Zurzuvae (zuranolone) is a prescription oral capsule used to treat postpartum depression in adults. This drug can interact with alcohol, other medications, and some supplements. For example, Zurzuvae can interact with opioids and benzodiazepines.

An interaction can occur because one substance causes another substance to have a different effect than expected. Interactions can also occur if you have certain health conditions.

Before you start taking Zurzuvae, tell your doctor and pharmacist about any prescription, over-the-counter, or other drugs you take. Sharing this information with them may help prevent possible interactions. (To learn whether Zurzuvae interacts with herbs or vitamins and supplements, see the “Are there other interactions with Zurzuvae?” section below.)

If you have questions about drug interactions that may affect you, talk with your doctor or pharmacist.

The table below lists drugs that may interact with Zurzuvae. Keep in mind that this table does not include all drugs that may interact with Zurzuvae. For more information about some of these interactions, see the “Drug interactions explained” section below.

Drug group or drug nameDrug examplesWhat can happen
opioidshydrocodone (Hysingla ER)
oxycodone (Oxycontin, Roxicodone, others)
tramadol (ConZip, Qdolo)
can increase the risk of CNS depression from Zurzuvae and opioids
tricyclic antidepressants (TCAs)amitriptyline
nortriptyline (Pamelor)
imipramine (Tofranil)
can increase the risk of CNS depression from Zurzuvae and TCAs
benzodiazepines• alprazolam (Xanax, Xanax XR)
diazepam (Valium)
lorazepam (Ativan, Loreev XR)
can increase the risk of CNS depression from Zurzuvae and benzodiazepines
certain antifungals• itraconazole (Sporanox, Tolsura)
ketoconazole
fluconazole (Diflucan)
can increase the risk of side effects from Zurzuvae
certain antibiotics• rifampin (Rifadin, Rimactane)
clarithromycin
erythromycin (Eryc, Ery-Tab, others)
can make Zurzuvae less effective or increase the risk of side effects from Zurzuvae
certain seizure drugscarbamazepine (Carbatrol, Epitol, others)
phenytoin (Dilantin, Phenytek)
can make Zurzuvae less effective
verapamil (Verelan, Verelan PM)can increase the risk of side effects from Zurzuvae

You should not drink alcohol during your Zurzuvae treatment.

Both Zurzuvae and alcohol can cause CNS depression. This can cause symptoms such as:

You may be more likely to experience CNS depression if you drink alcohol during your Zurzuvae treatment.

If you have questions about avoiding alcohol while taking Zurzuvae, talk with your doctor or pharmacist.

Learn more about certain drug interactions that can occur with Zurzuvae.

Interaction with opioids

Zurzuvae can interact with opioids, which are used to treat pain.

Examples of opioid medications include:

What could happen

Zurzuvae and opioids can both cause CNS depression. So taking these drugs together can raise your risk of this side effect.

The CNS includes the brain and spinal cord and regulates vital functions such as breathing and thinking. With CNS depression, the activity of the CNS slows down. This can cause symptoms such as:

What you can do

If you take Zurzuvae with an opioid, your doctor may prescribe a lower dosage of either drug for you. This can help reduce your risk of CNS depression. You should not take a higher dose of either medication than your doctor prescribes.

If you have questions about taking Zurzuvae with opioids, talk with your doctor or pharmacist.

Interaction with TCAs

Zurzuvae can interact with TCAs, which are used to treat depression and other conditions.

Examples of TCA medications include:

What could happen

Taking Zurzuvae with TCAs can raise your risk of CNS depression, a side effect that can occur with either drug.

Symptoms of CNS depression may include:

What you can do

If you take Zurzuvae with a TCA, your doctor may prescribe a lower dosage of either drug for you. This can help reduce your risk of CNS depression. It’s important that you do not take a higher dose of either medication than your doctor prescribes.

If you have questions about taking Zurzuvae with a TCA, talk with your doctor or pharmacist.

Interaction with benzodiazepines

Zurzuvae can interact with benzodiazepines, which are used to treat anxiety, seizures, and other conditions.

Examples of benzodiazepines include:

What could happen

Both Zurzuvae and benzodiazepines can cause CNS depression. So taking these medications together can raise your risk of this side effect.

CNS depression may lead to symptoms that affect breathing or thinking, including:

What you can do

If you take Zurzuvae with a benzodiazepine, your doctor may prescribe a lower dosage of either drug for you. Taking a lower dosage can help reduce your risk of CNS depression. You should not take a higher dose of either drug than your doctor prescribes.

If you have questions about taking Zurzuvae with a benzodiazepine, talk with your doctor or pharmacist.

Zurzuvae may have other interactions. They could occur with supplements, foods, vaccines, or even lab tests. See below for details. Note that the information below does not include all other possible interactions with Zurzuvae.

Does Zurzuvae interact with supplements?

Before you start taking Zurzuvae, talk with your doctor and pharmacist about any herbs or vitamins and supplements you take. Sharing this information with them may help you avoid possible interactions.

If you have questions about interactions that may affect you, talk with your doctor or pharmacist.

Zurzuvae interactions with herbs

Zurzuvae may interact with St. John’s wort, which is taken to ease symptoms of depression and other conditions.

Taking Zurzuvae with St. John’s wort could cause your body to break down Zurzuvae too quickly. This can lower the level of Zurzuvae in your system, which could make the drug less effective.

For this reason, it’s important to check with your doctor or pharmacist before taking St. John’s wort with Zurzuvae.

Zurzuvae and vitamins

There are currently no reports of Zurzuvae interacting with vitamins. But this doesn’t mean that vitamin interactions won’t be recognized in the future.

For this reason, it’s still important to check with your doctor or pharmacist before taking any of these products while taking Zurzuvae.

Does Zurzuvae interact with food?

Zurzuvae may interact with grapefruit or grapefruit juice. Taking the drug with grapefruit products could cause your body to break down Zurzuvae too slowly. This can increase the level of Zurzuvae in your system, which may raise your risk of side effects from the drug.

If you consume grapefruit products, talk with your doctor before taking Zurzuvae.

Does Zurzuvae interact with vaccines?

There are currently no reports of Zurzuvae interacting with vaccines. If you have questions about getting certain vaccines during your Zurzuvae treatment, talk with your doctor.

Does Zurzuvae interact with lab tests?

There are currently no reports of Zurzuvae interacting with lab tests. If you have questions about having certain lab tests during your treatment with Zurzuvae, talk with the healthcare professional ordering the test.

Does Zurzuvae interact with cannabis or CBD?

There are currently no reports of Zurzuvae interacting with cannabis (commonly called marijuana) or cannabis products such as cannabidiol (CBD). But as with any drug or supplement, talk with your doctor before using cannabis with Zurzuvae.

Note: Cannabis is illegal at a federal level but is legal in many states to varying degrees.

Certain medical conditions or other health factors may raise the risk of interactions with Zurzuvae. Before taking Zurzuvae, talk with your doctor about your health history. They’ll determine whether Zurzuvae is right for you.

Health conditions or other factors that might interact with Zurzuvae include:

Kidney or liver problems: Before taking Zurzuvae, tell your doctor if you have a kidney or liver problem. Examples include kidney failure and liver failure. Your doctor may prescribe a lower dosage of Zurzuvae for you.

Suicidal thoughts or behaviors: Before starting Zurzuvae treatment, tell your doctor if you’ve ever had suicidal thoughts or behaviors. Medications used to treat depression, such as Zurzuvae, may increase the risk of suicidal thoughts and behaviors in some people. This risk may be greater for people with a history of these thoughts or behaviors.

Your doctor can tell you whether Zurzuvae is a safe treatment option.

Current or past substance use disorder: Before taking Zurzuvae, tell your doctor if you’ve ever had a substance use disorder. Zurzuvae has the potential to be misused, meaning it could be taken in a way other than how a doctor prescribes it. The risk of misuse with Zurzuvae may be greater for people who’ve had a substance use disorder.

Your doctor can determine whether Zurzuvae is a safe treatment option for you.

Pregnancy: Zurzuvae is not safe to take during pregnancy. If you’re pregnant or planning a pregnancy, talk with your doctor before taking Zurzuvae.

If you do take Zurzuvae while pregnant, consider enrolling in the drug’s pregnancy registry. This registry collects details about pregnancy issues reported with Zurzuvae. To learn more, call 844-405-6185 or talk with your doctor.

Breastfeeding: It’s not known whether it’s safe to take Zurzuvae while breastfeeding. The drug passes into breast milk, but it isn’t known whether the drug may cause side effects in a child who’s breastfed. If you’re breastfeeding or planning to do so, talk with your doctor about your options.

Allergic reaction: If you’ve had an allergic reaction to Zurzuvae or any of its ingredients, your doctor will likely not prescribe Zurzuvae. This is because taking the drug could cause another allergic reaction. You can ask your doctor about other treatments that may be better choices for you.

Help is out there

If you or someone you know is in crisis and considering suicide or self-harm, please seek support:

If you’re calling on behalf of someone else, stay with them until help arrives. You may remove weapons or substances that can cause harm if you can do so safely.

If you are not in the same household, stay on the phone with them until help arrives.

Was this helpful?

Taking certain steps can help you avoid interactions with Zurzuvae. Before starting treatment, talk with your doctor and pharmacist. Things to discuss with them include:

  • Whether you drink alcohol or use cannabis.
  • Other medications you take, as well as any vitamins, supplements, and herbs. Your doctor or pharmacist can help you fill out a medication list.
  • What to do if you start taking a new drug during your Zurzuvae treatment.

It’s also important to understand Zurzuvae’s label and other paperwork that may come with the drug. Colored stickers that describe interactions may be on the label. And the paperwork (sometimes called the patient package insert or medication guide) may have other details about interactions. (If you did not get paperwork with Zurzuvae, ask your pharmacist to print a copy for you.)

If you have trouble reading or understanding this information, your doctor or pharmacist can help.

Taking Zurzuvae exactly as prescribed can also help prevent interactions.

If you still have questions about Zurzuvae and its possible interactions, talk with your doctor.

Questions you may want to ask your doctor include:

  • If I take Zurzuvae and have certain health conditions, will I be monitored more closely during treatment?
  • Do other drugs that treat my condition have similar interactions to Zurzuvae?
  • Do any of the other medications I take increase my risk of side effects from Zurzuvae?

To learn more about Zurzuvae, see these articles:

To get information on different conditions and tips for improving your health, subscribe to any of Healthline’s newsletters. You may also want to check out the online communities at Bezzy. It’s a place where people with certain conditions can find support and connect with others.

Disclaimer: Healthline 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.