Moderate
Bisoprolol × Linezolid
Selective beta-adrenergic blockers×Oxazolidinone antibiotic
Mechanism
Linezolid is a reversible MAO inhibitor. It does not directly block adrenergic signalling but may potentiate the hypotensive effect of beta-blockers in hypovolaemia or with the first dose.
Symptoms
Lower blood pressure, postural dizziness, fatigue. Older patients: fall risk. With additional antihypertensives: bradycardia (pulse below 60/min).
Management
The combination is acceptable for short linezolid courses (10–14 days) with blood pressure and pulse monitoring in the first 3 days. The main linezolid risk is serotonin syndrome with SSRI/SNRI (see those pairs).