What to Know About Addyi (flibanserin)

In This Article

When it comes to medications for treating female sexual dysfunction, options are limited. Addyi (flibanserin) is one of two medications currently approved by the FDA to treat female hypoactive sexual desire disorder (HSDD). Taken in the form of a pink tablet, Addyi is a non-hormonal option indicated for premenopausal women. It belongs to a class of drugs called Serotonin 5-HT receptor agonists, functioning as an agonist on 5-HT1A receptors and an antagonist on 5-HT2A receptors.

Uses

Addyi is intended for women experiencing hypoactive (low) sexual desire disorder regardless of the sexual partner, activity, or situation. These women will not have experienced sexual desire issues in the past, and cannot attribute the problem to mental health, other health problems, relationship issues, or drug use.

HSDD is just one type of female sexual dysfunction, a disorder that refers to a reduction or absence of sexual interest in a woman that lasts six or more months and causes distress or interpersonal difficulties.

Moreover, such disinterest is unattributable to another disease (think diabetes or depression) or drug (think antidepressants). It's important that this loss of sexual desire causes distress or difficulty because, otherwise, it's not really a problem.

How It Works

While the exact mechanism of action for Addyi is unknown, it is believed to bind to serotonin receptors in the central nervous system, becoming an agonist on 5-HT1A receptors and an antagonist on 5-HT2A receptors. As a result, dopamine levels in the prefrontal cortex area of the brain may increase while serotonin levels decrease. The net effect may be improved sexual desire.

Of particular note, Addyi works on neurotransmitters, not hormones. And it shouldn't be considered "female Viagra." Viagra works by increasing blood flow to the genitals using a completely different mechanism and affecting a different site of action (genitals vs. brain).

Before Taking

Prior to starting Addyi, talk to your doctor about any medical conditions, and mention if you:

  • Drink alcohol or have a history of alcohol abuse
  • Use drugs or have a history of drug abuse
  • Have or have ever had depression or mental health problems
  • Have low blood pressure, or a medical condition that could cause it
  • Are pregnant or planning on becoming pregnant
  • Are breastfeeding

Precautions, Contraindications, and Interactions

If you drink alcohol or have liver problems, you should not take Addyi. In addition, you should not take Addyi if you're already taking any of the following medications:

  • Certain HIV-1 medications:
    • amprenavir
    • atazanavir
    • fosamprenavir
    • ritonavir
    • saquinavir
    • nelfinavir
    • indinavir
  • Certain orally-administered fungal infections:
    • fluconazole
    • ketoconazole
    • itraconazole
    • posaconazole
  • Certain antibiotics:
    • ciprofloxacin
    • telithromycin
    • erythromycin
    • clarithromycin
  • Certain Hepatitis C medications:
    • boceprevir
    • telaprevir
  • Certain high blood pressure or angina medications:
    • diltiazem
    • verapamil
    • conivaptan
  • The depression medication nefazodone

Other HSDD Medication

One other drug is FDA-approved to treat HSDD in premenopausal women: Vyleesi (bremelanotide). Unlike Addyi, Vyleesi is administered via injection in the abdomen or thigh, and should be taken 45 minutes ahead of anticipated sexual activity. Rather than take it at the same time daily, patients can decide when to take Vyleesi, as long as they do not exceed more than one dose within 24 hours or more than eight doses a month.

Dosage

Take Addyi exactly as prescribed by your doctor. According to its label, patients should take one 100-milligram tablet per day at bedtime. If you miss a dose, do not double the next dose or take it the next morning; simply take your next dose at bedtime the following day. Generally, it takes eight weeks for Addyi to be effective.

Side Effects

You are at an increased risk for both low blood pressure and fainting if you take Addyi and drink alcohol, or take any of the medications mentioned above.

Low blood pressure and loss of consciousness are possible side effects even if you don't drink alcohol or take other medications or supplements. If you do lose consciousness, seek medical attention as soon as you can.

Common Side Effects

  • Dizziness
  • Sleepiness
  • Dry mouth
  • Difficulty falling asleep or staying asleep
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Article Sources

  1. National Institutes of Health. Flibanserin. Drug Information Portal, U.S. National Library of Medicine. Updated July 2019.

  2. Food and Drug Administration. Addyi Medication Guide. Issued August 2015.

  3. National Institutes of Health. Flibanserin. PubChem, National Center for Biotechnology Information.

  4. Food and Drug Administration. FDA approves new treatment for hypoactive sexual desire disorder in premenopausal women. FDA Newsroom. Published June 21, 2019.