Key result
Concurrent administration of linezolid and digoxin resulted in high serum concentrations of both drugs and thrombocytopenia, requiring significant dose reductions.
Why the study?
Digoxin requires therapeutic drug monitoring due to its narrow therapeutic range, and linezolid can cause variable exposures owing to potential drug-drug interactions.
Case Report (n=1)
Concurrent use of linezolid and digoxin may result in a significant drug-drug interaction causing elevated serum levels and toxicity, highlighting the need for therapeutic drug monitoring.
May warrant TDM and dose adjustments with concurrent linezolid-digoxin; case report leaves open confirmation in larger studies.
Drug-drug interactions lead to altered clinical effects, including adverse reactions. Therapeutic drug monitoring of digoxin is necessary due to its narrow therapeutic range. Linezolid can cause variable exposures in patients hospitalized in the intensive care unit owing to its possibility of drug-drug interactions. We present a patient with pneumonia and heart failure who experienced a possible drug interaction between linezolid and digoxin, resulting in high serum concentrations of both drugs. Also, the patient developed thrombocytopenia likely related to linezolid. The linezolid dose required to maintain sufficient levels had to reduce to 50% of the usual linezolid dose. A quarter dose of the standard digoxin dose was needed. Although the underlying mechanism of the drug interaction is unclear, we recommend conducting therapeutic drug monitoring when linezolid and digoxin are administered concurrently.
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Zhu et al. (2020) conducted a case report in Pneumonia and heart failure (n=1). Concurrent administration of linezolid and digoxin was evaluated. Concurrent administration of linezolid and digoxin resulted in high serum concentrations of both drugs and thrombocytopenia, requiring significant dose reductions.
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