Oral Linezolid Dosing for Adults
The recommended oral dose of linezolid for adults with normal renal function is 600 mg twice daily (every 12 hours) for most serious gram-positive infections. 1
Standard Dosing Regimen
600 mg orally every 12 hours is the established dose for treating complicated skin and soft tissue infections, pneumonia (both community-acquired and hospital-acquired), bacteremia, bone and joint infections, and central nervous system infections in adults with normal renal function. 1, 2
This dosing regimen applies whether linezolid is administered orally or intravenously, as the drug demonstrates complete bioavailability with oral administration. 3
Maximum plasma concentrations are typically achieved 1-2 hours after oral administration, and the elimination half-life is 5-7 hours, making twice-daily dosing appropriate for maintaining therapeutic concentrations. 3
Duration of Therapy by Indication
The duration varies based on infection type:
- Complicated skin and soft tissue infections: 7-14 days 2
- Pneumonia: 7-14 days 2
- Osteomyelitis: Minimum 8 weeks 2
- Meningitis: 2 weeks 2
- Brain abscess, subdural empyema, or spinal epidural abscess: 4-6 weeks 1, 2
- Infective endocarditis (resistant enterococci): Minimum 6 weeks 2
Important Clinical Considerations
No renal dose adjustment is required in patients with mild to severe renal impairment, though caution is advised in severe renal insufficiency requiring hemodialysis due to accumulation of metabolites. 3
Monitoring for thrombocytopenia is essential for treatment courses exceeding 14 days; complete blood counts should be checked weekly as reversible thrombocytopenia occurs in approximately 2.4% of patients, particularly with prolonged therapy. 4
Dietary restrictions apply: patients should avoid foods high in tyramine as linezolid is a weak, reversible monoamine oxidase inhibitor. 3, 4
Drug interactions: use caution when co-administering with adrenergic or serotonergic agents, as linezolid can potentiate their effects. 3, 4