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PT-141 (Bremelanotide)

PT-141 (bremelanotide) is an approved US medicine, sold as Vyleesi, for premenopausal women whose low sexual desire causes marked distress.

Approved in the US - Vyleesi (acquired, generalized low desire in premenopausal women)US label: not for men, not for postmenopausal women, and not to improve performance
OverviewDosingMixingResearchCommunitySafetyFAQSources

PT-141 (Bremelanotide) quick reference

TypeMelanocortin receptor agonist (bremelanotide)
Studied forLow desire in women; erection problems in men
EvidenceUS-approved (Vyleesi); phase 3 trials
RouteInjection under the skin; nasal tested
Half-lifeAbout 2.7 hours

What is PT-141 (Bremelanotide)?

Seven-amino-acid ring peptide that acts in the brain, not blood flow.

Approved as Vyleesi for premenopausal women with distressing low desire.

Use in men and nasal sprays is research only.

How PT-141 (Bremelanotide) works

Melanocortin receptors

Activates several subtypes; exact action on desire is unknown.

Brain, not blood vessels

Works differently from sildenafil or tadalafil.

Taken as needed

Used before sex, not on a daily cycle.

Short half-life

About 2.7 h, but onset and length vary per person.

What PT-141 (Bremelanotide) is studied for

PeopleLow desire in women

Desire score +0.5 to +0.6 vs +0.2 on placebo (two phase 3 trials).

PeopleDistress about low desire

Fell 0.7 vs 0.4 on placebo.

PeopleSatisfying sexual events

No significant gain over placebo (label).

PeopleSildenafil failures

Nasal 10 mg: 33.5% responded vs 8.5% on placebo (342 men).

PeopleWith sildenafil

Low-dose nasal PT-141 raised erection response (19 men).

PT-141 (Bremelanotide) dosing protocol

ItemUS label
Amount per dose1.75 mg under the skin (belly or thigh), autoinjector
TimingAt least 45 minutes before expected sexual activity
Most often1 dose in 24 hours
Per monthMore than 8 doses is not recommended
If no helpStop after 8 weeks

From the Vyleesi US prescribing information (DailyMed). The product is a ready-made single-use autoinjector (1.75 mg in 0.3 mL). The calculator shows vial maths only for a 10 mg vial and is not a label instruction.

LABEL DOSE1.75 mg under the skinLabel
TIMINGAt least 45 min before sexLabel
LIMIT1 dose per 24 h; max 8 per monthLabel
STOP RULEStop after 8 weeks if no helpLabel
NASAL TRIAL (MEN)10 mg spray, 45 min-2 h before sexTrial
COMMUNITY RANGE1-2 mg injectedCommunity

Label and trial amounts come from the sources below. Community amounts are what people report; they have not been tested.

Mixing

Vial10 mg
+
BAC water1 mL
=
Strength10 mg per mL

Example for vials. Vyleesi is a fixed 1.75 mg autoinjector.

Open the peptide calculator

What the research found

Two identical 24-week placebo-controlled trials (RECONNECT), about 600 women each. Measured: change in sexual desire score (FSFI-Desire):

+0.5Vyleesi, study 1
+0.2Placebo, study 1
+0.6Vyleesi, study 2
+0.2Placebo, study 2

Vyleesi US prescribing information. Distress about low desire also fell more with Vyleesi (-0.7 vs -0.4 in both studies). The label notes no significant difference in satisfying sexual events. Simon JA et al. Obstet Gynecol 2019 (PMID 31599847) covers the 52-week extension.

PT-141 (Bremelanotide) community experience

What users report. Not tested in trials.

Positive reports

  • Desire lift Many feel more desire in about 45-90 minutes.
  • Long window Effects often described as lasting 4-8 hours.
  • Stronger by injection Injection reported more reliable than nasal.
  • Erections Some men say it helped when sildenafil alone did not.

Negative & mixed

  • Nausea and flushing The usual deal-breakers, worse at higher doses.
  • Nasal is weak Nasal use often seems to do little.
  • No desire gain Some feel a body response without more desire.
  • Unpredictable timing Onset and length vary, which can spoil plans.

PT-141 (Bremelanotide) stacking

PT-141 + sildenafil

Low-dose nasal PT-141 plus sildenafil gave a bigger erection response in 19 men.

PT-141 + oxytocin

Community pairing for desire plus closeness. Not studied together.

PT-141 + melanotan-2

Same receptor family. Not studied together.

PT-141 (Bremelanotide) side effects & safety

Common

  • Nausea: 40% vs 1.3% on placebo.
  • Flushing: 20%.
  • Injection-site reactions: 13%.
  • Headache: 11%.
  • Vomiting: 4.8%.

Less common

  • Blood pressure rises about 6/3 mmHg for up to 12 hours.
  • Dark skin patches in 1%; 38% with daily dosing for 8 days.
  • Side effects made 18% stop vs 2% on placebo.
  • Anti-nausea drugs were needed by 13%.

Precautions

  • Label bars use with uncontrolled high blood pressure or heart disease.
  • Label: avoid with oral naltrexone; it lowers naltrexone levels.
  • Slows stomach emptying; may delay oral drug absorption.
  • Label: stop if pregnancy is suspected; use contraception.
  • Kidney impairment raises exposure 1.2-2x.

Our verdict on PT-141 (Bremelanotide)

Approved and well tested for one use: premenopausal women with low desire. Nausea is the big catch and benefit is modest.

PT-141 (Bremelanotide) FAQ

Is PT-141 approved?

Yes, as Vyleesi, for premenopausal women with distressing low desire.

Is it approved for men?

No. Male trials were small and no male product exists.

How often can it be used?

Once per 24 hours, and no more than 8 times a month.

How is it different from Viagra?

It acts in the brain on desire; sildenafil acts on blood flow.

Sources

  • VYLEESI (bremelanotide) US prescribing information, DailyMed setid f1d0c1b5-2f39-4bad-a6a4-0066e3ad5dcf
  • Simon JA et al. Obstet Gynecol 2019 (RECONNECT extension), PMID 31599847
  • ClinicalTrials.gov NCT02333071 and NCT02338960 (RECONNECT)
  • Salvage of sildenafil failures with bremelanotide, J Urol 2008, PMID 18206919
  • Intranasal PT-141 plus sildenafil in men with ED, Urology 2005, PMID 15833522