Major
fluvoxamine × Linezolid
SSRI×Oxazolidinone antibiotic
Mechanism
Linezolid is a reversible monoamine oxidase (MAO) inhibitor. Fluvoxamine (SSRI) raises synaptic serotonin. Co-administration: serotonin syndrome, fatal cases reported (FDA safety alert).
Symptoms
Serotonin syndrome: agitation, confusion, tremor, myoclonus, hyperreflexia. Autonomic features: sweating, tachycardia, fever.
Management
The combination is not prescribed. Stop fluvoxamine at least 2 weeks before linezolid. For urgent antibiotic therapy: vancomycin, daptomycin, or ceftaroline by susceptibility.
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.