Critical
Bupropion × Linezolid
Other antidepressants (NDRI)×Oxazolidinone antibiotic
Mechanism
Bupropion inhibits dopamine and norepinephrine reuptake. Linezolid reversibly inhibits MAO. Combined action raises monoamine levels, risking hypertensive crisis and seizures (bupropion lowers seizure threshold on its own).
Symptoms
Hypertension, tachycardia, tremor, agitation, headache. Seizures may occur, particularly in patients with prior epilepsy or eating disorders. Serotonin syndrome is less common unless other serotonergics are added.
Management
The combination is not prescribed. Stop bupropion 14 days before linezolid. As a smoking-cessation bridge during antibiotic therapy, use nicotine replacement or varenicline. Alternative antibiotics: vancomycin, daptomycin.
Check the full regimen, not just this pair
Opens the checker with these two drugs prefilled. Add the rest of the regimen and recompute additive risks.