Vyleesi (bremelanotide acetate)

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Last reviewed · Source: First Databank (FDB) drug data

Overview

Bremelanotide, a synthetic peptide analog of alpha-melanocyte-stimulating hormone (alpha-MSH), is a melanocortin receptor (MCR) agonist.

Bremelanotide, a synthetic peptide analog of alpha-melanocyte-stimulating hormone (alpha-MSH), is a melanocortin receptor (MCR) agonist. The precise mechanism of action of bremelanotide in the treatment of hypoactive sexual desire disorder (HSDD) in premenopausal women is not known. The drug binds to and nonselectively activates several MCR subtypes, with highest affinity for MC1R, followed by MC4R, MC3R, MC5R, and MC2R in decreasing order of affinity.

At therapeutic dosages, binding to MC1R and MC4R is the most relevant. Neurons expressing MC4R are present in many areas of the CNS; MC4R is thought to play a role in sexual function (including arousal, desire, and orgasm). MC1R is expressed on melanocytes; binding of bremelanotide to MC1R leads to melanin expression and increased pigmentation. (See Focal Hyperpigmentation under Cautions: Warnings/Precautions.)

Following subcutaneous administration, peak plasma bremelanotide concentrations occur at approximately 1 hour (range: 0.5-1 hour). The absolute bioavailability following subcutaneous administration is about 100%. Systemic exposure to bremelanotide is not substantially affected by subcutaneous administration site (abdomen or thigh).

Bremelanotide is 21% bound to serum proteins. The primary metabolic pathway of bremelanotide involves multiple hydrolyses of the amide bond of the cyclic peptide to form inactive metabolites. Bremelanotide undergoes minimal hepatic metabolism.

Following administration of a radiolabeled dose of bremelanotide, approximately 65% of the total radioactivity was recovered in urine and 23% in feces. The mean terminal half-life of bremelanotide is approximately 2.7 hours (range: 1.9-4.0 hours).

USES: This medication is used to treat women who have not gone through menopause who have low sexual desire and are concerned about it. Bremelanotide should not be used to treat low sexual desire caused by a medical or mental/mood disorder, problems in a relationship, or the effects of other drugs. This medication should not be used by women who have gone through menopause, or by men.

Bremelanotide is not used to enhance sexual performance.

Generic name: bremelanotide acetate
Pronunciation: (BRE-me-LAN-oh-tide)

Reference product & biosimilars

No reference, biosimilar or interchangeable associated with this drug.

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Indications

The following indications are listed for Vyleesi:

  • Premenopausal Acquired Hypoactive Sexual Desire Disorder

Also known as: Lack Of Sexual Desire In Premenopausal Woman, Low Sexual Desire In Premenopausal Woman, Premenopausal Acquired Hsdd.

Dosing

Dosage of bremelanotide acetate is expressed in terms of bremelanotide.

Drug interactions

Bremelanotide undergoes minimal hepatic metabolism and does not inhibit nor induce hepatic microsomal enzymes at therapeutic dosages in vitro. Clinically important pharmacokinetic interactions are therefore unlikely with drugs affecting or metabolized by hepatic microsomal enzymes.

Contraindications

Bremelanotide is contraindicated in patients with uncontrolled hypertension or known cardiovascular disease. (See Cardiovascular Effects under Cautions: Warnings/Precautions.)

Adverse reactions

Adverse effects reported in more than 4% of patients with acquired, generalized hypoactive sexual desire disorder (HSDD) in controlled clinical trials and more frequently than with placebo include nausea (see Nausea under Cautions: Warnings/Precautions), flushing, injection site reactions, headache, and vomiting.

Precautions

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ICD codes

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Formulary status

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Last reviewed · Source: First Databank (FDB) drug data