It’s estimated that around one in ten women experiences low sexual desire.
A low sex drive can be distressing for the woman and her partner.
Many factors play into sexual health and desire.
If you’ve exhausted all of your resources trying to find the root cause of your issues, you might be tempted to try a medication designed to help boost your sexual desire.
While men have had medications available to help with erectile dysfunction for years, it was only somewhat recently that medication was made for women suffering from low sexual desire.
If you suffer from low sex drive, you’re probably interested to learn more about this medication, along with its potential risks and side effects.
What is Addyi (Flibanserin)?
Addyi (flibanserin) is a prescription medication to treat decreased sexual desire in women (Hypoactive Sexual Desire Disorder (HSDD)). Also called “Viagra for women” and the “little pink pill,” the Food and Drug Administration approved Addyi in 2015.
The typical dose of Addyi is 100 milligrams per day. It’s best to take Addyi at bedtime because it can cause low blood pressure symptoms during the day (more on side effects later).
How does Addyi work?
Addyi is in a class of medications called Serotonin 5-HT-receptor agonists. The medication works to correct potential hormonal imbalances that might play into decreased sexual desire.
Addyi works to improve the balance of dopamine and norepinephrine, two hormones that can impact sexual desire.
Aside from sexual dysfunction, low levels of these hormones can cause fatigue, moodiness, anxiety, and depression. Mental health problems significantly impact sexual desire. People with depression are more affected by low libido than those who aren’t.
Addyi works to decrease serotonin levels as serotonin can negatively interfere with sexual desire. Serotonin can inhibit sexual desire by decreasing your body’s ability to be excited by sexual cues (1).
What are the side effects of Addyi (Flibanserin)?
The most common side effects of taking Addyi include:
- Difficulty falling asleep or staying asleep
- Dry mouth
The FDA issued a black box warning (the strongest warning the FDA issues) regarding alcohol consumption and taking Addyi. Drinking alcohol with Addyi can cause low blood pressure, dizziness, and fainting.
More rarely, Addyi might cause side effects like:
- Significantly low blood pressure
- Allergic reactions to the drug, such as anaphylaxis or angioedema
According to studies, women taking Addyi experienced weight loss as a side effect. In a study of over 1,200 women taking Addyi, 21% of the women lost at least 5% of their body weight while taking Addyi compared to under 8% of those in the placebo group (2).
Severe side effects and complications of Addyi
One of the more serious potential side effects of taking Addyi is the potential to cause low blood pressure (hypotension). Low blood pressure can make you lightheaded, dizzy, and even faint.
If you faint from low blood pressure, you could sustain an injury or serious accident.
Signs of low blood pressure to watch out for are:
- Blood pressure below 90/60
- Dizziness or lightheadedness
- Fainting (syncope)
- Dehydration and unusual thirst (dehydration is a major risk factor for developing low blood pressure)
- Lack of concentration
- Blurred vision
- Cold, clammy, and/or pale skin
- Rapid, shallow breathing
- Agitation or change in behavior
Chronic low blood pressure can negatively impact your heart as it works harder to pump blood throughout your body. Chronic hypotension can lead to permanent heart damage and even heart failure.
How long do Addyi side effects last?
It’s unknown how long Addyi side effects will last because medications impact people differently. According to the drug maker, there should be an improvement in symptoms (i.e., improved sexual desire) after four weeks of taking Addyi. If you don’t notice any improvements by eight weeks, you should discontinue Addyi.
If negative side effects persist beyond 4-8 weeks of taking Addyi as prescribed, consult with your healthcare provider.
Ways to reduce the side effects of Addyi
The best way to reduce the side effects of Addyi is to take it as prescribed and at the same time every day. You should also avoid certain medications and substances (which we’ll discuss in the next section).
If you are prone to low blood pressure while taking Addyi, there are some ways to help reduce this side effect.
Drink plenty of water
Dehydration is a significant cause of low blood pressure. Drink enough fluids that your urine isn’t strongly colored and doesn’t have a strong odor. Avoid drinking fluids with diuretic properties like caffeinated drinks, which are dehydrating.
Eat more salt
If you’re on a low sodium diet, it could contribute to low blood pressure. Eating more salt (sodium) helps increase your blood pressure and might help reduce the side effects of Addyi.
Be careful with exercise
Exercise can help raise your blood pressure during activity, but it can cause it to be lower afterward. Choose safe types of exercise, avoiding rapid changes in your body orientation, which can lead to dizziness and orthostatic hypotension (low blood pressure when changing orientation).
If you’re going to be swimming or near water, make sure you don’t go alone and have someone who can spot you if you start to feel faint.
Things to avoid while taking Addyi
Taking Addyi with certain medications can cause severely low blood pressure, fainting (loss of consciousness), and sleepiness.
Per the manufacturer, avoid taking Addyi if you are taking any of the following medications:
- Certain medicines used to treat HIV-1 infection
- Certain oral antifungal medications
- Specific antibiotics
- Certain medicines used to treat hepatitis C infections
- Certain medications used to treat high blood pressure, chest pain (angina), or other heart problems
- Nefazodone (used to treat depression)
If you’re unsure if a medication you’re taking interacts with Addyi, consult your healthcare provider or pharmacist.
Drinking alcohol while taking Addyi
Drinking alcohol while taking Addyi can increase your risk of developing low blood pressure and losing consciousness. It’s better to completely avoid drinking alcohol while taking Addyi.
If you do choose to drink alcohol, here are the guidelines for doing it more safely while taking Addyi:
- Wait at least two hours after drinking one or two standard alcoholic drinks before taking Addyi at bedtime. Examples of one standard alcoholic drink: one 12-ounce regular beer, five ounces of wine, and 1.5 ounces of distilled spirits (approximately one shot).
- If you drink three or more standard alcoholic drinks in the evening, skip your Addyi dose at bedtime that day.
Taking Addyi with grapefruit can increase the amount of the medication in your system and increase the intensity of side effects. Avoid drinking grapefruit juice and eating large amounts of grapefruit while taking Addyi.
Tranquilizers and sedating medications
Addyi can cause sleepiness as a potential side effect (3). You should avoid taking other medications that cause sleepiness while taking Addyi, including:
- Opioids (a type of pain medication)
- Benzodiazepines (used to treat anxiety)
- Sedating antihistamines (those used to treat allergies, hay fever, etc.)
- Addyi isn’t meant for people who have decreased sexual desire for other reasons. Examples of people Addyi is not meant for include those with low sex drive from a medical or mental health problem, problems in the relationship, or decreased libido due to a medication or other drug use.
- Addyi isn’t meant for women who have undergone menopause, nor is it suitable for men or children.
- Addyi shouldn’t be taken during pregnancy, nor is it considered safe during breastfeeding. Taking Addyi while breastfeeding could pass the medication to your infant and cause adverse side effects.
- Inform your healthcare provider of any supplements you take (or plan to take) before starting Addyi.
Addyi is the brand name for flibanserin, a drug meant to treat low sexual desire in premenopausal women. The FDA approved Addyi in 2015, making it the first medication for treating low sex drive in women.
Addyi works by correcting potential hormone imbalances that impact your sexual desire, including dopamine, norepinephrine, and serotonin.
The most serious potential side effect of taking Addyi is experiencing low blood pressure. Drinking alcohol around the same time as taking Addyi can increase your risk of low blood pressure, which might lead to dizziness and loss of consciousness.
More common and less serious side effects of Addyi include dry mouth, nausea, sleeping problems, and dizziness.