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‘Female Viagra’ Off to a Slow Start

Female Viagra

Flibanserin is the active ingredient in Addyi, the first medication approved by the FDA for the treatment of a common form of female sexual dysfunction.

Addyi, the first prescription medication approved to treat female sexual dysfunction, got off to a slow start in its first few weeks on the market. According to reports from Bloomberg.com, a total of 227 prescriptions of the so-called “female Viagra” were filled between the drug’s introduction on October 18, 2015, and November 6, 2015, roughly three weeks.

By contrast, nearly 600,000 prescriptions were filled for Viagra, the first of the new wave of drugs to treat erectile dysfunction, during its first five weeks on the market in the spring of 1998. However, despite its nicknames of “female Viagra” and “pink Viagra,” Addyi has very little in common with Viagra, apart from the fact that they both treat forms of sexual dysfunction.

Addyi Takes Time to Work

While Viagra produces near-instant gratification, enabling most men who use it to get an erection within 60 minutes or so of taking it, Addyi must be taken every day and for at least a few weeks before its results begin to be seen. And because it is a new drug, its costs per pill are relatively high, which may also be a factor in its slow start on the market. According to Bloomberg.com, the pharmacy at Rochester Women’s Health Clinic sells Addyi for $26 a pill. The monthly tab for the pill thus comes to a hefty total of $780.

Bloomberg’s mid-November report on Addyi also notes that most insurers and pharmacy-benefit managers are either not covering the drug or are placing it on the third tier of their prescription drug coverage plans. Addyi’s designation as a third-tier medication means that the drug will cost insureds significantly more than generic or preferred brand medications.

Conditions to FDA Approval

Other likely factors in the slow sales of Addyi thus far may well be the conditions that the U.S. Food and Drug Administration attached to its approval of the drug. Physicians who seek to prescribe the drug must first participate in an online training program to demonstrate their knowledge of the drug to be certified to prescribe Addyi. Pharmacists who want to dispense the drug also must be certified after a brief training program.

As of November 10, 2015, 5,600 physicians had been certified to prescribe Addyi, according to Michael Pearson, chief executive officer of Valeant Pharmaceuticals. Only two days after the FDA approved Addyi, Quebec-based Valeant acquired the drug’s manufacturer, Sprout Pharmaceuticals. North Carolina-based Sprout continues to operate as a division of Valeant.

Only About 1% of All Doctors

While 5,600 physicians is a fairly substantial number, it represents only a bit more than 1 percent of the 35,000 practicing obstetricians and gynecologists and 435,084 primary care physicians practicing in the United States, according to Bloomberg.com.

Another condition that the FDA attached to its approval of Addyi mandates the inclusion of a boxed warning on the drug’s label and/or package inserts warning of the dangers of using Addyi and alcohol together. Bloomberg reports that the alcohol restriction has discouraged some women from trying the drug. Tami Rowen, M.D., an obstetrician/gynecologist at the University of California San Francisco Medical Center, told Bloomberg that many women “want to have the option to have a glass of wine.”

First Developed by German Firm

The active ingredient in Addyi is flibanserin, a compound that was first developed by Boehringer Ingelheim, a large German pharmaceuticals company. Shortly after its petition to market the drug was turned down by the FDA, Boehringer Ingelheim sold the patent for the medication to Sprout. The small North Carolina company then doggedly pursued FDA approval for roughly four years before getting a thumbs-up in August 2015.

Both Boehringer and Sprout touted the drug as a treatment for hypoactive sexual desire disorder, or HSDD, the most common form of female sexual dysfunction. Despite media headlines labeling the drug “female Viagra” or “pink Viagra,” Addyi has very little in common with Viagra and the other PDE5 inhibitors sold to treat erectile dysfunction.

PDE5 Inhibitors Work on Blood Flow

Viagra, Cialis, and the other similar impotence drugs now on the market work by temporarily improving blood flow to the penis so that an erection can be achieved and maintained long enough for sexual activity. By contrast, Addyi works on brain chemistry and has nothing at all to do with blood flow.

Addyi rebalances brain chemistry to increase sexual desire in women who have lost their interest in and desire for sex. It accomplishes this goal by reducing brain levels of serotonin, a neurotransmitter believed to inhibit sexual desire, and increasing levels of dopamine and norepinephrine, which are said to increase sexual desire. Because it works on brain chemicals linked to appetite and mood, it bears more resemblance to an antidepressant than to the male impotence drugs, which work on the vascular system.

Female Viagra

Some women who have tried Addyi report that the drug has fired up their libido and increased their desire for sex.


It Works Wonders for One Woman

Among those women who have tried Addyi, Amanda Parrish is an enthusiastic champion of the little pink pill. In an interview on the TV show Inside Edition, Parrish said that Addyi has helped her to rekindle the romance with Ben, her husband of eight years. As a voluntary participant in clinical trials for the drug, Amanda was one of 11,000 women who took the drug to gauge its effects on sexual desire.

Amanda says that in the early years of her relationship with Ben, the two were like “teenagers in heat.” However, without warning, a few years back, Amanda’s interest in sex virtually disappeared. As she told Inside Edition, “If it was up to me, I never would have had sex.”

The impact of Amanda’s lack of interest in sex had a decidedly negative effect on her husband who couldn’t help but wonder if she was having an affair. “I was taking it personally. Was I doing something wrong?”

Addyi Turned Things Around

In a separate interview with NBC News national correspondent Kate Snow, Amanda said that things began to change dramatically once she began taking Addyi as part of the clinical trial. “It certainly didn’t make me feel any differently during the day,” she said. “What it did do was at the end of a long day, no matter how tired I was, I wanted to initiate and it was not work to do that.”

The change in Amanda’s attitude toward sex was immediately apparent to Ben, who told Snow, “She was flirty again. She was leaving me notes on my bathroom mirror in the morning.” Both Parrishes are enthusiastic in their support of Addyi, crediting the little pink pill with saving their marriage.

To access additional articles about Addyi and a host of related health topics, check out our blog.

Photo credits: Day Donaldson, DES Daughter

Don Amerman is a freelance author who writes extensively about a wide array of nutrition and health-related topics.

Don Amerman has spent more than three decades in the business of writing and editing. During the last 15 years, his focus has been on freelance writing. For almost all of his writing, He has done all of his own research, both online and off, including telephone and face-to-face interviews where possible. Don Amerman on Google+