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Ask the Pharmacist — Viagra for Women

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After 5 years and being told no by the FDA twice, Addyi, a drug called the “female Viagra,” was approved by the FDA in August. It is approved to treat pre-menopausal women with low sexual desire but can only be prescribed by select doctors with prescriptions coming from select pharmacies

1. What is Addyi and how does it work?

DR WHITE: Addyi is indicated for premenopausal women with low sexual desire that causes marked distress or interpersonal difficulty and is not caused by a medical, psychiatric, drug related, or relationship issue. Addyi is very different than Viagra. Viagra is taken periodically to increase penile blood flow, it does not impact men’s desire for sex. Addyi is taken daily and does nothing to vaginal blood flow. It works to increase chemicals in the brain like dopamine and norepinephrine and decrease serotonin levels. It is thought that an imbalance of these brain chemicals can lower sexual desire.

2. Is the drug effective for woman with low sexual desire?

DR WHITE: In clinical trials, women who averaged 2-3 satisfying sexual encounters per month at baseline and took Addyi 100mg once daily at bedtime for more than 4 weeks ended up having 0.5 to 1.0 more satisfying encounters while receiving the drug than with placebo. These benefits are counteracted by several adverse events that can occur including nausea, fatigue, sleep problems, and dizziness. The risk of severe dizziness or even passing out can occur if the drug is taken with alcohol. That is why it is part of a Risk Mitigation Strategy where only specially certified doctors and certified pharmacies are used. In addition, the FDA is requiring additional studies going forward to further assess the safety of the drug when it is taken with alcohol.

3. Wasn’t this met with controversy when it was first discussed?

DR WHITE: Yes, after two previous failed attempts Sprout Pharmaceuticals hired a marketing firm to promote the drug to the public and pressure the FDA to approve it. The “Even the Score” campaign’s message was that there are many products for men but none for woman and that this wasn’t fair. They also touted statistics saying the number of woman with low sexual desire was incredible high, over 40%, even though this was a distortion of that studies results for dramatic effect. This rubbed a number of people the wrong way. However, aside from the controversy, the drug is modestly effective overall but some woman had a more dramatic effect and others had no benefit at all. In most women Addyi had reasonable safety. So if you are premenopausal and feel that the number of satisfying sexual encounters you are having is lower than you would like and there is no other known reason for it, it may cost you around $30 to try. If you are not getting benefits by week 8, you are unlikely to benefit with future therapy and can stop. Women who want to consume alcohol, those with liver disease, or those on drugs that can impair liver function are particularly at risk of adverse effects.