Desire, Not Mechanics
Sildenafil and tadalafil work further downstream on blood flow. PT-141 acts on the desire that precedes it.
Prescription · Clinical Monograph
PT-141
A prescription drug that works on desire itself, prescribed off-label for men.
PT-141, or bremelanotide, acts on melanocortin receptors in the brain, on the pathways that govern arousal. Sildenafil and tadalafil, the drugs in Viagra and Cialis, work further downstream on blood flow. PT-141 acts on the desire that precedes it.
Its commercial version, Vyleesi, was FDA-approved in 2019 for hypoactive sexual desire disorder in premenopausal women. Prologue's PT-141 is compounded and prescribed off-label. Compounded medications are not FDA-approved.
Straight Past the Gut
Subcutaneous injection, taken as needed.
Off-Label, Stated Plainly
Compounded. Active ingredient FDA-approved as Vyleesi for women; prescribed off-label for men.
What getting it involves
A consultation
A consultation with a Prologue physician.
A physician reads it
Your blood pressure and your cardiac history, before prescribing.
Prescribed off-label
Compounded. Active ingredient FDA-approved as Vyleesi for women; prescribed off-label for men.
Dispensed
Subcutaneous injection, taken as needed, compounded by a licensed pharmacy partner.
Where the evidence stands
Understood
The mechanism is well understood.
In women
The trials behind Vyleesi enrolled premenopausal women with a specific diagnosis and showed a modest effect on desire. No comparable trial has been run in men.
Vyleesi’s trials
The human data is mostly in women.
What your physician screens for
Blood pressure and cardiac history
PT-141 raises blood pressure transiently after each dose. Vyleesi carries a contraindication for uncontrolled hypertension and for known cardiovascular disease, and that contraindication applies here. Your physician checks both before prescribing.
How it's prescribed
Subcutaneous injection, taken as needed.
There's no established dose for the off-label use. Your physician sets it and adjusts based on how you respond.
Compounded by a licensed pharmacy partner and tested for potency, sterility, and endotoxin levels before shipment.
PotencySterilityEndotoxin
Disclosures
Bremelanotide (PT-141) is FDA-approved in its commercial form, Vyleesi, for hypoactive sexual desire disorder in premenopausal women. Prologue prescribes it off-label for men. It is compounded by a licensed pharmacy partner and tested for potency, sterility, and endotoxin levels before shipment. Compounded medications are not FDA-approved and are not reviewed by the FDA for safety, effectiveness, or quality. Treatment is not appropriate for every patient, and outcomes vary. Talk with your physician about whether this fits your situation.
Begin
How to get it.
PT-141 requires a consultation with a Prologue physician.
Everyone else starts by joining the practice.
Members can bring it up at their next consultation.
Questions
Nothing is charged when you join. Billing begins only after a physician has approved your plan. If they decide treatment isn't appropriate for you, you are not charged.
It is gentler than most people expect. The needle is the size of an insulin pen — thin and short, designed for subcutaneous tissue rather than muscle. Your physician can walk you through the technique at your consultation, and most patients are comfortable with the routine by the end of the first week.
PT-141 is compounded by a licensed pharmacy partner and ships with everything you need: vials, syringes, alcohol swabs, and sharps disposal.
It's a subcutaneous injection, given at home. Your physician sets the schedule, so the frequency is decided for you rather than fixed in advance.
The first dose takes about a minute. Your physician can walk you through the technique at your consultation, and you'll have everything you need in the first shipment.
Tell your physician at your intake. The needle is short and fine, and most people settle into the routine within the first couple of weeks — but if self-injection isn't workable for you, say so and your physician will talk through the alternatives.
For anything urgent, call 911 or your primary care physician — Prologue is not an emergency service. For everything else, write to the care team. Clinical questions get a reply within 24 hours.
Standard shipping for oral medications. Cold-chain shipping for injectables.
Protocol adjustments happen as your response shows up. If the dose or cadence changes, your next shipment reflects the change. There is no additional fee for protocol adjustments within your existing protocol.
Refills go out on the cadence your physician sets, without you having to ask.
Not listed here? Read the full FAQ.