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Linezolid-SSRI serotonin syndrome — GPhC CRA MCQ

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HardInfection TherapeuticsLinezolid-SSRI serotonin syndromeGPhC CRA

A pharmacist is checking a discharge prescription for a patient who has completed a course of intravenous linezolid for a bone infection. The prescription includes continuation with oral linezolid 600 mg twice daily. The patient is also prescribed sertraline 100 mg daily for depression. What is the most important concern?

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Correct answer: C — Linezolid is a monoamine oxidase inhibitor and concurrent use with sertraline risks serotonin syndrome

Linezolid is a reversible, non-selective monoamine oxidase inhibitor (MAOI). Concurrent use with serotonergic drugs such as SSRIs (sertraline) carries a serious risk of serotonin syndrome, a potentially life-threatening condition characterised by agitation, hyperthermia, clonus, and autonomic instability. The BNF states that linezolid should not be given with SSRIs unless the patient can be closely monitored and the SSRI can be stopped.

Reference: BNF Linezolid; MHRA Drug Safety Update