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Brexanolone: Pediatric drug information

Brexanolone: Pediatric drug information
2025© UpToDate, Inc. and its affiliates and/or licensors. All Rights Reserved.
For additional information see "Brexanolone: Drug information" and "Brexanolone: Patient drug information"

For abbreviations, symbols, and age group definitions show table
ALERT: US Boxed Warning
Excessive sedation and sudden loss of consciousness:

Patients treated with brexanolone are at risk of excessive sedation or sudden loss of consciousness during administration. Because of the risk of serious harm, patients must be monitored for excessive sedation and sudden loss of consciousness and have continuous pulse oximetry monitoring. Patients must be accompanied during interactions with their child(ren).

Because of these risks, brexanolone is available only through a restricted program under a Risk Evaluation and Mitigation Strategy (REMS) called the ZULRESSO REMS.

Brand Names: US
  • Zulresso [DSC]
Therapeutic Category
  • Antidepressant;
  • Gamma-Aminobutyric Acid (GABA) A Receptor Positive Modulator
Dosing: Pediatric
Depression, postpartum

Depression, postpartum: Note: A health care provider must be onsite to monitor and intervene as necessary for entire duration of the infusion.

Adolescents ≥15 years: Continuous IV infusion over 60 hours; initiate continuous infusion early enough in the day to allow for recognition of excessive sedation; titrate the dose as follows:

0 to 4 hours: IV: 30 mcg/kg/hour.

4 to 24 hours: IV: 60 mcg/kg/hour.

24 to 52 hours: IV: 90 mcg/kg/hour; may reduce to 60 mcg/kg/hour if higher dose not tolerated.

52 to 56 hours: IV: 60 mcg/kg/hour.

56 to 60 hours: IV: 30 mcg/kg/hour.

Dosage adjustment for toxicity: Adolescents ≥15 years:

Excessive sedation: Immediately stop infusion at any sign of excessive sedation; after resolution, may resume infusion at the same or reduced dose, as clinically appropriate.

Hypoxia: Immediately stop infusion if pulse oximetry indicates hypoxia; do not resume therapy.

Dosage adjustment for concomitant therapy: Significant drug interactions exist, requiring dose/frequency adjustment or avoidance. Consult drug interactions database for more information.

Dosing: Kidney Impairment: Pediatric

Adolescents ≥15 years:

eGFR ≥15 mL/minute/1.73 m2: No dosage adjustment necessary.

eGFR <15 mL/minute/1.73 m2: Avoid use due to potential accumulation of solubilizing agent, betadex sulfobutyl ether sodium.

Dosing: Liver Impairment: Pediatric

Adolescents ≥15 years: No dosage adjustment necessary.

Dosing: Adult

(For additional information see "Brexanolone: Drug information")

Depression, postpartum

Depression, postpartum: IV: Note: Initiate 60-hour continuous infusion early enough in the day to allow for recognition of excessive sedation. Titrate the dose as detailed.

0 to 4 hours: 30 mcg/kg/hour

4 to 24 hours: 60 mcg/kg/hour

24 to 52 hours: 90 mcg/kg/hour; may reduce dose to 60 mcg/kg/hour based on tolerability

52 to 56 hours: 60 mcg/kg/hour

56 to 60 hours: 30 mcg/kg/hour

Dosage adjustment for concomitant therapy: Significant drug interactions exist, requiring dose/frequency adjustment or avoidance. Consult drug interactions database for more information.

Dosing: Kidney Impairment: Adult

eGFR ≥15 mL/minute/1.73 m2: No dosage adjustment necessary.

eGFR <15 mL/minute/1.73 m2: Use not recommended.

Dosing: Liver Impairment: Adult

No dosage adjustment necessary.

Adverse Reactions

The following adverse drug reactions and incidences are derived from product labeling unless otherwise specified.

>10%:

Cardiovascular: Presyncope (≤13%)

Central nervous system: Drowsiness (≤21%), sedated state (≤21%), dizziness (≤13%), vertigo (≤13%)

Gastrointestinal: Xerostomia (3% to 11%)

1% to 10%:

Cardiovascular: Flushing (≤5%), tachycardia (3%)

Central nervous system: Loss of consciousness (3% to 5%)

Endocrine & metabolic: Hot flash (≤5%)

Gastrointestinal: Diarrhea (2% to 3%), dyspepsia (2%)

Respiratory: Oropharyngeal pain (2% to 3%)

<1%, postmarketing, and/or case reports: Impaired consciousness

Contraindications

There are no contraindications listed in the manufacturer's labeling.

Warnings/Precautions

Concerns related to adverse effects:

• Excessive sedation and sudden loss of consciousness: Time to full recovery after dose interruption following altered or loss of consciousness ranged from 15 to 60 minutes. Caution patients about performing tasks that require mental alertness following the infusion (eg, operating machinery or driving).

• Suicidal thoughts and behaviors: The risk of suicidal thoughts and behaviors with brexanolone is unknown. Antidepressants increase the risk of suicidal thinking and behavior in children, adolescents, and young adults (18 to 24 years of age) with major depressive disorder (MDD) and other psychiatric disorders. Short-term studies did not show an increased risk in patients >24 years of age and showed a decreased risk in patients ≥65 years. Closely monitor all patients for clinical worsening, suicidality, or unusual changes in behavior. Consider changing the therapeutic regimen, including discontinuing brexanolone, in patients who experience worsening depression or emergent suicidal thoughts and behaviors.

Disease-related concerns:

• Drug abuse and dependence: May lead to abuse and dependence. Taper according to dose recommendations unless toxicity requires immediate interruption/discontinuation.

Other warnings/precautions:

• Risk Evaluation and Mitigation Strategy (REMS): Because of the risk of serious harm resulting from excessive sedation or sudden loss of consciousness, brexanolone is available only through a restricted program under a Risk Evaluation and Mitigation Strategy (REMS) called the ZULRESSO REMS. Health care facilities and pharmacies must be certified with the REMS program and patients must enroll in the program prior to administration. A list of certified healthcare facilities is available at www.zulressorems.com or 1-844-472-4379.

Dosage Forms: US

Excipient information presented when available (limited, particularly for generics); consult specific product labeling. [DSC] = Discontinued product

Solution, Intravenous [preservative free]:

Zulresso: 100 mg/20 mL (20 mL [DSC])

Generic Equivalent Available: US

No

Pricing: US

Solution (Zulresso Intravenous)

100 mg/20 mL (per mL): $447.00

Disclaimer: A representative AWP (Average Wholesale Price) price or price range is provided as reference price only. A range is provided when more than one manufacturer's AWP price is available and uses the low and high price reported by the manufacturers to determine the range. The pricing data should be used for benchmarking purposes only, and as such should not be used alone to set or adjudicate any prices for reimbursement or purchasing functions or considered to be an exact price for a single product and/or manufacturer. Medi-Span expressly disclaims all warranties of any kind or nature, whether express or implied, and assumes no liability with respect to accuracy of price or price range data published in its solutions. In no event shall Medi-Span be liable for special, indirect, incidental, or consequential damages arising from use of price or price range data. Pricing data is updated monthly.

Controlled Substance

C-IV

Administration: Pediatric

IV: Administer as a continuous IV infusion over 60 hours; infusion rate is weight-based and titrated throughout infusion (see "Dosing: Pediatric"); use a dedicated line using a programmable peristaltic infusion pump. Prime infusion administration sets with admixture before inserting into the pump and connecting to the venous catheter. Use a PVC, non-DHEP, nonlatex infusion set; do not use in-line filter infusion sets. Monitor sedation levels and pulse oximetry for duration of the infusion.

Administration: Adult

IV: Administer as a continuous infusion over 60 hours in a dedicated line using a programmable peristaltic infusion pump. Prime infusion administration sets with admixture before inserting into the pump and connecting to the venous catheter. Use a PVC, non-DHEP, nonlatex infusion set; do not use in-line filter infusion sets.

Storage/Stability

Undiluted vials: Store vials at 2°C to 8°C (36°F to 46°F). Do not freeze. Protect from light.

Diluted infusion solution: Infusion bags may be used at room temperature for up to 12 hours or stored under refrigeration for up to 96 hours.

Medication Guide and/or Vaccine Information Statement (VIS)

An FDA-approved patient medication guide, which is available with the product information and as follows, must be dispensed with this medication:

Zulresso: https://www.accessdata.fda.gov/drugsatfda_docs/label/2022/211371s007lbl.pdf#page=20

Use

Treatment of postpartum depression (FDA approved in ages ≥15 years and adults).

Metabolism/Transport Effects

None known.

Drug Interactions

Note: Interacting drugs may not be individually listed below if they are part of a group interaction (eg, individual drugs within “CYP3A4 Inducers [Strong]” are NOT listed). For a complete list of drug interactions by individual drug name and detailed management recommendations, use the drug interactions program by clicking on the “Launch drug interactions program” link above.

Note: Interacting drugs may not be individually listed below if they are part of a group interaction (eg, individual drugs within “CYP3A4 Inducers [Strong]” are NOT listed). For a complete list of drug interactions by individual drug name and detailed management recommendations, use the drug interactions program

Acrivastine: May increase CNS depressant effects of CNS Depressants. Risk C: Monitor

Alcohol (Ethyl): CNS Depressants may increase CNS depressant effects of Alcohol (Ethyl). Risk C: Monitor

Alizapride: May increase CNS depressant effects of CNS Depressants. Risk C: Monitor

Amisulpride (Oral): May increase CNS depressant effects of CNS Depressants. Risk C: Monitor

Articaine: May increase CNS depressant effects of CNS Depressants. Management: Consider reducing the dose of articaine if possible when used in patients who are also receiving CNS depressants. Monitor for excessive CNS depressant effects with any combined use. Risk D: Consider Therapy Modification

Azelastine (Nasal): May increase CNS depressant effects of CNS Depressants. Risk X: Avoid

Benperidol: May increase CNS depressant effects of CNS Depressants. Risk C: Monitor

Blonanserin: CNS Depressants may increase CNS depressant effects of Blonanserin. Management: Use caution if coadministering blonanserin and CNS depressants; dose reduction of the other CNS depressant may be required. Strong CNS depressants should not be coadministered with blonanserin. Risk D: Consider Therapy Modification

Brimonidine (Topical): May increase CNS depressant effects of CNS Depressants. Risk C: Monitor

Bromopride: May increase CNS depressant effects of CNS Depressants. Risk C: Monitor

Bromperidol: May increase CNS depressant effects of CNS Depressants. Risk X: Avoid

Buclizine: May increase CNS depressant effects of CNS Depressants. Risk C: Monitor

Buprenorphine: CNS Depressants may increase CNS depressant effects of Buprenorphine. Management: Consider reduced doses of other CNS depressants, and avoiding such drugs in patients at high risk of buprenorphine overuse/self-injection. Initiate buprenorphine at lower doses in patients already receiving CNS depressants. Risk D: Consider Therapy Modification

BuPROPion: May increase CNS depressant effects of Brexanolone. Risk C: Monitor

BusPIRone: May increase CNS depressant effects of CNS Depressants. Risk C: Monitor

Cannabinoid-Containing Products: CNS Depressants may increase CNS depressant effects of Cannabinoid-Containing Products. Risk C: Monitor

Cetirizine (Systemic): May increase CNS depressant effects of CNS Depressants. Management: Consider avoiding this combination if possible. If required, monitor for excessive sedation or CNS depression, limit the dose and duration of combination therapy, and consider CNS depressant dose reductions. Risk D: Consider Therapy Modification

Chloral Hydrate/Chloral Betaine: CNS Depressants may increase CNS depressant effects of Chloral Hydrate/Chloral Betaine. Management: Consider alternatives to the use of chloral hydrate or chloral betaine and additional CNS depressants. If combined, consider a dose reduction of either agent and monitor closely for enhanced CNS depressive effects. Risk D: Consider Therapy Modification

Chlormethiazole: May increase CNS depressant effects of CNS Depressants. Management: Monitor closely for evidence of excessive CNS depression. The chlormethiazole labeling states that an appropriately reduced dose should be used if such a combination must be used. Risk D: Consider Therapy Modification

Chlorphenesin Carbamate: May increase adverse/toxic effects of CNS Depressants. Risk C: Monitor

CNS Depressants: May increase CNS depressant effects of Brexanolone. Risk C: Monitor

Dantrolene: May increase CNS depressant effects of CNS Depressants. Risk C: Monitor

Daridorexant: May increase CNS depressant effects of CNS Depressants. Management: Dose reduction of daridorexant and/or any other CNS depressant may be necessary. Use of daridorexant with alcohol is not recommended, and the use of daridorexant with any other drug to treat insomnia is not recommended. Risk D: Consider Therapy Modification

DexmedeTOMIDine: CNS Depressants may increase CNS depressant effects of DexmedeTOMIDine. Management: Monitor for increased CNS depression during coadministration of dexmedetomidine and CNS depressants, and consider dose reductions of either agent to avoid excessive CNS depression. Risk D: Consider Therapy Modification

Difelikefalin: May increase CNS depressant effects of CNS Depressants. Risk C: Monitor

Difenoxin: May increase CNS depressant effects of CNS Depressants. Risk C: Monitor

Dihydralazine: CNS Depressants may increase hypotensive effects of Dihydralazine. Risk C: Monitor

Dimethindene (Topical): May increase CNS depressant effects of CNS Depressants. Risk C: Monitor

Dothiepin: May increase CNS depressant effects of CNS Depressants. Risk C: Monitor

Doxylamine: CNS Depressants may increase CNS depressant effects of Doxylamine. Risk C: Monitor

DroPERidol: May increase CNS depressant effects of CNS Depressants. Management: Consider dose reductions of droperidol or of other CNS agents (eg, opioids, barbiturates) with concomitant use. Risk D: Consider Therapy Modification

Emedastine (Systemic): May increase CNS depressant effects of CNS Depressants. Management: Consider avoiding this combination if possible. If required, monitor for excessive sedation or CNS depression, limit the dose and duration of combination therapy, and consider CNS depressant dose reductions. Risk C: Monitor

Entacapone: May increase CNS depressant effects of CNS Depressants. Risk C: Monitor

Esketamine (Nasal): May increase CNS depressant effects of CNS Depressants. Risk C: Monitor

Flunarizine: CNS Depressants may increase CNS depressant effects of Flunarizine. Risk X: Avoid

Flunitrazepam: CNS Depressants may increase CNS depressant effects of Flunitrazepam. Management: Reduce the dose of CNS depressants when combined with flunitrazepam and monitor patients for evidence of CNS depression (eg, sedation, respiratory depression). Use non-CNS depressant alternatives when available. Risk D: Consider Therapy Modification

HydrOXYzine: May increase CNS depressant effects of CNS Depressants. Management: Consider a decrease in the CNS depressant dose, as appropriate, when used together with hydroxyzine. Increase monitoring of signs/symptoms of CNS depression in any patient receiving hydroxyzine together with another CNS depressant. Risk D: Consider Therapy Modification

Isocarboxazid: May increase CNS depressant effects of Brexanolone. Risk C: Monitor

Ixabepilone: May increase CNS depressant effects of CNS Depressants. Risk C: Monitor

Kava Kava: May increase CNS depressant effects of CNS Depressants. Risk C: Monitor

Ketotifen (Systemic): May increase CNS depressant effects of CNS Depressants. Risk C: Monitor

Kratom: May increase CNS depressant effects of CNS Depressants. Risk X: Avoid

Lemborexant: May increase CNS depressant effects of CNS Depressants. Management: Dosage adjustments of lemborexant and of concomitant CNS depressants may be necessary when administered together because of potentially additive CNS depressant effects. Close monitoring for CNS depressant effects is necessary. Risk D: Consider Therapy Modification

Levocetirizine: May increase CNS depressant effects of CNS Depressants. Risk C: Monitor

Lisuride: May increase CNS depressant effects of CNS Depressants. Risk C: Monitor

Lofepramine: May increase CNS depressant effects of CNS Depressants. Risk C: Monitor

Lofexidine: May increase CNS depressant effects of CNS Depressants. Risk C: Monitor

Loxapine: CNS Depressants may increase CNS depressant effects of Loxapine. Management: Consider reducing the dose of CNS depressants administered concomitantly with loxapine due to an increased risk of respiratory depression, sedation, hypotension, and syncope. Risk D: Consider Therapy Modification

Magnesium Sulfate: May increase CNS depressant effects of CNS Depressants. Risk C: Monitor

Melitracen [INT]: May increase CNS depressant effects of CNS Depressants. Risk C: Monitor

Mequitazine: May increase CNS depressant effects of CNS Depressants. Risk C: Monitor

Metergoline: May increase CNS depressant effects of CNS Depressants. Risk C: Monitor

Methotrimeprazine: CNS Depressants may increase CNS depressant effects of Methotrimeprazine. Methotrimeprazine may increase CNS depressant effects of CNS Depressants. Management: Reduce the usual dose of CNS depressants by 50% if starting methotrimeprazine until the dose of methotrimeprazine is stable. Monitor patient closely for evidence of CNS depression. Risk D: Consider Therapy Modification

Methoxyflurane: May increase CNS depressant effects of CNS Depressants. Risk C: Monitor

Metoclopramide: May increase CNS depressant effects of CNS Depressants. Risk C: Monitor

MetyroSINE: CNS Depressants may increase sedative effects of MetyroSINE. Risk C: Monitor

Minocycline (Systemic): May increase CNS depressant effects of CNS Depressants. Risk C: Monitor

Moclobemide: May increase CNS depressant effects of Brexanolone. Risk C: Monitor

Moxonidine: May increase CNS depressant effects of CNS Depressants. Risk C: Monitor

Nabilone: May increase CNS depressant effects of CNS Depressants. Risk X: Avoid

Nalfurafine: May increase CNS depressant effects of CNS Depressants. Risk C: Monitor

Noscapine: CNS Depressants may increase adverse/toxic effects of Noscapine. Risk X: Avoid

Olopatadine (Nasal): May increase CNS depressant effects of CNS Depressants. Risk X: Avoid

Opicapone: May increase CNS depressant effects of CNS Depressants. Risk C: Monitor

Opioid Agonists: CNS Depressants may increase CNS depressant effects of Opioid Agonists. Management: Avoid concomitant use of opioid agonists and benzodiazepines or other CNS depressants when possible. These agents should only be combined if alternative treatment options are inadequate. If combined, limit the dosages and duration of each drug. Risk D: Consider Therapy Modification

Opipramol: May increase CNS depressant effects of CNS Depressants. Risk C: Monitor

Orphenadrine: CNS Depressants may increase CNS depressant effects of Orphenadrine. Risk X: Avoid

Oxomemazine: May increase CNS depressant effects of CNS Depressants. Risk X: Avoid

Oxybate Salt Products: CNS Depressants may increase CNS depressant effects of Oxybate Salt Products. Management: Consider alternatives to this combination when possible. If combined, dose reduction or discontinuation of one or more CNS depressants (including the oxybate salt product) should be considered. Interrupt oxybate salt treatment during short-term opioid use Risk D: Consider Therapy Modification

OxyCODONE: CNS Depressants may increase CNS depressant effects of OxyCODONE. Management: Avoid concomitant use of oxycodone and benzodiazepines or other CNS depressants when possible. These agents should only be combined if alternative treatment options are inadequate. If combined, limit the dosages and duration of each drug. Risk D: Consider Therapy Modification

Paliperidone: May increase CNS depressant effects of CNS Depressants. Risk C: Monitor

Paraldehyde: CNS Depressants may increase CNS depressant effects of Paraldehyde. Risk X: Avoid

Perampanel: May increase CNS depressant effects of CNS Depressants. Risk C: Monitor

Periciazine: May increase CNS depressant effects of CNS Depressants. Risk C: Monitor

Phenelzine: May increase CNS depressant effects of Brexanolone. Risk C: Monitor

Pipamperone: May increase adverse/toxic effects of CNS Depressants. Risk C: Monitor

Piribedil: CNS Depressants may increase CNS depressant effects of Piribedil. Risk C: Monitor

Pizotifen: May increase CNS depressant effects of CNS Depressants. Risk C: Monitor

Pramipexole: CNS Depressants may increase sedative effects of Pramipexole. Risk C: Monitor

Procarbazine: May increase CNS depressant effects of CNS Depressants. Risk C: Monitor

Rilmenidine: May increase CNS depressant effects of CNS Depressants. Risk C: Monitor

Ropeginterferon Alfa-2b: CNS Depressants may increase adverse/toxic effects of Ropeginterferon Alfa-2b. Specifically, the risk of neuropsychiatric adverse effects may be increased. Management: Avoid coadministration of ropeginterferon alfa-2b and other CNS depressants. If this combination cannot be avoided, monitor patients for neuropsychiatric adverse effects (eg, depression, suicidal ideation, aggression, mania). Risk D: Consider Therapy Modification

ROPINIRole: CNS Depressants may increase sedative effects of ROPINIRole. Risk C: Monitor

Rotigotine: CNS Depressants may increase sedative effects of Rotigotine. Risk C: Monitor

Selective Serotonin Reuptake Inhibitor: May increase CNS depressant effects of Brexanolone. Risk C: Monitor

Selegiline: May increase CNS depressant effects of Brexanolone. Risk C: Monitor

Serotonin Reuptake Inhibitor/Antagonists: May increase CNS depressant effects of Brexanolone. Risk C: Monitor

Serotonin/Norepinephrine Reuptake Inhibitor: May increase CNS depressant effects of Brexanolone. Risk C: Monitor

Suvorexant: CNS Depressants may increase CNS depressant effects of Suvorexant. Management: Dose reduction of suvorexant and/or any other CNS depressant may be necessary. Use of suvorexant with alcohol is not recommended, and the use of suvorexant with any other drug to treat insomnia is not recommended. Risk D: Consider Therapy Modification

Thalidomide: CNS Depressants may increase CNS depressant effects of Thalidomide. Risk X: Avoid

Tranylcypromine: May increase CNS depressant effects of Brexanolone. Risk C: Monitor

Trimeprazine: May increase CNS depressant effects of CNS Depressants. Risk C: Monitor

Valerian: May increase CNS depressant effects of CNS Depressants. Risk C: Monitor

Zolpidem: CNS Depressants may increase CNS depressant effects of Zolpidem. Management: Reduce the Intermezzo brand sublingual zolpidem adult dose to 1.75 mg for men who are also receiving other CNS depressants. No such dose change is recommended for women. Avoid use with other CNS depressants at bedtime; avoid use with alcohol. Risk D: Consider Therapy Modification

Zuranolone: May increase CNS depressant effects of CNS Depressants. Management: Consider alternatives to the use of zuranolone with other CNS depressants or alcohol. If combined, consider a zuranolone dose reduction and monitor patients closely for increased CNS depressant effects. Risk D: Consider Therapy Modification

Pregnancy Considerations

Based on the mechanism of action and data from animal reproduction studies, in utero exposure to brexanolone may cause fetal harm.

Untreated and undertreated mental health conditions are associated with adverse pregnancy outcomes (ACOG 2023). Untreated postpartum depression (PPD) is associated with impaired infant attachment and feeding, which is then associated with long-term impact on development (Saharoy 2023). Although PPD may have an onset during the third trimester, brexanolone is initiated after delivery. Management should be made as part of a shared decision-making process. Agents other than brexanolone should be used when treatment for depression requires initiation during pregnancy (ACOG 2023).

Data collection to monitor pregnancy and infant outcomes following exposure to antidepressant medications is ongoing. Pregnant patients 45 years and younger with a history of psychiatric illness are encouraged to enroll in the National Pregnancy Registry for Antidepressants (1-866-961-2388 or https://womensmentalhealth.org/research/pregnancyregistry/antidepressants).

Monitoring Parameters

Continuous pulse oximetry; sedation level every 2 hours during planned, nonsleep periods; suicidal ideation.

Mechanism of Action

Mechanism of action is not fully understood, but is thought to be related to positive allosteric modulation of GABA-A receptors.

Pharmacokinetics (Adult Data Unless Noted)

Distribution: Vd: ~3 L/kg

Protein binding: >99%

Metabolism: Extensively metabolized by keto-reduction (AKRs), glucuronidation (UGTs), and sulfation (SULTs) to inactive metabolites

Half-life elimination: ~9 hours

Excretion: Feces: 47%; Urine: 42% (<1% as unchanged drug)

Brand Names: International
International Brand Names by Country
For country code abbreviations (show table)

  • (PR) Puerto Rico: Zulresso
  1. American College of Obstetricians and Gynecologists (ACOG). Treatment and management of mental health conditions during pregnancy and postpartum: ACOG clinical practice guideline no. 5. Obstet Gynecol. 2023;141(6):1262-1288. doi:10.1097/AOG.0000000000005202 [PubMed 37486661]
  2. Anderson PO, Sauberan JB. Modeling drug passage into human milk. Clin Pharmacol Ther. 2016;100(1):42-52. doi:10.1002/cpt.377 [PubMed 27060684]
  3. Association of Women’s Health, Obstetric and Neonatal Nurses. Maternal and newborn safety during the administration of brexanolone: AWHONN practice brief number 10. Nurs Womens Health. 2020;24(6):468-469. doi:10.1016/j.nwh.2020.08.003 [PubMed 33069599]
  4. Ito S. Drug therapy for breast-feeding women. N Engl J Med. 2000;343(2):118-126. [PubMed 10891521]
  5. Meltzer-Brody S, Colquhoun H, Riesenberg R, et al. Brexanolone injection in post-partum depression: two multicentre, double-blind, randomised, placebo-controlled, phase 3 trials [published correction appears in Lancet. 2018;392(10153):1116]. Lancet. 2018;392(10152):1058-1070. doi: 10.1016/S0140-6736(18)31551-4. [PubMed 30177236]
  6. Rosen-Carole C, Ito S. Using brexanolone for postpartum depression must account for lactation. Matern Child Health J. 2021;25(7):1007-1009. doi:10.1007/s10995-021-03144-0 [PubMed 34019187]
  7. Saharoy R, Potdukhe A, Wanjari M, Taksande AB. Postpartum depression and maternal care: exploring the complex effects on mothers and infants. Cureus. 2023;15(7):e41381. doi:10.7759/cureus.41381 [PubMed 37546054]
  8. Wald J, Henningsson A, Hanze E, et al. Allopregnanolone concentrations in breast milk and plasma from healthy volunteers receiving brexanolone injection, with population pharmacokinetic modeling of potential relative infant dose. Clin Pharmacokinet. 2022;61(9):1307-1319. doi:10.1007/s40262-022-01155-w [PubMed 35869362]
  9. Zulresso (brexanolone) [prescribing information]. Cambridge, MA: Sage Therapeutics Inc; July 2024.
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