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Compounded — not FDA-approvedPrescription only
Compounded PT-141 (Bremelanotide)
Compounded — self-administered injection, as needed
A compounded injection of bremelanotide, a melanocortin agonist that works on desire pathways in the brain rather than on blood flow. Approved only in women; any prescription here is a provider's documented judgment.
Compounded PT-141 (bremelanotide) is prepared for you by a licensed 503A compounding pharmacy and is not FDA-approved. It uses the active ingredient of Vyleesi but is not that product, and the FDA has not reviewed it for safety, effectiveness or quality. A provider may prescribe it only where they document a clinical reason it is right for you specifically.
From$239/mo$32 consultation included, not refunded · medication and shipping if prescribed
Choose your plan
4-week supply
Price
$239for a 4-week supply, if prescribed
Includes your $32 provider consultation (non-refundable). If your provider decides treatment isn’t appropriate, the medication portion is refunded automatically.
- Your provider confirms the dose. If they start you on a lower step, we refund the difference; if they choose a higher one within the same plan, the price you paid stands.
Adding to cart books a provider visit. You pay the shown total; the provider decides; the medication portion comes back automatically if they say no.
Questions
Will I definitely be prescribed this?
No. A consultation does not guarantee a prescription. Because the approved product is for premenopausal women and this is a compounded version of it, a provider prescribes it to you only where they can document a specific clinical reason, and many will reasonably choose a PDE5 inhibitor, or no medication, instead. If they decline, the medication portion is refunded and the consultation is not.
Isn't this a women's medication?
The approved product, Vyleesi, is: for premenopausal women with hypoactive sexual desire disorder, and its label says plainly that it is not indicated in men. The molecule was first studied in men in the early 2000s and those studies were never carried through to approval. What you are looking at here is that unfinished evidence, compounded by a pharmacy, and we would rather you know that now than find out later.
Will it make me want sex more?
That is the pathway it acts on, and the honest answer is that it varies and we cannot promise it. The trials that led to approval were in women and measured desire and distress scores; in men the published data is a handful of single-dose laboratory studies. You and your provider will assess whether it is doing anything for you.
Does it interact with anything?
Bremelanotide slows stomach emptying, so it can blunt or delay oral medications taken around the same time, including antibiotics, and it sharply reduces absorption of oral naltrexone. Tell your provider about every medication you take, including low-dose naltrexone if you use it.
How it works
Bremelanotide is a synthetic analogue of melanocyte-stimulating hormone. It activates melanocortin receptors — MC1R and MC4R above the others — in the brain, where MC4R signalling is linked to sexual desire and arousal. That is a different route from the PDE5 inhibitors, which act on blood vessels in the penis: PT-141 does not depend on nitric oxide signalling being intact, which is why it was studied in men who responded poorly to sildenafil. It is injected under the skin about 45 minutes before anticipated activity. The brand-name product Vyleesi is FDA-approved only for premenopausal women with hypoactive sexual desire disorder; in men, and in this compounded form, it sits outside any approval, resting on single-dose studies from 2004 that measured rigidity in a laboratory rather than outcomes in real life.
The full mechanismWhat the trials found
Published results, with what each was measured against.
These results come from trials of the FDA-approved product named in each citation. The compounded preparation on this page is not that product, was not studied in these trials, and has not been reviewed by the FDA for safety, effectiveness or quality.
A statistically significant erectile response at 4 mg and 6 mg subcutaneous doses in 25 men who responded inadequately to sildenafil
vs placebo, in a crossover design with visual sexual stimulation
A single-dose laboratory measurement of rigidity, not a trial of real-world outcomes; no phase 3 programme in men was completed.
Rosen et al., Int J Impot Res 2004;16(2):135–142
Nausea in 40% of women taking the approved product in its phase 3 trials
vs 1.3% on placebo (627 vs 620 women)
The most common adverse reaction on the label; 8% of treated women left the trials because of it. Reported here so the risk is stated with the same rigour as any benefit.
Vyleesi prescribing information, Table 1 and section 5.3, 2019
Trial averages describe a study population, not a prediction for you. Your provider will be direct about what is realistic given your history — and results depend on continuing treatment.
A provider may consider it if
- Your provider has considered and ruled out the standard PDE5 options, or you have a documented reason they are not suitable
- Your blood pressure is well controlled and has been checked recently
- You understand this is an injection taken before activity, not a daily medication, and that the evidence in men is early
It won’t be prescribed if
- Uncontrolled blood pressure or known cardiovascular disease — the approved product is contraindicated in both, because each dose transiently raises blood pressure and slows the heart rate
- Anyone taking oral naltrexone for alcohol or opioid dependence — bremelanotide can sharply reduce how much naltrexone is absorbed, and treatment failure there has serious consequences
- Pregnancy, breastfeeding or trying to conceive — the approved label advises stopping it if pregnancy occurs
- Anyone at high cardiovascular risk, or anyone who cannot limit use to one dose in 24 hours and eight doses a month
- Anyone expecting it to fix the blood-flow side of erectile dysfunction — it works on desire, and it is not a substitute for a cardiovascular work-up
These are the same checks your provider runs in the visit. If one applies, they will tell you plainly — and the medication portion of what you paid comes back automatically.
What to expect
Before a dose
Injected under the skin of the abdomen or thigh at least 45 minutes before anticipated activity. No more than one dose in 24 hours; more than eight doses a month is not recommended on the approved label.
The first hours
Nausea is the common experience — it usually starts within an hour and lasts about two. Flushing and a temporary rise in blood pressure peak two to four hours after a dose and settle within about twelve.
Ongoing
Reviewed at check-ins like any prescription: whether it is earning its place, how your blood pressure is behaving, and whether any skin darkening has appeared.
Safety
Side effects, before you decide
Nausea is the dominant one — about four in ten women in the approval trials, with some stopping for that reason — along with flushing, injection-site reactions, headache and vomiting. Each dose raises blood pressure by a few points and lowers heart rate for several hours, which is why uncontrolled hypertension is a hard stop. Repeated use can darken patches of skin on the face, gums or breasts, and this did not always fade after stopping. Safety data in men is limited to small, short studies.
- FDA prescribing information: Vyleesi (bremelanotide) injection — DailyMed, approved 2019, SPL published 2025-11-18
- Rosen RC, Diamond LE, Earle DC, Shadiack AM, Molinoff PB. Int J Impot Res 2004;16(2):135–142 — subcutaneous PT-141 in healthy men and in men with an inadequate response to sildenafil
- Diamond LE, Earle DC, Rosen RC, Willett MS, Molinoff PB. Int J Impot Res 2004;16(1):51–59 — intranasal PT-141 in men with mild-to-moderate erectile dysfunction
Complete safety information is provided during your visit and with every prescription. This page is a summary, not a substitute for your provider's advice.
See whether compounded pt-141 (bremelanotide) is right for you.
A licensed provider reviews your visit and decides. You receive medication only if prescribed, and that portion of your payment is refunded automatically if they say no.