Addyi is a nightly prescription pill for low desire, now approved for women before and after menopause, up to age 65. Here’s what it is, its side effects, the alcohol rule, and how it compares with Vyleesi.
Addyi is a prescription pill for women with persistently low sexual desire that causes them distress. It’s taken once a day at bedtime, it contains no hormones, and since December 2025 it has been approved for women under 65, both before and after menopause. The most common Addyi side effects are dizziness, sleepiness, nausea, tiredness, trouble sleeping and dry mouth. The most serious risk is a sudden drop in blood pressure that can cause fainting, which is why it’s taken only at bedtime and comes with a strict rule about alcohol.
What is Addyi?
- What it is: Addyi is the brand name for flibanserin, a daily pill for women with low sexual desire. It was the first medicine of its kind approved by the FDA, in 2015.
- Who it’s for: women whose low desire has lasted a long time, bothers them, and isn’t explained by something else, such as a medical condition, another medicine, pain during sex or relationship problems. Doctors call this hypoactive sexual desire disorder, or HSDD.
- How it works: it acts on brain chemicals, such as serotonin and dopamine, that are involved in desire. It contains no hormones.
- How it’s different from Viagra: it’s often called “female Viagra,” but the two work in completely different ways. Viagra increases blood flow and is taken shortly before sex. Addyi works on the brain and is taken every night, whether or not you plan to have sex. Its effect builds over several weeks.
- How you get it: only with a prescription, from your own doctor or, increasingly, through telehealth services.
- Who can take it: since December 2025, women under 65, both before and after menopause. Before that, it was approved only for premenopausal women.
Common side effects
- Dizziness (about 1 in 10 women)
- Nausea (about 1 in 10)
- Sleepiness and tiredness
- Trouble sleeping
- Dry mouth
Taking it at bedtime means many of these happen while you sleep. They often ease as your body adjusts.
The alcohol rule
Alcohol and Addyi together can cause severe low blood pressure and fainting. The FDA’s rule is:
- Stop drinking at least two hours before your bedtime dose.
- If you can’t, or you’ve drunk more, skip that night’s dose.
- Don’t drink after taking it that night.
Other important warnings
- Medicines that interact: some antifungals, antibiotics and HIV medicines can raise Addyi to dangerous levels. Tell your doctor and pharmacist about everything you take.
- Grapefruit and grapefruit juice can have the same effect, so avoid them.
- Liver problems: Addyi isn’t suitable if you have liver disease.
- Other things that cause drowsiness, such as sleeping pills, some antihistamines or cannabis, add to the effect.
- Don’t drive or use machinery until you know how Addyi affects you.
How well does it work?
In the trial that led to approval for postmenopausal women, women taking Addyi reported about one extra satisfying sexual experience every two months compared with placebo, along with less distress about low desire. That’s a real benefit for some women, but not a dramatic one. The label advises stopping if there’s no improvement after eight weeks.
Addyi or Vyleesi?
| Addyi | Vyleesi | |
|---|---|---|
| Form | A daily pill at bedtime | An injection under the skin, at least 45 minutes before sex, as needed |
| Approved for | Women under 65, before or after menopause | Premenopausal women |
| Most common side effects | Dizziness, sleepiness, nausea | Nausea (about 4 in 10 women), flushing, injection-site reactions, headache |
| Alcohol | The two-hour rule | No specific alcohol rule |
| Key warnings | Low blood pressure and fainting | Briefly raised blood pressure; not for uncontrolled high blood pressure or heart disease; darker patches of skin on the face, gums or breasts, which may not go away |
Before you start: check the common causes
Low desire often has a cause that can be treated directly:
- Pain or dryness during sex, common after menopause. See our vaginal dryness guide and dyspareunia (painful sex).
- Medicines, especially some antidepressants.
- Tiredness, stress, poor sleep or low mood. See menopause fatigue.
- Relationship strain.
- Hormone changes around menopause.
For a fuller look at your options, see low desire after menopause.
When to get help
If you feel faint or very dizzy after a dose, lie down right away and ask someone to help you. Get urgent care if you faint or can’t stay conscious.
Another option for your overall well-being
Not every woman wants another prescription. Two sealed herbal pouches, worn over the navel with nothing to swallow, offer a whole-body wellness routine:
- Feminine Vitality, for women at this stage of life
- Emotional Balance, when everyday stress and tension are part of the picture
Neither is a treatment for low desire, and neither has evidence for desire or intimacy. Your first course is covered by our 90-Day Satisfaction Guarantee.
Reviewed October 2026. Author: Qingcai Wang, MD, PhD, developer of the Five Essences external herbal-pouch formulations, with a commercial interest in their sale. General education only; continue your medical care.
Sources: FDA safety labeling change for Addyi (April 2019); Addyi prescribing information (December 2025); Vyleesi prescribing information.