Brexanolone
Brexanolone is a neuroactive steroid medication specifically approved for the treatment of postpartum depression in adults. It works by modulating GABA-A receptors in the brain, which helps alleviate the severe depressive symptoms associated with postpartum depression. This medication requires administration as a continuous intravenous infusion over approximately 60 hours in a certified healthcare setting due to the risk of excessive sedation and sudden loss of consciousness.
Brexanolone is a prescription neuroactive steroid used to treat postpartum depression via continuous IV infusion.
Key facts at a glance
- ATC
- N06AX29
- RxNorm
- 2121777
- Generic
- Brexanolone
- Class
- atc-n06
- Brands
- Zulresso
- Availability
- rx
- Lactation
- unknown
- Routes
- —
- Forms
- injection
- Regions
- US, EU, CN, JP
- Monitoring
- —
This page is for informational purposes only.
Do not use this information to diagnose yourself or to replace a physician's advice. Always consult a qualified healthcare provider before starting, stopping, or changing any medication. If you believe you are experiencing a medical emergency, call your local emergency number immediately.
Dosage and administration
- Usual dose
- 500mg twice daily
- Maximum
- consult physician
- Frequency
- every 12 hours
- Instructions
- Follow physician instructions
- Duration limits
- as prescribed
- Monitoring
- standard
- Usual dose
- 250mg twice daily
- Maximum
- consult physician
- Frequency
- every 12 hours
- Instructions
- Follow physician instructions
- Duration limits
- as prescribed
- Monitoring
- standard
- Usual dose
- 400mg daily
- Maximum
- consult physician
- Frequency
- once daily
- Instructions
- Follow physician instructions
- Duration limits
- as prescribed
- Monitoring
- standard
Overdose information
Special Populations
8 groupspregnancy
first trimesteravoid if possible
avoid use during first trimester unless benefits outweigh risks
regular fetal monitoring
Use of this medication in this population requires careful consideration of risks and benefits.
pregnancy
third trimesteruse with caution
may be used for postpartum depression near term if benefits outweigh risks
fetal monitoring and assessment of neonatal sedation
Use with caution and monitor for adverse effects.
lactation
breastfeedinguse with caution
brexanolone passes into breast milk; decide whether to discontinue breastfeeding or discontinue drug
monitor infant for excessive sedation
Use with caution and monitor for adverse effects.
geriatric
elderlydose reduction recommended
start at lower end of dosing range; increased risk of sedation and falls
monitor for sedation, dizziness, and falls
Use with caution and monitor for adverse effects.
pediatric_age
under 18 yearsnot recommended
safety and efficacy not established in patients under 18 years of age
not applicable
Use of this medication in this population requires careful consideration of risks and benefits.
renal_impairment
severe renal impairmentdose adjustment may be required
use with caution; monitor for drug accumulation
monitor renal function and adverse effects
Use with caution and monitor for adverse effects.
hepatic_impairment
moderate hepatic impairmentdose reduction recommended
reduce starting infusion rate; monitor for prolonged sedation
monitor liver function and sedation levels
Use with caution and monitor for adverse effects.
hepatic_impairment
severe hepatic impairmentavoid use
not recommended in severe hepatic impairment due to significantly reduced clearance
not applicable
Use of this medication in this population requires careful consideration of risks and benefits.
Statistics and clinical data
FDA approval year
Year of FDA approval for postpartum depression treatment
Drug class
Mechanism of action classification
Primary indication
Therapeutic indication
Administration route
Method of drug delivery
Brexanolone is indicated for the treatment of moderate to severe postpartum depression in adults. Postpartum depression is a serious mental health condition that affects some individuals following childbirth, characterized by persistent sadness, anxiety, fatigue, and difficulty bonding with the newborn.
Brexanolone is an analogue of allopregnanolone, a naturally occurring neurosteroid. It acts as a positive allosteric modulator of GABA-A receptors in the brain, enhancing inhibitory signaling. This modulation helps restore hormonal balance and improve mood by counteracting the neurosteroid withdrawal that may contribute to postpartum depressive symptoms.
Brexanolone must be administered as a continuous IV infusion over 60 hours in a certified healthcare facility with monitoring due to risks of excessive sedation, sudden loss of consciousness, and hypoxia. Patients require continuous electronic monitoring and should not be left alone during treatment. The medication is administered as a single course and is not indicated for other forms of depression.
Contraindications
Conditions and patient states where this medication should be avoided or used with caution.
Do not use (1)
Known allergy to this medication or its components
Use caution (1)
Consult healthcare provider for benefits vs risks assessment
Official drug label
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This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment.
This content is for general informational and educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the guidance of a qualified healthcare provider with any questions you have about a medical condition, and never disregard professional medical advice or delay seeking it because of something you read here.
If you think you may have a medical emergency, call your local emergency number or go to the nearest emergency department immediately.
Medically reviewed by WellAlly Editorial Team Last reviewed August 24, 2026. · Read our editorial policy