Bremelanotide (brand name Vyleesi) is a shot you can give yourself about 45 minutes before sex to boost desire. Clinical trials show it does raise sexual interest and cut distress, but the effect is modest. Common side effects are nausea, facial flushing, and headache. It’s safe with few drug interactions, but you can only take one dose per day and no more than eight doses a month, stopping after eight weeks if it doesn’t help.

<b>Objective:</b> To review data regarding bremelanotide, a recently approved therapy for hypoactive sexual desire disorder (HSDD). <b>Data Sources:</b> Literature search of Medline, SCOPUS, and EMBASE was performed using the search terms <i>bremelanotide, bremelanotide injection, Vyleesi</i>, and <i>melanocortin 4 receptor agonist</i> between January 1, 1996, and December 15, 2019. Reference lists from included articles were also reviewed for pertinent citations. <b>Study Selection/Data Extraction:</b> We included phase 2 and 3 trials of bremelanotide. There were 2 reports of phase 3 trials and 2 reports of phase 2 trials. Additional information from supplementary analyses was also referenced. <b>Data Synthesis:</b> Bremelanotide demonstrates significant improvement in desire and a significant decrease in distress related to lack of desire. The most common adverse effects include nausea (39.9%), facial flushing (20.4%), and headache (11%). <b>Relevance to Patient Care and Clinical Practice:</b> Bremelanotide is the second Food and Drug Administration-approved medication for the treatment of HSDD. Bremelanotide's place in therapy is unknown, as the HSDD guidelines were last updated in 2017. Although the trials met statistical significance for change in sexual desire elements and distress related to sexual desire, the clinical benefit may only be modest. <b>Conclusion:</b> Bremelanotide is a subcutaneous injection that can be administered as needed approximately 45 minutes prior to sexual activity. Bremelanotide is safe and has limited drug-drug interactions, including no clinically significant interactions with ethanol. Prescribing guidelines recommend no more than 1 dose in 24 hours and no more than 8 doses per month. Individuals should discontinue use after 8 weeks without benefit.