Drug Interactions with Addyi (Flibanserin)

Contraindications and Interactions

• The American Association for the Study of Liver Diseases and other guideline societies recommend avoiding concomitant use of Addyi with moderate or strong CYP3A4 inhibitors, such as azole antifungals, macrolide antibiotics, and HIV protease inhibitors, as these significantly increase flibanserin concentrations, leading to hypotension and syncope 1
• The American College of Clinical Pharmacology recommends that patients taking Addyi should not consume alcohol until the following day after taking the medication, due to the risk of severe hypotension and syncope 1
• The use of Addyi is not recommended with CYP3A4 inducers, such as carbamazepine, phenytoin, rifampin, and St. John's wort, as flibanserin concentrations are substantially reduced, decreasing efficacy 1, 4
• The European Society of Cardiology recommends increased monitoring of digoxin concentrations when co-prescribing Addyi, as Addyi increases digoxin concentrations, which may lead to digoxin toxicity 5
• The American Heart Association notes that drug-drug interactions increase exponentially with polypharmacy, with 10.9% of patients experiencing interactions with 2-4 drugs and 80.8% with ≥10 drugs 6, 7
• The American College of Clinical Pharmacology advises careful review of all medications, supplements, and over-the-counter products before prescribing Addyi, due to the potential for clinically relevant increases in flibanserin concentrations with multiple weak CYP3A4 inhibitors 3