Zurzuvae (Zuranolone) Dosage Guide

What Is Zurzuvae & How Is It Used?

Zurzuvae contains the active ingredient zuranolone, a type of steroid affecting the brain that can be used to treat postpartum depression (PPD). It is taken as a once-daily oral medication in the evening for just two weeks, which is a much shorter duration than other medications currently approved to treat PPD.

Is Zurzuvae FDA-approved?

Zurzuvae was approved by the FDA for the treatment of postpartum depression. While it was also studied in its use for treating major depressive disorder, the FDA has requested additional drug trials be completed to provide more evidence of its effectiveness for treating major depression.

How Does Zurzuvae Work?

Zurzuvae is a steroid that affects areas of the brain responsible for emotion and self-perception. The drug binds to specific receptors that can trigger changes to improve mood and reduce depressive symptoms. Zurzuvae starts working relatively quickly, often within a few days, compared to other medicines that may take much longer to show results.¹ However, it’s essential to remember that every person’s body is unique, and responses to medications can vary from person to person.

Zurzuvae Forms & Strengths

Zurzuvae dosing is available in the following forms and strengths³

• 20 milligram (mg) oral capsule
• 25 milligram (mg) oral capsule
• 30 milligram (mg) oral capsule

Zurzuvae is taken once daily in the evening for 14 days. It should be taken every evening as directed for the full course of treatment unless otherwise instructed by a primary care doctor. It is recommended to take Zurzuvae with fat-containing food.³

Zurzuvae Dosage for Adults with Postpartum Depression (PPD)

Zurzuvae treats postpartum depression by having a positive effect on areas of the brain responsible for controlling mood and emotion. The recommended starting dose, regardless of age, is 50 milligrams taken once a day in the evening with a high-fat meal.³ Unlike other medications commonly used to treat postpartum depression, Zurzuvae is taken for two weeks and then discontinued. The anti-depressive effects of the drug have been shown to last for up to 45 days but may last much longer.^4,5 Zurzuvae can be taken alone or with other antidepressant medications.³

Here is Zurzuvae dosage information for adult postpartum depression:^1,2

• Typical starting dosage: 50 milligrams per day. If the dose is not tolerated, it can be lowered to 40milligrams per day
• Dosage increases: Dose increases beyond 50 milligrams per day are not recommended
• Maximum dosage: The current maximum dose is 50 milligrams

Zurzuvae Dosing Considerations

Most patients taking Zuranlone should start by taking 50 milligrams every evening for 14 days. If you miss a dose of Zurzuvae, take the next dose at the regular time during the following evening. It’s important not to miss a dose. If you need help remembering to take your dose, try setting an alarm to remind you. Patients with liver or kidney impairment may be told to take a lower dose. Your doctor will help to determine what the best dose is for you.

Zurzuvae Clinical Trial Studies

Phase 3 clinical trials are used to show that the medication has been tested in large populations to be both safe and effective. Demonstrating this is required in order to gain approval from the FDA. Below is a summary of the phase 3 clinical trial with Zurzuvae in PPD:

Zurzuvae and treatment of postpartum depression were studied in 2 large clinical trials with people taking either 30 milligrams, 50 milligrams, or a placebo once daily. (A placebo is a medication that has no active ingredients so that it can be used to compare against the studied medication). The medication was given for 14 days, with follow-up occurring for 45 days after the first dose.

The results were measured by having the patients complete surveys before and after that measured depression. The study concluded that Zurzuvae did improve PPD symptoms more than the placebo group and was well tolerated with minimal side effects. Patients in both the 30 and 50-milligram groups saw improvement as early as day three that continued through day 45. It was determined the best dose for people with PPD is 50 mg once daily in the evening for 14 days.^1,2

Common Side Effects of Zurzuvae

Most of the side effects from Zurzuvae are mild, with tiredness, dizziness, and headache being the most common. Because of this, it is recommended to avoid driving for at least 12 hours after taking every dose of Zurzuvae.³

Unlike other medications used to treat depression, Zurzuvae has not been shown to cause weight gain, mental impairment, or sexual dysfunction, which are often reasons why patients will stop taking those medications.³

Common side effects of Zurzuvae include:^1,2,3,4,5,6

• Dizziness
• Tiredness
• Headache
• Diarrhea
• Sleepiness
• Exhaustion
• Upset stomach
• Sweating
• Strange dreams

*All medications, including Zurzuvae, can cause side effects which can be mild or serious. This is not a comprehensive list of all possible side effects. You should talk with your doctor about any questions you have and to understand the potential side effects and benefits of any medication.

Questions to Ask Your Healthcare Provider About Zurzuvae Dosage

For postpartum depression, most patients will start by taking 50 milligrams every evening. Those with kidney or liver issues may be started at a lower dose.³ Patients should ask their doctor or psychiatrist if Zurzuvae is safe for them to take with other medications they may be on or with conditions they may have. Online psychiatry services may be an option for patients who need to change providers.

Questions to ask your care team about Zurzuvae dosage include:

• How long will it take for me to adjust to taking Zurzuvae?
• How long before I should begin seeing results?
• Am I at risk for more serious symptoms if I am already taking other anxiety /depression medications?
• What is the best dosage to ensure fewer side effects?
• When should I reach out to you if I am experiencing side effects?
• Is there anything I should tell my therapist about this new medication?
• Will my insurance cover the cost of Zurzuvae?

In My Experience

In my experience, research results indicate that Zurzuvae may be a beneficial medication for patients experiencing postpartum depression. The medication was only recently approved by the FDA, so there are still many unknowns about Zurzuvae and its long-term effects that will need to be studied in the coming years. There are multiple claims about Zurzuvae effects lasting up to 6 months, however, the evidence supporting this has not been made available. Patients looking to start taking Zurzuvae should first talk with their doctor about all the available options to decide if Zurzuvae is right for them.

For Further Reading

• Peripartum Depression: What You Can Do & Who Can Help
• Depression vs. Sadness: Understanding the Differences
• Perinatal Mood & Anxiety Disorders (PMADs): Types, Symptoms, & Treatments
• Coping With Stress During Pregnancy: 10 Ways to Stay Calm