Arlin 400

Indications

Arlin is prescribed to treat:

• Nosocomial pneumonia
• Community-acquired pneumonia
• Complicated skin and skin structure infections, including diabetic foot infections (excluding cases with concomitant osteomyelitis)
• Uncomplicated skin and skin structure infections
• Vancomycin-resistant Enterococcus faecium infections

Limitations: Arlin is not effective against Gram-negative infections. Its safety and efficacy for use beyond 28 days have not been established.

Pharmacology

Arlin contains linezolid, a synthetic antibiotic in the oxazolidinone class. Linezolid targets Gram-positive bacteria by inhibiting bacterial protein synthesis through binding to the 23S ribosomal RNA of the 50S ribosomal subunit. This action prevents the formation of the 70S initiation complex, crucial for bacterial protein synthesis. Linezolid exhibits bacteriostatic activity against enterococci and staphylococci, and bactericidal activity against most streptococci strains. Metabolism of linezolid does not significantly alter its efficacy or safety.

Dosage & Administration

• Tablets: Administer orally with or without food. The dosage varies based on infection type and patient age:
  • Nosocomial pneumonia: 600 mg every 12 hours (adults) or 10 mg/kg every 8 hours (pediatric patients).
  • Community-acquired pneumonia & complicated skin infections: 600 mg every 12 hours (adults) or 10 mg/kg every 8 hours (pediatric patients).
  • Uncomplicated skin infections: 400 mg every 12 hours (adults) or 10 mg/kg every 12 hours (pediatric patients).
• IV Infusion: Administer over 30 to 120 minutes. The IV solution should be inspected for particulate matter and should not be used with additives or in series connections.

Interactions

Arlin is a reversible, nonselective monoamine oxidase (MAO) inhibitor and may interact with adrenergic and serotonergic agents. Avoid concurrent use with MAO inhibitors, sympathomimetic agents, and certain antidepressants. Advise patients to limit tyramine-rich foods and beverages.

Contraindications

Arlin is contraindicated in patients with hypersensitivity to linezolid or other components, those using MAO inhibitors, or those with uncontrolled hypertension, pheochromocytoma, thyrotoxicosis, or carcinoid syndrome.

Side Effects

Common adverse effects include diarrhea, headache, and nausea. Other potential effects are oral and vaginal moniliasis, hypertension, dyspepsia, localized abdominal pain, pruritus, and tongue discoloration.

Pregnancy & Lactation

• Pregnancy: Use only if the benefits outweigh potential risks, as data on linezolid during pregnancy is limited.
• Lactation: Linezolid is present in breast milk. Monitor breastfed infants for possible side effects such as diarrhea and vomiting.

Precautions & Warnings

Regular monitoring of blood counts is recommended for patients on Arlin, especially those with myelosuppression or those on long-term therapy. Monitor for visual disturbances and potential increases in blood pressure. Discontinue if symptoms of Clostridium difficile-associated diarrhea (CDAD) occur. Reassess insulin or oral hypoglycemic agents if hypoglycemia develops.

Overdose Effects

In cases of overdose, provide symptomatic and supportive care. Linezolid is partially removed by hemodialysis, though no data is available for peritoneal dialysis.

Therapeutic Class

Macrolides

Reconstitution

For oral suspension: Add 75 ml of boiled and cooled water to the powder in the bottle, shaking well after each addition. Store the reconstituted suspension in a cool, dry place and use within 21 days.

For IV administration: Use the ready-to-use infusion bottles at room temperature, avoiding freezing. The infusion solution may become yellow over time, which does not affect its potency.

Storage Conditions

Store Arlin at room temperature (15°C-30°C), away from light and moisture. Keep out of reach of children.