Comprehensive medication guide to Vyleesi including estimated pricing, availability information, side effects, and how to find it in stock at your local pharmacy.
Estimated Insurance Pricing
$0 for eligible commercially insured patients through the BlinkRx Copay Assistance program; otherwise copay varies widely by plan. Prior authorization is required by many commercial insurers. Most Medicaid plans do not cover Vyleesi. Medicare Part D coverage is limited.
Estimated Cash Pricing
$290 per single autoinjector or ~$1,295 for a 4-pack at retail; the maximum monthly supply of 8 doses can exceed $2,000. No generic available. GoodRx discounts do not apply (specialty pharmacy only). The manufacturer's BlinkRx Copay Assistance program can reduce costs to $0 for eligible commercially insured patients.
Medfinder Findability Score
45/100
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Vyleesi (bremelanotide) is an FDA-approved prescription injectable medication for the treatment of acquired, generalized hypoactive sexual desire disorder (HSDD) in premenopausal women. It was approved by the FDA on June 21, 2019, and is one of only two FDA-approved medications specifically indicated for HSDD (the other being Addyi/flibanserin). Vyleesi is manufactured and distributed by Cosette Pharmaceuticals.
Unlike daily pill-based treatments, Vyleesi is an on-demand therapy — you use it only when you anticipate sexual activity, at least 45 minutes before. It comes as a 1.75 mg / 0.3 mL prefilled autoinjector that delivers a subcutaneous (under-the-skin) injection to the abdomen or thigh. HSDD, the condition Vyleesi treats, is defined as a persistent and distressing loss of sexual desire that is not caused by a medical condition, psychiatric disorder, relationship problems, or medication side effects.
Vyleesi is not indicated for postmenopausal women or men, and should not be used to enhance sexual performance in people without HSDD. No generic version is currently available, and the earliest estimated generic entry is around November 2033.
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Vyleesi is classified as a melanocortin receptor (MCR) agonist. Bremelanotide, its active ingredient, is a synthetic peptide that activates melanocortin receptors in the central nervous system — primarily MC1R and MC4R. MC4R receptors, which are found in neurons throughout the brain, are believed to play a role in modulating sexual desire and arousal.
When injected, bremelanotide travels through the bloodstream to the brain, where it engages these excitatory neural pathways involved in sexual motivation. The exact molecular mechanism by which this improves HSDD isn't fully characterized — the FDA's prescribing information states that 'the mechanism by which VYLEESI improves HSDD in women is unknown.' However, clinical Phase 3 trials demonstrated meaningful improvements in sexual desire scores and reductions in distress related to low desire in premenopausal women with HSDD.
Importantly, Vyleesi is a non-hormonal treatment. It does not affect estrogen, progesterone, or testosterone levels. Because bremelanotide is a peptide (which would be destroyed by digestive enzymes if swallowed), it must be administered as a subcutaneous injection. The drug takes effect within 45 minutes of injection.
1.75 mg / 0.3 mL — subcutaneous autoinjector
Single-dose prefilled autoinjector pen. Inject into abdomen or thigh at least 45 minutes before anticipated sexual activity. Max 1 dose per 24 hours; max 8 doses per month.
Vyleesi is not in a formal FDA-declared shortage in 2026, but it has a findability score of 45 out of 100 — reflecting significant structural access challenges that make it genuinely difficult for many patients to fill. The primary reason is distribution: Vyleesi is a specialty-pharmacy-only medication and is not stocked at standard retail chains like CVS, Walgreens, or Walmart.
Additionally, many commercial insurance plans require prior authorization before covering Vyleesi, and the high cash price ($290 per single autoinjector) creates a financial barrier for uninsured and underinsured patients. HSDD is also frequently underdiagnosed, and many providers are not familiar with Vyleesi, further limiting prescribing volume and pharmacy stocking.
To find a specialty pharmacy near you that can fill your Vyleesi prescription, use medfinder — medfinder contacts pharmacies on your behalf and texts you which ones can fill your prescription, saving you hours of phone calls.
Vyleesi is not a controlled substance and has no REMS program, meaning any licensed healthcare provider with prescribing authority can issue a Vyleesi prescription. No special certification, DEA scheduling, or training program is required. The prescriber simply needs to diagnose HSDD appropriately and route the prescription to a Vyleesi-approved specialty pharmacy.
The following types of providers commonly prescribe Vyleesi:
Vyleesi is also available via telehealth. Several platforms specializing in women's sexual health can evaluate patients online and issue prescriptions directly to specialty pharmacies. This is often the fastest route to obtaining a Vyleesi prescription, particularly for patients in areas where HSDD-familiar providers are not readily available in person.
No. Vyleesi (bremelanotide) is not a controlled substance and has no DEA scheduling. It does not have abuse potential in the way that scheduled medications do, and it is not subject to the prescribing restrictions, refill limitations, or documentation requirements that apply to DEA-scheduled drugs.
Any licensed healthcare provider with prescribing authority can write a Vyleesi prescription without additional DEA registration or special certification. There is no REMS (Risk Evaluation and Mitigation Strategy) program for Vyleesi. This means OB/GYNs, PCPs, NPs, PAs, and telehealth providers can all prescribe it straightforwardly.
The most commonly reported side effects (occurring in more than 4% of patients) include:
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Addyi (flibanserin)
FDA-approved daily 100 mg oral tablet for HSDD in women under 65. Serotonin agonist/antagonist; takes 4-8 weeks to work; some alcohol restrictions. Available via specialty pharmacy.
Compounded bremelanotide (PT-141)
Same active ingredient as Vyleesi in compounded form (injections, troches, nasal spray). Not FDA-approved but may be available at lower cost through telehealth providers.
Off-label testosterone
Compounded low-dose testosterone cream or gel. Not FDA-approved for women but commonly prescribed off-label for HSDD, especially postmenopausal. Requires monitoring.
Bupropion (off-label)
Antidepressant with dopamine/norepinephrine activity. Sometimes used off-label for HSDD with overlapping depressive symptoms. Limited evidence; widely available and inexpensive.
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Oral naltrexone
majorVyleesi significantly decreases systemic exposure of orally-administered naltrexone by slowing gastric motility. Avoid concomitant use with oral naltrexone-containing products intended to treat alcohol or opioid addiction (e.g., ReVia, oral Vivitrol).
Other oral medications
moderateVyleesi may delay the rate and extent of absorption of other oral medications taken close in time to a dose due to slowed gastric emptying. Usually not clinically significant for most drugs, but discuss with provider for time-sensitive medications.
Antihypertensive medications
moderateVyleesi transiently raises blood pressure after each dose. Patients with hypertension on antihypertensives should ensure blood pressure is well-controlled before starting. Contraindicated in uncontrolled hypertension or known cardiovascular disease.
Alcohol
minorNo known clinically significant interaction with alcohol. Unlike Addyi (flibanserin), Vyleesi has no alcohol restriction.
Vyleesi (bremelanotide) represents a meaningful advance in the treatment of female hypoactive sexual desire disorder. As one of only two FDA-approved medications specifically for HSDD, it offers premenopausal women an on-demand, non-hormonal option that works through a unique brain-based mechanism. Clinical trials confirm that it meaningfully improves sexual desire and reduces distress in a significant proportion of patients.
The primary challenge with Vyleesi isn't its clinical profile — it's access. The specialty pharmacy-only distribution model, frequent insurance prior authorization requirements, and high cash cost create real barriers. However, the BlinkRx Copay Assistance program can reduce costs to $0 for eligible commercially insured patients, making affordability achievable for many.
If you've been prescribed Vyleesi and are struggling to find a pharmacy that can fill it, medfinder can help. You tell us your medication and location — we call pharmacies near you and text you which ones can fill your prescription. We cover all medications, not just Vyleesi.
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Our medication guides are researched and written to help patients make informed decisions. All content is reviewed for accuracy and updated regularly. Learn more about our standards
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