What is the Female Viagra?

If you’re new to the party, welcome. The medication known as Flibanserin, Addyi, or “The Female Viagra” was released on the market in 2015. The initial excitement was high. Pop a pill, get your sex drive back, easy as pie. But with all medications, there are benefits and limitations. Let’s talk about both.

How Do I Take Flibanserin? What Must I Avoid?

Dosing:

Typical dosing is one tab taken by mouth daily. Current recommendation is to take medication at night time to decrease risk of low blood pressure and fainting.

Interaction with alcohol:

The use of flibanserin and alcohol together close in time increases the risk of severe hypotension and syncope (aka low blood pressure and passing out/fainting). You should wait two hours after 1-2 alcoholic beverages before taking Flibanserin. If you have 3 or more drinks on one occasion, you should skip your dose that day. For most people, this is a limiting factor and could change how they proceed with their “date night.” Having 1 or 2 glasses of wine with your dinner isn’t an option, and if we’re being honest, most women with low sexual desire will use alcohol as a social/sexual lubricant.

Contraindicated with strong or moderate CYP3A4 inhibitors:

Use of these medications with flibanserin can cause severe hypotension and syncope. There is a long list of medications that can have this effect, so always keep your provider updated on what you are taking. There are also herbs like St. John’s Wort, and foods like grapefruit that can have a similar effect, and should be avoided. 

Use: Labeled Indications

Hypoactive sexual desire disorder: Treatment of premenopausal patients with hypoactive sexual desire disorder (HSDD), which means low sexual desire that causes distress or interpersonal difficulty and not due to a coexisting medical or psychiatric condition, problems within the relationship, or the effects of a medication or other drug substance.

Limitations of use: Flibanserin is not indicated for the treatment of HSDD in postmenopausal women or in men, or to enhance sexual performance.

From my perspective, this is a huge limiting factor as most of my patients who are presenting with “low libido” are postmenopausal, or are getting close. For more information on “what do you when you just don’t want to,” I have a blog post for that.

Reproductive Considerations

An increased risk of adverse events was not observed with use of hormonal contraceptives and Flibanserin. Oral contraceptives are weak CYP3A4 inhibitors; use caution in patients taking flibanserin with multiple weak CYP3A4 inhibitors.

Pregnancy Considerations

Adverse events were observed in some animal reproduction studies.

Outcome information on pregnancy while taking Flibanserin in humans is minimal, so probably best to stay away for now.

Breastfeeding Considerations

It is not known if flibanserin is present in breast milk.

Due to the potential for adverse reactions in the breastfeeding infant, including sedation, breastfeeding is not recommended by the manufacturer.

Bottom Line: This medication can ONLY be used before menopause. It cannot be used at the same time as alcohol. And it is not guaranteed that it will bring an individual’s libido up to a high level, or even a place they are happy with. Feel free to ask your provider about this medication. It could potentially help, but it no silver bullet.

All above information was gathered on UpToDate. There are no sponsorships or payments to disclose.