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Bremelanotide (Vyleesi)
Also known as: Vyleesi, PT-141 (original designation), BMT-141
Confidence
Updated 2026-03-18
Bremelanotide is a synthetic melanocortin receptor agonist FDA-approved (Vyleesi) for the treatment of hypoactive sexual desire disorder (HSDD) in premenopausal women. It is the commercially developed form of the research peptide PT-141. Unlike PDE5 inhibitors, it acts centrally through melanocortin pathways in the brain to enhance sexual desire rather than peripheral vascular mechanisms.
Class
Melanocortin Receptor Agonist (Sexual Health)
Routes
Subcutaneous
Half-Life
~2.7 hours
Bremelanotide activates melanocortin-4 receptors (MC4R) in the central nervous system, particularly in the hypothalamus and limbic system. MC4R activation modulates dopaminergic and oxytocinergic pathways involved in sexual arousal and desire. It enhances sexual desire through a central mechanism independent of vascular or hormonal effects. Also has affinity for MC1R (pigmentation) and MC3R.
Half-Life
~2.7 hours
Bioavailability
Subcutaneous: ~100%
FDA-approved: Hypoactive sexual desire disorder (HSDD) in premenopausal women. Limited to ≤8 doses/month per labeling. Off-label interest in male sexual dysfunction and female arousal disorders.
RECONNECT Phase III trials (two pivotal, n=1247 total) demonstrated statistically significant improvement in sexual desire scores (eDiary) and reduction in distress related to low sexual desire compared to placebo. Effect size was modest — approximately 0.4-point improvement on desire score. About 25% of treated patients reported meaningful improvement vs. 17% placebo. FDA approval was controversial given modest efficacy and significant nausea.
Human Studies
30
Animal Studies
40
Common: nausea (40% — most common reason for discontinuation), flushing (20%), headache (11%), injection site reactions. Transient blood pressure elevation. Hyperpigmentation with repeated use (darkening of face, gingiva, breasts). Contraindicated in uncontrolled hypertension. Limited to 8 doses/month per FDA labeling.
FDA-approved since 2019. FDA limited dosing to ≤8 doses/month due to blood pressure concerns. Commercial uptake has been limited. Available by prescription as an autoinjector.
Drug Interactions: Contraindicated with naltrexone (blocks efficacy). Caution with antihypertensives (may cause BP changes). May reduce efficacy of melanocortin-based drugs. Monitoring: Blood pressure, skin pigmentation changes, nausea severity. Research Gaps: Long-term pigmentation effects, efficacy in postmenopausal women, male HSDD applications, optimal dosing frequency.
Subcutaneous (Vyleesi autoinjector)
Common Range
1.75 mg per dose
Timing
At least 45 minutes before anticipated sexual activity
Frequency
As needed, ≤8 doses per month, ≤1 dose per 24 hours
Cycling
As needed — not daily dosing
Storage
Room temperature
Important Note
FDA-approved for HSDD in premenopausal women. High nausea rate (~40%). Antiemetic pretreatment may help. Do not exceed 8 doses/month.
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Sexual Health
PT-141 (bremelanotide) is a melanocortin receptor agonist FDA-approved as Vyleesi for the treatment of hypoactive sexual desire disorder (HSDD) in premenopausal women. It is unique among sexual health therapeutics in that it acts centrally through the nervous system rather than peripherally on blood flow.
Tanning / Sexual Health
Melanotan II is a synthetic analog of alpha-melanocyte stimulating hormone (α-MSH) originally developed at the University of Arizona. It stimulates melanogenesis (tanning without UV exposure) and has sexual arousal effects through melanocortin receptor activation. PT-141 (bremelanotide) was developed as a derivative of Melanotan II, isolating the sexual health effects.
Neuropeptide Hormone
Oxytocin is a nine-amino acid endogenous neuropeptide hormone produced in the hypothalamus and released by the posterior pituitary. FDA-approved (Pitocin) for labor induction and postpartum hemorrhage, it is also widely investigated for social bonding, anxiety, autism spectrum disorder, PTSD, and relationship enhancement. It plays a central role in maternal bonding, social cognition, and stress regulation.
Disclaimer: This content is for educational and informational purposes only and does not constitute medical advice. Always consult with a licensed healthcare provider before starting, stopping, or modifying any peptide therapy. PeptideSupplierMatch does not prescribe, sell, or distribute peptides.
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