Addyi (Flibanserin 100mg)
Addyi is the brand name for flibanserin, the first FDA-approved oral medication for hypoactive sexual desire disorder (HSDD) in premenopausal women. Taken as 100mg once daily at bedtime, with caution required around alcohol use.
- Active ingredients
- Flibanserin
- Manufacturer
- Sprout Pharmaceuticals
- Dosage forms
- tablet
- Available dosages
- 100mg
- Category
- Women's Sexual Health
What is it?
Addyi is the brand name for flibanserin, the first oral medication approved by the FDA (in 2015) for hypoactive sexual desire disorder (HSDD) in premenopausal women. It is currently marketed by Sprout Pharmaceuticals. Addyi was the first treatment specifically approved for low sexual desire in women — distinct from sildenafil-based products marketed as 'female Viagra' but lacking female sexual indication approval. The medication works on central nervous system pathways rather than genital blood flow.
Active ingredients
Each Addyi tablet contains 100mg of flibanserin, a multifunctional serotonin agonist/antagonist with additional effects on dopamine and norepinephrine signalling. The molecule was originally investigated as an antidepressant but was repurposed for HSDD when efficacy on sexual desire was identified. Unlike sildenafil-based products, flibanserin does not act on genital blood flow; it modulates central nervous system pathways involved in sexual desire. Daily steady-state dosing is required for therapeutic effect.
Forms and dosages
Addyi is supplied as round, light pink, film-coated tablets containing 100mg of flibanserin. The recommended dose is one tablet once daily, taken at bedtime to minimise the risks of dizziness and somnolence during waking hours. The medication should not be taken in the morning or during the day. According to the prescribing information, daily dosing is required for therapeutic effect; the medication is not designed for on-demand use before sexual activity, in contrast to sildenafil-based products.
Indications
Addyi is indicated for the treatment of acquired, generalised hypoactive sexual desire disorder (HSDD) in premenopausal women. The diagnosis requires personal distress associated with low sexual desire, not better explained by another medical or psychiatric condition, relationship issues, or medication side effects. Addyi is not approved for postmenopausal women, men, or for sexual problems caused by other identifiable conditions. According to the prescribing information, treatment efficacy should be assessed after 8 weeks; the medication should be discontinued if there is no clinical improvement.
How it works
Sexual desire is modulated by complex central nervous system pathways involving serotonin (generally inhibitory) and dopamine and norepinephrine (generally excitatory). Flibanserin acts as a 5-HT1A receptor agonist and 5-HT2A receptor antagonist, with additional effects favouring dopamine and norepinephrine signalling in cortical regions. Over weeks of daily dosing, this is hypothesised to shift the balance toward sexual desire. Onset is gradual, with full effect typically evaluated after 8 weeks of continuous use according to the prescribing information.
Frequently asked questions
How is Addyi different from 'female Viagra' products? ▾
Addyi (flibanserin) is the only FDA-approved oral medication specifically for HSDD in premenopausal women. Sildenafil-based products marketed as 'female Viagra' are not FDA-approved for any female sexual indication. Addyi targets central nervous system pathways involved in desire and is taken daily; sildenafil targets genital blood flow and is taken on demand. The two products address different aspects of female sexual function: Addyi targets desire (the dominant complaint in HSDD); sildenafil targets arousal/blood flow.
When should I take Addyi? ▾
According to the prescribing information, Addyi should be taken once daily at bedtime to minimise the risks of dizziness and somnolence during waking hours. Taking the medication during the day is associated with greater risk of these side effects, including potentially dangerous lightheadedness or fainting. The bedtime schedule also reduces interaction risk with alcohol consumed earlier in the day, although alcohol use still requires caution.
Can I drink alcohol with Addyi? ▾
Alcohol use with Addyi requires caution. The current FDA labeling allows moderate alcohol use only when separated by at least 2 hours from the Addyi dose, with the medication taken at bedtime. Patients should not take Addyi if they have already consumed 1 to 2 alcoholic drinks that evening. Heavy alcohol use is contraindicated. According to the prescribing information, patients should be aware of the increased risk of severe hypotension and syncope with combined alcohol use.
How long until Addyi works? ▾
Some patients report improvement within the first weeks of daily use, but full effect is typically evaluated after 8 to 12 weeks of continuous treatment. According to the prescribing information, treatment should be discontinued if there is no clinical improvement after 8 weeks of regular use. The clinical effect in trials was modest in absolute terms, with improvements in satisfying sexual events of approximately 0.5 to 1 additional event per month versus placebo.
What contraindications apply to Addyi? ▾
Addyi is contraindicated with strong CYP3A4 inhibitors (such as ketoconazole, clarithromycin, ritonavir, grapefruit juice in large quantities) due to risk of severe hypotension and syncope. It is also contraindicated in hepatic impairment of any severity. Caution is required with alcohol, with moderate use only and at least 2 hours apart from dosing. According to the prescribing information, all current medications and conditions should be reviewed before starting Addyi.
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