-linezolid drug-drug interaction

Keywords: methadone, linezolid, serotonin syndrome, drug interaction (PubMed Search)

Posted: 4/1/2017 by Michelle Hines, PharmD (Updated: 4/3/2017)
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Linezolid is a weak, nonselective monoamine oxidase inhibitor (MAOI). A recent FDA Drug Safety Communication released in March 2016 noted reports of serotonin syndrome associated with certain opioids, particularly fentanyl and methadone. Development of serotonin syndrome after concomitant administration of linezolid with other serotonergic agents has been reported. Due to a potential risk of serotonin syndrome, a patient on chronic methadone should not be started on concomitant linezolid unless they will be monitored.


  1. FDA Drug Safety Communication from 3/22/2016:
  2. Product Information: DOLOPHINE(R) oral tablets, methadone HCl oral tablets. West-Ward Pharmaceuticals Corp. (per FDA), Eatontown, NJ, 2016.
  3. Product Information: ZYVOX(R) intravenous injection, oral tablets, oral suspension, linezolid intravenous injection, oral tablets, oral suspension. Pharmacia & Upjohn Co (per FDA), New York, NY, 2013.

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