Addyi (Flibanserin) - Oral

Warning:

Using alcohol with Addyi (flibanserin) can increase the risk of severe low blood pressure and fainting. Avoid drinking alcohol while you are using this medication.

Severe low blood pressure and fainting can also occur if Addyi is used with moderate or strong CYP3A4 inhibitors or in people with liver problems. Before starting Addyi, tell your healthcare provider about all of the medications you are taking.

What Is Addyi?

Addyi (flibanserin) is a prescription medication option for the treatment of hypoactive sexual desire disorder (HSDD) in people who have not gone through menopause. It’s thought to work by influencing chemicals in the brain—serotonin and sometimes dopamine.

Addyi is available in tablet form.

Drug Facts

Generic Name: Flibanserin

Brand Name(s): Addyi

Administration Route(s): Oral

Drug Availability: Prescription

Therapeutic Classification: Central nervous system agent

Available Generically: No

Controlled Substance: N/A

Active Ingredient: Flibanserin

Dosage Form(s): Tablet

What Is Addyi Used For?

Addyi is used to treat HSDD, which affects an estimated 10% of people assigned female at birth.

People with HSDD experience the following symptoms for at least six months:

  • Distressing feelings about low libido
  • Little motivation or desire to take part in sexual activity

Addyi is not used for those who have low sexual desire due to a coexisting medical or psychiatric condition, have problems within the relationship, or are experiencing the effects of a medication or other drug substance.

Although the Food and Drug Administration (FDA) approved Addyi as a medication option for premenopausal people with HSDD, it is not the first choice. Healthcare professionals generally recommend Addyi after trying other options, such as finding other potential HSDD causes—like alcohol use, medications, relationship issues, or sleeping difficulties.

The FDA has issued a black box warning, the agency’s strictest warning that appears on a prescription drug label, about the use of Addyi and alcohol. Using alcohol while taking Addyi can cause severe low blood pressure (hypotension) and fainting. 

Addyi should not be used by women who have gone through menopause, or by men. It is also not used to enhance sexual performance.

Addyi (Flibanserin) Drug Information

Verywell / Zoe Hansen

How to Take Addyi

Take Addyi once a day, at bedtime. Taking Addyi during the day raises your risk of drowsiness, sleepiness, and fainting due to low blood pressure.

There are also many things to keep in mind about mixing alcohol and Addyi. Drinking alcohol too close to your Addyi dose might lead to fainting due to drastically low blood pressure.

So, if you have had one to two drinks, wait at least two hours before taking your scheduled bedtime Addyi dose. If you’ve had three or more drinks, however, skip the evening Addyi dose. Then take the following tablet during the next night’s scheduled bedtime.

Also important, if you have already taken your Addyi dose for the evening, don’t drink any alcoholic beverages until the next day.

Storage

Addyi is a non-controlled prescription. Your healthcare provider may give you refills up to one year of the originally written date. Like many medications, you may store Addyi at room temperature, which is 77 F, with a safe storage range of 59 F to 86 F.

When traveling with Addyi, keep this medication in its original pharmacy container. To be safe, consider making a copy of your Addyi prescription.

How Long Does Addyi Take to Work?

Some people notice an improvement in their symptoms within four weeks of starting Addyi treatment.

What Are the Side Effects of Addyi?

This is not a complete list of side effects, and others may occur. A medical professional can advise you on side effects. If you experience other effects, contact your pharmacist or a medical professional. You may report side effects to the FDA at www.fda.gov/medwatch or 1-800-FDA-1088.

Similar to many medications, side effects are possible with Addyi. Talk to your healthcare provider about any side effects you experience, especially ones that persist or worsen.

Common Side Effects

Some common side effects with Addyi include:

  • Dizziness
  • Drowsiness or sleepiness
  • Dry mouth
  • Nausea
  • Tiredness
  • Sleeping difficulties

Severe Side Effects

Seek medical attention if you’re experiencing severe sleepiness. Also, seek immediate medical attention if you’re experiencing the following symptoms of dangerously low blood pressure:

  • Blue skin tone
  • Cold and sweaty skin
  • Fainting
  • Fast breathing
  • Severe dizziness and lightheadedness
  • Weak and rapid heartbeat

Long-Term Side Effects

Additional studies are needed to determine the long-term effects of taking Addyi.

Report Side Effects

Addyi may cause other side effects. Call your healthcare provider if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your provider may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting Program or by phone (800-332-1088).

Dosage: How Much Addyi Should I Take?

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The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For oral dosage form (tablets):
    • For treatment of hypoactive sexual desire disorder:
      • Adults—100 milligrams (mg) once a day at bedtime.
      • Children—Use is not recommended.

Modifications

Addyi is available as 100 mg tablets. However, some people may need to modify their treatment or be more closely monitored while taking Addyi.

People With Liver Concerns

The liver is responsible for clearing out Addyi from the body. If your liver doesn’t work as well as it used to, avoid Addyi. You might be at a higher risk of serious side effects due to higher amounts of medication in your body.

People With Slow CYP2C19

CYP2C19 is a protein in the liver that helps break down Addyi. If your CYP2C19 works slower than that in other people, there will be higher amounts of Addyi in your body. In this case, your healthcare provider may want to closely monitor you due to a higher risk of side effects.

Postmenopausal People

The manufacturer reported one death in a 54-year-old postmenopausal person who also had one to three drinks every day. After 14 days of taking Addyi, this individual passed away with a high blood alcohol level (BAC). Although the cause of death is not confirmed, Addyi isn’t recommended in postmenopausal individuals or older adults over 65 years of age.

Pregnant or Nursing Parents

Addyi has little data about its safety and effectiveness in pregnant people. Based on animal studies, however, the manufacturer couldn’t rule out potential harm to the unborn baby of pregnant parents.

There is also little safety data in nursing babies. In reference to animal studies, Addyi is present in the breast milk of rats. However, the manufacturer is unsure whether Addyi is also present in human breast milk. Although more studies are needed, the manufacturer doesn’t recommend taking Addyi while nursing—due to the potential for severe drowsiness and sleepiness in nursing babies.

Missed Dose

If you ever miss a dose of Addyi, don’t try to double up to take more than one dose at a time. Just wait to take the following Addyi dose at your next scheduled bedtime.

Overdose: What Happens If I Take Too Much Addyi?

If you accidentally took too many Addyi tablets, seek immediate medical attention. You might experience worsening side effects—like symptoms of very low blood pressure—with multiple Addyi doses.

What Happens If I Overdose on Addyi?

If you think you or someone else may have overdosed on Addyi call a healthcare provider or the Poison Control Center (800-222-1222).

If someone collapses or isn't breathing after taking Addyi, call 911 immediately.

Precautions

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It is very important that your doctor check your progress at regular visits to make sure that this medicine is working properly and to check for unwanted effects.

Do not use this medicine together with amprenavir, atazanavir (Reyataz®), boceprevir (Victrelis®), ciprofloxacin (Cipro®), clarithromycin (Biaxin®), conivaptan (Vaprisol®), diltiazem (Cardizem®), erythromycin (Ery-Tab®), fluconazole (Diflucan®), fosamprenavir (Lexiva®), indinavir (Crixivan®), itraconazole (Sporanox®), ketoconazole (Nizoral®), nefazodone, nelfinavir (Viracept®), posaconazole (Noxafil®), ritonavir (Norvir®), saquinavir (Invirase®), telaprevir, telithromycin (Ketek®), or verapamil (Calan®). Using these medicines together may increase risk for low blood pressure and fainting.

Lightheadedness, dizziness, or fainting may occur when you take flibanserin within 2 hours of drinking alcohol. It is recommended to wait at least 2 hours after drinking 1 or 2 standard alcoholic drinks (eg, one 12-ounce regular beer, 5 ounces of wine, or 1.5 ounces of distilled spirits or shot) before taking flibanserin at bedtime, or you may skip your dose if you drink 3 or more standard alcoholic drinks in the evening. If you have taken flibanserin at bedtime, do not drink alcohol until the following day.

This medicine will add to the effects of alcohol and other CNS depressants (medicines that may make you drowsy or less alert). Some examples of CNS depressants are antihistamines or medicines for hay fever, allergies, or colds, sedatives, tranquilizers, or sleeping medicine, prescription pain medicine or narcotics, medicine for seizures or barbiturates, muscle relaxants, or anesthetics, including some dental anesthetics. Check with your doctor before taking any of these medicines while you are using flibanserin.

If your condition does not improve within 8 weeks, or if it become worse, check with your doctor.

This medicine may cause you to feel dizzy, drowsy, or lightheaded. Avoid driving, using machines, or doing anything else that could be dangerous if you are not alert for at least 6 hours after you take this medicine and until you know how this medicine affects you. If you feel lightheaded, getting up slowing after sitting or lying down may help.

This medicine may cause serious allergic reactions, including anaphylaxis and angioedema, which can be life-threatening and require immediate medical attention. Check with your doctor right away if you have chest tightness, cough, difficulty swallowing, dizziness, fast heartbeat, hives, itching, skin rash, large, hive-like swelling on face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs, or unusual tiredness or weakness.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal (eg, St. John's wort) or vitamin supplements.

What Are Reasons I Shouldn’t Take Addyi?

There are several reasons why Addyi may not be the right treatment for you.

Your healthcare provider may avoid prescribing Addyi for you if you:

  • Take CYP3A4-inhibiting medications
  • Have liver concerns
  • Are breastfeeding
  • Are postmenopause

CYP3A4-Inhibiting Medication Use

Like CYP2C19, CYP3A4 is another protein in the liver that helps break down Addyi. Some medications might prevent CYP3A4 from working as well at breaking down Addyi.

Due to higher amounts of Addyi in your body, there is a higher risk of serious side effects, so avoid taking these medications and Addyi together. If you and your healthcare provider decide to stop the CYP3A4-inhibiting medication, your healthcare provider will recommend waiting two weeks before starting Addyi. On the other hand, if you and your healthcare provider decide to discontinue Addyi, then your healthcare provider will recommend a two-day waiting period before starting the CYP3A4-inhibiting medication.

Liver Concerns

The manufacturer recommends avoiding Addyi if you have a lower-functioning liver.

Breastfeeding

Due to the potential of severe drowsiness and sleepiness in the nursing baby, the manufacturer recommends avoiding Addyi while breastfeeding.

Postmenopausal Person 

Due to one report of death in a postmenopausal person, the manufacturer doesn’t recommend Addyi for postmenopausal individuals or older adults.

What Other Medications Interact With Addyi?

In addition to CYP3A4-inhibiting medications, there are other medications that may interact with Addyi when taken together.

The following substances can cause drug interactions with Addyi:

  • Alcohol: As previously mentioned, drinking alcohol too close to your Addyi dose can lead to fainting due to drastically low blood pressure.
  • CYP2C19-inhibiting medications: If you take a medication that prevents CYP2C19 from working as well, you may have a higher risk of side effects from higher amounts of Addyi in your body.
  • CYP3A4-inducing medications: Some medications influence CYP3A4 to break down Addyi more quickly, so there isn’t enough Addyi in your body to work as well. 
  • Digoxin: Taking Addyi and digoxin together raises the risk of severe heart-related side effects with digoxin. Your healthcare provider may want to closely monitor you.

If you have any questions about these drug interactions, ask your healthcare provider or pharmacist.

What Medications Are Similar?

Another FDA-approved medication used to treat HSDD is Vyleesi (bremelanotide). Like Addyi, Vyleesi isn’t the go-to choice for HSDD.

Vyleesi is thought to work differently from Addyi by mimicking a naturally occurring hormone in the brain called melanocortin—which has many functions that include sexual behaviors. Vyleesi is also not available as a convenient tablet. Instead, you must administer Vyleesi as an injection before sex.

Addyi and Vyleesi are usually not taken together. If you have any questions, please ask your healthcare provider.

Frequently Asked Questions

  • Where is Addyi available?

    Addyi is available as a prescription from a healthcare provider. If you are having symptoms of HSDD, talk to your provider about possible treatment options for you.

  • How much does Addyi cost?

    Since Addyi is a brand-name prescription medication, it’s usually expensive. If cost is a concern, the manufacturer does have a savings card for you to use at a retail pharmacy. Talk to your healthcare provider or pharmacist about financial assistance options.

  • What if Addyi isn’t working for me?

    If you don’t notice any improvement in your symptoms by eight weeks, notify your healthcare provider. They may stop Addyi and discuss the next steps with you.

How Can I Stay Healthy While Taking Addyi?

Having distressing feelings about low sexual desire can be lonely. Consider talking with your healthcare provider, who will help you find other potential HSDD causes. Also, counseling services may help uncover any possible underlying relationship issues.

If you and your healthcare provider decide to start Addyi, continue to talk with your healthcare provider about any medication changes to prevent drug interactions and serious side effects. Also, let your healthcare provider know whether Addyi is working for you. 

While taking Addyi, be cautious with alcohol. Drinking alcohol too close to your Addyi dose may lead to fainting due to very low blood pressure. There are so many things to remember about combining Addyi and alcohol. If you’re considering drinking alcohol while taking Addyi, talk with your healthcare provider.

Medical Disclaimer

Verywell Health's drug information is meant for education purposes only and not intended as a replacement for medical advice, diagnosis, or treatment from a healthcare professional. Consult your doctor before taking any new medication(s). IBM Watson Micromedex provides some of the drug content, as indicated on the page.

4 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Food and Drug Administration. ADDYI (flibanserin) tablets label. Updated October 2019.

  2. Clayton AH, Goldstein I, Kim NN, et al. The International Society for the Study of Women’s Sexual Health process of care for management of hypoactive sexual desire disorder in women. Mayo Clinic Proceedings. March 12, 2018. doi: https://doi.org/10.1016/j.mayocp.2017.11.002

  3. English C, Muhleisen A, Rey JA. Flibanserin (Addyi). The first FDA-approved treatment for female sexual interest/arousal disorder in premenopausal women. Pharmacy & Therapeutics. 2017 Apr; 42(4): 237-241.

  4. Food and Drug Administration. VYLEESI- bremelanotide injection. Updated February 2021.

By Ross Phan, PharmD, BCACP, BCGP, BCPS
Ross is a writer for Verywell with years of experience practicing pharmacy in various settings. She is also a board-certified clinical pharmacist and the founder of Off Script Consults.