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Peptides Explained

Growth-hormone axis

Ipamorelin

A lab-made peptide that releases growth hormone. Testing in patients stopped. It is not an approved medicine.

Not an authorised medicine

At a glance

Is it an approved medicine?
No Not approved as a medicine in the EU, the UK or the US.
Has it been tested in people?
Some Small trials in patients. No large trials published yet.
Is it allowed in sport?
No Banned in sport at all times. Anti-doping list (WADA), section S2
What is the biggest risk?
Vials may hold germs or the wrong substance. Blood sugar may rise. More about the risks

Status checked on . The details and sources are further down this page.

Stop and get help if you notice

  • Hot, red, swollen injection site, or fever90,2
  • Hives, swollen face or throat, hard to breathe92,2
  • Swollen legs and short of breath93,31,66

If it is severe, call your local emergency number.

All warning signs, further down this page Warning signs for any peptide

The 30-second version

About 9 minutes for the short version; 38 with every detail open.

  • Ipamorelin is a lab-made peptide. It is not an approved medicine in Europe or the US.
  • It copies ghrelin, a hunger hormone. This makes a small gland under the brain release growth hormone.
  • About 150 people took part in two published studies. It did not clearly help the gut after surgery.
  • Nobody knows what months of use do. Similar drugs raised blood sugar and caused water retention.
  • It is banned in sport. In 2024, US advisers voted against letting pharmacies make it.
Class
Growth-hormone axis
Route in human trials
Into a vein; no published data under the skin
Half-life in people
About 2 hours, after a drip into a vein
Growth hormone response
One pulse, peaking after about 40 minutes
Trial in patients
After bowel surgery, 2014: no clear benefit
Status in the EU
Not authorised
Tested in people
Some

Label facts, not dosing advice. Sources are in the sections below.

Last reviewed
A thin slice of gland tissue under a microscope. Round cells stained pink, purple or pale blue lie close together, each with a dark centre.
The front part of the pituitary gland, a small gland under the brain. Growth hormone is made here. Photo: Mikael Häggström, M.D. (Wikimedia Commons) CC0 1.0 Image details

Each section starts with the short answer. The rest is folded under “In detail”.

Evidence profile

Four separate questions. Not a score.

Human clinical evidence How far has it been tested in people?
Phase II (dose and early effect)
Preclinical volume How much laboratory and animal research exists?
Moderate
Source independence How many independent groups produced it?
A few groups
Safety characterisation How well do we know the harms in humans?
Partial
In detail Why these grades: the reason for each step
Human clinical evidence
Phase 2. The highest published evidence is one randomised, double-blind, placebo-controlled phase 2 trial in 114 adults after bowel surgery (2014), which found no significant benefit. A placebo-controlled phase 1 study in healthy men (eight at each of five dose levels) measured blood levels and growth hormone. A second phase 2 trial with 320 patients finished in 2014 but was never published, so under our rubric it does not count.
Preclinical volume
Moderate. By our count on 22 October 2026, PubMed holds roughly 15 to 20 primary cell and animal studies in which ipamorelin itself was tested, plus about ten chemistry papers that used it as a starting point for other molecules. That is above the threshold of 10 and well below 50.
Source independence
Few groups. Most animal pharmacology comes from Novo Nordisk, which discovered ipamorelin, and its Danish and Swedish university partners. Most gut studies come from one University of Oklahoma laboratory working with Helsinn, the company that later developed it. A handful of single studies by other groups exist; few repeat the key experiments directly.
Safety characterisation
Partial. In published studies, people received ipamorelin into a vein: once, in about 30 healthy men, and for up to 7 days in 56 patients after bowel surgery (plus one volunteer who used a nasal spray in a doping-test study). The surgery trial recorded more high blood sugar, low potassium and trouble sleeping than placebo, and two deaths whose link to ipamorelin is unclear. There are no published safety data for injections under the skin, for nasal or oral use, or for use longer than a week, and the FDA found no formal toxicity studies.

We never add these up. A compound can have a large animal literature from one laboratory and no human data at all — that is a specific situation, and a single number would hide it. How we grade evidence

In detail The molecule: amino-acid sequence and technical details
Amino-acid sequence5 amino acids

H–Aib-His-D-2Nal-D-Phe-Lys-NH2

Read from the N-terminus (start) to the C-terminus (end).

Modifications
position 1: Aib (2-aminoisobutyric acid), a non-coded amino acid
position 3: D-2Nal: D-3-(2-naphthyl)alanine, a non-coded, mirror-image amino acid
position 4: D-Phe: mirror-image (D-form) phenylalanine
position 5: Lys: C-terminal amide
D-form (mirror-image) amino acid
D-2Nal (3), D-Phe (4)
non-standard amino acid
Aib (1)
International non-proprietary name
ipamorelin
Also called
NNC 26-0161, ipamorelin acetate, Aib-His-D-2Nal-D-Phe-Lys-NH2
Class
Growth-hormone axis
Body systems
Hormones, Gut, Metabolism
Formula
C38H49N9O5
Molecular mass
711.9 Da

What it actually is

What is ipamorelin?

A lab-made peptide that makes the body release growth hormone. It is not an approved medicine.
It has a medicine name and was tested in patients. But it is not an approved medicine. What is known about the substance sold under this name, checked on 22 October 2026.
Ipamorelin
Made in a lab?Yes A chain of five building blocks. Three are forms the body does not use to make proteins.1,2
Copies a body hormone?Yes It acts like ghrelin, a hunger hormone from the stomach.2,3
An official medicine name?Yes “Ipamorelin” is its international non-proprietary name.4
One substance under that name?No It is sold as a free base or an acetate salt. The FDA treats them as different substances.2
Tested in patients?Yes In one published trial after bowel surgery. It did not clearly help.5
Approved as a medicine?No Not in the EU, the UK or the US.6,7,2

US wellness clinics and websites promote ipamorelin for weight loss, muscle, sleep and anti-ageing, often mixed with CJC-1295 or sermorelin. The FDA looked for evidence on growth hormone deficiency and on bowel recovery after surgery. It found one bowel-surgery trial, and that trial was negative.2

In detail The molecule, and how it is made

Ipamorelin is a pentapeptide: Aib-His-D-2Nal-D-Phe-Lys-NH2. Its formula is C38H49N9O5 and its mass 711.9 g/mol.8,1 Only two of its five building blocks, histidine and lysine, are ordinary protein amino acids:2,7

  • Aib (2-aminoisobutyric acid) at the start, the same unusual amino acid used in semaglutide.9
  • D-2Nal, a mirror-image form of naphthylalanine, an amino acid with a large double ring.
  • D-Phe, the mirror-image form of phenylalanine.
  • An amide at the end instead of the usual acid group.

The enzymes that cut peptides are built for the usual building blocks, so mirror-image amino acids and Aib probably slow its breakdown. In rats, most of an injected dose left the body unchanged in urine and bile, which fits that idea.10

How it is made

It is made by solid-phase peptide synthesis: amino acids are added one at a time to a chain anchored on resin beads, then the chain is cut free and purified.1,2 Each step can leave chains that are too short or slightly wrong, and leftover solvents and reagents. The FDA notes that unusual amino acids make such impurities harder to measure.2

The free base barely dissolves in water; a university laboratory had to add acetic acid to dissolve it.2,11 The acetate salt dissolves. Both forms are sold, and the FDA treats them as different substances.2

In detail Where it came from, and why testing stopped

Researchers at Novo Nordisk in Denmark made ipamorelin in the mid-1990s, under the code NNC 26-0161.2,10 In 1998 they called it “the first selective growth hormone secretagogue”: a substance that makes the pituitary gland release growth hormone without, in their pig experiments, also releasing the stress hormones ACTH and cortisol.1,8 It has an official international non-proprietary name, from the WHO’s family of “-morelin” growth hormone-releasing peptides.4

The Swiss company Helsinn later developed it as a drip to restart the bowel after surgery.11,12 It ran two phase 2 trials in the United States between 2008 and 2014. The first showed no significant benefit; the second, with 320 patients, was never published.12,13,5 The FDA, quoting a 2020 review, says development was reportedly stopped because of the disappointing results.2

Ipamorelin belongs to a real drug class. Macimorelin, another substance that triggers growth hormone release, is authorised in the EU (as Ghryvelin, since 11 January 2019) as a single-dose test for growth hormone deficiency in adults.14 The EU refused anamorelin, a ghrelin-receptor tablet meant to treat weight loss and muscle wasting in people with lung cancer, in 2017: its effect on lean body mass was marginal, and no effect on grip strength or quality of life was shown.15 So these drugs can move hormones in people. A lasting benefit from long-term use has not been shown.

How it is used now

In the United States, outsourcing facilities reported making ipamorelin injections from at least 2017 until 2020. Compounding pharmacy websites offer it mostly as injections or as lozenges that melt in the mouth, often mixed with CJC-1295 or sermorelin. One adverse-event report to the FDA involved a nasal spray.2

Proposed mechanism

How does it work?

It copies a hunger hormone. A gland under the brain then sends out a burst of growth hormone.
Where ipamorelin acts in the growth hormone system, and how well each step is shown.
StepWhat happensShown in
1. The brain sets the rhythmThe hypothalamus sends GHRH (a “go” signal) and somatostatin (a “stop” signal) to the pituitary gland, so growth hormone comes in pulses.People (normal body function)
2. Ghrelin or ipamorelinGhrelin from the stomach, or ipamorelin, switches on the ghrelin receptor on pituitary cells and in the hypothalamus.Cells and animals
3. A growth hormone pulseThe pituitary releases a burst of growth hormone. After ipamorelin into a vein: one peak at about 40 minutes, very low again by 6 hours.People (healthy men, one drip)
4. IGF-1 from the liverGrowth hormone makes the liver release IGF-1, which carries many of its growth effects.Rats, with mixed results; not reported in people given ipamorelin
5. The brakeGrowth hormone and IGF-1 switch on somatostatin and damp the next pulse (negative feedback).People (normal body function)
6. Other places with the same receptorThe stomach, gut nerves, pancreas and brain areas for hunger and reward.Animals; ghrelin itself in people

Sources 16, 17, 18, 1, 19, 20, 21, 22, 23

Ipamorelin contains no growth hormone. It works through the body’s own pituitary gland, so it can only release what that gland can make. The FDA notes that it would likely not help people whose pituitary gland makes no growth hormone at all.2

In detail Step by step: the chain and what each step rests on
The proposed causal chain, step by step

Each step is labelled with how well the link from the previous step is established.

  1. Step 1 Binding In cells

    Switches on the ghrelin receptor

    Ipamorelin copies ghrelin, a hormone made mainly in the stomach, and switches on its receptor (GHS-R1a). In rat pituitary cells in a dish it released growth hormone about as strongly as the older peptide GHRP-6. Tests with blockers showed that it acts through the same receptor type as GHRP-6, not through the GHRH receptor.

  2. Step 2 Signal inside the cell In cells

    A signal inside the pituitary cell

    The ghrelin receptor works mainly through the Gq protein, which switches on a phospholipase enzyme; this leads the cell to release its stored growth hormone. This is described for ghrelin receptors in general; it has not been traced step by step for ipamorelin in human cells.

  3. Step 3 Cell response In humans

    A short pulse of growth hormone

    In healthy men given a 15-minute drip into a vein (eight at each of five dose levels, two of them on placebo), growth hormone rose to one peak after about 40 minutes (0.67 hours) and fell to very low levels by 6 hours. Ipamorelin itself had a half-life of about 2 hours.

  4. Step 4 Tissue response In animals

    IGF-1, bone growth and body weight in rats

    Growth hormone tells the liver to make IGF-1. In rats, repeated ipamorelin made bones grow longer and raised body weight; IGF-1 rose in one rat study but not in another. We found no published measurement of IGF-1 in people given ipamorelin.

  5. Step 5 Tissue response In animals

    Faster stomach and bowel after surgery, in rats

    Ghrelin receptors on gut nerves speed up gut movement. After abdominal surgery in rats, ipamorelin into a vein emptied the stomach faster and brought the first bowel movement forward. In the patient trial after bowel surgery, the difference from placebo was not statistically significant.

  6. Step 6 Effect on the body Hypothesised

    Muscle, fat loss, sleep or healing in people: not shown

    Ipamorelin is promoted for muscle, fat loss, sleep, recovery and anti-ageing. No study in people has tested any of these. In mice it increased body fat, the opposite of fat loss.

The receptor and the hormone it copies

In 1996 Merck scientists found the receptor that synthetic growth hormone-releasing substances act on, in the pituitary gland and hypothalamus of pigs and people. These substances “stimulate and amplify pulsatile growth hormone (GH) release”.18 In 1999 a Japanese group found its natural partner in the rat stomach: ghrelin, a 28-amino-acid peptide.3 Besides hunger, ghrelin is now known to act on gut movement, stomach acid, blood sugar, sleep and reward-seeking.23,24

In rat pituitary cells in a dish, ipamorelin released growth hormone with a potency and strength similar to GHRP-6; tests with blockers showed that it acts through the same receptor type, not through the GHRH receptor .1 The FDA describes the receptor’s signal as running mainly through the Gq protein and phospholipase.2

The growth hormone pulse in people

Growth hormone normally comes in bursts, driven by GHRH and held back by somatostatin. Each burst switches on somatostatin, which damps the next one; IGF-1 adds a slower brake.16,17 In healthy men, one drip of ipamorelin into a vein produced one growth hormone pulse that peaked after about 40 minutes and had fallen to very low levels by 6 hours ; the peptide’s half-life was about 2 hours.19,2

IGF-1, bone and weight

The evidence after the pulse is from rats, and it is mixed. Three times daily for 15 days, ipamorelin made rats’ long bones grow faster and raised their weight, but total IGF-1 did not change .21 In another rat study, IGF-1 rose with repeated doses into a vein.22 In the 15-day study, the growth hormone response to a test dose was slightly smaller afterwards, an early hint that the pituitary may answer less with repeated pushing.21,2 We found no published measurement of IGF-1 in people given ipamorelin.

The gut

After abdominal surgery in rats, ipamorelin into a vein brought the first bowel movement forward and emptied the stomach faster ; in stomach muscle in a dish it restored contractions, as ghrelin did.25,11 In patients after bowel surgery, the effect on recovery was not statistically significant .5

In detail Why 'selective' in pigs does not mean 'safe' in people

Ipamorelin is often described as “selective”. That word comes from one 1998 experiment. In awake pigs, GHRP-6 and GHRP-2 raised the stress hormones ACTH and cortisol, but ipamorelin did not, even at more than 200 times the dose needed for half its growth hormone effect . None of the three changed the reproductive hormones LH and FSH, prolactin or thyroid-stimulating hormone in those pigs.1

That result matters, because natural ghrelin is not selective in people. In four healthy men, a ghrelin injection raised ACTH, cortisol and prolactin as well as growth hormone .26 But four gaps separate the pig finding from safety in people:

  1. Species and dose. It was shown in pigs, after single doses. The study in healthy men measured growth hormone, not cortisol or prolactin.19,2
  2. Only pituitary hormones. “Selective” says nothing about the same receptor in the stomach, pancreas and brain. That receptor also drives hunger, gut movement and blood sugar.23
  3. More growth hormone has its own risks. For approved growth hormone medicines, the labels warn about high blood sugar and diabetes, fluid retention, raised pressure in the skull and possible tumour growth. The FDA sees no data showing ipamorelin avoids these.2
  4. The product may not be pure ipamorelin. Any selectivity belongs to the exact molecule, not to whatever is in a vial.2,27
In detail Hunger and blood sugar: what the ghrelin receptor does

Ghrelin is a hunger hormone. In a double-blind crossover study in nine volunteers, a ghrelin drip made people eat 28% more from a buffet .24 In mice, ipamorelin raised body fat, also in mice that make little growth hormone; growth hormone releasers, but not growth hormone itself, raised food intake .28 How much ipamorelin changes appetite in people has not been measured.

The blood-sugar picture is mixed. In 11 volunteers, ghrelin raised blood sugar and lowered insulin within minutes, while hexarelin, a synthetic growth hormone releaser, did not .29 In pieces of rat pancreas, ipamorelin increased insulin release .30 But in the bowel-surgery trial, high blood sugar when leaving hospital was more common with ipamorelin (14.3% versus 8.6%).2 And over a year, a related daily tablet, MK-677, raised fasting blood sugar and lowered insulin sensitivity in 65 healthy older adults .31

What the evidence actually shows

Does it work?

It releases growth hormone in people. But the only published patient trial found no clear benefit.

It did not clearly help after bowel surgery

25.3 vs 32.6 h

hours until half the patients kept a meal down, on ipamorelin vs placebo. The gap could be chance.

Who took part Phase 2 trial, 2014: 114 adults after bowel surgery, randomised and double-blind; drips into a vein for up to 7 days Source Beck et al. (2014)5 Evidence Human trials

Growth hormone rose in one short pulse

0.67 h

until growth hormone peaked (about 40 minutes) after one 15-minute drip; very low again by 6 hours

Who took part Phase 1 study, 1999: healthy men, eight at each of five dose levels (six on ipamorelin, two on placebo), one drip into a vein Sources Gobburu et al. (1999); FDA Evaluation of Ipamorelin-related Bulk Drug Substances (Ipamorelin (free base) and Ipamorelin acetate) for Inclusion on the 503A Bulk Drug Substances List (briefing document 4, Pharmacy Compounding Advisory Committee, 29 October 2024)19,2 Evidence Human trials

The biggest trial was never made public

320 patients

took part in a second bowel-surgery trial that ended in 2014. No results have been posted or published.

Who took part NCT01280344: phase 2, placebo-controlled, run by the developer Helsinn Source ClinicalTrials.gov (2014)13

The picture is not empty. In healthy men, ipamorelin released growth hormone, and in rats it sped up the gut after surgery and made bones grow.19,11,21 But no study in people has tested the uses it is promoted for, and the only published patient trial missed its goal.2,5

In detail Every study in one table, and where the evidence comes from

13 studies: 4 in humans, 7 in animals, 1 in cells, 1 reviews or other.

Studies discussed on this page
Study Species n Design Funding Research group What it found What it did not show
Johansen et al. 1998 10 Rats not reported Pharmacokinetic study (uncontrolled) Industry Originating group In male rats, ipamorelin was cleared from the blood five times more slowly than GHRP-6, left the body mainly in urine, and was largely recovered intact. Through the nose, about a fifth of the dose reached the blood. Rats only, from the developer; says nothing about injection under the skin or about people.
Raun et al. 1998 1 Mixed not reported Animal experiment (controlled) Industry Originating group In rat pituitary cells, ipamorelin released growth hormone about as strongly as GHRP-6, through the same receptor type. In anaesthetised rats and awake pigs it raised growth hormone dose by dose. In pigs it did not raise ACTH or cortisol, even at more than 200 times the dose needed for half the growth hormone effect; GHRP-6 and GHRP-2 did. Run entirely by the company that discovered it. 'Selective' was shown in pigs, for single doses, and only for pituitary hormones; it was not tested in people. Animal numbers are not given in the abstract.
Gobburu et al. 1999 19 Humans 40 Phase I trial (controlled) Not disclosed Mixed In healthy men given one 15-minute drip into a vein at one of five dose levels, ipamorelin's half-life was about 2 hours. Growth hormone rose in one pulse, peaked after about 40 minutes and was back to very low levels by 6 hours. Healthy men, single doses, into a vein only; only ipamorelin and growth hormone were measured, so other hormones, blood sugar and IGF-1 are not reported; no adverse events are mentioned; university study with the developer's pharmacokinetics staff.
Johansen et al. 1999 21 Rats not reported Animal experiment (controlled) Not disclosed Originating group Adult female rats given ipamorelin under the skin three times a day for 15 days grew their shin bones faster (from 42 to up to 52 micrometres a day) and gained more weight, in a dose-dependent way. Total IGF-1 did not change, and the growth hormone response to a test dose was slightly smaller afterwards. Rats, 15 days, from the developer with university partners. Adult rats' long bones can still grow in length; adult human bones cannot, because their growth plates have closed.
Svensson et al. 2000 33 Rats not reported Animal experiment (controlled) Not disclosed Mixed Female rats given ipamorelin, GHRP-6 or growth hormone by pump for 12 weeks gained weight and bone mineral. Corrected for body weight, total bone mineral did not change: bones grew larger, not denser. Rats; 7 or 8 animals per treatment group; partly run with the developer's staff; no fracture or strength outcome.
Lall et al. 2001 28 Mice not reported Animal experiment (controlled) Not disclosed Independent group In mice, twice-daily ipamorelin raised body weight by about 15% within 2 weeks and increased fat relative to body weight, also in mice that make little growth hormone. In mice with normal growth hormone, the growth hormone releasers tested (ipamorelin and GHRP-6) raised food intake and leptin; growth hormone itself did not. Mice; group sizes not given in the abstract; the increase in fat may not apply to people, but it runs against the claim that ipamorelin causes fat loss.
Adeghate & Ponery 2004 30 Cells (lab) not reported Laboratory (cells) (controlled) Not disclosed Independent group Pieces of pancreas from normal and diabetic rats released more insulin when ipamorelin was added in a dish; drugs that block calcium channels and adrenaline receptors reduced the effect. Rat tissue in a dish; one laboratory; says nothing about blood sugar in a living animal or person, where other effects (growth hormone, appetite) also act.
Venkova et al. 2009 25 Rats not reported Animal experiment (controlled) Not disclosed Independent group In rats after abdominal surgery, one dose of ipamorelin into a vein brought the first bowel movement forward. Repeated doses over 2 days increased stool output, food intake and weight gain. Rats; one university laboratory that later worked with the company developing ipamorelin; funding not stated in the abstract.
Greenwood-Van Meerveld et al. 2012 11 Rats not reported Animal experiment (controlled) Mixed Independent group After abdominal surgery, 78% of a test meal stayed in the rats' stomachs with a dummy drip and 52% with ipamorelin (44% in rats without surgery). In stomach muscle in a dish, ipamorelin and ghrelin restored contractions. Rats, small groups (5 to 10 per group), a 15-minute test; compound supplied by the developer, with a company co-author.
Beck et al. 2014 5 Humans 114 Phase II trial (controlled, blinded) Industry Independent group In 114 adults after bowel surgery, drips of ipamorelin twice a day for up to 7 days did not significantly shorten the time to keeping down a first meal (median 25.3 hours versus 32.6 with placebo, p = 0.15) or other recovery measures. A small proof-of-concept trial paid for by the developer, in patients with many different conditions. Into a vein in hospital: it says nothing about injections under the skin or use outside hospital.
ClinicalTrials.gov 2014 13 Humans 320 Phase II trial (controlled, blinded) Industry Independent group A second phase 2 trial by the same company tested three dosing schedules, given into a vein, against placebo in 320 patients after bowel surgery. It finished in 2014. No results have been posted or published. Results unknown. An unpublished trial cannot be judged, and leaving trials unpublished can make the published evidence look better or worse than it is.
Semenistaya et al. 2015 35 Humans 1 Pharmacokinetic study (uncontrolled) Not disclosed Independent group After one volunteer took ipamorelin through the nose, it was heavily broken down; one breakdown product stayed detectable in urine after the intact peptide had gone. One person, one dose; designed for doping tests, not to measure effects or safety.
Gajda et al. 2019 27 — not reported Product testing Not disclosed Independent group Powders seized by Danish customs turned out to be modified versions of growth hormone releasing peptides, including ipamorelin with an extra amino acid (glycine) added at the start of the chain. A few seized samples from one country; shows that such products exist, not how common they are. The effects and safety of the modified molecule have never been studied.
Where the evidence comes from. We counted it on 22 October 2026.
LevelRoughly how muchWho produced itMain limitation
Cells and tissue in a dishA few studiesNovo Nordisk; single studies from other universitiesConcentrations not linked to real exposure
AnimalsAbout 15 studies, mostly in rats, mice and pigsMostly Novo Nordisk and its partners; gut studies from one Oklahoma laboratory working with HelsinnShort; no formal toxicity studies found by the FDA
People, controlledOne phase 1 study (about 40 to 48 healthy men) and one phase 2 trial (114 patients)Universities working with the developers (Novo Nordisk staff; Helsinn funding)Into a vein only; at most 7 days
People, unpublishedOne phase 2 trial, 320 patients, finished 2014HelsinnNo results available
ProductsTwo lab analyses of seized or black-market productsAnti-doping and forensic laboratories in Denmark, Germany and NorwayFew samples; shows what exists, not how often

Sources 1, 21, 25, 19, 5, 13, 2, 27, 32

In detail Cell and animal studies, one by one

The discovery work at Novo Nordisk

The first paper set out the basic profile. In rat pituitary cells, anaesthetised rats and awake pigs, ipamorelin released growth hormone about as strongly as GHRP-6, without raising ACTH or cortisol in pigs .1 In rats it was cleared from the blood five times more slowly than GHRP-6 and left the body mostly unchanged in urine .10

The same company and its university partners then tested longer use in rats. Over 15 days, ipamorelin made adult female rats’ long bones grow faster, by up to about a quarter, and increased weight gain .21 Over 12 weeks, a Swedish and British team with a Novo Nordisk co-author found that ipamorelin, GHRP-6 and growth hormone all raised bone mineral, but only because bones grew bigger; per gram of body weight nothing changed .33 In rats given a steroid that weakens muscle and bone, adding ipamorelin for 3 months kept calf muscles stronger and quadrupled the rate of new bone formation on the bone surface .34

Other groups

Independent academic studies are few and single. A Cambridge and Göteborg team found that ipamorelin increased body fat in mice, also in mice that make little growth hormone, and that growth hormone releasers raised food intake , the opposite of the fat-loss claims made for it today.28 A group in the United Arab Emirates found that ipamorelin increased insulin release from pieces of rat pancreas .30

The gut programme

A University of Oklahoma laboratory tested ipamorelin for the bowel paralysis that follows surgery. One dose into a vein brought the first bowel movement forward in rats; repeated doses over 2 days increased stool output, food intake and weight .25 In a later study, with ipamorelin supplied by Helsinn and a Helsinn co-author, 78% of a test meal stayed in the stomach of operated rats with a dummy drip, against 52% with ipamorelin .11 These are the results that led to the patient trials.

In detail Studies in people, and trials that were never published

Healthy volunteers

In a randomised, placebo-controlled phase 1 study, healthy men received one 15-minute drip into a vein: eight at each of five dose levels, six on ipamorelin and two on placebo.19,2 That makes 40 men, although the FDA’s summary gives 48 enrolled; the full paper may explain the difference.2 Ipamorelin had a half-life of about 2 hours; growth hormone rose in a single pulse that peaked after about 40 minutes and fell to very low levels by 6 hours .19,2 The abstract says growth hormone rose at all dose levels. The FDA’s summary says the lowest-dose group had too little growth hormone to analyse.19,2 The FDA notes that the paper does not mention any adverse events. It was built to measure drug levels, not safety.2

The bowel-surgery trial

Helsinn’s phase 2 trial enrolled 117 adults having part of the bowel removed; 114 were treated. They received ipamorelin or placebo as a drip into a vein twice a day, from the day after surgery for up to 7 days.5 The median time until patients kept down a first solid meal was 25.3 hours with ipamorelin and 32.6 hours with placebo (p = 0.15); time to first bowel movement, recovery of bowel function and hospital stay did not differ significantly either .5,2 In a subgroup having open surgery, bowel recovery seemed faster with ipamorelin. The authors urged caution: the trial was small, with a wide mix of patients.2,5

The trial nobody can read

Helsinn then ran a larger phase 2 trial in 320 patients, testing three dosing schedules, given into a vein, against placebo; it finished in May 2014. No results have been posted on the registry or published in a journal that we could find.13 Whatever it showed, its silence means the published record is incomplete.

Other human data

One volunteer took ipamorelin through the nose in a doping-test study: the peptide was heavily broken down, and one breakdown product was still found in urine after the intact peptide had gone .35 A US observational study of veterans lists ipamorelin among several supplements in a hormone programme given before other treatments; it cannot separate ipamorelin’s effect.36 As of 22 October 2026, ClinicalTrials.gov lists no running or planned trial of ipamorelin.37

In detail Where the evidence is promising, and what the gap costs

Some of the biology is solid. Ipamorelin releases growth hormone in people, and drugs that act on the same system have passed regulators: macimorelin as a diagnostic test.19,14 In a 2-year trial in 65 older adults, the related tablet MK-677 raised growth hormone and IGF-1 to young-adult levels and added about 1 kg of fat-free mass. But strength and function did not change, although the authors say the trial was too small to judge them.31 Raising a hormone level is not the same as making people stronger or healthier.

The gap has a cost. Bowel paralysis after surgery is a real problem with few drug options, so testing a ghrelin-like drug for it was reasonable. The FDA notes that one drug, alvimopan, is approved for it in the US.5,2 The development stopped, the largest trial was never published, and the compound turned up in wellness clinics and on websites for uses nobody had tested in people.13,2

What is genuinely unknown

What is still not known?

No study in people has lasted more than a week or tested a jab under the skin.
In studies, people got ipamorelin for one week at most. Longer use has never been studied. Weeks of use covered by the evidence. The animal studies tested effects, not safety.

  • Healthy men: one drip into a vein

    a single dose

  • Patients after bowel surgery: drips into a vein

    up to 7 days

  • Longest animal study (rats; not a safety study)

    3 months

  • Longer use in people, under the skin

    Not known: never studied

Sources Gobburu et al. (1999); Beck et al. (2014); Andersen et al. (2001); FDA Evaluation of Ipamorelin-related Bulk Drug Substances (Ipamorelin (free base) and Ipamorelin acetate) for Inclusion on the 503A Bulk Drug Substances List (briefing document 4, Pharmacy Compounding Advisory Committee, 29 October 2024)19,5,34,2 Checked

In detail All open questions, with their sources

As of 22 October 2026, these are specifically unknown:

  • Whether it helps with anything people use it for. No study in people has tested muscle, fat loss, sleep, recovery or ageing. The FDA found no effectiveness data for growth hormone deficiency either.2
  • How the body handles it under the skin, through the nose or by mouth. Apart from one volunteer in a doping-test study, human data exist only for drips into a vein.2,19,35
  • Long-term safety. The FDA found no repeat-dose toxicity, genotoxicity, carcinogenicity or reproductive studies.2
  • Whether it is selective in people. In the published studies, cortisol, ACTH and prolactin were measured only in pigs.1,19
  • What months of use do to IGF-1, blood sugar and blood pressure in people. No study has looked beyond one week in hospital.2,5
  • Whether the effect fades. In rats the growth hormone response was slightly smaller after 15 days; the FDA raises the same concern for people.21,2
  • Immune reactions. No study has tested whether it triggers antibodies.2
  • Combinations with CJC-1295, sermorelin or other growth hormone boosters. They are sold together, but we found no study that tested them together in people.2
  • Pregnancy and fertility. No data; in mice, both switching on and blocking the ghrelin receptor harmed fertilisation and embryo development.2
  • Reward and dependence. The ghrelin receptor sits in brain reward areas; whether ipamorelin affects them is untested.2,23
  • The results of the 320-patient trial, finished in 2014.13
  • What products contain. Seized powders held a modified ipamorelin with an extra amino acid, and we found no survey of the content, purity or sterility of products on the market.27,32

Regulatory status

Is it legal?

It is not approved in Europe or the US, and it is banned in sport at all times.
Nobody has approved it as a medicine. US experts said pharmacies should not make it. Status in the Netherlands, the EU and the US, and in sport, checked on 22 October 2026.
Netherlands and the EUUnited States
Approved as a medicine?No No EU or Dutch authorisation. EMA’s medicines data hold no record of it.6,38No Not FDA-approved, and part of no approved drug.2
Legal to sell or supply as a medicine?No Dutch law forbids selling or supplying a medicine without a marketing authorisation, with narrow exceptions.39No Pharmacies may not make it from raw powder: it has no official quality standard and is not on the 503A list.40,2
Assessed by a regulator?No EMA and Dutch records show no application for it.6,38Yes In October 2024. FDA staff advised against it; the advisers voted 0–12, with one abstention.2,41
Changed by the July 2026 US vote?No Nothing the FDA or its advisers decide changes the law here.42No Ipamorelin was not among the seven peptides discussed in July 2026.43
Allowed in sport?No Banned at all times, as a growth hormone releasing factor.44No The same worldwide rule applies.44
In detail Status in each country, and in sport
Regulatory status by jurisdiction
Jurisdiction Status Note Checked
European Union Not authorised No authorised product, and no record in EMA's medicines data (checked 22 October 2026). 48,6,7
Netherlands Not authorised Not authorised; no product in the CBG database. Supplying a medicine without authorisation is prohibited (Geneesmiddelenwet art. 40). 38,39
Germany Not authorised No EU authorisation, and no approval anywhere in ChEMBL. The Anti-Doping Act annex names it as a growth hormone secretagogue. 50,6,7
Belgium Not authorised Not authorised: the 1964 Medicines Act requires a national or EU licence. No EU licence exists, and ChEMBL records no approval anywhere. 53,6,7
United Kingdom Not authorised Not authorised; supplying an unlicensed medicine is prohibited by the Human Medicines Regulations 2012. 54,7
United States Not authorised Not FDA-approved. In October 2024 FDA advisers voted 0–12 (one abstention) against adding either form to the 503A list; the acetate is in 503B category 2. 2,41,59,60,58
Sport (WADA) Prohibited in sport · S2, at all times Prohibited at all times under S2 (growth hormone releasing factors); named as an example since the 2015 List. 44,45,46,47

All statuses were checked on 22 October 2026.

Sport (WADA)

Ipamorelin is on the World Anti-Doping Agency’s Prohibited List under S2.2.4, growth hormone releasing factors, as an example of a growth hormone secretagogue. S2 substances are banned at all times, in and out of competition, and are non-Specified Substances.44,45 It has been named since the 2015 List; WADA said the named examples were already prohibited under earlier lists.46,47 Doping laboratories can find a breakdown product in urine after the intact peptide has gone.35

In detail The European Union, the Netherlands, Germany, Belgium and the United Kingdom

European Union and member states

No ipamorelin product has an EU marketing authorisation. EMA’s medicines data, which also include refused and withdrawn applications, contain no record of it.48,6 ChEMBL, a European drug database, records no approval anywhere; its highest stage reached is phase 2.7

  • Netherlands. The CBG database lists no ipamorelin product.38 A substance presented as treating disease, or one that can be used to change body functions through a pharmacological effect, is a medicine (Geneesmiddelenwet art. 1). Selling, supplying, stocking or importing a medicine without a marketing authorisation is prohibited, with narrow exceptions (art. 40).49,39
  • Germany. Finished medicines need a national licence or an EU authorisation (AMG § 21). Ipamorelin has no EU authorisation, and ChEMBL records no approval anywhere; we did not search the German national database.50,6,7 The annex to the Anti-Doping Act names ipamorelin as a growth hormone secretagogue. Acquiring or possessing more than a small amount of it for doping in sport is prohibited (§ 2(3)).51,52
  • Belgium. A medicine may be placed on the market only with a national or EU marketing authorisation (Medicines Act of 25 March 1964, art. 6 § 1). Ipamorelin has no EU authorisation.53,6

United Kingdom

Selling or supplying a medicinal product without a UK authorisation is prohibited (Human Medicines Regulations 2012, regulation 46).54 We found no UK licence for ipamorelin; the MHRA’s product database could not be searched automatically, so this rests on the absence of any approval in ChEMBL.7

In detail The United States: the 2024 advisory vote, point by point

Ipamorelin is not FDA-approved, has no US Pharmacopeia standard and is part of no approved drug. A pharmacy may therefore compound it from raw powder only after it is placed on the 503A bulks list through rulemaking.40,2,55

  • Two compounding businesses nominated it for that list: one the acetate, one the free base. Both withdrew their nominations on 19 September 2024, but the FDA presented both forms to its advisers anyway.56
  • FDA staff recommended against listing either form. Their reasons: the substance is not well characterised, effectiveness for growth hormone deficiency and bowel paralysis is not supported, safety signals exist, and approved treatments are available.2
  • On 29 October 2024 the Pharmacy Compounding Advisory Committee voted on each form separately. Free base: 0 in favour, 12 against, 1 abstention. Acetate: 0 in favour, 12 against, 1 abstention. Members cited a lack of safety and effectiveness data.41
  • The vote is advisory and not binding.57 Here it agreed with the FDA staff. By 22 October 2026 the FDA had not proposed a rule either way.58
  • For outsourcing facilities, ipamorelin acetate has been in “category 2”, substances that may pose significant safety risks, since 29 September 2023. The FDA cites possible immune reactions, unusual amino acids and the serious adverse events in the bowel-surgery trial.59,60 It was also in category 2 for pharmacies until the nominations were withdrawn.59
  • Ipamorelin was not part of the July 2026 committee meeting, which considered seven other peptides.43

The July 2026 vote, for context

That later meeting is often confused with ipamorelin’s own vote, so here are its facts:

  • On 23 July 2026 the same committee voted 8–6, with one abstention, to recommend BPC-157 for the 503A list. It considered seven peptides and recommended six: BPC-157, KPV, TB-500, MOTS-c, Semax and epitalon. Emideltide (DSIP) was not recommended. The FDA has posted no minutes, so these results are as reported from the public meeting.61,62,43
  • That vote is advisory and not binding. It went against FDA staff’s own recommendation.61,43
  • Legal compounding of those peptides stays prohibited until the FDA adopts the advice and completes rulemaking.55
  • None of them is an approved medicine in the EU, the UK or the US; Semax is registered as a medicine in Russia. A 503A listing would only allow pharmacy compounding on prescription in the US. It is not a marketing authorisation, says nothing about whether a substance works, and changes nothing in the EU or the Netherlands.63,64,65,40,42

None of this makes ipamorelin an approved medicine, and none of it changes anything in the EU or the Netherlands.

Risk profile

What are the risks?

Unknown products, higher blood sugar and fluid build-up are the main worries. Long-term risks are untested.
In one trial, some problems were more common with it. The groups were small. People in 100 with each problem: 56 patients on ipamorelin and 58 on placebo, given drips into a vein for up to 7 days after surgery.

  • High blood sugar when leaving hospital

    14 in 100 Ipamorelin

    9 in 100 Placebo

  • Low potassium in the blood

    13 in 100 Ipamorelin

    3 in 100 Placebo

  • Trouble sleeping

    11 in 100 Ipamorelin

    5 in 100 Placebo

  • A serious medical event, from any cause

    18 in 100 Ipamorelin

    16 in 100 Placebo

Each square is one person in 100. Source FDA Evaluation of Ipamorelin-related Bulk Drug Substances (Ipamorelin (free base) and Ipamorelin acetate) for Inclusion on the 503A Bulk Drug Substances List (briefing document 4, Pharmacy Compounding Advisory Committee, 29 October 2024)2 Evidence Human trials

The FDA’s summary gives no statistical tests for these differences, and surgery itself causes many of these problems. Overall, slightly fewer patients had any problem at all on ipamorelin (87.5%) than on placebo (94.8%).2,5

In detail What has been reported in people

Unless stated otherwise, this section draws on the FDA’s 2024 review and the studies named.2

In the bowel-surgery trial, almost everyone had some health problem (an adverse event) after their operation: 87.5% with ipamorelin and 94.8% with placebo. Most were mild to moderate and linked to the surgery or the illness. Nausea, vomiting and a swollen belly were the commonest, and slightly less frequent with ipamorelin.5,2 High blood sugar when leaving hospital (14.3% versus 8.6%), low potassium (12.5% versus 3.4%) and trouble sleeping (10.7% versus 5.2%) were more common with ipamorelin. Three patients in each group stopped treatment because of side effects. The authors reported that ipamorelin was well tolerated.2,5

Serious events, such as infections and leaks where the bowel was joined, occurred in 17.9% with ipamorelin and 15.5% with placebo; most happened after treatment had ended. Two patients on ipamorelin died. Both had colon cancer surgery followed by a leak at the join, and both died of complications such as sepsis and kidney failure. The FDA says it is unclear whether the deaths were related to ipamorelin. Their occurrence, with the higher rates of low potassium and high blood sugar, is one reason it calls the substance a safety concern.2

The FDA’s adverse-event database held two non-serious reports up to 30 September 2023, both with compounded products: tearing and headache after a nasal spray, and elbow pain after injections that mixed ipamorelin with sermorelin.2 Neither proves a cause. The FDA does not receive all reports, especially for compounded products, so two reports say little about how often problems occur.2

In detail Blood sugar, fluid and the heart: lessons from related drugs

In published studies, ipamorelin itself has never been given for months. Related drugs have, and they show what pushing this system for months can do. In a 2-year trial, 65 healthy older adults took the ghrelin-receptor tablet MK-677 (ibutamoren) or placebo. MK-677 raised fasting blood sugar by about 0.3 mmol/L and lowered insulin sensitivity; cortisol rose; the commonest side effects were more appetite, mild swelling of the lower legs and muscle pain .31 In 123 older people recovering from a broken hip, a trial of MK-677 was stopped early because of a safety signal of heart failure in a few patients .66

For approved growth hormone medicines, the labels warn about high blood sugar and diabetes, fluid retention, raised pressure in the skull, an inflamed pancreas and, in children, hip and spine problems. The FDA sees no data showing that ipamorelin avoids these risks. It also notes a heart-rhythm effect (QT prolongation) with macimorelin, an approved drug acting on the same system.2 These are class warnings, not findings for ipamorelin, but the mechanism that would cause them is the one ipamorelin is used for.

In detail Why an effect on cancer is theorised

The reasoning is a chain, and only its first links are established:

  1. Ipamorelin releases growth hormone in people.19
  2. Growth hormone raises IGF-1, a growth signal for many cells. With MK-677, IGF-1 rose to young-adult levels in older adults.20,31
  3. People with higher IGF-1 have modestly more of some cancers. In a meta-analysis of 21 observational studies, higher IGF-1 was linked with more prostate cancer and breast cancer before menopause ; such studies cannot prove cause.67
  4. Labels of approved growth hormone medicines warn of a higher risk of tumours.2

So the worry is not that ipamorelin starts a cancer. It is that a growth signal could help an existing, perhaps undiagnosed, tumour grow. No study has tested this for ipamorelin, and the FDA found no carcinogenicity studies.2

In detail Product quality and immune reactions

The most immediate risk may be the product itself. The certificates of analysis the FDA reviewed reported purity only. They did not test impurities, clumps of peptide or bacterial toxins (endotoxins), which the FDA calls critical for anything injected.2 The nominators’ certificates named one form in the title and gave the formula of the other.2 Forensic and anti-doping laboratories in Denmark, Germany and Norway found products containing “Gly-ipamorelin”, ipamorelin with an extra amino acid. Its effects and safety have never been studied.27,32

Peptides can clump together during storage, and synthesis leaves near-copies of the chain. Both can trigger the immune system. The FDA is concerned about immune reactions to injected ipamorelin, more so under the skin than into a vein. Reactions range from antibodies without symptoms to life-threatening reactions, and no study has tested this.2 See product risk.

In detail Hunger, sleep, reward and pregnancy
  • Hunger and weight. Ghrelin made volunteers eat 28% more, and ipamorelin raised food intake and body fat in mice.24,28
  • Sleep. Trouble sleeping was more common with ipamorelin in the bowel-surgery trial (10.7% versus 5.2%).2
  • Reward. The ghrelin receptor sits in brain areas that process reward, and ghrelin increased heroin-seeking in rats. The FDA says ipamorelin could, in theory, have reinforcing effects; this is untested.2
  • Pregnancy. There are no reproductive studies of ipamorelin. In mice, ghrelin and a ghrelin blocker both harmed fertilisation and embryo development.2

If someone is going to do this anyway

This section exists to reduce harm. It gives no doses, schedules or sourcing advice, and it is not a recommendation to use this compound.

How can someone lower the risk?

Check the product, ask a doctor for a few blood tests, and know when to stop.

This section is for people who have decided to use ipamorelin, or already do. It is not a recommendation, and it gives no amounts, schedules or sources.

If your product did not come from a pharmacy: check before you use it

These checks can show that something is wrong. None of them can show that a product is good or free of germs.68,69,70

Tick each box when you have checked it.

  • The seal and the vial are whole

    A broken cap or seal, or a cracked vial, can let germs in. Then do not use it.71,72,73

  • The label shows the name, amount, batch number and expiry date

    In the EU, a medicine must show all four, even on a small vial. If one is missing, or the date has passed, that is a warning sign. Take a photo of the label.74,71

  • For Ipamorelin

    Check which form the label names. Ipamorelin is sold as a free base or an acetate salt. The FDA treats them as different substances.2

  • It looks right

    A liquid, or a powder after mixing, should be clear and colourless, with no bits. Is it cloudy, has it changed colour, or do you see bits? Then do not use it.75,76

  • A lab report proves little if:

    • its batch number is not the one on your vial;
    • it does not name the lab, or has no date or signature;
    • it shows only purity (HPLC), with no test of what it is, such as mass spectrometry;
    • it has no test for germs (sterility) or for toxins from germs (endotoxin).

    Even a full report covers only one sample. A report from the seller comes from someone who gains if it looks good. It cannot show that your vial is clean.77,78,79,80,81

    What a certificate of analysis shows, and what it does not

  • It was kept as the label says

    Heat, freezing and sunlight can damage a peptide. Did it arrive warm, or was it frozen? Then do not use it. Often nobody can tell you how it was kept on the way. If you cannot know, you cannot rule out damage. When in doubt, throw it out.76,82,83,73

    When to throw a vial away

  • Clean steps, and a new sterile needle and syringe every time

    Wash your hands and wipe the rubber top with alcohol. Never share a needle, a syringe or a vial.73,84,82

    Sterile technique, step by step

  • Keep the vial, its label and any papers

    Keep them, even when the vial is empty, until you know you feel well. If you need a doctor, bring them. A lab can test what was inside.85,86

    If something goes wrong

  • Tell a doctor, and agree which checks fit you

    A doctor can help you choose blood tests that fit what you use. In the Netherlands, your doctor must keep what you say private.87,88,89

    Which checks matter, and whyTalking to your doctor

  • Know the warning signs before you start

    Spreading redness, fever, a swollen face or hard breathing need help fast. If it is severe, call your local emergency number.90,91,92

    All warning signs, and how fast to act

How a doctor can help

A doctor can check what ipamorelin may change: blood sugar, fluid and blood pressure, and hormone levels.2,31 If the reason for using it is tiredness, poor sleep or muscle loss, a doctor can also look for treatable causes. True growth hormone deficiency, for example, is diagnosed with special tests and has approved treatments.2 See talking to your doctor.

Sources 90, 91, 92, 93, 94, 95, 96, 2

Stop-now warning signs

Call your local emergency number now

  • Confusion or slurred speech, very fast breathing, or pale, blue or blotchy skin, often with fever or shivering These can be signs of sepsis: the body's reaction to an infection has started to damage its own organs.
  • Fainting and not waking up within a minute, or fainting with chest pain, a racing heart or a fit This can be a dangerous heart rhythm or a severe allergic reaction.
  • Pain at the injection spot that is much worse than it looks, or dark, purple or grey patches or blisters there This can be a rare, fast-spreading infection of the deep layers under the skin (necrotising fasciitis).
  • Swelling of the lips, tongue or throat, trouble breathing or swallowing, wheezing, a hoarse voice, or feeling faint, soon after an injection This can be a severe allergic reaction (anaphylaxis), which is life-threatening and gets worse very quickly.
  • Pain, pressure or tightness in the chest, or pain that spreads to the arm, neck, jaw or back This can be a heart attack, which needs treatment in hospital straight away.
  • Sudden, severe shortness of breath: gasping, or not able to finish a sentence This can be a serious problem with the heart, the lungs or an allergic reaction.
  • A racing, pounding or irregular heartbeat that does not settle, or that comes with chest pain, breathlessness or fainting This can be a dangerous heart rhythm.
  • A sudden, severe headache with blurred vision, chest pain, confusion or vomiting Blood pressure may be dangerously high, which can damage the brain, heart, kidneys and eyes.
  • An erection that lasts more than 3 hours, or a painful erection that will not go down Blood trapped in the penis can damage it for good if it is not treated quickly.
  • Shaking, sweating or sudden hunger that turns into confusion or drowsiness Very low blood sugar can cause a fit or loss of consciousness; take something sugary if you can still swallow safely.
  • Severe, constant pain in the upper belly that spreads to the back, often with vomiting This can be an inflamed pancreas (pancreatitis), a known risk of GLP-1 medicines such as semaglutide and tirzepatide.

Get medical help today

  • Fever, shivering or feeling very ill in the days after an injection Germs from the needle, the skin or the product may have reached your blood. If you also have a fast heartbeat or fast breathing, call your local emergency number.
  • Redness, heat, swelling or pain around the injection spot that keeps growing or getting worse This can be a skin infection (cellulitis), which needs antibiotics before it spreads.
  • Red lines that run from the injection spot towards the armpit or groin The infection may be spreading along the lymph vessels, and from there into the blood. If you also have a fever with a fast heartbeat or fast breathing, call your local emergency number.
  • A painful, warm lump that fills with pus This is probably an abscess: it often needs draining by a doctor, so do not squeeze it.
  • You were pricked by a needle that someone else had used Blood on a used needle can pass on HIV and hepatitis B or C, and preventive treatment works best within hours.
  • Vomiting so often that you cannot keep fluids down, or passing very little urine Losing too much fluid can damage the kidneys.
  • Yellow skin, or yellow whites of the eyes This can be a sign of a liver problem, gallstones or an inflamed pancreas.
  • Dark, red or cola-coloured urine together with muscle pain, tenderness or weakness Damaged muscle can release a protein that harms the kidneys (rhabdomyolysis).

Stop and contact a doctor

  • You fainted, but woke up quickly and now feel well Fainting is often harmless, but a doctor should check the cause.
  • A new mole, or a mole that changes size, shape or colour, itches or bleeds A changing mole can be skin cancer, and tanning peptides such as melanotan II have been linked to new and changing moles in case reports.
  • A lump at an injection spot that does not go away, or keeps growing A doctor should check whether it is an abscess, a reaction to the product or something else.
  • An itchy, raised rash, or puffy eyes or lips, while breathing stays normal Your body may be reacting to the product, and using it again can bring the reaction back.
  • Palpitations that keep coming back, even if they pass and you then feel well A doctor can check whether your heart rhythm is normal.
In detail What you cannot know about the product

A vial labelled ipamorelin may hold the free base or the acetate, more or less peptide than stated, near-copies of the chain, a modified version, solvents or bacterial toxins. No regulator has checked it.2,27 See product risk. If you inject anything, follow sterile technique: a new sterile needle and syringe every time lowers the risk of infection, whatever is in the vial.97

In detail Checks that make sense, and why

A doctor can help you choose which of these fit you:

  • Blood sugar (fasting glucose or HbA1c), before and during use, because ghrelin-receptor drugs and growth hormone can raise blood sugar. HbA1c shows the average over two to three months.31,2,98
  • Blood pressure, weight and your ankles, because fluid retention was a common side effect of a related drug.31
  • IGF-1, because its level is steadier than growth hormone, which comes in pulses, so it shows the growth hormone effect better. It is a safety check, not a target.20
  • Potassium, if you feel weak or have cramps or palpitations, because low potassium was more common with ipamorelin in the trial.2
  • Cancer screening that is due for your age, and any unexplained lump checked first, because of the theoretical effect of more growth hormone and IGF-1.67,2

Tell any doctor who treats you that you use it, so a change in blood sugar or a reaction is not mistaken for something else.

In detail Who should not use it at all, and interactions

Who should not use it at all

  • Anyone pregnant, breastfeeding or trying to conceive: there are no reproductive studies, and in mice ghrelin affected fertilisation and embryo development.2
  • Anyone with cancer, a history of cancer or an unexplained lump, because of the growth hormone and IGF-1 mechanism above.67,2
  • People with diabetes or prediabetes, because blood sugar may rise.31,2
  • People with heart failure, or kidney or liver disease that causes swelling, because related drugs caused fluid retention and a heart-failure signal.31,66
  • Children and teenagers, whose bones are still growing: growth hormone labels warn of hip and spine problems in children, and there are no data.2
  • Athletes subject to anti-doping rules, because it is prohibited at all times.44

Plausible interactions (none has been studied)

  • Diabetes medicines, including insulin, because a rise in blood sugar could work against them.31,2
  • Other growth hormone boosters (CJC-1295, sermorelin, tesamorelin, growth hormone itself or MK-677), which push the same system. Mixtures are sold, but we found no study of their combined effect in people.2
  • Medicines that affect heart rhythm, because an approved drug acting on the same system can prolong the QT interval.2

Sources

Every claim on this page links to one of these sources. Scholarly sources link to their DOI; regulatory sources to the regulator's own page.

In detail All 98 sources, numbered as in the text
  1. Raun K, Hansen BS, Johansen NL, Thøgersen H, Madsen K, Ankersen M, Andersen PH (1998). Ipamorelin, the first selective growth hormone secretagogue. European Journal of Endocrinology 139:552-561. Research article doi:10.1530/eje.0.1390552 ↩
  2. U.S. Food and Drug Administration (2024). FDA Evaluation of Ipamorelin-related Bulk Drug Substances (Ipamorelin (free base) and Ipamorelin acetate) for Inclusion on the 503A Bulk Drug Substances List (briefing document 4, Pharmacy Compounding Advisory Committee, 29 October 2024). Regulator fda.gov — accessed 22 October 2026 ↩
  3. Kojima M, Hosoda H, Date Y, Nakazato M, Matsuo H, Kangawa K (1999). Ghrelin is a growth-hormone-releasing acylated peptide from stomach. Nature 402:656-660. Research article doi:10.1038/45230 ↩
  4. World Health Organization, INN Programme (2014). International Nonproprietary Names (INN) for biological and biotechnological substances (a review), WHO/EMP/RHT/TSN/2014.1. World Health Organization. Report who.int — accessed 22 October 2026 ↩
  5. Beck DE, Sweeney WB, McCarter MD; Ipamorelin 201 Study Group (2014). Prospective, randomized, controlled, proof-of-concept study of the Ghrelin mimetic ipamorelin for the management of postoperative ileus in bowel resection patients. International Journal of Colorectal Disease 29:1527-1534. Clinical trial doi:10.1007/s00384-014-2030-8 ↩
  6. European Medicines Agency (2026). Medicines data download (JSON report of all EPARs: authorised, refused, withdrawn and suspended medicines). Dataset ema.europa.eu — accessed 20 October 2026 ↩
  7. EMBL-EBI (2026). ChEMBL compound report card: CHEMBL58547 (IPAMORELIN). ChEMBL. Dataset ebi.ac.uk — accessed 22 October 2026 ↩
  8. National Center for Biotechnology Information (2026). PubChem Compound Summary for CID 9831659, Ipamorelin. PubChem. Dataset pubchem.ncbi.nlm.nih.gov — accessed 22 October 2026 ↩
  9. National Center for Biotechnology Information (2026). PubChem Compound Summary for CID 56843331, Semaglutide. PubChem. Dataset pubchem.ncbi.nlm.nih.gov — accessed 20 October 2026 ↩
  10. Johansen PB, Hansen KT, Andersen JV, Johansen NL (1998). Pharmacokinetic evaluation of ipamorelin and other peptidyl growth hormone secretagogues with emphasis on nasal absorption. Xenobiotica 28:1083-1092. Research article doi:10.1080/004982598238976 ↩
  11. Greenwood-Van Meerveld B, Tyler K, Mohammadi E, Pietra C (2012). Efficacy of ipamorelin, a ghrelin mimetic, on gastric dysmotility in a rodent model of postoperative ileus. Journal of Experimental Pharmacology 4:149-155. Research article doi:10.2147/JEP.S35396 ↩
  12. ClinicalTrials.gov (2009). NCT00672074 — A Phase II, Double-Blind, Placebo-Controlled, Multiple-Dose Study to Evaluate the Safety and Efficacy of Ipamorelin Compared to Placebo for the Management of Post-Operative Ileus in Patients. Trial registration clinicaltrials.gov — accessed 22 October 2026 ↩
  13. ClinicalTrials.gov (2014). NCT01280344 — Phase II Double-Blind Placebo-Controlled Dose Finding Study to Evaluate Safety/Efficacy of Ipamorelin Compared to Placebo for Recovery of Gastrointestinal Function in Patients Following Small or Large Bowel Resection w/Primary Anastomosis. Trial registration clinicaltrials.gov — accessed 22 October 2026 ↩
  14. European Medicines Agency (2024). Ghryvelin (previously Macimorelin Aeterna Zentaris): EPAR – medicine overview. Regulator ema.europa.eu — accessed 22 October 2026 ↩
  15. European Medicines Agency (2017). Adlumiz (anamorelin): refusal of marketing authorisation. Regulator ema.europa.eu — accessed 22 October 2026 ↩
  16. Veldhuis JD, Anderson SM, Shah N, Bray M, Vick T, Gentili A, et al. (2001). Neurophysiological regulation and target-tissue impact of the pulsatile mode of growth hormone secretion in the human. Growth Hormone & IGF Research 11 Suppl A:S25-S37. Review doi:10.1016/s1096-6374(01)80005-8 ↩
  17. de Sousa LMM, Vicente VAN, Donato J (2025). Negative Feedback Loops and Hormonal Factors that Regulate GH Secretion. Endocrinology 166:bqaf139. Review doi:10.1210/endocr/bqaf139 ↩
  18. Howard AD, Feighner SD, Cully DF, Arena JP, Liberator PA, Rosenblum CI, et al. (1996). A receptor in pituitary and hypothalamus that functions in growth hormone release. Science 273:974-977. Research article doi:10.1126/science.273.5277.974 ↩
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