Zulresso vs. Irenka

Zulresso (brexanolone) Injection and Irenka (duloxetine capsule) are antidepressants used to treat depression.

Zulresso is specifically used to treat postpartum depression (PPD) in adults. Zulresso is available only through a restricted program under a Risk Evaluation and Mitigation Strategy (REMS) called the Zulresso REMS.

Irenka is also used to treat generalized anxiety disorder, diabetic peripheral neuropathy, and chronic musculoskeletal pain.

Zulresso and Irenka are different types of antidepressants. Zulresso is a neuroactive steroid gamma-aminobutyric acid (GABA) A receptor positive modulator and Irenka is a selective serotonin and norepinephrine reuptake inhibitor (SNRI).

Side effects of Zulresso and Irenka that are similar include drowsiness, fatigue, sleepiness, and dry mouth.

Side effects of Zulresso that are different from Irenka include loss of consciousness, flushing, and hot flushes.

Side effects of Irenka that are different from Zulresso include nausea, headache, insomnia, constipation, dizziness, diarrhea, decreased appetite, increased sweating, and abdominal pain.

Both Zulresso and Irenka may interact with other antidepressants.

Zulresso may also interact with CNS depressants (e.g., opioids, benzodiazepines).

Irenka may also interact with monoamine oxidase inhibitors (MAOIs), cimetidine, fluoroquinolone antibiotics, nonsteroidal anti-inflammatory drugs (NSAIDs), aspirin, warfarin, aluminum- and magnesium-containing antacids, theophylline, caffeine, desipramine, alcohol, triptans, fentanyl, lithium, tramadol, tryptophan, buspirone, and St. John's wort.

Common side effects of Zulresso include:

• nausea
• diarrhea
• dry mouth
• constipation
• vomiting
• gas
• dizziness
• abnormal dreams
• itching, and
• decreased sexual desire

Common side effects of Irenka include:

• nausea,
• headache,
• dry mouth,
• drowsiness,
• fatigue,
• insomnia,
• constipation,
• dizziness,
• diarrhea,
• decreased appetite,
• increased sweating, and
• abdominal pain

Zulresso (vortioxetine) tablets are an antidepressant indicated for the treatment of major depressive disorder (MDD).

Irenka (duloxetine capsule) is a serotonin-norepinephrine reuptake inhibitor (SNRI) antidepressant used to treat major depressive disorder, generalized anxiety disorder, diabetic peripheral neuropathy, and chronic musculoskeletal pain.

Zulresso may interact with monoamine oxidase inhibitors (MAOIs), selective serotonin reuptake inhibitors (SSRIs), serotonin norepinephrine reuptake inhibitors (SNRIs), triptans, buspirone, tramadol, tryptophan products, NSAIDs, aspirin, warfarin, bupropion, fluoxetine, paroxetine, quinidine, rifampicin, carbamazepine, and phenytoin. Tell your doctor all medications and supplements you use.

Irenka may interact with monoamine oxidase inhibitors (MAOIs), cimetidine, fluoroquinolone antibiotics, selective serotonin reuptake inhibitors (SSRIs), nonsteroidal anti-inflammatory drugs (NSAIDs), aspirin, warfarin, aluminum- and magnesium-containing antacids, theophylline, caffeine, desipramine, alcohol, triptans, tricyclic antidepressants, fentanyl, lithium, tramadol, tryptophan, buspirone, and St. John's wort. Tell your doctor all medications and supplements you use.

The recommended starting dose of Zulresso is 10 mg administered orally once daily without regard to meals. Dosage should then be increased to 20 mg/day, as tolerated.

The dose of Irenka is 40 mg/day (given as 20 mg twice daily) to 60 mg/day (given either once daily or as 30 mg twice daily) for major depressive disorder, and 60 mg/day for generalized anxiety disorder, diabetic peripheral neuropathy, and chronic musculoskeletal pain.