PT-141

Dosing from the Literature

Published for libido: 1.75 mg under the skin at least 45 minutes before sex, the approved dose for premenopausal women with hypoactive sexual desire disorder (Vyleesi label, 2024). Not published: an approved dose for men.

The labeled dose is the one tested in the two RECONNECT Phase 3 trials, where women could take up to 12 doses per 4 weeks, no more than one in 24 hours (Kingsberg et al., 2019); the label set the limit at 8 doses a month (Vyleesi label, 2024). The off-label doses for men below are what user reports and clinic protocols describe; the label does not cover men.

What It Is

PT-141 is the development code for bremelanotide, a synthetic cyclic heptapeptide (a chain of 7 amino acids) analog of the endogenous neuropeptide α-melanocyte-stimulating hormone (α-MSH) (Rosen et al., 2004; Dhillon & Keam, 2019). It was developed by Palatin Technologies, out-licensed to AMAG Pharmaceuticals for North American rights (Dhillon & Keam, 2019), and approved by the US FDA on June 21, 2019 (Drugs@FDA), under the brand name Vyleesi, for acquired, generalized hypoactive sexual desire disorder (HSDD) in premenopausal women (Vyleesi label, 2024); Cosette Pharmaceuticals now markets it. That approval makes PT-141 one of the very few "research peptides" in the community lexicon that has actually completed the full preclinical-through-Phase-3-through-FDA pipeline to become a legitimate prescription drug.

Structurally, bremelanotide is Ac-Nle-cyclo(Asp-His-D-Phe-Arg-Trp-Lys)-OH, a cyclic heptapeptide with a free acid at its carboxyl end (Vyleesi label, 2024). It is the deaminated (carboxylate) derivative, and likely metabolite, of Melanotan II (MT-II) (King et al., 2007). Like MT-II, it is not selective: its label lists activity at MC1R, MC4R, MC3R, MC5R and MC2R, in that order of potency, with MC1R (on pigment cells) and MC4R most relevant at the labeled dose (Vyleesi label, 2024).

Melanocortins' sexual effects were first reported in the mid-20th century, when Ferrari and colleagues gave α-MSH and ACTH into the brains of several mammal species; interest in people followed in the 1980s, when a self-experimenter testing Melanotan II as a tanning agent took twice the intended dose and had an 8-hour erection (King et al., 2007). Early bremelanotide development pursued intranasal dosing for erectile dysfunction in men, which was abandoned after blood pressure signals in Phase 2 at the doses required for an ED effect. Subsequent clinical development pivoted to subcutaneous on-demand dosing in premenopausal women with HSDD. The two identical RECONNECT Phase 3 trials (pooled N=1,247) demonstrated statistically significant improvement in sexual desire and related distress, forming the basis of FDA approval.

Outside of the FDA-approved indication, PT-141 has a substantial off-label following in the optimization community for situational use in both men and women. Telehealth clinics dispense compounded PT-141 off-label for sexual dysfunction in men. Because PT-141 acts centrally (CNS-mediated) rather than peripherally (vascular, like sildenafil/tadalafil), its mechanism complements rather than overlaps with the PDE5 class, and the two are sometimes combined — though that combination has not been systematically studied in a registrational trial.

Mechanism of Action

PT-141's effect on desire is thought to arise in the brain: in rats it activated neurons in the hypothalamus (Molinoff et al., 2003), and its label notes that neurons carrying MC4R are found throughout the central nervous system, though how it improves desire in women is unknown (Vyleesi label, 2024). PDE5 inhibitors (sildenafil, tadalafil) act on the blood vessels of the penis instead (King et al., 2007).

• MC4R agonism — Bremelanotide activates MC4R, one of the two receptors its label calls most relevant at the labeled dose (Vyleesi label, 2024); a 2007 review describes MC4R as emerging as the main receptor behind melanocortin-induced erection (King et al., 2007). In rats, intranasal PT-141 (50 µg/kg) increased erections and activated neurons in the paraventricular nucleus of the hypothalamus (King et al., 2007), and in female rats it increased solicitation, a behavior the authors link to sexual desire, without changing lordosis or pacing (Pfaus et al., 2004).
• MC3R agonism — Bremelanotide also activates MC3R, less potently than MC1R and MC4R (Vyleesi label, 2024). The receptor's role in sexual function is poorly understood; in one group's rat work, blocking forebrain MC3R enhanced melanocortin-induced erections (King et al., 2007).
• MC1R activity — MC1R, the receptor on pigment cells, is bremelanotide's most potent target, and binding there leads to melanin production and darker pigmentation (Vyleesi label, 2024). Focal hyperpigmentation was reported in 1% of women taking up to 8 doses a month and in 38% after 8 daily doses (Vyleesi label, 2024).
• Oxytocin pathways (hypothesis) — A 2007 review proposes that melanocortin agents may interact with oxytocin pathways in the hypothalamus, brainstem or spinal cord (King et al., 2007).
• Pharmacokinetics — After the labeled injection, blood levels peak at about 1 hour and the half-life is about 2.7 hours (range 1.9–4.0); the label states that how long the effect lasts after each dose is unknown (Vyleesi label, 2024).
• Blood pressure effect — Systolic pressure rises by up to 6 mmHg and diastolic by up to 3 mmHg, peaking 2–4 hours after a dose, while heart rate falls by up to 5 beats per minute; both usually return to baseline within 12 hours. The label ties its contraindication in uncontrolled hypertension or known cardiovascular disease to this effect (Vyleesi label, 2024).
• Baseline testosterone — In the RECONNECT trials, bremelanotide improved desire and distress across all four quartiles of baseline bioavailable testosterone, with few exceptions (Simon et al., 2022).

What the Research Shows

Across the clinical development program, 3,500 subjects took part in 43 completed studies (Clayton et al., 2022).

• Melanocortin origin (King et al., 2007; PMID 17584130) — In the mid-20th century, Ferrari and colleagues reported sexual excitement in several mammal species after α-MSH and ACTH were given into the brain; interest in people began in the 1980s, when Melanotan II, a cyclic analog based on the linear Melanotan I, caused an erection in a self-experimenter testing it as a tanning agent.
• PT-141 proof of concept (Molinoff et al., 2003; PMID 12851303) — Initial human pharmacology characterization of PT-141 as a centrally-acting melanocortin agonist suitable for clinical development in sexual dysfunction.
• Male ED Phase 2 (Rosen, Diamond et al., Int J Impot Res 2004; PMID 14999221) — Subcutaneous PT-141 at 0.3–10 mg in healthy men and sildenafil-non-responder ED patients. Statistically significant erectile response at doses >1 mg, well-tolerated up to 10 mg in healthy men and up to 6 mg in ED patients.
• Intranasal ED trials (2006–2008) — Program pursued intranasal PT-141 for situational ED but was discontinued due to transient blood pressure elevation at the doses required for consistent ED efficacy. This forced the subsequent clinical pivot to SubQ on-demand dosing.
• PT-141 with sildenafil (Diamond et al., Urology 2005; PMID 15833522) — 19 men with erectile dysfunction who responded to Viagra or Levitra took 25 mg sildenafil with 7.5 mg intranasal PT-141, 25 mg sildenafil alone, or placebo, in a crossover: the combination gave a larger erectile response than sildenafil alone, with no new side effects.
• Sildenafil non-responders (Safarinejad & Hosseini, J Urol 2008; PMID 18206919) — 342 men whose erectile dysfunction had not responded to sildenafil took 10 mg intranasal bremelanotide alone or placebo before sex; 33.5% vs 8.5% had positive results. The Journal of Urology added an expression of concern to Safarinejad and Hosseini's paper in 2023 (PMID 36626345).
• HSDD Phase 2b dose-ranging (Clayton et al., 2016) — Selected 1.75 mg SubQ as the dose for Phase 3 after showing efficacy on sexual desire and distress with acceptable tolerability.
• RECONNECT Phase 3 (Kingsberg et al., Obstet Gynecol 2019; PMID 31599840) — Two identical trials in premenopausal women with acquired, generalized HSDD. Subcutaneous 1.75 mg as needed, no more than once in 24 hours and up to 12 doses per 4 weeks (the label later set 8 a month; Vyleesi label, 2024). Both trials demonstrated statistically significant increases in sexual desire (FSFI-desire subscale) and statistically significant reductions in distress (FSDS-DAO item 13) vs placebo. This was the registrational basis for FDA approval.
• RECONNECT exit study (Koochaki et al., 2021; PMID 33538638) — Qualitative patient-experience assessment showing meaningful subjective improvement in intimate relationship quality and self-reported satisfaction among responders.
• Integrated safety (Clayton et al., J Womens Health 2022; PMID 35147466) — Pooled safety across the clinical development program. In the pooled double-blind phase 3 trials (N = 1,247), the most common AEs were nausea (40% vs 1.3% placebo), flushing (20.3% vs 1.3%), headache (11.3% vs 1.9%) and injection site reactions (5.4% vs 0.5%). Most AEs mild-to-moderate; no deaths.
• Prespecified RECONNECT subgroup analyses (Simon et al., 2022; PMID 35230162) — Improvements in desire and distress held across age, weight, BMI and baseline bioavailable testosterone subgroups, with or without hormonal contraception or decreased arousal, and regardless of HSDD duration, with few exceptions.

Human Data

Bremelanotide has one of the largest human-study databases of any peptide in the optimization space. A summary of the major human datasets:

• Phase 1 pharmacokinetics/safety — Healthy men and women across multiple single-ascending and multiple-ascending dose studies. SubQ, IV, and intranasal routes characterized. PK profile: half-life about 2.7 hours after the labeled injection (range 1.9–4.0), with exposure rising less than in proportion to dose from 0.3 to 10 mg (Vyleesi label, 2024).
• Male ED Phase 2 (Rosen et al., 2004; PMID 14999221) — Subcutaneous PT-141 produced erectile responses at doses above 1 mg in healthy men (0.3–10 mg tested) and at 4 and 6 mg in men with an inadequate response to Viagra.
• Intranasal ED Phase 2 (2006–2008) — Program terminated due to dose-dependent blood-pressure signal at efficacious doses.
• Sildenafil studies (Diamond et al., 2005; Safarinejad & Hosseini, 2008; PMID 18206919) — In 19 men with erectile dysfunction who responded to PDE5 inhibitors, 7.5 mg intranasal PT-141 plus 25 mg sildenafil gave a larger erectile response than sildenafil alone; in 342 men whose erectile dysfunction had not responded to sildenafil, 10 mg intranasal bremelanotide alone gave positive results in 33.5% vs 8.5% on placebo (that paper has carried an expression of concern since 2023).
• HSDD Phase 2b dose-ranging (Clayton et al., Womens Health (Lond) 2016) — Established 1.75 mg SubQ as the Phase 3 dose.
• RECONNECT Phase 3 — Study 301 (NCT02333071) — ~640 premenopausal HSDD patients; co-primary endpoints: change in FSFI-desire domain and FSDS-DAO item 13. Both met statistical significance.
• RECONNECT Phase 3 — Study 302 (NCT02338960) — Identical design replicate. Both endpoints met.
• RECONNECT open-label extension (Simon et al., 2019) — 52-week open-label extension demonstrated sustained treatment effect and consistent safety.
• Integrated safety database (N ≈ 3,500; Clayton 2022) — Across the development program, safety findings consistent with Phase 3.
• FDA approval — June 21, 2019. Brand name Vyleesi. Developed by Palatin Technologies; now marketed by Cosette Pharmaceuticals (Vyleesi label, 2024). Label restricts to premenopausal women, on-demand use, max 8 doses/month, with explicit cardiovascular and blood-pressure cautions.

Outside the labeled indication, use in men rests on earlier-phase trials (Rosen et al., 2004; Diamond et al., 2005) and practitioner reports, not on registrational trials; the label covers neither men nor postmenopausal women (Vyleesi label, 2024).

Reconstitution & Storage

Vyleesi is supplied as a sterile pre-filled single-dose autoinjector (1.75 mg bremelanotide in 0.3 mL) (Vyleesi label, 2024). Compounded bremelanotide is sold as freeze-dried powder in vials and as nasal spray, and research-chemical seller listings include 10 mg vials of powder.

• Reconstitution — Reconstitution guides describe injecting BAC water down the inside vial wall at 45°, then swirling gently rather than shaking.
• Storage — The Vyleesi label lists storage at or below 25°C (77°F), not frozen and protected from light (Vyleesi label, 2024).
• Injection site — The Vyleesi instructions name the abdomen, avoiding the 2 inches around the navel, or the front of the thigh, with a different site each time (Vyleesi label, 2024).
• Timing — Blood levels peak about 1 hour after the injection (range 0.5–1 hour); the label states that how long the effect lasts after each dose is unknown (Vyleesi label, 2024).
• Inspection — The Vyleesi label says to discard the solution if it is cloudy, discolored or has visible particles (Vyleesi label, 2024).

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Side Effects & Risks

The label's rates come from the two pooled Phase 3 trials, 627 women on bremelanotide and 620 on placebo (Vyleesi label, 2024):

• Nausea (40% vs 1.3% on placebo) — The most common side effect: reported by 21% of women after the first dose and about 3% after later doses; 13% took an anti-emetic and 8% stopped because of it (Vyleesi label, 2024). In a study of 228 healthy women, 8 mg of oral ondansetron taken 30 minutes before a dose did not reduce nausea, and the label does not recommend it (Vyleesi label, 2024).
• Flushing (20.3% vs 0.3% on placebo) — Facial warmth and redness; none of the flushing events were serious (Vyleesi label, 2024).
• Headache (11.3% vs 1.9% on placebo) — Mostly mild to moderate: severe headache was reported by 0.8% of women on bremelanotide (Kingsberg et al., 2019; Vyleesi label, 2024).
• Injection site reactions (5.4% vs 0.5% on placebo; Clayton et al., 2022) — The label, counting pain, redness, bruising, bleeding, itching and numbness or tingling together, lists 13.2% vs 8.4% (Vyleesi label, 2024).
• Blood pressure elevation — Systolic pressure rose by up to 6 mmHg and diastolic by up to 3 mmHg, peaking 2–4 hours after a dose, with heart rate down by up to 5 beats per minute; both usually returned to baseline within 12 hours (Vyleesi label, 2024). The label contraindicates Vyleesi in uncontrolled hypertension or known cardiovascular disease and does not recommend it for patients at high risk of cardiovascular disease (Vyleesi label, 2024). The dose-finding trial excluded women with repeated readings of 140 systolic or 90 diastolic or higher (Clayton et al., 2016).
• Focal hyperpigmentation (1%) — Darkening of the face, gums or breasts in 1% of women taking up to 8 doses a month (none on placebo), and in 38% after 8 daily doses; more likely with darker skin, and not always resolved after stopping (Vyleesi label, 2024).
• Cardiovascular cautions and drug interactions — Contraindicated in uncontrolled hypertension or known cardiovascular disease. Bremelanotide may slow gastric emptying and so reduce the absorption of oral medicines taken with it; it lowered blood levels of oral naltrexone and indomethacin, and the label advises against using it with oral naltrexone for alcohol or opioid addiction (Vyleesi label, 2024).
• Alcohol interaction — In a crossover study of 24 healthy adults given 20 mg intranasal bremelanotide after alcohol (0.6 g/kg, about three drinks for a 70 kg person), alcohol did not change bremelanotide blood levels; flushing was as common as with bremelanotide alone, headache as common as with alcohol alone, and drops in standing blood pressure matched alcohol alone (Vyleesi label, 2024).
• Pregnancy — The label advises effective contraception during use and stopping if pregnancy is suspected; in pregnant dogs, exposures 16 or more times the human level caused fetal loss (Vyleesi label, 2024).
• Melanoma / pigmentation concerns — MC1R, the receptor on pigment cells, is bremelanotide's most potent target, and binding there leads to melanin production (Vyleesi label, 2024). The label does not mention melanoma or moles; it tells patients that skin darkening may not fully clear after stopping and to raise any skin changes with their provider (Vyleesi label, 2024).
• Contraindications — Uncontrolled hypertension or known cardiovascular disease (Vyleesi label, 2024).

Bloodwork & Monitoring

The Vyleesi label lists no laboratory tests. It asks prescribers to weigh the patient's cardiovascular risk before starting and periodically during treatment and to make sure blood pressure is well controlled, to consider stopping if focal hyperpigmentation develops, and to stop after 8 weeks if the patient reports no improvement (Vyleesi label, 2024). In the RECONNECT trials, blood pressure was measured before and up to 2 hours after a first dose taken in the clinic, and physical examination, vital signs, ECG, laboratory tests and adverse events were checked at monthly safety visits; desire and distress were scored with the FSFI desire domain and FSDS-DAO item 13 (Kingsberg et al., 2019). No trial, label or guideline sets monitoring for off-label use in men.

What to Expect — Timeline

The timings below come from the Vyleesi label and the Phase 3 trials in premenopausal women.

• First hour — Blood levels peak about 1 hour after the injection (Vyleesi label, 2024). In the Phase 3 trials, nausea began a median of 30 minutes after a dose and lasted a median of 2.4 hours (Kingsberg et al., 2019).
• 2–4 hours — The rise in blood pressure peaks, at up to 6 mmHg systolic and 3 mmHg diastolic, while heart rate falls by up to 5 beats per minute (Vyleesi label, 2024).
• By 12 hours — Blood pressure and heart rate are usually back to baseline. How long the effect on desire lasts after each dose is unknown (Vyleesi label, 2024).
• First dose vs later doses — Nausea was reported by 21% of women after the first dose and by about 3% after later doses (Vyleesi label, 2024). Improvements in desire and distress held through the 52-week open-label extension (Simon et al., 2019).
• No response — The label calls for stopping after 8 weeks if the patient reports no improvement (Vyleesi label, 2024).

Practical User Notes

• Lower first dose — Clinic protocols describe a 0.5–1 mg first dose, taken away from sex, to gauge nausea before a full dose; it is not a label dose.
• Anti-nausea pre-treatment — In a placebo-controlled study of 228 healthy women, 8 mg of oral ondansetron taken 30 minutes before a 1.75 mg dose did not reduce nausea, and the label does not recommend it; ondansetron after nausea starts has not been formally studied (Vyleesi label, 2024).
• Timing — The label gives at least 45 minutes before anticipated sexual activity and says the best window has not been fully characterized (Vyleesi label, 2024).
• Dose size — 1.75 mg is the dose tested in women in the Phase 3 trials (Kingsberg et al., 2019). User reports describe 1.0–2.0 mg in men. The label states that nausea, focal hyperpigmentation and larger blood-pressure increases are more likely at higher doses (Vyleesi label, 2024).
• Dosing frequency — The label does not recommend more than one dose in 24 hours or more than 8 a month: few Phase 3 patients took more than 8, and more frequent dosing raises the risk of focal hyperpigmentation and lengthens the time each month that blood pressure is raised (Vyleesi label, 2024).
• Combination with PDE5 inhibitors (men) — Off-label. Clinic protocols describe lower doses of both, such as 1.0 mg PT-141 with 25 mg sildenafil. The one published study of the pair gave 7.5 mg intranasal PT-141 with 25 mg sildenafil to 19 men with erectile dysfunction (Diamond et al., 2005).
• When the label calls for stopping — The label tells prescribers to consider stopping for focal hyperpigmentation or for persistent or severe nausea, and to stop if pregnancy is suspected or after 8 weeks without improvement (Vyleesi label, 2024).

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References

1. Kingsberg SA, Clayton AH, Portman D, Williams LA, Krop J, Jordan R, Lucas J, Simon JA. Bremelanotide for the Treatment of Hypoactive Sexual Desire Disorder: Two Randomized Phase 3 Trials. Obstet Gynecol. 2019;134(5):899-908. PMID: 31599840. DOI: 10.1097/AOG.0000000000003500.
2. Dhillon S, Keam SJ. Bremelanotide: First Approval. Drugs. 2019;79(14):1599-1606. PMID: 31429064. DOI: 10.1007/s40265-019-01187-w.
3. Clayton AH, Kingsberg SA, Portman D, Sadiq A, Krop J, Jordan R, Lucas J, Simon JA. Safety Profile of Bremelanotide Across the Clinical Development Program. J Womens Health (Larchmt). 2022;31(2):171-182. PMID: 35147466.
4. Rosen RC, Diamond LE, Earle DC, Shadiack AM, Molinoff PB. Evaluation of the safety, pharmacokinetics and pharmacodynamic effects of subcutaneously administered PT-141, a melanocortin receptor agonist, in healthy male subjects and in patients with an inadequate response to Viagra. Int J Impot Res. 2004;16(2):135-142. PMID: 14999221.
5. Molinoff PB, Shadiack AM, Earle D, Diamond LE, Quon CY. PT-141: a melanocortin agonist for the treatment of sexual dysfunction. Ann N Y Acad Sci. 2003;994:96-102. PMID: 12851303.
6. Simon JA, Kingsberg SA, Portman D, Williams LA, Krop J, Jordan R, Lucas J, Clayton AH. Long-term safety and efficacy of bremelanotide for hypoactive sexual desire disorder. Obstet Gynecol. 2019;134(5):909-917. PMID: 31599847.
7. Koochaki P, Revicki D, Wilson H, et al. The Patient Experience of Premenopausal Women Treated with Bremelanotide for Hypoactive Sexual Desire Disorder: RECONNECT Exit Study Results. J Womens Health (Larchmt). 2021. PMID: 33538638.
8. Simon JA, Kingsberg SA, Portman D, et al. Prespecified and Integrated Subgroup Analyses from the RECONNECT Phase 3 Studies of Bremelanotide. J Sex Med. 2022. PMID: 35230162.
9. Clayton AH, Althof SE, Kingsberg S, DeRogatis LR, Kroll R, Goldstein I, Kaminetsky J, Spana C, Lucas J, Jordan R, Portman DJ. Bremelanotide for female sexual dysfunctions in premenopausal women: A randomized, placebo-controlled dose-finding trial. Womens Health (Lond). 2016;12(3):325-337. PMID: 27181790.
10. Diamond LE, Earle DC, Heiman JR, Rosen RC, Perelman MA, Harning R. An effect on the subjective sexual response in premenopausal women with sexual arousal disorder by bremelanotide (PT-141), a melanocortin receptor agonist. J Sex Med. 2006;3(4):628-638. PMID: 16839319.
11. Rosen RC, Diamond LE, Earle DC, Shadiack AM. Salvage of Sildenafil Failures With Bremelanotide: A Randomized, Double-Blind, Placebo Controlled Study. J Urol. 2008;179(3):1060-1066.
12. Molinoff PB, Shadiack AM, Hadley ME. Melanocortin-4 receptor agonists and erectile dysfunction. Endocrine. 2006;30(1):39-48.
13. Hadley ME, Dorr RT. Melanocortin peptide therapeutics: historical milestones, clinical studies and commercialization. Peptides. 2006;27(4):921-930. PMID: 16412534.
14. US Food and Drug Administration. VYLEESI (bremelanotide injection) prescribing information. 2019. Reference ID: 4436693.
15. Pfaus JG, Shadiack A, Van Soest T, Tse M, Molinoff P. Selective facilitation of sexual solicitation in the female rat by a melanocortin receptor agonist. Proc Natl Acad Sci U S A. 2004;101(27):10201-10204. PMID: 15226502.
16. ClinicalTrials.gov. Study to Evaluate the Efficacy and Safety of Bremelanotide in Premenopausal Women With Hypoactive Sexual Desire Disorder (RECONNECT 301). NCT02338960.
17. ClinicalTrials.gov. Study to Evaluate the Efficacy and Safety of Bremelanotide in Premenopausal Women With Hypoactive Sexual Desire Disorder (RECONNECT 302). NCT02333071.
18. King SH, Mayorov AV, Balse-Srinivasan P, Hruby VJ, Vanderah TW, Wessells H. Melanocortin receptors, melanotropic peptides and penile erection. Curr Top Med Chem. 2007;7(11):1098-1106. PMID: 17584130.
19. Kingsberg SA, Althof S, Simon JA, et al. Female Sexual Dysfunction—Medical and Psychological Treatments, Committee 14. J Sex Med. 2017;14(12):1463-1491. PMID: 29198504.
20. Bremelanotide. In: LiverTox: Clinical and Research Information on Drug-Induced Liver Injury. Bethesda (MD): National Institute of Diabetes and Digestive and Kidney Diseases; 2021. Bookshelf ID NBK573221.
21. FDA. Bulk Drug Substances Nominated for Use in Compounding Under Section 503A of the FD&C Act (503A categories list), versions updated April 15, April 22 and May 14, 2026. fda.gov/media/94155/download. Read October 3, 2026. (Notice that 12 peptides would leave Category 2 because their nominations were withdrawn; their removal; GHK-Cu, except injectable, back in Category 1.)
22. Cosette Pharmaceuticals. VYLEESI (bremelanotide injection), for subcutaneous use, prescribing information. NDA 210557; initial U.S. approval 2019; revised 03/2024. DailyMed set ID f1d0c1b5-2f39-4bad-a6a4-0066e3ad5dcf (version 1, published November 18, 2025). dailymed.nlm.nih.gov. Read October 4, 2026.
23. Diamond LE, Earle DC, Garcia WD, Spana C. Co-administration of low doses of intranasal PT-141, a melanocortin receptor agonist, and sildenafil to men with erectile dysfunction results in an enhanced erectile response. Urology. 2005;65(4):755-759. PMID: 15833522. DOI: 10.1016/j.urology.2004.10.060.

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