Bremelanotide

VYLEESI

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Pronunciation: bre-me-LAN-oe-tide

Bremelanotide ballicule: receptor binding, kinetics and half-life diagram — Mechanism of action: Bremelanotide ballicule

Bremelanotide VYLEESI mascot mnemonic cartoon — Visual mnemonic: Bremelanotide mascot
**“Vial o’ easy br(ings) Melanin tide”**
stimulates melanocytes → may cause tan-like coloration

What it isMelanocortin-4 receptor agonist; acquired generalized hypoactive sexual desire disorder in premenopausal women.

Why this oneOn-demand injection distinguishes it from daily flibanserin and avoids serotonergic or hormonal treatment.

What limits itNausea affects about 40%, blood pressure rises transiently, and repeated use can cause focal hyperpigmentation.

Bremelanotide molecular structure (skeletal formula) — Molecular structure: Bremelanotide

FDA-approved for

hypoactive sexual desire disorder (2019)

FDA label

Read the full label on DailyMed ↗

FDA dosing	Population	Start	Target	Max
Acquired, generalized hypoactive sexual desire disorder (HSDD)	Premenopausal women	1.75 mg SC ≥45 min before sexual activity, PRN	1.75 mg SC PRN	1.75 mg per dose

Renal Undefined

Hepatic Undefined

Do not administer more than one dose within 24 hours; >8 doses/month not recommended

Instructions

Inject SC into abdomen or thigh via autoinjector
Administer at least 45 minutes before anticipated sexual activity
No more than one dose within 24 hours; no more than 8 doses per month

Available strengths

inj 1.75 mg/0.3 mL

Contraindications

Uncontrolled hypertension
Known cardiovascular disease

Cautions

Transient increase in blood pressure and decrease in heart rate after each dose — not recommended if high cardiovascular risk
Focal hyperpigmentation (higher risk with darker skin/daily dosing)
Nausea (may require anti-emetic)

Adverse reactions

Nausea
Flushing
Injection site reactions
Headache
Vomiting

Pregnancy May be associated with fetal harm (animal data); pregnancy exposure registry available

Lactation No information on presence in human milk

Cost

Bremelanotide (VYLEESI)

Strength		#/mo	generic $/unit	CostPlus
1.75 mg/0.3 mL	inj	per unit		not offered

NADAC is a voluntary CMS survey of what retail community pharmacies pay for the drugs they stock. Bremelanotide is administered under clinical supervision and dispensed outside retail pharmacies, so it rarely appears on surveyed invoices.

Generic entry2033 est.

NO BOXED WARNINGS

Principal riskNausea in about 40%, and transient blood pressure rise

Classes and tags

Clinical profile

Therapeutic safety burden1 / 4

Overdose danger1 / 4

Weight-gain liability0 / 4

Sedation liability0 / 4

QT / Torsades0 / 4

Direct muscarinic antagonism0 / 4

Embryofetal risk1 / 4

Legacy pregnancy categoryNot assigned — PLLR-era drug

Defining liabilityGenerally tolerated at therapeutic doses; clinically important risks are agent-specific and increase with interactions or organ impairment.

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Memory aids: interaction avatars

Box: minimal PK interactions

Open Bremelanotide in the interactive console ↗