Vyleesi Drug Interactions: What to Avoid and What to Tell Your Doctor

Before starting any new medication, it's essential to review how it might interact with the other medications, supplements, or substances you're using. Vyleesi (bremelanotide) has a relatively short list of well-documented drug interactions compared to many medications — but the ones that do exist are clinically important.

Here's a complete guide to Vyleesi drug interactions in 2026, including what to avoid, what to monitor, and what to tell your healthcare provider.

Most Important Interaction: Oral Naltrexone

The most significant and well-documented drug interaction with Vyleesi is with orally administered naltrexone. Vyleesi significantly decreases the systemic exposure (blood levels) of naltrexone by slowing gastric motility — meaning your stomach empties more slowly when Vyleesi is active, reducing how much of the oral naltrexone gets absorbed into your bloodstream.

This is clinically significant because oral naltrexone is used to treat alcohol use disorder (Vivitrol, ReVia) and opioid use disorder. If you're taking naltrexone for either of these conditions, Vyleesi could render it less effective — potentially with serious consequences.

The Vyleesi prescribing information explicitly states: avoid use with orally administered naltrexone-containing products intended to treat alcohol or opioid addiction.

Note: injectable extended-release naltrexone (Vivitrol given as a monthly shot) is not affected by Vyleesi's gastric motility effect, since it doesn't pass through the digestive system. If you use injectable naltrexone, discuss with your provider whether any additional cautions apply.

General Interaction: Oral Medications Taken at the Same Time

Beyond naltrexone, Vyleesi can slow gastric motility more broadly, which may delay the absorption of other orally administered medications taken close to the time of a Vyleesi dose. In clinical pharmacology studies, this effect was not clinically significant for most drugs tested. But because the timing could theoretically affect absorption of any oral medication, it's worth being aware of.

Practical guidance: If you take time-sensitive oral medications (such as emergency contraception, anticoagulants, or medications with narrow therapeutic windows), ask your provider whether you should separate the timing from your Vyleesi injection.

Blood Pressure Medications

Vyleesi transiently raises blood pressure after each dose. If you're taking antihypertensive medications to control blood pressure, discuss this interaction with your prescriber before starting Vyleesi. In patients with uncontrolled hypertension, Vyleesi is contraindicated entirely.

If your blood pressure is well-controlled on medication, your provider may still feel it's appropriate to prescribe Vyleesi while monitoring cardiovascular risk. The key question is whether your baseline blood pressure is stable and within normal limits.

Alcohol

Unlike Addyi (flibanserin), Vyleesi has no known clinically significant interaction with alcohol. The official prescribing information does not restrict alcohol consumption while using Vyleesi. This is one key difference that makes Vyleesi preferable for patients who consume alcohol socially.

Cardiovascular Medications and High-Risk Patients

Vyleesi is contraindicated in patients with known cardiovascular disease. If you take medications for heart failure, arrhythmias, or other cardiovascular conditions, Vyleesi may not be appropriate for you. Your provider should evaluate your cardiovascular risk profile before prescribing.

Interactions to Discuss With Your Doctor

Always tell your doctor and pharmacist about ALL medications you take before starting Vyleesi, including:

• Prescription medications (especially oral naltrexone, antihypertensives, and time-sensitive medications)
• Over-the-counter (OTC) medications, particularly antacids, NSAIDs, and cold/flu products
• Herbal supplements (St. John's Wort, ginkgo, and similar supplements that interact with many medications)
• Hormonal medications (birth control pills, hormone therapy) — while not contraindicated, discuss the timing to ensure Vyleesi's gastric motility effects don't interfere with oral contraceptive absorption

Key Interactions Summary

• Oral naltrexone (MAJOR) — AVOID: Vyleesi significantly reduces naltrexone blood levels. Do not use together if taking oral naltrexone for alcohol or opioid use disorder.
• Other oral medications (MODERATE — timing): Vyleesi may delay absorption of co-administered oral medications. Usually not clinically significant, but discuss with provider for time-sensitive drugs.
• Antihypertensives (MODERATE — blood pressure): Vyleesi transiently raises BP; contraindicated in uncontrolled hypertension or cardiovascular disease.
• Alcohol (NONE): No known clinically significant interaction with alcohol (unlike Addyi).

See also our guide to Vyleesi side effects and warnings for more information on what to watch for during treatment.

Once you and your provider have reviewed interactions and you're ready to fill your Vyleesi prescription, medfinder can help you find specialty pharmacies near you that have it in stock.