Tedizolid
SIVEXTRO
Pronunciation: te-DIZ-oe-lid
What it isOxazolidinone inhibiting the 50S subunit; acute bacterial skin infection.
Why this oneOnce daily for six days rather than twice daily for ten, with less myelosuppression than linezolid.
What limits itIt is a weaker MAO inhibitor than linezolid but the caution remains. No Gram-negative cover.
FDA label
Read the full label on DailyMed ↗
| FDA dosing | Population | Start | Target | Max |
|---|---|---|---|---|
| Acute bacterial skin & skin structure infection (ABSSSI) | Adults | 200 mg QD | 200 mg QD | 200 mg QD |
| ABSSSI | Peds ≥35 kg (oral) | 200 mg QD | 200 mg QD | |
| ABSSSI (IV) | Peds ≥26 wk gestational age & ≥1 kg | weight-based IV QD | weight-based IV QD |
Renal Undefined
Hepatic Undefined
Instructions
- 6-day course, oral (with or without food) or IV infusion over 1 hour
- No dose adjustment when switching IV to oral
- Do not give Sivextro tablets to pediatric patients <35 kg
Available strengths
- tab 200 mg
- inj 200 mg
Cautions
- Serotonin syndrome reported with concomitant serotonergic agents — monitor; consider discontinuing
- Not adequately studied in neutropenia (<1000 cells/mm3) — consider alternatives
- C. difficile-associated diarrhea
Adverse reactions
- Adults: nausea, headache, diarrhea, infusion/injection-site reactions, vomiting, dizziness
- Peds: phlebitis, increased hepatic transaminases, injection reactions, vomiting
Pregnancy May cause fetal harm (animal data); human data insufficient — advise of potential risk
Lactation No human data; present in rat milk — weigh benefits vs need
Cost
| Strength | #/mo | generic $ | brand $ | CostPlus | |
|---|---|---|---|---|---|
| 200 mg | tab | 30 qd | — | $14,273.71/mo | not offered |
| 200 mg | inj | per unit | — | not offered |
Generic entry2030 est.
NO BOXED WARNINGS
Principal riskIt is a weaker MAO inhibitor than linezolid but the caution remains
Classes and tags
Clinical profile
Legacy pregnancy categoryC
Defining liabilityAllergy, gastrointestinal effects and agent-specific renal, hepatic, hematologic or interaction risks.
Serotonin and MAOI
Provisional washout figures
Elevating mechanismMAO-A inhibitor
Non-elevating actionNone recorded
Exposure dependenceUncertain/exposure dependent
Washout AFTER an MAOI1 days
Evidence confidenceModerate
InterpretationOxazolidinone with weaker/less certain clinically relevant MAO-A inhibition than linezolid.