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Monitoring Recommendations For patients with Child-Pugh A or B hepatic impairment who receive bremelanotide: Check blood pressure before the first dose and 1 to 2 hours after administration Assess for nausea, which occurred in 40% of trial participants and may be more pronounced in patients with hepatic congestion or gastroparesis Review the medication list for drugs with narrow therapeutic indices that could be affected by slowed gastric emptying Repeat liver function tests (ALT, AST, bilirubin, albumin) if the patient transitions from as-needed use to more frequent dosing patterns Nausea Management in Hepatic Impairment Nausea is the most common adverse effect of bremelanotide, reported in 40.0% of patients receiving the 1.75 mg dose versus 1.3% on placebo in the RECONNECT program [1]