Select a medication above to begin.
Zurzuvae
zuranolone
Black Box Warnings .
Impaired Ability to Drive or Engage in Other Potentially Hazardous Activities
causes driving impairment due to CNS depressant effects; advise pts not to drive or engage in other potentially hazardous activities for at least 12h after each dose; inform pts they may not be able to assess driving competence or degree of impairment
Adult Dosing .
Dosage forms: CAP: 20 mg, 25 mg, 30 mg
postpartum depression
- [50 mg PO qpm x14 days]
- Info: give w/ fat-containing food; may decr. dose to 40 mg PO qpm if CNS depression occurs
renal dosing
- [adjust dose amount]
- eGFR 15-59: 30 mg qpm x14 days; eGFR <15: not defined
- HD/PD: not defined
hepatic dosing
- [adjust dose amount]
- Child-Pugh Class C: 30 mg qpm x14 days
Peds Dosing .
Peds dosing is currently unavailable or not applicable for this drug.
Contraindications / Cautions .
- hypersensitivity to drug or ingredient
- avoid: driving for at least 12h after dose
- caution: female pts of reproductive potential
- caution: pts <25 yo
- caution: CNS depressant use, concurrent
- caution: alcohol use, concurrent
- caution: substance abuse hx
- caution: eGFR <60
- caution: hepatic impairment, Child-Pugh Class C
Drug Interactions .
Overview
zuranolone
GABA modulator
- CYP3A4 substrate
- CNS depression
Avoid/Use Alternative
- 5-HTP
- aldesleukin
- alfentanil
- allopurinol
- almotriptan
- alprazolam
- amantadine
- amitriptyline
- amoxapine
- apalutamide
- apomorphine
- apraclonidine ophthalmic
- aripiprazole bimonthly injection
- aripiprazole lauroxil
- aripiprazole monthly injection
- aripiprazole oral
- armodafinil
- artemether/lumefantrine
- asenapine
- baclofen
- baclofen intrathecal
- belzutifan
- bexarotene
- bosentan
- brexpiprazole
- brigatinib
- brimonidine ophthalmic
- brimonidine topical
- brivaracetam
- bromocriptine
- brompheniramine
- buprenorphine
- buspirone
- butalbital
- butorphanol
- cannabidiol
- cannabis
- carbamazepine
- carbinoxamine
- cariprazine
- carisoprodol
- cenobamate
- ceritinib
- cetirizine
- chamomile, German
- chlophedianol
- chlordiazepoxide
- chlorpheniramine
- chlorpromazine
- chlorzoxazone
- clemastine
- clobazam
- clomipramine
- clonazepam
- clonidine
- clorazepate
- clozapine
- codeine
- cyclobenzaprine
- cyproheptadine
- dabrafenib
- danshen
- dantrolene
- daridorexant
- darifenacin
- darolutamide
- desflurane
- desipramine
- deutetrabenazine
- dexamethasone
- dexbrompheniramine
- dexchlorpheniramine
- dexmedetomidine
- dexmedetomidine injection
- diazepam
- dichlorphenamide
- dicloxacillin
- difelikefalin
- difenoxin
- dihydrocodeine
- dimenhydrinate
- diphenhydramine
- diphenoxylate
- domperidone
- doxepin
- doxepin topical
- doxylamine
- dronabinol
- droperidol
- echinacea
- efavirenz
- elafibranor
- elagolix
- eletriptan
- enasidenib
- encorafenib
- entacapone
- entrectinib
- enzalutamide
- esketamine
- eslicarbazepine acetate
- estazolam
- eszopiclone
- ethanol
- ethanol (in some formulations)
- ethosuximide
- etomidate
- etravirine
- felbamate
- fenfluramine
- fentanyl
- fesoterodine
- fexinidazole
- flibanserin
- fluphenazine
- flurazepam
- fosamprenavir
- foslevodopa
- fosphenytoin
- frovatriptan
- gabapentin
- gabapentin enacarbil
- ganaxolone
- garlic
- ginkgo
- ginseng, Asian
- glofitamab
- glycerol phenylbutyrate
- glycopyrrolate
- griseofulvin
- guanfacine
- haloperidol
- hydrocodone
- hydromorphone
- hydroxyzine
- hyoscyamine
- ifosfamide
- iloperidone
- imipramine
- isocarboxazid
- isoflurane
- ivosidenib
- kava
- ketamine
- kratom
- lacosamide
- lamotrigine
- lasmiditan
- lemborexant
- levetiracetam
- levocetirizine
- levodopa
- levorphanol
- lofexidine
- lorazepam
- lorlatinib
- loxapine
- lumacaftor/ivacaftor
- lumateperone
- lurasidone
- mavacamten
- meclizine
- melatonin
- meperidine
- meprobamate
- metaxalone
- methadone
- methocarbamol
- methohexital
- methsuximide
- methyldopa
- metoclopramide
- metyrapone
- metyrosine
- midazolam
- milnacipran
- mitapivat
- mitotane
- mobocertinib
- modafinil
- molindone
- morphine
- mosunetuzumab
- mycophenolate mofetil
- nafcillin
- nalbuphine
- naltrexone
- naratriptan
- nelarabine
- nevirapine
- nortriptyline
- olanzapine
- oliceridine
- olutasidenib
- omaveloxolone
- opicapone
- opium
- orphenadrine
- oxazepam
- oxcarbazepine
- oxybate
- oxybutynin
- oxycodone
- oxymorphone
- pacritinib
- paliperidone
- passion flower
- pentazocine
- pentobarbital
- perampanel
- perphenazine
- pexidartinib
- phenelzine
- pheniramine
- phenobarbital
- phenytoin
- pimozide
- pioglitazone
- pramipexole
- prednisone
- pregabalin
- primidone
- procarbazine
- prochlorperazine
- promethazine
- propofol
- protriptyline
- pyrilamine
- quazepam
- quetiapine
- ramelteon
- rasagiline
- remifentanil
- remimazolam
- repotrectinib
- rifabutin
- rifampin
- rifapentine
- risperidone
- rizatriptan
- ropeginterferon alfa-2b
- ropinirole
- rotigotine transdermal
- rufinamide
- safinamide
- sarilumab
- scopolamine
- selegiline
- selegiline transdermal
- selinexor
- sevoflurane
- solifenacin
- somatropin
- sotorasib
- St. John's wort
- stiripentol
- sufentanil
- sumatriptan
- suvorexant
- suzetrigine
- tapentadol
- tasimelteon
- tazemetostat
- tecovirimat
- telotristat ethyl
- temazepam
- tetrabenazine
- thalidomide
- thioridazine
- thiotepa
- thiothixene
- tiagabine
- tizanidine
- tocilizumab
- tolcapone
- tolterodine
- topiramate
- tovorafenib
- tramadol
- tranylcypromine
- triazolam
- trifluoperazine
- trihexyphenidyl
- trimethobenzamide
- trimipramine
- triprolidine
- trospium
- valbenazine
- valerian
- valproic acid
- vamorolone
- vemurafenib
- vigabatrin
- viloxazine
- vinblastine
- vorasidenib
- zaleplon
- zanubrutinib
- ziconotide
- ziprasidone
- zolmitriptan
- zolpidem
- zonisamide
Monitor/Modify Tx
- adagrasib
- atazanavir
- chloramphenicol
- clarithromycin
- cobicistat
- idelalisib
- itraconazole
- ketoconazole
- levoketoconazole
- lonafarnib
- lopinavir/ritonavir
- mifepristone
- mirtazapine
- nefazodone
- nelfinavir
- posaconazole
- ribociclib
- ritonavir
- tipranavir
- tucatinib
- voriconazole
Caution Advised
- citalopram
- desvenlafaxine
- duloxetine
- escitalopram
- fluoxetine
- fluvoxamine
- levomilnacipran
- meropenem
- paroxetine
- sertraline
- trazodone
- vaborbactam
- venlafaxine
- vilazodone
Adverse Reactions .
Serious Reactions
- CNS depression
- confusion, severe
- suicidality
- depression exacerbation
- abuse
- dependency
Common Reactions
- somnolence
- dizziness
- nasopharyngitis
- diarrhea
- fatigue
- UTI
- xerostomia
- impaired memory
- abdominal pain
- sinus congestion
- tremor
- hypoesthesia
- muscle twitching
- myalgia
- anxiety
- rash
Safety/Monitoring .
Monitoring Parameters
eGFR at baseline; s/sx depression, behavior changes, suicidality
Pregnancy/Lactation .
Pregnancy
Clinical Summary
weigh risk/benefit during pregnancy; inadequate human data available; risk of developmental toxicity, incl. embryo-fetal death and fetal malformations, based on animal data at >7x MRHD; possible risk of fetal neurodegeneration based on animal data at >1x MRHD
Pregnancy Registry
encourage pts to enroll in National Pregnancy Registry for Antidepressants at 1-844-405-6185 or www.womensmentalhealth.org/research/pregnancyregistry/antidepressants
Individuals of Reproductive Potential
avoid pregnancy by using effective contraception during tx and x1wk after D/C in female pts
Lactation
Clinical Summary
weigh risk/benefit while breastfeeding; no human data available to assess risk of infant harm, though drug excreted into milk; no human data available to assess effects on milk production
Pharmacology .
Metabolism: liver extensively; CYP450: 3A4 substrate
Excretion: urine 45%, feces 41% (<2% unchanged); Half-life: 19.7-24.6h
Subclass: Allopregnanolone Analogs
Mechanism of Action
exact mechanism of action unknown; neuroactive steroid provides positive allosteric modulation of GABA-A receptors
Formulary .
No Formulary Selected
Join Now to View Patient Handouts!
Create a FREE epocrates Online account to access patient medication instructions. Your patients and caregivers will appreciate you printing these friendly handouts, available in English and Spanish. Each handout addresses common concerns such as how to take the medication, and possible side effects.
Current Members: Sign In.
Pill Pictures
Join Now to View Pill Pictures!
Create a FREE epocrates Online account to access full-color images of medications within the drug monograph.
Current Members: Sign In.