PT-141
Bremelanotide
- Injection
- Oral
- Nasal spray
- Suppository
- Gel or cream
Injection · Nasal spray — on demand, about 45 minutes beforehand.
PT-141 — also called bremelanotide — is a synthetic cyclic heptapeptide engineered from alpha-melanocyte-stimulating hormone (α-MSH), the same family of signaling molecules that controls skin pigmentation, appetite, and sexual motivation in the brain. It’s one of a small handful of peptides that cleared FDA review and got a brand name: Vyleesi, approved in June 2019 for premenopausal women with hypoactive sexual desire disorder (HSDD).
Most sexual-function drugs work in the bloodstream. PT-141 works in the brain. It’s a melanocortin-receptor agonist that binds MC3R and MC4R in the hypothalamus, stimulating dopamine release into the mesolimbic reward pathway — the desire signal. In men, it also initiates the nitric oxide cascade that produces erection, working upstream from where sildenafil and tadalafil act. The practical implication: PT-141 addresses low desire and, in men, can help when PDE5 inhibitors don’t.
“PT-141 is the only FDA-approved on-demand treatment for low desire in women — and the only peptide in sexual wellness with Phase 3 trial data showing it works.”
Who it's for (or who should avoid)
What it's aimed at
PT-141 protocols are most commonly prescribed for:
- Premenopausal women with HSDD — the FDA-approved indication; acquired and generalized loss of desire that causes distress
- Men with low libido or PDE5-non-responsive ED — off-label use based on Phase 2 and observational data
- Patients whose desire problem is upstream — central nervous system rather than vascular or hormonal
- Patients who don’t tolerate daily pills — PT-141 is on-demand, taken 30–60 minutes before anticipated intimacy
- Patients for whom flibanserin (Addyi) didn’t work or wasn’t tolerated — PT-141 works on a different receptor system
The approved use is narrow: loss of desire that is acquired rather than lifelong, and not explained by another medical or psychiatric condition, problems in the relationship, or the effects of a medication.
Who should avoid it
- Anyone with uncontrolled hypertension or known cardiovascular disease — PT-141 causes transient blood pressure increases
- Anyone on nitrates — severe hypotension risk; this is a hard contraindication
- Postmenopausal women — the trials didn’t include them and the safety profile isn’t established
- Anyone pregnant, breastfeeding, or planning a pregnancy in the near term
- Patients planning to use the drug more than 8 times per month long-term — risk of focal skin pigmentation changes
PT-141 works on desire, not mechanics.
If the problem is purely vascular ED with intact libido, a PDE5 inhibitor is typically the right first-line tool. PT-141 is for the upstream problem — the desire signal itself.
Route, dose and course
PT-141 is most commonly prescribed as a subcutaneous injection, taken on-demand about 45 minutes before anticipated sexual activity. The FDA-approved product (Vyleesi) is a 1.75 mg autoinjector; compounded versions typically come in multi-dose vials that let providers titrate.
What the label and sellers say:
- Label dose (women, Vyleesi): 1.75 mg subcutaneous, abdomen or thigh, sites rotated, no more than once per 24 hours
- Off-label dose (men, compounded): Rx Peps Direct lists 0.4 mg per injection, or a nasal spray of 5 mg per use (checked 16 October 2026). The figure is the seller’s; no dose is approved for men
- Frequency cap: the Vyleesi label allows no more than one dose in 24 hours and eight a month
- Timing: the label says to inject at least 45 minutes before sexual activity
- Nausea: the most common side effect on the label
The intranasal route (7.5–20 mg) was studied in early Phase 2 trials but is not an FDA-approved formulation. Some compounding pharmacies prepare it as a nasal spray anyway, and it is sold that way — TeleZenMD, the only provider on our list carrying PT-141, offers the injection and the nasal spray at the same price. There is no Phase 3 data behind the spray, so the choice between the two is about tolerating a needle, not about evidence.
No measured timeline
PT-141 is taken when you want it rather than every day, which makes it feel unlike a maintenance medication. The approved product, Vyleesi, is injected ahead of the occasion and was tested that way in two Phase 3 trials covering 1,267 women. Those trials measured desire and distress over months, not how many attempts it takes to know whether it works for you, so we do not draw a response timeline.
Available · from about $65/mo
Every headline price in this market excludes something. These are normalized to a calendar month, cheapest first, with the exclusion spelled out — the published figure is the footnote under it. Monthly figures here run from about $65 to $280. We may earn a commission when you purchase from some of the partners listed here, at no extra cost to you.
| Provider | From, per month | What that figure excludes | Coverage | Their own site |
|---|---|---|---|---|
| EverlifeMDSublingual and injectable peptide telehealth | $65read 2026-11-04 | The nasal spray (10 mL, 10 mg/mL) starts at $155/mo. | Not published | Go to site |
| New Blue HealthPeptide, GLP-1 and hormone telehealth | $126read 2026-11-04 | Strength, which is not published. Offered for women with hypoactive sexual desire disorder. | All but some, named | Go to site |
| Hone HealthMembership telehealth for hormones and longevity | $130read 2026-11-04 | The membership, $25 or $155 a month; strength. | Not published | Go to site |
| TeleZenMDWidest peptide menu | $166read 2026-11-04 | The quarterly rate requires paying three months up front. Branded Vyleesi is a separate product at a different price. | All 50, stated | Go to site |
| Invigor MedicalCompounded catalogue, Kennewick WA | $280read 2026-11-04 | No dose, vial size or concentration is published. | All 50, stated | Go to site |
| AgelessRxLongevity prescribing, runs its own trials | No price for this compound | Every headline figure on the site is a first-month rate. Sermorelin and NAD+ both advertise below $100 and both go to $149 a month after it. | All 50, stated | Go to site |
| Defy MedicalTampa clinic, physician-led | $205 per vialread 2026-11-11 | The consultation and lab work. Their page notes Hallandale requires overnight shipping with an ice pack, and that no discount applies to peptides. | Not published | Go to site |
| PeRxPeptide-only telehealth, Wellness MD Group PC | No price for this compound | The only peptide figure on the site is a floor for the whole menu — treatment plans "starting at $199" — so there is no price for any individual compound. The provider review is included; there is no separate consultation fee. | All 50, stated | Go to site |
| RxPepsDirectPer-vial prices, 503A pharmacy in Texas | $75 per vialread 2026-11-04 | The $39 telehealth visit, charged per order. | A named list | Go to site |
Will it work where you live?
Most sellers claim all fifty states or publish nothing about coverage; a few name the states they serve or the ones they exclude, and the Coverage column says which. Either way it is the seller's own claim, so we can't filter this list by state without inventing a fact. What we can tell you is which state-level rules decide access: telehealth rules, non-resident pharmacy licensing, and who is allowed to prescribe.
Prices and providers change. We keep track.
Questions we get about PT-141
Is PT-141 FDA-approved?
Yes — as Vyleesi, a 1.75 mg subcutaneous autoinjector for premenopausal women with acquired, generalized hypoactive sexual desire disorder (HSDD). It's the only FDA-approved on-demand treatment for low desire in women. Off-label use in men, or compounded versions for either sex, are not FDA-approved but are prescribed by licensed clinicians.
Is it legal?
With a prescription from a licensed clinician, yes. The branded product (Vyleesi) is FDA-approved. Compounded PT-141 is prescribed off-label and prepared by licensed 503A pharmacies, but because an FDA-approved version (Vyleesi) is commercially available, the FDA limits routine compounding of what is essentially a copy of it — so availability from compounders varies. Buying it without a prescription — particularly from international or "research peptide" sources — is not legal, and quality is untested. Availability can vary by state — confirm current access with the provider or your clinician.
Are there side effects?
Nausea is the most common — around 40% of users in the Phase 3 trials reported it, typically mild to moderate and peaking about two hours after dosing. Flushing (20%), headache (11%), and injection-site reactions (5%) also occur. PT-141 causes transient increases in blood pressure and decreases in heart rate; effects resolve within 12 hours. Chronic high-frequency use carries a risk of focal skin pigmentation changes (hyperpigmentation), which is why the label caps use at roughly 8 doses per month.
Can I take it with my current medications?
PT-141 is contraindicated with nitrates (severe hypotension risk) and in patients with uncontrolled hypertension or known cardiovascular disease. It lowers plasma concentrations of indomethacin and naltrexone, so patients on those drugs should flag it with their provider. There's no clinically significant interaction with alcohol, which is a real differentiator from flibanserin (Addyi). Always disclose your full medication list to your provider.
How much does it cost?
In the price table on this page, monthly figures run from about $65 to $280, read on November 4, 2026. Some sellers price it per vial or unit instead, shown in the same table. Two prices, and they are nothing like each other. Vyleesi is the FDA-approved branded version, and its manufacturer sells a 4-dose box for $99 in cash if your insurance declines; most commercially insured patients pay nothing (vyleesi.com, August 13, 2026). The figures in the table are for compounded PT-141 from telehealth sellers. Insurance does not touch the compounded version.
How the bill breaks downWe publish no medical reviewer by design. Every claim on this page traces to a source we hold on file, and the reviewed write-up with those citations lives on our hub. Read the full research on PeptideWellness ↗
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