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Multifunctional serotonin agonist/antagonist (HSDD)

Flibanserin with the birth control pill

Many women of reproductive age take a combined or progestogen-only oral contraceptive while also using a chronic medication such as Flibanserin (Flibanserin). The combination is generally fine at 100mg, but a small number of medications can reduce contraceptive efficacy meaningfully and need either a backup method or a switch.

How Flibanserin can affect contraceptive efficacy

Combined and progestogen-only contraceptives are metabolised through CYP3A4. Strong CYP3A4 inducers (some antiepileptics, rifampicin, St John's Wort) lower contraceptive plasma levels and reduce efficacy. Whether Flibanserin acts on CYP3A4 determines whether Flibanserin affects contraception. Most agents in Multifunctional serotonin agonist/antagonist (HSDD) have no clinically meaningful effect on the pill at 100mg.

Practical guidance

According to the prescribing information for Flibanserin, women on hormonal contraception should review Flibanserin with the prescribing pharmacist or doctor. Where an interaction is documented, additional barrier contraception or switching to a non-oral method (IUD, implant) for the duration of Flibanserin therapy is the standard mitigation.

Frequently asked questions

Will Flibanserin make my pill less effective?

Most Multifunctional serotonin agonist/antagonist (HSDD) medications at 100mg do not affect oral contraceptive efficacy. The exceptions are CYP3A4-inducing drugs and a small number of others. The prescribing information for Flibanserin states whether the interaction is meaningful.

Do I need a backup contraceptive on Flibanserin?

Backup contraception is needed only when there is a documented interaction between Flibanserin and the contraceptive method. For most users at 100mg, no backup is required. The pharmacist confirms whether Flibanserin interacts with hormonal contraception.

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The information on this website is provided for reference and educational purposes only. It does not replace consultation with a qualified healthcare professional.