Linezolid Injection and Bupropion: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Linezolid Injection
Bupropion
How we grade severity & evidence
Severity levels
- Contraindicated: These should generally not be used together.
- Major: Potentially serious — often needs a change or close monitoring.
- Moderate: Can be significant — usually manageable with monitoring.
- Minor: Usually limited clinical impact.
Evidence grades
- Established: Well documented — supported by controlled studies or strong clinical data.
- Probable: Good supporting evidence, though not definitively proven.
- Suspected: Some evidence suggests this interaction, but it is not well established.
- Possible: Limited or conflicting evidence; the interaction may occur.
- Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.
Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.
What happens
Increased risk of hypertensive reactions
Interaction Deep Dive
BuPROPion initiation in a patient treated with linezolid (reversible MAOI) is contraindicated due to an increased risk of hypertensive reactions. Do not start buPROPion in a patient who is being treated with linezolid. If acceptable alternatives to linezolid treatment are not available and the potential benefits of linezolid are judged to outweigh the risks of hypertensive reactions, buPROPion should be stopped promptly and linezolid can be administered. In nonurgent settings, discontinue buPROPion at least 14 days before beginning linezolid treatment. In urgent settings, promptly discontinue buPROPion and evaluate risks and benefits before administering linezolid. Monitor the patient for 2 weeks or 24 hours after the last dose of linezolid, whichever occurs first. BuPROPion may resume 24 hours after the last dose of linezolid23456.
Why it happens (mechanism)
Inhibition of the reuptake of DOPamine and norepinephrine by buPROPion
Literature reports
1 report — tap to read
a) In a retrospective cohort study in older adults who were prescribed oral linezolid 600 mg twice daily (N=1134), serotonin syndrome occurred in fewer than 6 patients (less than 0.5%) who were taking a concomitant antidepressant (n=215). In the propensity score-matched cohort (n=332), there was no difference in the risk of clinically significant serotonin syndrome in patients taking concomitant antidepressants and linezolid compared with patients taking linezolid without antidepressants (adjusted risk difference, -1.2%; 95% CI, -2.9% to 0.5%). There was also no difference in the rate of altered mental status or confusion, hospitalization, or death from any cause between groups. Patients were aged 66 years or older, and of those taking an antidepressant, 47.9% were taking an SSRI, 16.7% were taking an SNRI, 7% were taking a tricyclic antidepressant, 3.3% were taking a norepinephrine and dopamine reuptake inhibitor, and none were taking an MAOI 1.
Common questions
Can I take Linezolid Injection and Bupropion together?
Increased risk of hypertensive reactions Always confirm with your pharmacist or prescriber before making any change.
How serious is the Linezolid Injection and Bupropion interaction?
It is rated contraindicated. These should generally not be used together.
How quickly could this interaction happen?
The documented onset is "unspecified". The timing of this interaction is not well characterized.
How strong is the evidence for this interaction?
The evidence is graded "theoretical". Predicted from the drugs' pharmacology; not yet confirmed in people.
From our Q&A
Real reader questions about these medications, each personally answered by our pharmacist:
Questions for your pharmacist
- Does my dose of Linezolid Injection or Bupropion need adjusting while I take them together?
- What symptoms should prompt me to call you or my prescriber right away?
- Does the timing of my doses matter for this combination?
- Is there a safer alternative to one of these medications for me?
References (6)
- Bai AD, McKenna S, Wise H, et al: Association of linezolid with risk of serotonin syndrome in patients receiving antidepressants. JAMA Netw Open 2022; 5(12):e2247426. DOI
- Product Information: APLENZIN(R) oral extended-release tablets, bupropion hydrobromide oral extended-release tablets. Bausch Health US LLC (per FDA), Bridgewater, NJ, 2024. DailyMed
- Product Information: WELLBUTRIN XL(R) oral extended-release tablets, bupropion hydrochloride oral extended-release tablets. Bausch Health US, LLC (per FDA), Bridgewater, NJ, 2024. DailyMed
- Product Information: WELLBUTRIN(R) SR oral sustained-release tablets, bupropion hydrochloride oral sustained-release tablets. GlaxoSmithKline (per FDA), Durham, NC, 2024. DailyMed
- Product Information: WELLBUTRIN(R) oral tablets, bupropion hydrochloride oral tablets. GlaxoSmithKline (per FDA), Durham, NC, 2024. DailyMed
- Product Information: FORFIVO XL(R) oral extended-release tablets, bupropion hydrochloride oral extended-release tablets. TWi Pharmaceuticals USA, Inc (per FDA), Paramus, NJ, 2024. DailyMed
Keep reading about Linezolid Injection
Keep reading about Bupropion
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