Drug General Information (ID: DDIWET58UF)
  Drug Name Linezolid Drug Info Anisindione Drug Info
  Drug Type Small molecule Small molecule
  Therapeutic Class Antibiotics Anticoagulants
  Structure

 Mechanism of Linezolid-Anisindione Interaction (Severity Level: Moderate)
     Increased risk of bleeding Click to Show/Hide Mechanism Graph
Could Not Find 2D Structure
      Drug Name Linezolid Anisindione
      Mechanism Potentiate the hypoprothrombinemic effect of vitamin K antagonist Vitamin K antagonist
      Key Mechanism Factor 1
Factor Name Bleeding
Factor Description Patients may be at risk for bleeding when the outcome of a disease or disease treatment confounds the standard mechanisms for maintaining hemostasis. Signs or symptoms of abnormal bleeding include: bleeding that takes a long time to stop (including nosebleeds, bleeding gums, bleeding from cuts and abrasions, and menstrual bleeding); severe unexplained bruising, or bruising that becomes larger; blood in the urine or stool, etc.
      Mechanism Description
  • Increased risk of bleeding by the combination of Linezolid and Anisindione 

Recommended Action
      Management Until more data are available, caution may be advisable if linezolid is used in combination with warfarin. The INR should be checked frequently and warfarin dosage adjusted accordingly, particularly following initiation or discontinuation of linezolid in patients who are stabilized on their warfarin regimen. The same precaution may be applicable during therapy with other similar oral anticoagulants, although clinical data are lacking. Patients should be advised to promptly report any signs of bleeding to their doctor, including pain, swelling, headache, dizziness, weakness, prolonged bleeding from cuts, increased menstrual flow, vaginal bleeding, nosebleeds, bleeding of gums from brushing, unusual bleeding or bruising, red or brown urine, or red or black stools.

References
1 Product Information. Zyvox (linezolid) Pharmacia and Upjohn, Kalamazoo, MI.
2 Sakai Y, Naito T, Arima C, et al. "Potential drug interaction between warfarin and linezolid." Intern Med 54 (2015): 459-64
3 Kinoshita S, Wada K, Kuwahara T, et.al "Interaction between warfarin and linezolid in patients with left ventricular assist system in Japan." Intern Med 55 (2016): 719-24