All About Zurzuvae

What is Zurzuvae used for?

Zurzuvae is used to treat postpartum depression (PPD) in adults. Your doctor may prescribe Zurzuvae alone or with other antidepressant medications.

PPD is a mood disorder that can occur following the birth of a baby. It may cause feelings of sadness and hopelessness. It may make you feel as though you aren’t connecting with your baby. It’s a serious disorder, but treatment is available to help you recover.

It’s known that pregnancy and childbirth cause hormonal changes, including changes in the levels of a chemical messenger in the brain called gamma aminobutyric acid (GABA). Low GABA levels have been found in people with symptoms of depression. Zurzuvae is thought to ease symptoms of PPD by increasing GABA levels.

What are Zurzuvae’s side effects?

Like most drugs, Zurzuvae may cause mild or serious side effects. The lists below describe some of the more common side effects that Zurzuvae may cause. These lists don’t include all possible side effects.

Keep in mind that side effects of a drug can depend on:

• your age
• other health conditions you have
• other medications you take

Your doctor or pharmacist can tell you more about the potential side effects of Zurzuvae. They can also suggest ways to help reduce side effects.

Mild side effects

Here’s a list of some of the mild side effects that Zurzuvae can cause. To learn about other mild side effects, talk with your doctor or pharmacist, or read Zurzuvae’s prescribing information.

Mild side effects of Zurzuvae that have been reported include:

• sleepiness
• slow thinking
• dizziness
• stomach pain
• upper respiratory infections, such as the common cold
• diarrhea
• urinary tract infection (UTI)
• muscle pain, twitch, or tremor
• feeling numb in certain parts of your body
• feeling anxious
• skin rash
• mild allergic reaction*

Mild side effects of many drugs may go away within a few days to a couple of weeks. But if they become bothersome, talk with your doctor or pharmacist.

* To learn more about this side effect, see the “Allergic reaction” section below.

Serious side effects

Serious side effects from Zurzuvae can occur, but they aren’t common. If you have a serious side effect from Zurzuvae, call your doctor right away. But if you think you’re having a medical emergency, you should call 911 or your local emergency number.

Serious side effects of Zurzuvae that have been reported include:

• suicidal thoughts and behavior, especially if you’re 24 years old or younger
• memory problems
• confusion
• problems with walking and coordination, which can increase your risk of falls
• boxed warning: risk of decreased ability to drive and do other potentially dangerous activities safely*
• severe allergic reaction†

* For more information, see the “What should be considered before taking Zurzuvae?” section.
† To learn more about this side effect, see the “Allergic reaction” section below.

Allergic reaction

While an allergic reaction to Zurzuvae wasn’t reported in studies, it can still happen.

Symptoms of a mild allergic reaction can include:

• skin rash
• itchiness
• flushing (temporary warmth, redness, or deepening of skin color)

A more severe allergic reaction is rare but possible. Symptoms of a severe allergic reaction can include swelling under your skin, usually in your eyelids, lips, hands, or feet. They can also include swelling of your tongue, mouth, or throat, which can cause trouble breathing.

Call your doctor right away if you have an allergic reaction to Zurzuvae. But if you think you’re having a medical emergency, call 911 or your local emergency number.

What is Zurzuvae’s dosage?

Your doctor will recommend the dosage of Zurzuvae that’s right for you. Below are commonly used dosages, but always take the dosage your doctor prescribes.

Form and strengths

Zurzuvae is available as an oral capsule in three strengths: 20 milligrams (mg), 25 mg, and 30 mg.

Recommended dosage

For treatment of postpartum depression (PPD), your doctor will likely prescribe a dosage of 50 mg taken once per day. You’ll take the dose in the evening for 14 days. You should take your dose with a meal that contains fat.

Questions about taking Zurzuvae

Below are some common questions about taking Zurzuvae.

• Can Zurzuvae be chewed, crushed, or split? Zurzuvae is a capsule. Generally, capsules should not be chewed, crushed, or split. If you have trouble swallowing capsules, this article provides some tips on how to take this form of medication.
• Should I take Zurzuvae with food? Yes. Zurzuvae should be taken with food. In fact, it should be taken with a meal that contains a good amount of fat. This helps your body absorb Zurzuvae. Ask your doctor for examples of meals to eat when you take your Zurzuvae dose.
• Is there a best time of day to take Zurzuvae? Zurzuvae should be taken in the evening. And it should be taken around the same time each evening. This helps keep a consistent level of the drug in your body, which helps Zurzuvae work effectively.
• What if I miss a dose of Zurzuvae? If you miss a dose of Zurzuvae, take your next dose at your usual time the following evening. Continue taking Zurzuvae once per evening until you’ve taken all the capsules you’ve been prescribed. You should not take two doses at once to make up for a missed dose. Doing so could raise your risk of side effects.
• Will I need to use Zurzuvae long term? No. Zurzuvae is usually prescribed for 14 days.

Overdose

Do not take more Zurzuvae than your doctor prescribes. Using more than this can lead to harmful effects.

Symptoms of overdose

An overdose of Zurzuvae can cause decreased consciousness. Levels of decreased consciousness include:

• confusion
• disorientation
• delirium
• lethargy
• stupor
• coma

What to do in case you take too much Zurzuvae

Call your doctor if you think you’ve taken too much Zurzuvae. You can also call 800-222-1222 to reach America’s Poison Centers or use its online resources. But if you have severe symptoms, immediately call 911 or your local emergency number. Or go to the nearest emergency room.

What should be considered before taking Zurzuvae?

Below is important information you should consider before taking Zurzuvae.

Interactions

Taking a drug with certain medications, vaccines, foods, and other things can affect how the drug works. These effects are called interactions.

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.

Drug interactions

Below is a list of medications 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.

* CYP3A4 stands for cytochrome P450 3A4. It’s a liver enzyme (a type of protein) that helps to break down Zurzuvae. When other drugs slow down or speed up this enzyme, it affects the amount of Zurzuvae in your body.

Zurzuvae and alcohol

It is not safe to consume alcohol while taking Zurzuvae. Consuming alcohol while taking Zurzuvae can cause difficulty breathing.

Consuming alcohol while taking Zurzuvae can also increase the risk of having side effects from Zurzuvae. And it can make any side effects you already have more severe. Examples of side effects that are worsened by alcohol include sleepiness and problems with walking and coordination.

Talk with your doctor if you have any questions or concerns about not consuming alcohol while taking Zurzuvae.

Other interactions

Zurzuvae can interact with other substances such as:

• Vitamins or supplements: Zurzuvae may interact with St. John’s wort. Your doctor may recommend that you avoid taking this supplement during your Zurzuvae treatment.
• Foods: Zurzuvae may interact with grapefruit and grapefruit juice. Your doctor may recommend that you do not consume grapefruit products during your Zurzuvae treatment.

Pregnancy and breastfeeding

Zurzuvae is prescribed following the birth of a child. It is not safe to take while pregnant.

If you’ve taken Zurzuvae while pregnant, consider enrolling in the National Pregnancy Registry for Antidepressants. This registry collects information about the effect of antidepressants, such as Zurzuvae, on pregnancy outcomes. To learn more, talk with your doctor or call the registry directly at 844-405-6185.

It’s not known if Zurzuvae is safe to take while breastfeeding. Zurzuvae passes into breast milk in small amounts. But the effects on a breastfed child haven’t been studied. If you’re breastfeeding, or planning to breastfeed, talk with your doctor about your options.

Birth control

It’s recommended that adults who can become pregnant use birth control during treatment with Zurzuvae and for at least 1 week after taking the last dose.

Boxed warning

Zurzuvae has a boxed warning about the risk of an impaired ability to drive or do other potentially dangerous activities safely. A boxed warning is the most serious warning from the Food and Drug Administration (FDA) about drug effects that may be dangerous.

Zurzuvae can affect how quickly chemical signals are sent in your brain and spinal cord. This can cause you to feel less alert. It can also slow down your reaction time.

It’s important to note that you may not notice these subtle changes. But in studies, the driving ability of adults who had taken Zurzuvae was impaired.

You should not drive or do other potentially dangerous activities, such as operate machinery, for 12 hours after each dose. This is recommended for each dose until you have completed the treatment.

If you have questions or concerns about not driving or doing other potentially dangerous activities during the 12 hours after each dose of Zurzuvae, talk with your doctor.

Other warnings

Zurzuvae can sometimes cause harmful effects in people who have certain conditions. This is known as a drug-condition interaction. Other factors may also affect whether Zurzuvae is a good treatment option for you.

Talk with your doctor about your health history before you take Zurzuvae. Be sure to tell them if you:

• drink alcohol
• have liver problems
• have kidney problems
• have had suicidal thoughts or behaviors
• have had problems with substance use
• have had an allergic reaction to Zurzuvae
• could become pregnant
• are breastfeeding

What are some frequently asked questions about Zurzuvae?

Find answers to some commonly asked questions about Zurzuvae.

Does Zurzuvae cause long-term side effects?

It’s unlikely. Long-term side effects weren’t reported in studies.

If you’re concerned about possible long-term side effects from Zurzuvae, talk with your doctor or pharmacist.

How does Zurzuvae compare with Celexa?

Both Zurzuvae and citalopram (Celexa) are antidepressants used to treat postpartum depression (PPD). They come in oral forms that are taken once per day.

Zurzuvae may be prescribed with Celexa or other similar antidepressants known as selective serotonin reuptake inhibitors (SSRIs). This combination can be helpful because Zurzuvae starts to work soon after starting treatment but isn’t a long-term treatment. In contrast, SSRIs typically take several weeks or longer to begin to work but can be prescribed long term. In other words, Zurzuvae can help you to feel better quickly, and Celexa can be continued for as long as necessary to treat your PPD.

If you have more questions about how Zurzuvae and Celexa, talk with your doctor.

Is Zurzuvae used for postpartum anxiety?

Although Zurzuvae isn’t approved to treat postpartum anxiety, your doctor may prescribe it off-label for this use. (With off-label use, doctors prescribe a drug for a purpose other than what it was originally approved for.)

In studies, when prescribed to treat postpartum depression, Zurzuvae was shown to help ease symptoms of postpartum anxiety and insomnia.

To learn more about treatment options for postpartum anxiety, talk with your doctor.

Zurzuvae cost and coupons

Whether you have health insurance or not, cost may be a factor when you’re considering Zurzuvae. What you’ll pay for Zurzuvae may depend on several things, such as your treatment plan and the pharmacy you use.

If you have questions about how to pay for your prescription, talk with your doctor or pharmacist.

You can also check out this article to learn more about saving money on prescriptions.

Similar drugs

Zurzuvae is the first oral medication prescribed to specifically treat postpartum depression (PPD).

Zulresso (brexanolone) is another drug available for treatment of PPD. But unlike Zurzuvae, it’s given as an intravenous (IV) infusion (an injection into your vein given over a period of time).

Other antidepressants that are sometimes prescribed to treat PPD include:

• selective serotonin reuptake inhibitors (SSRIs), such as sertraline (Zoloft) and citalopram (Celexa)
• serotonin-norepinephrine reuptake inhibitors (SNRIs), such as duloxetine (Cymbalta) and venlafaxine (Effexor XR)
• tricyclic antidepressants (TCAs), such as amitriptyline and nortriptyline (Pamelor)
• atypical antidepressants, such as bupropion (Wellbutrin) and trazodone (Desyrel)

If you’d like to explore an alternative to Zurzuvae, talk with your doctor. They can tell you about other medications that might work well for you.

Can Zurzuvae be misused? Can it cause withdrawal or dependence?

Zurzuvae is a controlled substance and is classified as a Schedule IV prescription drug. A controlled substance is a drug the government regulates due to risks of misuse or dependence. With misuse, a drug is taken in a way other than how it was prescribed. And with dependence, your body needs the drug to feel like it usually does.

You should take Zurzuvae only as your doctor has prescribed. Misuse increases the risk of overdose, which in serious cases can lead to coma.

Zurzuvae may cause dependence. The risk of dependence may be greater when taken at higher doses or for more days than typically prescribed. Abruptly stopping Zurzuvae may cause withdrawal symptoms, including nightmares, nausea, and paranoia.

Let your doctor know if you’ve had problems with substance use in the past. They can help you decide whether Zurzuvae is the right treatment for you.

If you have any questions or concerns about the risks of misuse, dependence, or withdrawal with Zurzuvae, talk with your doctor.