II. Indications
- Hypoactive sexual drive in women (libido)
III. Mechanism
- Serotonin Agonist-Antagonist
- Does not increase sexual organ Blood Flow (unlike Phosphodiesterase Inhibitors such as Viagra)
IV. Dosing
- One tablet daily at bedtime
V. Efficacy
- Premenopausal women may experience 1 more satisfying sexual encounter in 1-2 months (NNT 11)
- Only effective if consistently taken daily (and may take 8 weeks of continuous use for full effect)
VI. Adverse Effects
-
Hypotension (especially in liver disease, when taken with Alcohol or when taken with CYP3A4 Inhibitor)
- Systolic Blood Pressure dropped >50 mmHg in some cases when combined with Alcohol (NNH 6)
VII. Disadvantages
- Marginal efficacy in premenopausal women (and less effective in postmenopausal women)
- Expensive ($350/month)
- Severe Hypotension may occur (esp. with Alcohol, CYP3A4 inhibitors)
- Prescribers must undergo REMS training before prescribing
VIII. Drug Interactions
-
CYP3A4 inhibitors (e.g. Fluconazole, Grapefruit)
- Avoid CYP3A4 inhibitors for 2 weeks before starting Addyi and for 2 days after stopping
- Single dose of a strong CYP3A4 inhibitor could significantly raise Addyi doses with Hypotension risk
IX. References
- (2015) Presc Lett 22(10):60