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Flibanserin

Flibanserin is licensed for one narrowly defined diagnosis. Its label indicates it for women under 65 with acquired, generalised hypoactive sexual desire disorder, and only where the low desire is not explained by something else. It carries a boxed warning about blood pressure and fainting.

Flibanserin Tablets

Acquired Generalised Hypoactive Sexual Desire Disorder

100mg

Designed to support sexual desire pathways to manage hypoactive sexual desire and address neurotransmitter balance.

From$8.16/ tabletView

Key points

  • The label indicates it for women less than 65 years of age with acquired, generalised hypoactive sexual desire disorder characterised by low sexual desire causing marked distress or interpersonal difficulty.
  • The diagnosis requires that the low desire is not due to a co-existing medical or psychiatric condition, or problems within the relationship.
  • The boxed warning states that using it and alcohol together close in time increases the risk of severe hypotension and syncope.
  • The label states it is not indicated to enhance sexual performance and is not indicated in men.

How it works

Flibanserin acts centrally rather than on blood flow, which is why it is taken at bedtime every day rather than before sex. That distinction matters because it is often assumed to be a female counterpart to the medicines used for erectile dysfunction, and the label rules that reading out directly: it is not indicated to enhance sexual performance.

Safety specific to flibanserin

Alcohol. The boxed warning is explicit about both the risk and what to do. Using flibanserin and alcohol together close in time increases the risk of severe hypotension and syncope. Patients are counselled to wait at least two hours after one or two standard alcoholic drinks before taking it at bedtime, or to skip that night’s dose if they have consumed three or more standard drinks that evening.

CYP3A4 inhibitors. Concomitant use with moderate or strong CYP3A4 inhibitors increases flibanserin concentrations, which can cause severe hypotension and syncope, so their use is contraindicated in patients taking it. That group includes several common antifungals and antibiotics, which is why the full medicine list matters rather than the obvious entries.

Hepatic impairment. Use in patients with hepatic impairment increases flibanserin concentrations and can cause severe hypotension and syncope, so it is contraindicated in hepatic impairment.

Who it is not for. The label states it is not indicated to enhance sexual performance, not indicated in men, not indicated for use in paediatric patients, and not indicated for the treatment of HSDD in geriatric patients.

When to seek urgent care

Fainting, or feeling faint with lightheadedness after taking flibanserin, particularly where alcohol or a new medicine has been introduced, warrants prompt medical attention rather than waiting for it to pass.

Further reading

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