The recommended dosage for Zyvox formulations for the treatment of infections is described in Table 10.
Click on icon to see table/diagram/image
Adult patients with infection due to MRSA should be treated with Zyvox 600 mg every 12 hrs.
In controlled clinical trials, the protocol-defined duration of treatment for all infections ranged from 7-28 days. Total treatment duration was determined by the treating physician based on site and severity of the infection, and on the patient's clinical response.
No dose adjustment is necessary when switching from IV to oral administration. Patients whose therapy is started with Zyvox IV injection may be switched to Zyvox tablets at the discretion of the physician, when clinically indicated.
Patients with Severe Renal Insufficiency (ie, CrCl <30 mL/min): No dose adjustment is required. Due to the unknown clinical significance of higher exposure (up to 10-fold) to the 2 primary metabolites of linezolid in patients with severe renal insufficiency, linezolid should be used with special caution in these patients and only when the anticipated benefit is considered to outweigh the theoretical risk.
As approximately 30% of a linezolid dose is removed during 3 hrs of hemodialysis, linezolid should be given after dialysis in patients receiving such treatment. The primary metabolites of linezolid are removed to some extent by hemodialysis, but the concentrations of these metabolites are still very considerably higher following dialysis than those observed in patients with normal renal function or mild to moderate renal insufficiency.
Therefore, linezolid should be used with special caution in patients with severe renal insufficiency who are undergoing dialysis and only when the anticipated benefit is considered to outweigh the theoretical risk. To date, there is no experience of linezolid administration to patients undergoing continuous ambulatory peritoneal dialysis (CAPD) or alternative treatments for renal failure (other than hemodialysis).
Patients with Hepatic Insufficiency: No dose adjustment is required. However, there are limited clinical data and it is recommended that linezolid should be used in such patients only when the anticipated benefit is considered to outweigh the theoretical risk.
Elderly: No dose adjustment is required.
IV Administration: Zyvox IV injection is supplied in single-use, ready-to-use infusion bags. Parenteral drug products should be inspected visually for particulate matter prior to administration. Check for minute leaks by firmly squeezing the bag. If leaks are detected, discard the solution, as sterility may be impaired.
Zyvox IV injection should be administered by IV infusion over a period of 30-120 min. Do not use this IV infusion bag in series connections. Additives should not be introduced into this solution. If Zyvox IV injection is to be given concomitantly with another drug, each drug should be given separately in accordance with the recommended dosage and route of administration for each product. In particular, physical incompatibilities resulted when Zyvox IV injection was combined with the following drugs during simulated Y-site administration: Amphotericin B, chlorpromazine HCl, diazepam, pentamidine isothionate, erythromycin lactobionate, phenytoin sodium and trimethoprim-sulfamethoxazole. Additionally, chemical incompatibility resulted when Zyvox IV injection was combined with ceftriaxone sodium.
If the same IV line is used for sequential infusion of several drugs, the line should be flushed before and after infusion of Zyvox IV injection with an infusion solution compatible with Zyvox IV injection and with any other drug(s) administered via this common line (see Compatible IV Solutions).
Compatible IV Solutions: 5% Dextrose Injection; 0.9% Sodium Chloride Injection; Lactated Ringer's Injection.