There is an overwhelming sea of misconceptions and misinformation surrounding the drug Addyi / flibanserin and the FDA’s August 2015 decision to approve it.

Mostly, people can learn the basics from reading the FDA’s Addyi / flibanserin label [ text ] ( or get a brief overview from the PharmedOut factsheet [ here ] ).

Here’s a breakdown of some common misconceptions around what Addyi / flibanserin is, who it is and is not approved for, and why many people are justifiably upset about it:

1)

Myth: Addyi / flibanserin is the “female Viagra” and can help women who want to have sex but whose bodies aren’t cooperating or won’t orgasm.



Reality: Addyi / flibanserin is *not* the equivalent of a “female Viagra” and is specifically and explicitly *not* indicated to “enhance sexual performance” [ source ].

Viagra is taken on an “as needed” basis but Addyi / flibanserin is something to be taken every day

Viagra works on sexual arousal by increasing blood flow to genital region but Addyi/flibanserin is a psychoactive drug that is supposed to increase subjective sexual arousal ( and it is not clear how it works [ source, e.g., page 8 ] )

Viagra has minimal side effect for indicated usage [ source ] but Addyi / flibanserin has common serious side effects [ source ] requiring a black-box warning for “serious or life-threatening” side effects [ explanation ], for which the FDA requires a serious risk management strategy [ text ]

Note that it is very dangerous for anyone taking flibanserin to consume alcohol ( ever ) or use certain drugs

2)

Myth: There are many drugs to treat low sexual desire in men and this is a the first for women: “those drugs for men are advertised all the time!”.

Reality: Addyi / flibanserin is the *only* drug the FDA has ever approved to treat low sexual desire in anyone, and it is for women. There are currently no drugs approved to treat low sexual desire in men [ source ]

There does exist much advertising or marketing fraudulently claiming drugs for men are available to increase sexual desire.

Some of that misleading marketing and incorrect medical information was actually put out there by the same people who sought FDA approval for Addyi / flibanserin this time. ( For example Robert Whitehead– one of Sprout’s current Vice Chair and past Chief Executive Officer [ board profiles ]– was already issued a warning by the FDA to withdraw its misleading marketing and incorrect medical information around another drug [ text ] ( including falsely promoting it as a treatment for low sexual desire in men ).

this time. ( For example Robert Whitehead– one of Sprout’s current Vice Chair and past Chief Executive Officer [ board profiles ]– was already issued a warning by the FDA to withdraw its misleading marketing and incorrect medical information around another drug [ text ] ( including falsely promoting it as a treatment for low sexual desire in men ). Sprout Pharmaceutical openly financially supported [ source ] the misleading “Even the Score” Campaign which spread misleading information [ source ] about the availability of drugs to treat men’s sexual dysfunction while concealing the fact that none of these drugs are approved to treat low sexual desire [ “Even The Score”’s misleading info ]

3)

Myth: Addyi / flibanserin is for women whose libidos were “killed” by anti-depressants or other drugs, by menopause or by other issues like depression.



Reality: Addyi / flibanserin was approved only for pre-menopausal ( cis ) women whose low sexual desire was *not* a side effect of some other medication or anything else.

Addyi / flibanserin is specifically and explicitly *not* approved for:

menopausal women,

women whose low sexual desire is a side effect of medication or other physical or mental health issue

women whose low sexual desire is due to relationship problems or partner abuse

And Addyi / flibanserin is contraindicated with CYP3A4 inhibitors [ text ] ( i.e., flibanserin cannot be taken with those drugs because it is very dangerous ). Substances that function as CYP3A4 inhibitors [ source ] include:

grapefuit juice



cannibanoids ( compounds found in marijuana )

many antibiotics ( e.g., Erythromycin & Claritrhomycin )

many anti-fungals

many common anti-depressants / anti-anxiety meds ( e.g., Sertraline / Zoloft & Fluoextine / Prozac / Sarafem )

many other drugs for various things from heart regulation ( e.g., Amioderone ) to hormonals ( e.g., Ethinyl estradiol )

[ Edited to add ] oral contraceptives [ source1; source2 ]

And many drugs classes like SSRIs & SNRIs are known to increase certain side effects while the impact of other drugs is still unknown [ FDA report pages 63-70 ].

That doesn’t mean that Addyi / flibanserin won’t be prescribed to these women. [ Edit: “these women” refers to women who are going through or have already going through menopause; women whose low sexual desire is a the result of some other medication or medical issue; and women whose low sexual desire is the result of relationship problems or partner abuse. ]

It means that if it is prescribed “off-label” to these women, it will be prescribed without information about the drug’s safety ( or effectiveness ) or despite information showing that it is not safe and / or effective for those women. How often it will be prescribed “off-label” remains to be seen.

4)

Myth: The FDA’s decision to approve Addyi / flibanserin won’t affect the ace community or anyone who doesn’t actively want the drug. It won’t be forced on anyone and it’s great for women to have the choice!



Reality: The FDA’s decision to approve Addyi / flibanserin can and will adversely affect the ace community and many women outside of the ace community. And Addyi / flibanserin absolutely could be coercively prescribed to asexual ( and other ) women [ discussion– cw for rape culture and coercion ] and its clinical usage and the reasons behind its approval will both contribute to the pathologising of women’s sexuality more generally [ explanation ].