Can You Take Flibanserin and Wellbutrin Together?
Yes, you can take flibanserin and bupropion (Wellbutrin) together—there are no significant drug interactions between these medications based on FDA pharmacokinetic studies. 1
Evidence Supporting Concurrent Use
FDA drug interaction studies specifically evaluated flibanserin with bupropion and found no clinically significant pharmacokinetic interactions. When flibanserin 50 mg twice daily was given with bupropion 150 mg twice daily, flibanserin did not change bupropion exposure (AUC and Cmax remained at 1.0-fold, meaning no change), and only minimally decreased the active metabolite hydroxybupropion by 9-11%. 1
Bupropion is actually recognized as an off-label treatment option for hypoactive sexual desire disorder (HSDD) itself, the same condition flibanserin treats, suggesting these medications work through complementary mechanisms rather than conflicting ones. 2, 3
Clinical Context
Flibanserin works as a postsynaptic 5-HT1A agonist and 5-HT2A antagonist, decreasing serotonin while increasing dopamine and norepinephrine levels in the brain. 4
Bupropion is a dopamine/norepinephrine reuptake inhibitor, which means both medications may actually have synergistic effects on dopamine and norepinephrine pathways that are relevant to sexual desire. 5
The International Society for the Study of Women's Sexual Health expert consensus panel considers bupropion an off-label option for HSDD, despite limited safety and efficacy data, indicating the medical community views it as a reasonable treatment in this context. 3
Important Monitoring Considerations
Watch for additive CNS effects, as both medications can cause dizziness, somnolence, and fatigue. Flibanserin's most common side effects include somnolence (11.8%), dizziness (10.5%), and fatigue (10.3%). 6
Take flibanserin at bedtime (100 mg once daily) to minimize daytime CNS side effects, which is the FDA-approved dosing regimen. 7, 6
Set realistic expectations about flibanserin's efficacy: it results in approximately 0.5-1 additional satisfying sexual events per month (or about 1 every 2 months) compared to placebo. 7, 8
Common Pitfalls to Avoid
Do not combine flibanserin with alcohol, as this significantly increases the risk of hypotension and syncope—this is a critical contraindication not present with bupropion alone. 1
Avoid strong CYP3A4 inhibitors (like fluconazole, ketoconazole) while on flibanserin, as these can increase flibanserin exposure by 4.5-7.0 fold, significantly raising the risk of adverse effects. 1
If you are a CYP2C19 poor metabolizer (2-15% of the population, more common in Asians), flibanserin exposure increases by 1.3-1.5 fold, which may increase side effects but does not contraindicate use with bupropion. 1