| Major Depressive Disorder
Fetzima vs Zoloft
Side-by-side clinical, coverage, and cost comparison for major depressive disorder.Deep comparison between: Fetzima vs Zoloft with Prescriber.AI
AI compares prescribing info and payer-specific access barriers across 1,200+ formularies. Here's a preview of what prescribers are already asking.Safety signalsZoloft has a higher rate of injection site reactions vs Fetzima based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Zoloft but not Fetzima, including UnitedHealthcare
Sign up to reveal the full AI analysis
Category
Fetzima
Zoloft
At A Glance
Oral
Once daily
SNRI
Oral
Daily
SSRI
Indications
- Major Depressive Disorder
- Major Depressive Disorder
- Obsessive-Compulsive Disorder
- Panic Disorder
- Post-Traumatic Stress Disorder
- Phobia, Social
- Premenstrual Dysphoric Disorder
Dosing
Major Depressive Disorder Initiate at 20 mg once daily for 2 days, then increase to 40 mg once daily; may increase in 40 mg increments at intervals of 2 or more days; max 120 mg once daily, oral, with or without food.
Renal Impairment Severe (CrCl 15-29 mL/min): max 40 mg once daily; moderate (CrCl 30-59 mL/min): max 80 mg once daily; ESRD: not recommended.
Major Depressive Disorder Starting 50 mg/day orally; max 200 mg/day; titrate by 25-50 mg/day increments once weekly if inadequate response.
Obsessive-Compulsive Disorder Starting 25 mg/day (ages 6-12) or 50 mg/day (ages >=13) orally; max 200 mg/day; titrate by 25-50 mg/day increments once weekly if inadequate response.
Panic Disorder, Post-Traumatic Stress Disorder, Phobia, Social Starting 25 mg/day orally; max 200 mg/day; titrate by 25-50 mg/day increments once weekly if inadequate response.
Premenstrual Dysphoric Disorder Continuous dosing: starting 50 mg/day orally, max 150 mg/day; intermittent (luteal phase only): starting 50 mg/day, max 100 mg/day.
Contraindications
- Hypersensitivity to levomilnacipran, milnacipran HCl, or any excipient in the formulation
- Concomitant use with MAOIs intended to treat psychiatric disorders, or within 7 days of stopping FETZIMA
- Use of FETZIMA within 14 days of stopping an MAOI intended to treat psychiatric disorders
- Concomitant use with linezolid or intravenous methylene blue
- Concomitant use or use within 14 days of stopping MAOIs, including linezolid and intravenous methylene blue, due to increased risk of serotonin syndrome
- Concomitant use of pimozide
- Known hypersensitivity to sertraline (e.g., anaphylaxis, angioedema)
- Concomitant use of disulfiram with ZOLOFT oral solution (contains alcohol)
Adverse Reactions
Most common (>=5%) Nausea, constipation, hyperhidrosis, heart rate increased, erectile dysfunction, ejaculation disorder, tachycardia, vomiting, palpitations
Serious Suicidal thoughts and behaviors, serotonin syndrome, elevated blood pressure, elevated heart rate, increased risk of bleeding, angle closure glaucoma, urinary hesitation or retention, activation of mania/hypomania, seizure, discontinuation syndrome, hyponatremia, sexual dysfunction
Postmarketing Takotsubo cardiomyopathy, anosmia, hyposmia
Most common (>=5%) Nausea, diarrhea/loose stools, tremor, dyspepsia, decreased appetite, hyperhidrosis, ejaculation failure, decreased libido
Serious Suicidal thoughts and behaviors, serotonin syndrome, QTc prolongation and ventricular arrhythmias, increased risk of bleeding, activation of mania/hypomania, seizures, angle-closure glaucoma, hyponatremia, sexual dysfunction
Postmarketing Agranulocytosis, aplastic anemia, Stevens-Johnson Syndrome, toxic epidermal necrolysis, severe liver events including hepatitis and liver failure, QTc-interval prolongation, ventricular tachycardia, extrapyramidal symptoms, pulmonary hypertension, cerebrovascular spasm
Pharmacology
Levomilnacipran is a potent and selective serotonin and norepinephrine reuptake inhibitor (SNRI) that potentiates serotonin and norepinephrine neurotransmission in the central nervous system through inhibition of reuptake at their respective transporters, with no significant affinity for other receptors, ion channels, or transporters.
Sertraline is a selective serotonin reuptake inhibitor (SSRI) that potentiates serotonergic activity in the central nervous system through inhibition of neuronal reuptake of serotonin (5-HT), with only very weak effects on norepinephrine and dopamine reuptake and no significant affinity for adrenergic, cholinergic, GABA, dopaminergic, or histaminergic receptors; it does not inhibit monoamine oxidase.
Enter your patient's insuranceCheck specific coverage details for your patient.
Most Common Insurance
Anthem BCBS
Fetzima
- Covered on 5 commercial plans
- PA (3/12) · Step Therapy (11/12) · Qty limit (12/12)
Zoloft
- Covered on 5 commercial plans
- PA (1/12) · Step Therapy (0/12) · Qty limit (3/12)
UnitedHealthcare
Fetzima
- Covered on 4 commercial plans
- PA (1/8) · Step Therapy (8/8) · Qty limit (6/8)
Zoloft
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Humana
Fetzima
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (3/3) · Qty limit (2/3)
Zoloft
- Covered on 0 commercial plans
- PA (0/3) · Step Therapy (0/3) · Qty limit (0/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
No savings programs available for Fetzima.
No savings programs available for Zoloft.
Compare Other Drugs
Let us handle your prior authsJust enter your patient's info and we'll:
- Verify eligibility with the payer.
- Pull the right PA forms directly from the payer.
- Submit, track & send live updates to your dashboard.
Free to start · HIPAA compliant
Next Steps for Your Patient
FetzimaView full Fetzima profile
ZoloftView full Zoloft profile
Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.