Comprehensive medication guide to Linezolid including estimated pricing, availability information, side effects, and how to find it in stock at your local pharmacy.
Estimated Insurance Pricing
$30–$100+ copay after prior authorization approval; generic linezolid is typically Tier 3 or higher on most formularies. Most plans require ID specialist prescribing or consultation and documentation of step therapy failure.
Estimated Cash Pricing
$1,785–$1,927 retail for 14 tablets (600 mg) without a discount; as low as $33–$35 with a GoodRx or SingleCare coupon at CVS, Walgreens, Walmart, and Kroger. IV bags are distributed through hospital and specialty pharmacies and are not available at retail.
Medfinder Findability Score
45/100
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Linezolid is a synthetic antibiotic in the oxazolidinone class, best known by its brand name Zyvox. It was FDA-approved on April 18, 2000 — the first member of a new antibiotic class developed in decades — and remains one of the most important drugs for treating infections caused by drug-resistant gram-positive bacteria.
Linezolid is FDA-approved to treat hospital-acquired and community-acquired pneumonia, complicated and uncomplicated skin and skin structure infections, and vancomycin-resistant Enterococcus faecium (VRE) infections including those complicated by bacteremia. It is the only antibiotic with specific FDA approval for VRE infections. It is active against MRSA, VRE, Streptococcus pneumoniae, and other dangerous gram-positive pathogens.
Available as oral tablets (600 mg), oral suspension (100 mg/5 mL), and IV infusion bags (2 mg/mL), linezolid's near-100% oral bioavailability means patients can often step down from IV to oral therapy without losing efficacy. Generic linezolid has been available since approximately 2015.
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Linezolid works by inhibiting bacterial protein synthesis at the very beginning of the process. It binds to the 23S ribosomal RNA of the 50S ribosomal subunit, preventing formation of the functional 70S initiation complex required for bacterial protein production. This unique mechanism — targeting the initiation step rather than later stages — means bacteria resistant to other protein synthesis inhibitors (macrolides, aminoglycosides, tetracyclines) remain vulnerable to linezolid.
Linezolid is bacteriostatic against staphylococci and enterococci (it stops growth but relies on the immune system to clear them) and bactericidal against most streptococci. It has no activity against gram-negative bacteria due to their outer membrane structure. Additionally, linezolid acts as a reversible, non-selective MAO inhibitor, which gives rise to its significant interactions with serotonergic drugs and tyramine-containing foods.
600 mg — tablet
Standard adult dose for most indications; take every 12 hours with or without food
400 mg — tablet
Dose for uncomplicated skin and skin structure infections in adults
100 mg/5 mL — oral suspension
For patients unable to swallow tablets; orange-flavored; use within 21 days of mixing; invert gently to mix, do not shake
2 mg/mL (200 mg/100 mL) — IV infusion bag
IV formulation for hospitalized patients; 100 mL bag
2 mg/mL (600 mg/300 mL) — IV infusion bag
IV formulation for hospitalized patients and home infusion; 300 mL bag (currently subject to ASHP-listed shortage)
10 mg/kg (children <12 years) — weight-based dosing
Pediatric dosing: 10 mg/kg every 8 hours for children under 5 years; 10 mg/kg every 12 hours for children 5–11 years
Linezolid injection is currently on the ASHP active drug shortage list (first listed October 2024). The shortage specifically affects IV bag formulations from Pfizer (Zyvox brand) and Hikma due to manufacturing delays. Five other manufacturers (Eugia, Fresenius Kabi, Piramal Critical Care, Sandoz, Sun Pharma) have reported their linezolid injection products are available, meaning the impact is a supply disruption rather than a complete absence.
Oral linezolid tablets (600 mg) are not on the active shortage list and are more widely available at retail pharmacies. However, because linezolid is used primarily for serious infections, many community pharmacies do not stock large quantities and may need to order it. IV bags are only available through specialty and home infusion pharmacies, not retail locations.
Use medfinder to locate pharmacies near you that have linezolid in stock — medfinder calls pharmacies on your behalf and texts you results, saving you hours of phone calls.
Linezolid is not a controlled substance and can technically be prescribed by any licensed healthcare provider. However, due to its complex interaction profile, serious adverse effects, and the drug-resistant infections it treats, linezolid is almost always prescribed by or in consultation with an infectious disease specialist. Most insurance plans require ID specialist prescribing or consultation as a condition of prior authorization approval.
Clinicians who commonly prescribe linezolid include:
Telehealth prescribing of linezolid is limited — new prescriptions typically require in-person evaluation and laboratory results. Established patients may follow up via telehealth with their ID specialist for monitoring and refill authorization during a treatment course.
No. Linezolid is not a controlled substance and is not listed under any DEA drug schedule. Any licensed prescriber — physician, nurse practitioner, or physician assistant — can legally prescribe linezolid without DEA registration or specific controlled substance prescribing authority.
However, most insurance plans require prior authorization and prescribing by or consultation with an infectious disease specialist. This is not a DEA requirement but rather an insurer utilization management policy designed to ensure linezolid is used appropriately for drug-resistant infections. Linezolid can be prescribed for refills (up to 28 days is the typical authorized duration per prior authorization cycle), though refills beyond initial authorization will require reauthorization from the insurer.
Most patients experience at least one of the following common side effects during a standard 10–14 day course:
Serious side effects requiring immediate medical attention:
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Vancomycin
Glycopeptide antibiotic; first-line for most MRSA infections; IV only for systemic infections; not effective for VRE (which by definition is vancomycin-resistant)
Daptomycin (Cubicin)
Cyclic lipopeptide; used off-label for VRE bacteremia and MRSA infections; IV only; cannot treat pneumonia (inactivated by lung surfactant)
Tedizolid (Sivextro)
Newer oxazolidinone (same class as linezolid); once-daily dosing; FDA-approved for acute skin infections only; no generic available; significantly more expensive
Telavancin (Vibativ)
Lipoglycopeptide antibiotic; FDA-approved for MRSA hospital-acquired pneumonia and complicated skin infections; IV only; nephrotoxicity risk
Prefer Linezolid? We can find it.
SSRIs (fluoxetine, sertraline, escitalopram, paroxetine, citalopram)
majorRisk of life-threatening serotonin syndrome due to combined serotonin-raising effects. Generally should not be used together; if unavoidable, extremely close monitoring required.
SNRIs (venlafaxine, duloxetine, desvenlafaxine)
majorRisk of serotonin syndrome. Avoid concomitant use unless life-threatening infection makes it unavoidable.
MAO inhibitors (phenelzine, tranylcypromine, selegiline, rasagiline)
majorDangerous combination; risk of serotonin syndrome and hypertensive crisis. Wait at least 14 days after stopping an MAOI before starting linezolid.
Meperidine (Demerol)
majorHighest-risk opioid combination with linezolid; can cause serotonin syndrome rapidly. Contraindicated.
Tricyclic antidepressants (amitriptyline, nortriptyline, doxepin)
majorRisk of serotonin syndrome. Avoid unless absolutely necessary.
Pseudoephedrine and phenylephrine (decongestants)
majorRisk of hypertensive crisis. Avoid OTC cold and decongestant products while on linezolid.
Bupropion (Wellbutrin)
majorRisk of serotonin syndrome and seizures when combined with linezolid's MAO inhibitor activity.
Triptans (sumatriptan, rizatriptan, etc.)
majorRisk of serotonin syndrome due to combined serotonin-raising effects.
Insulin and oral hypoglycemic agents
moderateLinezolid may cause hypoglycemia in diabetic patients. Monitor blood glucose more frequently.
St. John's Wort
moderateHerbal supplement that raises serotonin; risk of serotonin syndrome when combined with linezolid.
Tyramine-rich foods (aged cheese, cured meats, soy sauce, red wine, tap beer)
majorFood-drug interaction; MAO inhibition prevents tyramine breakdown, causing dangerous blood pressure elevation.
Linezolid is one of the most clinically important antibiotics for drug-resistant gram-positive infections. Its unique mechanism of action, oral bioavailability equivalent to IV, and specific FDA approval for VRE make it irreplaceable in certain clinical scenarios. The 2026 IV injection shortage is a real challenge, particularly for patients requiring home infusion therapy, but oral linezolid tablets remain more widely available and can substitute for IV in most stable outpatient cases.
Cost is a major barrier for uninsured patients, with retail prices exceeding $1,800 for a 14-day course. However, free discount cards like GoodRx and SingleCare can reduce this to $33–$35 — one of the most dramatic price reductions available for any medication. Patients should always ask their pharmacist about discount card options before paying cash price.
If you're struggling to find linezolid in stock at your pharmacy, medfinder can help — we call pharmacies near you to confirm linezolid availability and text you the results, so you know exactly where to go before making the trip.
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Our medication guides are researched and written to help patients make informed decisions. All content is reviewed for accuracy and updated regularly. Learn more about our standards
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