Flibanserin

Key points

• The label covers women under 65 whose low desire is acquired, generalised and distressing.
• It is not indicated in men, and it is not a product for enhancing sexual performance.
• Taking a dose close in time to alcohol increases the risk of severe low blood pressure and fainting.

What it is used for

Flibanserin is licensed for hypoactive sexual desire disorder in women below 65 years of age, where the loss of desire is acquired rather than lifelong and occurs in general rather than in specific situations. The feature that defines the condition is distress or interpersonal difficulty caused by the low desire. More background sits on the women’s health pages.

How it works

Flibanserin is a serotonin receptor modulator. It acts as an agonist at 5-HT1A receptors and an antagonist at 5-HT2A receptors, which rebalances neurotransmitters involved in sexual desire and motivation. This is a different approach from sildenafil, which works on blood flow. Onset of effect is usually seen over 2 to 4 weeks of continuous use.

Forms available

Flibanserin is supplied as a 100mg tablet. You can view Flibanserin in the catalogue for strength and pack details.

Safety

Flibanserin is contraindicated in people with hepatic impairment and in anyone hypersensitive to it. Moderate or strong CYP3A4 inhibitors must not be combined with it, because they raise flibanserin concentrations and can cause severe hypotension and syncope. Alcohol, fluconazole and ketoconazole are listed interactions. It may cause hypotension, so monitor for syncope; both severe hypotension and syncope need immediate medical attention. Dizziness, nausea and fatigue are common; insomnia and dry mouth also occur. It is not recommended in pregnancy and advised against during breastfeeding. Adults only.

What the sources say

• The label covers women under 65 with acquired, generalised HSDD, described as low sexual desire causing marked distress or interpersonal difficulty. (DailyMed)
• A boxed warning states that using flibanserin and alcohol close together in time raises the risk of severe hypotension and syncope. (DailyMed)
• Patients are counselled to wait at least two hours after one or two standard drinks before the bedtime dose, or to skip the dose after three or more. (DailyMed)

Further reading

• Flibanserin: MedlinePlus Drug Information
• Flibanserin - StatPearls (NCBI Bookshelf)
• Flibanserin (oral route) - Side effects & dosage - Mayo Clinic
• Loss of female libido - healthdirect