Home Drug Guide Zuranolone

Drug Guide

Generic Name

Zuranolone

Brand Names Zurzuvae

Classification

Therapeutic: Anxiolytic, Antidepressant, Antianxiety Agent

Pharmacological: GABA-A receptor positive allosteric modulator

FDA Approved Indications

  • Treatment of postpartum depression in adult women

Mechanism of Action

Zuranolone is a positive allosteric modulator of GABA-A receptors, enhancing GABAergic inhibitory neurotransmission in the central nervous system, which results in anxiolytic and antidepressant effects.

Dosage and Administration

Adult: 100 mg once daily for 14 days, orally; dosing may vary based on clinical response and tolerability.

Pediatric: Not approved for pediatric use.

Geriatric: No specific dosage adjustments; start at lower doses if necessary, monitor closely.

Renal Impairment: No specific adjustments necessary; however, caution advised.

Hepatic Impairment: Data limited; use caution and monitor for adverse effects.

Pharmacokinetics

Absorption: Rapid absorption; peak plasma concentrations typically occur within 2 hours.

Distribution: Widely distributed; highly protein-bound.

Metabolism: Primarily metabolized by CYP3A4 and other liver enzymes.

Excretion: Excreted mainly via the feces and urine.

Half Life: Approximately 13-17 hours.

Contraindications

  • Hypersensitivity to zuranolone or excipients.

Precautions

  • Use with caution in patients with liver impairment; monitor hepatic function. Caution advised in patients with history of psychiatric disorders or suicidal ideation.

Adverse Reactions - Common

  • Dizziness (Common)
  • Somnolence (Common)
  • Fatigue (Common)

Adverse Reactions - Serious

  • Suicidal thoughts or behaviors (Rare)
  • Severe allergic reactions (Rare)
  • Hypersensitivity reactions including rash (Rare)

Drug-Drug Interactions

  • CYP3A4 inhibitors or inducers may affect zuranolone plasma levels.

Drug-Food Interactions

  • No significant food interactions identified.

Drug-Herb Interactions

  • Caution with concomitant use of herbal products affecting CYP pathways.

Nursing Implications

Assessment: Assess for mood improvement and watch for adverse neurological effects including sedation and dizziness.

Diagnoses:

  • Risk for injury related to dizziness or sedation.
  • Imbalanced nutrition: less than body requirements if nausea or GI discomfort occurs.

Implementation: Administer as prescribed; monitor patient response and side effects.

Evaluation: Evaluate effectiveness through mood assessments; monitor for adverse reactions.

Patient/Family Teaching

  • Take medication exactly as prescribed.
  • Do not operate heavy machinery until response is known.
  • Report any suicidal thoughts or unusual side effects to healthcare provider.
  • Avoid alcohol and CNS depressants.

Special Considerations

Black Box Warnings:

  • Suicidality has been observed in patients taking drugs that modulate GABA receptors, particularly in young adults.

Genetic Factors: Genetic variations affecting CYP3A4 may influence drug levels.

Lab Test Interference: No known interference.

Overdose Management

Signs/Symptoms: Drowsiness, dizziness, confusion, respiratory depression in severe cases.

Treatment: Supportive care, airway management, monitor vital signs, activated charcoal if ingestion is recent, consider hospitalization.

Storage and Handling

Storage: Store at room temperature, away from moisture, heat, and light.

Stability: Stable under recommended storage conditions for the duration of efficacy.

🛡️ 5 Critical Medication Safety Tips for Nurses

1

Triple-Check High-Risk Medications

Always have another nurse verify insulin, heparin, warfarin, and chemotherapy drugs. These "high-alert" medications cause the most serious errors. Check concentration, dose calculation, and pump settings twice.

2

Know Look-Alike, Sound-Alike Drugs

Common mix-ups: hydromorphone/morphine, Celebrex/Celexa, Zyprexa/Zyrtec. Always use BOTH generic and brand names, read labels twice, and use barcode scanning when available. One wrong letter can be fatal.

3

Assess Before AND After Giving Meds

Check vitals before cardiac meds, pain levels before analgesics, and blood glucose before insulin. Always reassess within 30 minutes to evaluate effectiveness and watch for adverse reactions.

4

Watch for Drug Interactions

Common dangerous combinations: warfarin + aspirin (bleeding), ACE inhibitors + potassium (hyperkalemia), digoxin + diuretics (toxicity). Always check drug interactions before administering new medications.

5

Educate Your Patients

Teach patients medication names, purposes, major side effects, and what to report. Informed patients catch errors and improve compliance. Always encourage questions - an educated patient is a safer patient.

⚡ Remember: When in doubt, don't give it out! It's always safer to double-check than regret later.

⚠️ Medical Disclaimer

This drug guide is for educational purposes only and is NOT intended for clinical use. Always consult current prescribing information, healthcare providers, and institutional protocols before administering any medication. Do not use this information for patient care decisions.