Brexanolone (Zulresso™)


Indications for Prior Authorization:
  • Indicated for the treatment of postpartum depression (PPD) in adults.
Patients must meet the following criteria for the indication(s) above:
  • Patient is 18 years of age or older, AND
  • Diagnosis of postpartum depression (PPD), AND
  • Documentation of HAM-D score range, PHQ-9 score, or MADRS score range indicating moderate-to-severe PPD, AND
  • Tried and failed an 8-week trial of a selective serotonin reuptake inhibitor (SSRI) (e.g. paroxetine, sertraline, citalopram), serotonin-norepinephrine reuptake inhibitor (SNRI) (e.g. desvenlafaxine, duloxetine, venlafaxine), tricyclic antidepressant (TCA) (e.g. nortriptyline), bupropion, or mirtazapine, AND
  • No more than 6 months have passed since giving birth, AND
  • Avoid use in patients with end stage renal disease (ESRD)
  • Administered as a continuous intravenous infusion over 60 hours (2.5 days):
  • Recommended dose:
    • 0-4 hours: 30 mcg/kg/hour
    • 4-24 hours: increase dose to 60 mcg/kg/hour
    • 24-52 hours: increase dose to 90 mcg/kg/hour
    • 52-56 hours: decrease dose to 60 mcg/kg/hour
    • 56-60 hours: decrease dose to 30 mcg/kg/hour
  • Dose does not exceed 90 mcg/kg per hour over 60 hours
  • 1 IV infusion

Last review date: February 18, 2020

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