A PT-141 prescription comes in one of two forms: the brand, Vyleesi, or compounded bremelanotide, made by a compounding pharmacy on a prescriber’s order. Either way, a licensed practitioner has to write it[3].
PT-141 is the research name for bremelanotide, and the brand's price is covered separately. That price is in Vyleesi cost.
What the label allows
Vyleesi is indicated for premenopausal women with acquired, generalized hypoactive sexual desire disorder[1]. The label rules out low desire caused by another medical or psychiatric condition, a relationship problem, or a drug[1].
It is not indicated for postmenopausal women or men, or to enhance sexual performance[1]. A prescription for anyone else is outside the label, which usually matters for coverage as well as for the evidence behind it.
The label also sets limits the prescriber will work within: one 1.75 mg dose, no more than once in 24 hours, and more than 8 a month is not recommended[1]. It says to stop after 8 weeks if symptoms have not improved[1].
The brand route
The maker sends new patients to a third-party telemedicine partner and notes that fees may apply[4]. The prescription then goes to the maker’s pharmacy partner, which handles coverage and delivery[4].
Without coverage, the maker lists a 4-dose box at $99[4]. How a telehealth visit works from intake to shipping is in how online peptide therapy works.
The compounded route
Federal law lets a state-licensed pharmacist compound for an identified patient on a prescription from a practitioner authorized by state law to prescribe[3]. The bulk ingredient must meet a USP monograph where one exists, or be a component of an approved drug[3]. Bremelanotide is the active ingredient of Vyleesi[1].
The limit is the copy rule. A 503A pharmacy may not compound, regularly or in inordinate amounts, drugs that are essentially copies of a commercially available product[3]. FDA treats a product as a copy when it has the same active ingredient, a similar strength, and the same route[2].
A prescriber can override that for one patient by recording a change that produces a significant difference for that patient[2][3]. FDA says the change must be tied to the individual, not used as a reason to supply everyone[2].
| Form | Typical month | Range | Sellers |
|---|---|---|---|
| Injection | $199 | $73 to $328 | 28 |
| Nasal spray | $187 | $151 to $249 | 8 |
Route is the one criterion a buyer can see. Vyleesi is injected under the skin[1], so a compounded injection shares its route, and a nasal spray does not. Either way, a compounded drug is not FDA-approved and has not had FDA’s premarket review[2].
Who the pharmacy is, and whether it is a 503A pharmacy or a 503B facility, is covered in 503A vs 503B and the guide to compounded peptides.
Across state lines
The practitioner must be authorized to prescribe under state law[3], which in practice means licensed where you are. The rules for a visit with a clinician in another state are in telehealth across state lines, and which clinicians may prescribe at all is in who can prescribe peptides.
Four questions for the seller
- Is this Vyleesi, or compounded bremelanotide, and in which form?
- Which pharmacy compounds it, and in which state is it licensed?
- Is the visit billed separately from the drug?
- Is the price per dose, per vial or per month?
Reviewed sellers, including those that list PT-141, are on the reviews page.