Flibanserin: Side Effects, Warnings, Interactions, And Dosage
Flibanserin, more commonly available under its brand name – Addyi, is a drug used to treat low sexual desire, especially in premenopausal women. Originally created as an anti-depressant, the FDA approved it for treating female sexual interest/arousal disorders (FSAID) back in 2015.
FDA conducted three clinical trials over the course of 24 weeks. These trials brought them modest results with approximately 10 percent of premenopausal women reacting positively to the medicine. They reported a “much improved” status after the completion.
Addyi is not yet FDA approved for postmenopausal women since as per trials, it did not show any significant improvements.
What is Flibanserin?
This prescribed drug is ideal for women who are diagnosed with acquired generalized hypoactive sexual desire disorder (HSDD). Remember, it is not used to improve sexual performance. Rather, it is used by premenopausal women who do not experience sexual desire and thus experience stress or interpersonal difficulties as a result.
Who should not take this medicine:
- Women who experience a lack of sexual arousal due to relationship issues, underlying biological or neurological reasons, or due to the effect of other drugs or medicines.
- Postmenopausal women
Flibanserin works by suppressing the serotonin activity in the brain while boosting dopamine and norepinephrine. Both of these neurotransmitters are responsible for sexual arousal and promoting sexual desire respectively.
Side Effects Of Flibanserin
The most common side effects reported during the trial and by other patients are:
- Hypersomnia or sleepiness
- Insomnia or lack of sleep
- Dry mouth
Also Read: Effective Ways To Treat Insomnia
Taking Flibanserin by itself can increase the risk of low blood pressure (hypotension) and fainting episodes. It is advised to not consume the drug at least two hours before or after drinking alcohol, at any other time than before bedtime, and more than the prescribed dose. All of these can lead to unwanted reactions.
Only a few people out of the majority might experience the less common severe symptoms like:
- Abdominal pain
- Abnormal bleeding (menstrual spotting)
Rashes or itching due to an allergic reaction to this medication is a rare case, but not impossible. Immediately get help or ask someone to get help in case of any dizziness, rashes, itching, or breathing troubles.
Warnings And Interactions
1. Alcohol Interaction
Alcohol and Flibanserin contradict each other in many ways. Alcohol consumption can increase the risk of drowsiness or sudden loss of consciousness while also causing low blood pressure.
Many studies have shown that moderate drinking is fine but medications can be highly subjective. It usually depends on the specific patient. The doctor will likely take into consideration any history of alcohol usage or abuse and other medical histories before prescribing Flibanserin. The FDA prescribes to abstain from drinking completely when consuming Flibanserin to prevent its adverse effects.
2. Pregnancy & Lactation
The effects of Flibanserin are unknown during pregnancy. However, to prevent any adverse effects on the fetus, abstain from consuming the drug unless absolutely necessary. Doctors are unsure if human breast milk contains Flibanserin, thus its precise impact on a breastfed baby is unknown. It can lead to possible sedation. Avoid using the drug while lactating, and rather consult a doctor.
There are no indications for the use of Flibanserin on pediatric and geriatric patients. It is still advisable to avoid using the drug on children below the age of 18 and the elderly.
3. Birth control/Oral Contraceptives
Even though some studies suggest that using oral contraceptives can lead to a loss of sexual libido, there is no substantial evidence for the same. Many women reported no change in sexual desire if not an increase.
4. CYP3A4 Inhibitors
Foods or drugs containing CYP3A4 inhibitors can react negatively when mixed with Flibanserin. Moderate to high amounts of these inhibitors can slow down the speed by which your liver processes Flibanserin, thus causing the concentration of Flibanserin to rise in your blood. This can directly lead to a rise in the amount and severity of the possible side effects.
CYP3A4 inhibitors are also known to increase the chances of syncope (sudden loss of consciousness) and also lead to low blood pressure. Grapefruit and grapefruit products also contain these inhibitors; hence it is advised to avoid them. Others include certain antibiotics, HIV medications, and antifungal medications.
Certain hypnotics, opioids, and other CNS depressants were found to increase the risk of CNS depression when taken with Flibanserin, as compared to when the latter was taken alone.
5. Hepatic Or Liver Impairment
It is not advised for people with hepatic impairments to take Flibanserin. Studies concluded that the effect of Flibanserin can multiply thus making them more susceptible to syncope, low blood pressure, and CNS depression.
Drug interactions can drastically affect how your medication works or in the worst-case scenario, can increase the severity or chances of side-effects. Provide the doctor with a complete list of all past and current medications and do not change the dosage, start with or stop any of them without asking the doctor first.
Usually, the recommended dosage is 100mg taken orally at bedtime. As mentioned above, this is an important measure since Flibanserin taken during the daytime can lead to increased severity in adverse effects like syncope, low blood pressure, accidental injury, and CNS depression.
In case of a missed dose, continue with the normal dose from the next day onwards. Do not take an additional pill. Improvements should be visible within 8 weeks. If not, it is advised to stop the medication. However, consult a doctor before this.
An overdose of this drug can increase the severity or occurrence of adverse effects. With no known antidote for Flibanserin, immediately call for help in case of overdose.
Every human body is different and the reason one would seek a medication to treat sexual arousal varies.
- Dissatisfaction from partner
- Societal norms and expectations
- Lack of open communication with partner
If any of these reasons or other similar reasons are plaguing your thoughts, try consulting a therapist before going to a physician. It will most probably prove to be better in terms of efficacy.
Male erectile dysfunction has been studied since the late ’90s. It was only recently that doctors were baffled by the complexities of the female sexual libido. Therefore, there are only a few trusted solutions out there.
There are many factors that come into play when treating FSAD. It can even be due to a combination of these factors. Medications won’t always solve your problems and neither would they eliminate the need for you to go to therapy. Talk to a trusted and licensed healthcare provider for any sexual concerns. If the medication still does not help you nip the issue in the bud, try exploring other options.
November 27, 2020 Sam Bell