Bremelanotide is a 7-amino-acid cyclic melanocortin peptide (MW ~1025.2 g/mol) that acts as an agonist at melanocortin receptors MC4R and MC3R. It was FDA-approved in June 2019 (Vyleesi) for the treatment of hypoactive sexual desire disorder (HSDD) in premenopausal women, making it the first melanocortin-based therapy approved for sexual dysfunction. Bremelanotide is administered as an on-demand subcutaneous autoinjector at least 45 minutes before anticipated sexual activity.
Category: Sexual Health. Evidence rating: A (strong human clinical data).
Clinical status: FDA-approved (Vyleesi for premenopausal HSDD, June 2019)
Bremelanotide activates melanocortin 4 receptors (MC4R) and melanocortin 3 receptors (MC3R) in the central nervous system, particularly in hypothalamic nuclei involved in sexual arousal and desire. Unlike phosphodiesterase inhibitors that act on peripheral blood flow, bremelanotide acts centrally…
Safety considerations: Common (>=5%): nausea (40%, typically mild-moderate and decreases with subsequent doses), flushing (20%), injection site reactions (13%), headache (11%); Transient increase in blood pressure: systolic +3 mmHg, diastolic +2 mmHg within 12 hours of dosing; resolves within 12 hours; Skin hyperpigmentation: reported in 1% of patients, particularly in areas of darkly pigmented skin; mechanism related to MC1R cross-activation. May not fully resolve after discontinuation.
Reviewed by the PeptideAtlas Editorial Team. Last reviewed: 2026-08-12.
Related peptides: PT-141.
Compare: Bremelanotide vs PT-141.
Bremelanotide is the pharmaceutical name for the same molecule previously known in research as PT-141. Vyleesi is the FDA-approved, GMP-manufactured, precisely dosed autoinjector form. Grey-market PT-141 refers to the unregulated research peptide version with unverified purity and dosing.
Both treat HSDD in premenopausal women, but they differ in mechanism and administration. Flibanserin is a daily oral pill acting on serotonin receptors; bremelanotide is an on-demand subcutaneous injection acting on melanocortin receptors. Flibanserin has an alcohol interaction warning; bremelanotide does not.
Nausea is the most common side effect (~40%) and is related to melanocortin receptor activation in the area postrema of the brainstem. It typically diminishes with repeated use and is generally mild to moderate in severity.