Zurzuvae is a brand-name oral capsule prescribed for postpartum depression. Zurzuvae contains the active drug zuranolone and belongs to the neuroactive steroid antidepressant drug class.

Zurzuvae is FDA-approved to help treat postpartum depression in adults.

Drug details

You’ll find key information about Zurzuvae below.

  • Drug class: neuroactive steroid gamma-aminobutyric acid (GABA) type A receptor modulator
  • Drug form: oral capsule
  • Generic available? no
  • Prescription required? yes
  • Controlled substance? yes
  • Year of FDA approval: 2023

Zurzuvae is available only as a brand-name medication. It’s not currently available in generic form.

A generic drug is an exact copy of the active drug in a brand-name medication. Generics usually cost less than brand-name drugs.

The Zurzuvae dosage your doctor prescribes will depend on several factors. These include:

  • other medical conditions you may have
  • other medications you may take
  • whether you have bothersome side effects with Zurzuvae

The following information describes dosages that are commonly used or recommended. However, be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to fit your needs.

Drug forms and strengths

Zurzuvae comes as a capsule that you swallow. It’s available in three strengths: 20 milligrams (mg), 25 mg, and 30 mg.

Dosage for postpartum depression

The recommended dosage of Zurzuvae for adults is 50 mg once every evening for 14 days.

If you have bothersome side effects, such as sleepiness, your doctor may reduce your dosage to 40 mg once every evening.

About taking Zurzuvae

Below you’ll find information about key dosage issues.

  • When to take. You should take Zurzuvae with your evening meal. Taking the medication around the same time of day helps keep a steady level of the drug in your body. This helps Zurzuvae work effectively.
  • If you miss a dose. If you miss a dose in the evening, skip the missed dose. Take your next dose as usual the following evening. Do not take two doses together to make up for missing a dose. And do not take any extra doses. Doing so can increase your risk of side effects.
  • Taking Zurzuvae with food. You should take Zurzuvae with food that’s high in fat. This helps the body to absorb the drug, which makes it more effective. You should take it with a meal containing about 400–1,000 calories and around 25–50% fat. You can ask your doctor or pharmacist for advice on the types of food you should eat.
  • Crushing, splitting, or chewing Zurzuvae. Zurzuvae is meant to be swallowed whole. The manufacturer doesn’t state whether you can crush, split, or chew Zurzuvae capsules. If you have trouble swallowing the capsules, talk with your doctor or pharmacist.
  • Length of use. Zurzuvae is meant to be used as a short-term course of treatment. You’ll typically take it for 14 days only.

Overdose

Taking more than the recommended dosage of Zurzuvae can lead to serious side effects. Do not take more Zurzuvae than your doctor recommends.

Overdose symptoms

Symptoms of an overdose can include:

  • severe sleepiness
  • reduced consciousness

What to do in case of overdose

If you think you’ve taken too much of this drug, call your doctor. You can also call America’s Poison Centers at 800-222-1222 or use its online tool. However, if your symptoms are severe, call 911 or your local emergency number or go to the nearest emergency room right away.

Zurzuvae can cause mild or serious side effects. The following lists contain some of the key side effects that may occur while taking Zurzuvae. These lists do not include all possible side effects.

For more information about the possible side effects of Zurzuvae, talk with your doctor or pharmacist. They can give you tips on how to manage any side effects that may be concerning or bothersome.

Note: The Food and Drug Administration (FDA) tracks side effects of drugs it has approved. If you’d like to notify the FDA about a side effect you’ve had with Zurzuvae, you can do so through MedWatch.

Mild side effects

Below is a partial list of mild side effects of Zurzuvae. To learn about other mild side effects, talk with your doctor or pharmacist or view Zurzuvae’s prescribing information.

Mild side effects of Zurzuvae can include:

Most of these side effects may go away within a few days to a couple of weeks. However, if they become more severe or don’t go away, talk with your doctor or pharmacist.

* For more information about allergic reaction and Zurzuvae, see “Allergic reaction” below.

Serious side effects

Serious side effects from Zurzuvae aren’t common, but they can occur. Call your doctor right away if you have serious side effects. Call 911 or your local emergency number if your symptoms feel life threatening or if you think you’re having a medical emergency.

Serious side effects and their symptoms can include:

  • Possible risk of suicidal thoughts or behavior in people under age 25 years. Symptoms can include:
    • worsening depression
    • new or worsening anxiety, irritability, or agitation
    • new or increased trouble sleeping
    • extreme levels of excitement and activity, or talking very fast
    • new or increased thoughts about dying or harming yourself
    • trying to harm yourself or attempt suicide
  • Central nervous system depression (slowed activity in your brain and nerves). Symptoms can include:
    • severe sleepiness
    • reduced awareness
    • slowed thinking
    • confusion
    • dizziness
    • unsteadiness and trouble walking
  • Impaired ability to drive.*
  • Severe allergic reaction.†

* Zurzuvae has a boxed warning for this side effect. This is the most serious warning from the FDA. To learn more, see the “Zurzuvae precautions” section below.
† For details about allergic reaction and Zurzuvae, see “Allergic reaction” below.

Suicide prevention

If you know someone at immediate risk of self-harm, suicide, or hurting another person:

  • Ask the tough question: “Are you considering suicide?”
  • Listen to the person without judgment.
  • Call 911 or the local emergency number, or text TALK to 741741 to communicate with a trained crisis counselor.
  • Stay with the person until professional help arrives.
  • Try to remove any weapons, medications, or other potentially harmful objects.

If you or someone you know is having thoughts of suicide, a prevention hotline can help. The 988 Suicide and Crisis Lifeline is available 24 hours a day at 988. During a crisis, people who are hard of hearing can use their preferred relay service or dial 711 then 988.

Find more links and local resources.

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ALLERGIC REACTION

As with most drugs, some people can have an allergic reaction after taking Zurzuvae. This side effect wasn’t reported in clinical trials of this drug but can still occur.

Symptoms of a mild allergic reaction can include:

A more severe allergic reaction is rare but possible. Symptoms of a severe allergic reaction can include:

  • swelling under your skin, typically in your eyelids, lips, hands, or feet
  • swelling of your tongue, mouth, or throat
  • trouble breathing

Call your doctor right away if you have an allergic reaction to Zurzuvae, as the reaction could become severe. Call 911 or your local emergency number if your symptoms feel life threatening or if you think you’re having a medical emergency.

The Food and Drug Administration (FDA) approves prescription drugs such as Zurzuvae to treat certain conditions.

Zurzuvae for postpartum depression

Zurzuvae is FDA-approved to help treat postpartum depression in adults.

Postpartum depression is a mental health condition that can occur after childbirth. It may begin within a few weeks or up to 1 year after delivery. The condition causes low mood and depression that lasts longer than 2 weeks.

Other symptoms may include feeling hopeless, worthless, or guilty and losing interest in things you used to enjoy. You may have changes in your appetite or sleeping habits, anxiety, irritability, and lack of energy. You may also have difficulty bonding with your baby.

For this purpose, Zurzuvae may be prescribed by itself or with other antidepressant drugs.

Examples of other antidepressant drugs that may be used with Zurzuvae include selective serotonin reuptake inhibitors (SSRIs), such as citalopram (Celexa) and serotonin-norepinephrine reuptake inhibitors (SNRIs), such as duloxetine (Cymbalta).

Zurzuvae and children

Zurzuvae is not approved for use in children under age 18 years. The medication hasn’t been studied in this age group.

Zurzuvae can interact with several other medications. It can also interact with certain supplements as well as certain foods.

Before taking Zurzuvae, talk with your doctor and pharmacist. Tell them about all prescription, over-the-counter, and other drugs you take. Also tell them about any vitamins, herbs, and supplements you use. Sharing this information can help you avoid potential interactions.

Interactions with medications, foods, and supplements

Below is a list of medications, supplements, and foods that can interact with Zurzuvae. This list does not contain all drugs that may interact with Zurzuvae. If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Medications that can interact with Zurzuvae• opioid pain relievers such as morphine (MS Contin, others) or tramadol (ConZip)
• benzodiazepines such as alprazolam (Xanax) or lorazepam (Ativan)
• sleeping pills such as eszopiclone (Lunesta) or zolpidem (Ambien)
• seizure medications such as phenytoin (Dilantin) or carbamazepine (Tegretol, others)
• muscle relaxants such as methocarbamol or metaxalone
• certain antifungals such as itraconazole (Sporanox) or ketoconazole
• certain antibiotics such as clarithromycin or rifampin (Rifadin, Rimactane)
• certain HIV drugs such as ritonavir (Norvir) or cobicistat (Tybost)
• certain antidepressants, such as amitriptyline or nefazodone
Vitamins or supplements that can interact with Zurzuvae• St John’s wort
Foods that can interact with Zurzuvae• grapefruit

Alcohol interaction

It may not be safe to consume alcohol while taking Zurzuvae. Drinking alcohol with Zurzuvae may increase the risk of certain side effects, such as sleepiness, confusion, dizziness, and unsteadiness.

If you drink alcohol and have questions about the safety of drinking it while taking Zurzuvae, talk with your doctor or pharmacist.

As with all medications, the cost of Zurzuvae can vary. The actual price you’ll pay depends on your insurance plan, your location, and the pharmacy you use.

Financial and insurance assistance. If you need financial support to pay for Zurzuvae or help to understand your insurance coverage, help is available.

To learn more about saving money on prescriptions, check out this article.

Generic version. Zurzuvae is not available in a generic form. A generic drug is an exact copy of the active drug in a brand-name medication. Generics tend to cost less than brand-name drugs.

Other drugs are available that can treat your condition. Some may be a better fit for you than others. If you’re interested in finding an alternative to Zurzuvae, talk with your doctor. They can tell you about other medications that may work well for you.

The following drugs are possible alternatives to Zurzuvae:

If you can become pregnant, consider the following information about pregnancy, birth control, and breastfeeding.

Zurzuvae and pregnancy

Zurzuvae should not be taken during pregnancy because it can harm a developing fetus. If you’re planning a pregnancy or can become pregnant, talk with your doctor before taking this medication. Your doctor may suggest birth control options to use during treatment with Zurzuvae.

If you take Zurzuvae while pregnant, you’re encouraged to register with the National Pregnancy Registry for Antidepressants. The aim of this registry is to collect information about the safety of antidepressants during pregnancy. For more information, call 844-405-6185 or talk with your doctor.

Zurzuvae and birth control

Zurzuvae is not safe to take during pregnancy. If you’re sexually active and you or your partner can become pregnant, talk with your doctor about your birth control needs while you’re using Zurzuvae.

Note: Sex and gender exist on spectrums. Use of the term “female” in this article refers to sex assigned at birth.

For females taking Zurzuvae

If you can become pregnant, you should use birth control while taking Zurzuvae and for 1 week after your last dose.

Zurzuvae and breastfeeding

It’s not known whether Zurzuvae should be taken while breastfeeding. If you’re currently breastfeeding or planning to do so, talk with your doctor before taking this medication.

Here are answers to some frequently asked questions about Zurzuvae.

How does Zurzuvae work?

Zurzuvae is prescribed to help treat postpartum depression, which is a form of depression that occurs after childbirth. The cause of postpartum depression isn’t fully understood, but it likely involves a combination of many different factors. These may include changing hormone levels following childbirth, and in particular, the sudden drop in progesterone levels that occurs after delivery.

Zurzuvae works in a different way than most other antidepressants. It contains zuranolone, which is a type of drug called a neuroactive steroid. It’s similar to a natural neurosteroid called allopregnanolone, which your brain usually makes from progesterone.

Neurosteroids are chemicals that help control nerve activity in your brain. Your brain makes them from certain hormones. Neurosteroids have a calming effect on nerve cells in your brain and are involved in controlling anxiety, stress responses, mood, and sleep. Due to the drop in your progesterone levels after childbirth, you may have a sudden decrease in the levels of these calming neurosteroids in your brain. In some people, this may lead to postpartum depression.

Zuranolone works in a similar way to natural neurosteroids in your brain. Like neurosteroids, the drug acts on gamma-aminobutyric acid type A (GABA-A) receptors (attachment sites) on nerve cells in your brain. This helps calm nerve activity and allows your brain to function better to control your mood and behavior. In turn, this helps reduce the symptoms of postpartum depression.

If you have questions about how Zurzuvae works, talk with your doctor or pharmacist.

Can Zurzuvae cause long-term side effects?

Zurzuvae is not known to cause any long-term side effects. Long-term side effects weren’t reported in clinical trials of the medication.

If you’re concerned about the risk of side effects with Zurzuvae, talk with your doctor.

Will Zurzuvae cure postpartum depression?

In clinical trials, Zurzuvae was effective for reducing the symptoms of postpartum depression. Symptoms typically began to improve within 3 days of starting treatment and continued to improve over the 14-day treatment course.

Zurzuvae’s effect was found to last for 4 weeks after the 14-day course of treatment ended. But at this time, it’s not known how long the effects of the medication will last or whether it can be considered a cure for postpartum depression.

Note that not everyone will respond to this treatment. The medication may have different effects in different people.

To find out more about what you may be able to expect with Zurzuvae treatment, talk with your doctor.

This drug comes with several precautions.

FDA warning: Risk of impaired ability to drive

This drug has a boxed warning. This is the most serious warning from the Food and Drug Administration (FDA). A boxed warning alerts doctors and patients about drug effects that may be dangerous.

Zurzuvae may cause drowsiness and slowed reaction times that can reduce your ability to drive safely or do other dangerous activities. The medication can also affect your ability to decide whether you’re able to drive or do other activities safely. Because of this, you should not drive for at least 12 hours after taking each dose of Zurzuvae.

Other precautions

Before taking Zurzuvae, discuss your health history with your doctor. Zurzuvae may not be right for you if you have certain medical conditions or other factors affecting your health. Be sure to talk with your doctor if any of the following apply to you:

Note: For more information about the potential negative effects of Zurzuvae, see the “Zurzuvae side effects” section above.

Zurzuvae has a risk of misuse and can cause drug dependence. With misuse, a drug is taken in a way that’s not prescribed, usually for a rewarding effect. With drug dependence, you rely on a drug to function normally, either physically or mentally. If you become physically dependent on a drug, you may have withdrawal symptoms if you suddenly stop taking it.

Withdrawal symptoms that have been reported after suddenly stopping Zurzuvae include mild to moderate:

You should only take Zurzuvae as prescribed by your doctor. Do not take it in a higher dosage or for longer than your doctor prescribes. If you have withdrawal symptoms after stopping treatment, talk with your doctor.

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.