Scream cream vs the approved options (Vyleesi, Addyi)
Every row cites its source. Where a cell reflects our own reading of the evidence rather than an external source, the row says so.
| Aspect | Scream cream (compounded) | Vyleesi (bremelanotide) | Addyi (flibanserin) | Source |
|---|---|---|---|---|
| What it is | Pharmacy-compounded topical vasodilator blend; recipe varies by pharmacy | FDA-approved SC autoinjector (June 21, 2019) | FDA-approved nightly oral tablet (August 18, 2015) | source |
| Diagnosis it addresses | Marketed for arousal (FSAD); no drug is approved for FSAD | Acquired, generalized HSDD (low desire), premenopausal women | Acquired, generalized HSDD, premenopausal women | source |
| FDA review | None: compounded drugs are not FDA-approved and are not evaluated before marketing | Full NDA review (NDA 210557) | Full NDA review (NDA 022526) | source |
| Evidence for the exact product | Zero published trials of any blend as sold | Two phase 3 RCTs, 1,267 women | Eight trials, 5,914 women, meta-analyzed | source |
| Measured benefit | Unknown (per-ingredient record only; closest cream trial ITT-null) | Desire +0.30 to +0.42 placebo-adjusted (1.2-to-6.0 scale); satisfying sexual events unchanged | +0.49 satisfying sexual events/month; FSFI desire +0.27; evidence graded very low | source |
| Defining risks | Local burning by class analogy; systemic risk unquantifiable (absorption never measured); formula changes risk profile | Nausea 40%; transient blood-pressure rise each dose | Boxed warning: hypotension and syncope with alcohol, CYP3A4 inhibitors, hepatic impairment | source |
| Consistency between prescriptions | None guaranteed: three documented recipes across two pharmacies, custom strengths on request | Fixed 1.75 mg autoinjector, identical everywhere | Fixed 100 mg tablet, identical everywhere | source |
The three products are usually shopped against each other, but they answer different diagnoses: the approved pair treat low desire (HSDD), scream cream is marketed for arousal, and arousal disorder has no approved drug. The approved drugs offer modest, printed numbers with known risks; the compounded cream offers no blend-level numbers at all.
Researching Vyleesi (bremelanotide) and Addyi (flibanserin) itself? Its dedicated guide site is at bremelanotiderx.com.