Flibanserin
Drugs for hypoactive sexual desire disorder
Drugs for hypoactive sexual desire disorder
A bedtime tablet for low sexual desire that causes distress in premenopausal women. With alcohol it can cause severe low blood pressure and fainting.
Quick facts
- Group
- Drugs for hypoactive sexual desire disorder
- Target
- Serotonin 5-HT1A (agonist) and 5-HT2A (antagonist) receptors
- Used for
- Acquired
- Key effects
- Dizziness and sleepiness · Nausea and tiredness
- Monitor
- Blood pressure and dizziness · Mood and alcohol use
- ATC
- G02CX02
No doses: the clinician sets them by the current guideline.
Mechanism of action
Flibanserin acts in the brain as an agonist at serotonin 5-HT1A receptors and an antagonist at 5-HT2A receptors, changing the balance of serotonin and other neurotransmitters involved in desire. How this improves sexual desire is not known. It is taken daily, not on demand.
- Activates 5-HT1A receptors
- Blocks 5-HT2A receptors
- Shifts serotonin and related signalling in the brain
- Desire may improve over weeks
Indications
- Acquired, generalised hypoactive sexual desire disorder in premenopausal women; not for men or for improving sexual performance
Adverse effects
Common
- Dizziness and sleepiness
- Nausea and tiredness
- Trouble sleeping, dry mouth and constipation
- Anxiety
Contraindications
- Liver disease
- Alcohol close to the time of a dose (see the label's timing rules)
Key interactions
- Alcohol
- Severe hypotension and fainting; the label sets strict timing rules
- Cimetidine and proton pump inhibitors (omeprazole, esomeprazole, lansoprazole)
- Listed as needing review before use together
- Ginkgo, St John's wort and resveratrol
- Listed as needing review before use together
- Grapefruit and grapefruit juice
- Avoided during treatment
What is monitored
- Blood pressure and dizziness, especially early in treatment
- Response after about eight weeks; it is stopped if there is no benefit
- Mood and alcohol use
Administration and safety
- Taken once daily at bedtime
- Alcohol timing follows the label's rules
- No driving or machinery until the patient knows how it affects them
Pregnancy and breastfeeding
Information on use in pregnancy and breastfeeding is limited; patients are asked to tell their doctor if they are pregnant or breastfeeding.
Nursing care
- Take an alcohol history before treatment starts
- Teach the patient to lie down if dizzy and to seek help after fainting
- Ask about herbal products and acid-reducing medicines
- Ask about liver disease
Pharmacokinetics
- Absorption
- Taken by mouth once daily at bedtime
Test yourself
Think of the answer, then tap the question to see it.
What are flibanserin's actions at serotonin receptors?
Agonist at 5-HT1A and antagonist at 5-HT2A.
What is the boxed warning for flibanserin?
Severe low blood pressure and fainting, with higher risk when alcohol is taken near the dose.
Who is flibanserin approved for?
Premenopausal women with acquired, generalised hypoactive sexual desire disorder; it is not for men or for improving sexual performance.
Connections
← Back to the class: Drugs for hypoactive sexual desire disorder
Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given.
Sources: Flibanserin: MedlinePlus Drug Information (MedlinePlus (U.S. National Library of Medicine), 2026); ATCDDD - ATC/DDD Index (WHO Collaborating Centre for Drug Statistics Methodology, 2026).
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Representative model, for educational purposes only.