cyclophosphamide will increase the level or effect of flibanserin by affecting hepatic/intestinal enzyme CYP3A4 metabolism.
| Side Effect | Incidence | Recommendations |
|---|---|---|
| Hypotension | Rare | Monitor blood pressure |
| Syncope | Rare | Avoid alcohol and sedatives |
| Severe Allergic Reactions | Very rare | Immediate medical intervention |
drospirenonedrospirenone will increase the level or effect of flibanserin by affecting hepatic/intestinal enzyme CYP3A4 metabolism.
Society and culture
tamoxifen will increase the level or effect of flibanserin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. tecovirimattecovirimat will increase the level or effect of flibanserin by affecting hepatic enzyme CYP2C19 metabolism. Monitor for adverse effects if coadministered with sensitive substrates of these enzymes.tecovirimat will decrease the level or effect of flibanserin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Monitor sensitive CYP3A4 substrates for effectiveness if coadministered. tecovirimat will increase the level or effect of flibanserin by affecting hepatic enzyme CYP2C19 metabolism.
What should I do if I miss a dose of Addyi?
Monitor for adverse effects if coadministered with sensitive substrates of these enzymes. temsirolimustemsirolimus will increase the level or effect of flibanserin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. temsirolimus will increase the level or effect of flibanserin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. teniposideteniposide will increase the level or effect of flibanserin by affecting hepatic/intestinal ed gels enzyme CYP3A4 metabolism. teniposide will increase the level or effect of flibanserin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. drospirenone will increase the level or effect of flibanserin by affecting hepatic/intestinal enzyme CYP3A4 metabolism.
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Coadministration of flibanserin and alcohol close in time increases risk of severe hypotension and syncope Counsel patients to wait at least 2 hr after consuming 1 or 2 standard alcoholic drinks before taking flibanserin at bedtime or to skip flibanserin dose if ≥3 standard alcoholic drinks were consumed that evening Coadministration with moderate or strong CYP3A4 inhibitors increases flibanserin concentrations, which can cause severe hypotension and syncope Therefore, use of moderate or strong
WHY is this medicine prescribed?
scopolamine intranasalscopolamine intranasal and flibanserin both increase sedation. scopolamine intranasal and flibanserin both increase sedation. selegilineselegiline will increase the level or effect of flibanserin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. selegiline will increase the level or effect of flibanserin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. selegiline transdermal will increase the level or effect of flibanserin by affecting hepatic/intestinal enzyme CYP3A4 metabolism.
Pediatric Precautions
sirolimusflibanserin increases levels of sirolimus by P-glycoprotein (MDR1) efflux transporter. Increase monitoring of concentrations of drugs transported by P-gp that have a narrow therapeutic index if coadministered with flibanserin.sirolimus will increase the level or effect of flibanserin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. sodium oxybatesodium oxybate and flibanserin both increase sedation. sodium oxybate and flibanserin both increase sedation. sparsentansparsentan will decrease the level or effect of flibanserin by affecting hepatic enzyme CYP2C19 metabolism. CYP3A4 inhibitors is contraindicated Contraindicated for use with any degree of hepatic impairment Flibanserin exposure increased 4.5-fold in patients with hepatic impairment, compared with those with normal hepatic function, increasing the risk of hypotension and syncope Coadministration
Find out if treatment is right for you.
sufentanil SL and flibanserin both increase sedation. sulconazolesulconazole will increase the level or effect of flibanserin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. sulconazole will increase the level or effect of flibanserin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. tacrolimustacrolimus will increase the level or effect of flibanserin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. tacrolimus will increase the level or effect of flibanserin by affecting hepatic/intestinal enzyme CYP3A4 metabolism.
Black Box Warnings
talazoparibflibanserin increases levels of talazoparib by P-glycoprotein (MDR1) efflux transporter. Coadministration with P-gp inhibitors may increase talazoparib exposure. Monitor for increased talazoparib adverse reactions and adjust dose as necessary. flibanserin increases levels of talazoparib by P-glycoprotein (MDR1) efflux transporter. tamoxifentamoxifen will increase the level or effect of flibanserin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. with moderate or strong CYP3A4 inhibitors Hypersensitivity reactions, including anaphylaxis, reactions consistent with angioedema (eg, swelling of the face, lips, and mouth), pruritus, and urticaria reported Coadministration within 2 hr of consuming alcohol increases risk of severe hypotension and syncope (see Black Box Warnings) Hypotension and syncope can also occur with flibanserin taken alone; because of this risk, instruct patient to take at bedtime Patients who drink >3 standard alcoholic drinks should skip their dose that evening; 1 standard alcoholic drink contains 14 grams of pure alcohol and is equivalent to one 12-ounce regular beer (5% alcohol), 5-ounces wine (12% alcohol), or 1.5 ounces of distilled spirits/shot (40% alcohol); after
it’s harder for me to become aroused
valproic acidvalproic acid will increase the level or effect of flibanserin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Increased flibanserin adverse effects may occur if coadministered with multiple weak CYP3A4 inhibitors.valproic acid and flibanserin both increase sedation. valproic acid will increase the level or effect of flibanserin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. vinblastinevinblastine will increase the level or effect of flibanserin by affecting hepatic/intestinal enzyme sexual tablets for women CYP3A4 metabolism. vinblastine will increase the level or effect of flibanserin by affecting hepatic/intestinal enzyme CYP3A4 metabolism.
Dosage Forms & Strengths
vincristinevincristine will increase the level or effect of flibanserin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. vincristine will increase the level or effect of flibanserin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. vincristine liposomal will increase the level or effect of flibanserin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. vinorelbinevinorelbine will increase the level or effect of flibanserin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. vinorelbine will increase the level or effect of flibanserin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. takingflibanserin, patients should not use alcohol until the following day Use in patients with hepatic impairment is contraindicated; hepatic impairment significantly increases flibanserin concentrations, which can lead to hypotension and syncope Malignant mammary tumors in female mice
Medical uses
Sparsentan (a CYP2C19 inducer) decreases exposure of CYP2C19 substrates and reduces efficacy related to these substrates. sparsentan will decrease the level or effect of flibanserin by affecting hepatic enzyme CYP2C19 metabolism. St John's WortSt John's Wort will decrease the level or effect of flibanserin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. St John's Wort will decrease the level or effect of flibanserin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Monitor CYP3A4 substrates coadministered with stiripentol for increased or decreased effects.
Storage Class
CYP3A4 substrates may require dosage adjustment.stiripentol will increase the level or effect of flibanserin by affecting hepatic enzyme CYP2C19 metabolism. Consider reducing the dose of CYP2C19 substrates, if adverse reactions are experienced when administered concomitantly with stiripentol.stiripentol, flibanserin. Concomitant use stiripentol with other CNS depressants, including alcohol, may increase the risk of sedation and somnolence. sufentanil SLsufentanil SL and flibanserin both increase sedation. Risk for sedation increased if flibanserin is coadministration with other CNS depressants.sufentanil sex tablet for women SL, flibanserin. were observed at exposures 3 and 10 times the recommended clinical dose; no increases were seen in male mice or in male or female rats; clinical significance of this observations is unknown AlcoholCounsel patients to wait at
What does it ‘treat’?
testosteronetestosterone will increase the level or effect of flibanserin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. testosterone will increase the level or effect of flibanserin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. testosterone topical will increase the level or effect of flibanserin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. tranylcyprominetranylcypromine will increase the level or effect of flibanserin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. tranylcypromine will increase the level or effect of flibanserin by affecting hepatic/intestinal enzyme CYP3A4 metabolism.
Key Takeaways
trazodonetrazodone will increase the level or effect of flibanserin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. trazodone will increase the level or effect of flibanserin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. triclabendazoletriclabendazole will increase the level or effect of flibanserin by affecting hepatic enzyme CYP2C19 metabolism. If plasma concentrations of the CYP2C19 substrates are elevated during triclabendazole, recheck plasma concentration of the CYP2C19 substrates after discontinuation of triclabendazole. triclabendazole will increase the level or effect of flibanserin by affecting hepatic enzyme CYP2C19 metabolism. least 2 hr after consuming 1 or 2 standard alcoholic drinks before taking flibanserin at bedtime or to skip flibanserin dose if ≥3 alcoholic drinks were consumed that eveningAlcohol potentiates toxicities of flibanserin the risk of hypotension, syncope, and CNS depression Counsel patients to wait at least 2 hr after consuming 1 or 2 standard alcoholic drinks before taking flibanserin at bedtime or to skip flibanserin dose if ≥3 alcoholic drinks were consumed
- Direct comparison trials between flibanserin and bremelanotide are lacking.
- Choice of treatment depends on patient preference, risk profile, and cost.
- Psychological and interpersonal factors are important contributors to HSDD.
- Combining medication with sex therapy or counseling may improve outcomes.
- Flibanserin does not increase libido in individuals without HSDD.
- It is not approved or intended for use as a recreational or enhancement drug.
- Off-label use, such as in postmenopausal women or men, is not supported by evidence.
- Healthcare providers must complete an online knowledge assessment for REMS certification.
- Certification must be renewed periodically according to the REMS program.
that evening Alcohol potentiates toxicities of flibanserin the risk of hypotension, syncope, and CNS depression CNS depressantsMonitor and consultCoadministration with other drugs that also cause CNS depression may increase risk of somnolence, sedation, or fatiguePatients should not drive or do other activites requiring full alertness for at least 6 hr after taking flibanserin until they know how the drug affects them Coadministration with other drugs that also cause CNS depression may increase risk of
Related/similar drugs
zafirlukastzafirlukast will increase the level or effect of flibanserin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. zafirlukast will increase the level or effect of flibanserin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. ziprasidoneziprasidone will increase the level or effect of flibanserin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Increased flibanserin adverse effects may occur if coadministered with multiple weak CYP3A4 inhibitors.flibanserin, ziprasidone. ziprasidone will increase the level or effect of flibanserin by affecting hepatic/intestinal enzyme CYP3A4 metabolism.
Pregnancy Precautions
acetazolamideacetazolamide will increase the level or effect of flibanserin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. acetazolamide will increase the level or effect of flibanserin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. anastrozoleanastrozole will increase the level or effect of flibanserin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. anastrozole will increase the level or effect of flibanserin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. cyclophosphamidecyclophosphamide will increase the level or effect of flibanserin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. somnolence, sedation, or fatigue Patients should not drive or do other activites requiring full alertness for at least 6 hr after taking flibanserin until they know how the drug affects them Moderate or strong CYP3A4 inhibitorsContraindicatedModerate or
- Summary: A daily, non-hormonal pill for premenopausal women with HSDD.
- Key benefit: Modest increase in sexual desire and satisfying events for some.
- Key risk: Potentially severe interactions with alcohol and many medications.
- Management: Strict adherence to REMS, bedtime dosing, and no alcohol.
- Patient profile: Premenopausal woman with distress from low desire, otherwise healthy.
- Provider role: Certify, counsel, monitor, and manage expectations.
- Place in therapy: One option among a comprehensive approach to sexual health.
- Public health impact: Highlighted need for and challenges in female sexual medicine.
- Future: Continued evaluation of real-world outcomes and safety profile.
strong CYP3A4 inhibitors increases flibanserin exposure, which increases risk of hypotension and syncope Moderate or strong CYP3A4 inhibitors increases flibanserin exposure, which increases risk of hypotension and syncope Weak CYP3A4 inhibitorsMonitor and consultMultiple weak CYP3A4 inhibitors may
| Parameter | Description | Typical Values |
|---|---|---|
| Absorption | Rapid, high bioavailability | ~52% |
| Peak Plasma Levels | 1-2 hours after dosing | ~1.5 hours |
| Half-life | Duration of effect | 11 hours |
| Metabolism | Hepatic via CYP3A4 | Major route |
| Excretion | Mainly via urine | 87% in urine |
increase risk of adverse reactions of flibanserin Multiple weak CYP3A4 inhibitors may increase risk of adverse reactions of flibanserin Strong CYP2C19 inhibitorsMonitorStrong CYP2C19 inhibitors may increase flibanserin exposure which may increase risk of hypotension, syncope, and CNS
- Flibanserin was one of the first drugs approved specifically for female hypoactive sexual desire.
- The drug's mechanism is different from that of PDE5 inhibitors used in men.
- It can induce side effects like low blood pressure and syncope, requiring caution.
- Patients should be monitored regularly for adverse effects during therapy.
- Flibanserin's approval marked significant progress in women's sexual health.
- It should be used with caution in women on other serotonergic medications.
- The medication's safety profile is still under ongoing research.
- It is not indicated for women with a history of alcohol abuse.
- The benefits of flibanserin are generally seen as modest but meaningful for some women.
depression Strong CYP2C19 inhibitors may increase flibanserin exposure which may increase risk of hypotension, syncope, and CNS depression CYP3A4 inducersNot recommendedCYP3A4 inducers substantially decrease flibanserin exposure Digoxin or other P-glycoprotein substratesMonitorClosely monitor P-gp substrates with a narrow
- Flibanserin's development was rooted in attempts to find antidepressants with sexual side effects.
- It was repurposed as a treatment for female sexual desire disorder.
- The medication is available by prescription only.
- It belongs to the class of serotonergic drugs affecting brain chemistry.
- Women with liver disease should avoid taking flibanserin.
- The medication is primarily metabolized in the liver via CYP3A4.
- Flibanserin has been the subject of debates over its cost-benefit ratio.
- It is not approved for use in men or non-binary individuals.
- Clinical guidelines recommend using flibanserin only after other causes of low desire are addressed.
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