Brem

Bremelanotide (brand name Vyleesi) is a peptide medication used for the treatment of premenopausal women with hypoactive sexual desire disorder (HSDD). It is administered via subcutaneous injection and works by activating melanocortin receptors in the brain, which are believed to be involved in sexual arousal and response mechanisms.

Medical Uses

Bremelanotide is indicated for the treatment of hypoactive sexual desire disorder (HSDD) in premenopausal women. HSDD is characterized by a lack or absence of sexual desire and distress that cannot be attributed to an existing medical condition or relationship issue. Bremelanotide is not intended for use in treating HSDD in postmenopausal women or in men, nor is it intended to enhance sexual performance.

Mechanism of Action

Bremelanotide acts as an agonist at melanocortin receptors, specifically the MC1R and MC4R, in the central nervous system. Its exact mechanism of action in treating HSDD is not fully understood but is thought to involve the activation of pathways in the brain that contribute to sexual desire and arousal.

Administration

Bremelanotide is administered via subcutaneous injection into the abdomen or thigh approximately 45 minutes before anticipated sexual activity. It should not be used more than once within a 24-hour period or more than eight times per month.

Side Effects

Common side effects of bremelanotide include nausea, flushing, injection site reactions, and headache. Less common but more serious side effects may include high blood pressure and darkening of the skin in areas repeatedly exposed to the drug. Patients are advised to monitor for symptoms and report any severe or persistent side effects to their healthcare provider.

Pharmacology

Bremelanotide has a half-life of approximately 2.7 hours and is primarily metabolized by the liver. Its pharmacokinetics may be affected by hepatic impairment, and caution is advised in patients with liver disease.

History

Bremelanotide was developed from a peptide initially used to induce skin tanning. During clinical trials for its tanning effects, it was discovered to have potential benefits in treating sexual dysfunction, leading to its development and approval for HSDD.

Regulatory Approval

In the United States, bremelanotide was approved by the Food and Drug Administration (FDA) in June 2019 for the treatment of premenopausal women with hypoactive sexual desire disorder. It is the first medication of its kind to be approved for this condition.

See Also

• Hypoactive Sexual Desire Disorder
• Melanocortin receptor
• Sexual dysfunction
• Subcutaneous injection