Summary
Ipamorelin (NNC 26-0161) is a synthetic amidated pentapeptide growth hormone secretagogue, described by Novo Nordisk investigators in 1998 as the first growth hormone-releasing peptide receptor agonist with selectivity for growth hormone release 1. Three of its five residues are non-proteinogenic or non-natural in configuration, and FDA records that such residues add to the complexity of characterisation 23.
The evidence base is a nonclinical characterisation programme, one phase 1 intravenous pharmacokinetic and pharmacodynamic study in 48 healthy men, and two phase 2 trials in postoperative ileus sponsored by Helsinn Therapeutics: a published proof-of-concept trial that did not separate from placebo on its primary endpoint and a larger dose-finding trial with no posted results 4567. No marketing authorisation was found in the United Kingdom, the European Union or the United States on 2026-09-21 891011. In October 2024 the FDA Pharmacy Compounding Advisory Committee voted against adding either the free base or the acetate to the 503A bulk drug substances list 12. Ipamorelin is named in section S2.2.4 of the WADA Prohibited List in force and is prohibited at all times 13.
- Synonyms
- NNC 26-0161, Aib-His-D-2-Nal-D-Phe-Lys-NH2, 2-Methylalanyl-L-histidyl-3-(2-naphthalenyl)-D-alanyl-D-phenylalanyl-L-lysinamide, Ipamorelina, Ipamoreline
- CAS
- 170851-70-4· PubChem, National Center for Biotechnology Information, FDA / NCATS Global Substance Registration System, US Food and Drug Administration
- UNII
- Y9M3S784Z6· FDA / NCATS Global Substance Registration System, PubChem, National Center for Biotechnology Information, US Food and Drug Administration
- PubChem CID
- 9831659
- Formula
- C38H49N9O5· PubChem, National Center for Biotechnology Information, FDA / NCATS Global Substance Registration System, European Bioinformatics Institute, US Food and Drug Administration
- Mol. weight
- 711.9 g/mol· PubChem, National Center for Biotechnology Information, FDA / NCATS Global Substance Registration System, European Bioinformatics Institute, US Food and Drug Administration
- Class
- Synthetic pentapeptide growth hormone secretagogue (ghrelin mimetic)
- Targets
- Growth hormone secretagogue receptor type 1a (GHSR-1a, ghrelin receptor) - agonist
- Modifications
- N-terminal 2-aminoisobutyric acid (Aib); D-2-naphthylalanine at position 3 and D-phenylalanine at position 4; C-terminal lysinamide (amidated C-terminus). No disulfide bridge, glycosylation or lipidation is described in the sources retrieved.
- Aib
- His
- D
- 2
- Nal
- D
- Phe
- Lys
- NH2
Identity and structure
A pentapeptide with three non-proteinogenic residues
Ipamorelin is the pentapeptide Aib-His-D-2-Nal-D-Phe-Lys-NH2 114. Three of the five positions are occupied by residues that are either not proteinogenic or not in the L configuration: 2-aminoisobutyric acid (Aib) at the N-terminus, D-3-(2-naphthyl)alanine at position 3 and D-phenylalanine at position 4. The C-terminus is the amide of L-lysine rather than a free carboxylate, and only histidine at position 2 and lysine at position 5 are ordinary L-amino acids 23. No disulfide bridge, glycosylation, pegylation or lipidation is described in the sources retrieved 12.
Why there is no one-letter sequence
The single-letter amino acid code is defined only for the twenty proteinogenic L-residues, and it encodes neither Aib nor a D-configured residue. The dossier therefore records the one-letter sequence field as null, with the reason that none of the sources retrieved gives a standard one-letter sequence for this molecule 31. The three-letter representation Aib-His-D-2-Nal-D-Phe-Lys-NH2 carries the stereochemistry and the amidation explicitly and is the form used by the original characterisation, by the FDA substance registry and by the agency's briefing document 1142.
The molecule was identified within a series lacking the central Ala-Trp dipeptide of GHRP-1, and became the starting point for a further series of shortened peptidomimetic secretagogues, among them the tetrapeptide NNC 26-0235 115.
Free base and acetate are distinct substances
FDA treats ipamorelin (free base) and ipamorelin acetate as separate bulk drug substances that share one active moiety 2. The free base carries CAS 170851-70-4, UNII Y9M3S784Z6, PubChem CID 9831659 and the formula C38H49N9O5; reported molecular weights differ in the fourth significant figure, at 711.9 in PubChem, 711.8544 in the FDA substance registry, 711.87 in ChEMBL and 711.85 in FDA's prose against 711.9 in its own table 314162. PubChem records the acetate as a 1:1 salt, CAS 1258196-85-8, formula C40H53N9O7 and 771.9 g/mol, while FDA writes the formula as the free base with an unspecified number of acetate equivalents and records the molecular weight as not available for that reason 172.
Three features of the salt-level record matter when reading a certificate. No UNII exists for the acetate, so salt identity cannot be confirmed against an FDA substance record; FDA warns that public references apply the free-base CAS number to the acetate, and that both nomination packages quoted the free-base number, formula and weight on certificates titled for the acetate 2. PubChem also holds a di-acetate and a tri-acetate under the same name, so a molecular weight quoted for "the acetate" is uninterpretable without its stoichiometry 17.
Mechanism and pharmacology
The dossier records the target as growth hormone secretagogue receptor type 1a (GHSR-1a, the ghrelin receptor), with ipamorelin acting as an agonist 1421. Raun and colleagues demonstrated growth hormone release through a growth hormone-releasing peptide receptor by profiling against growth hormone-releasing peptide and GHRH antagonists; the receptor was identified as GHSR-1a in later regulatory and database records, and the FDA substance registry records a target-agonist relationship to it directly 1142.
In that characterisation, ipamorelin released growth hormone from primary rat pituitary cells with an EC50 of 1.3 plus or minus 0.4 nmol/L and an Emax of 85 plus or minus 5 per cent of the growth hormone-releasing peptide-6 response; the ED50 was 80 plus or minus 42 nmol/kg in anaesthetised rats and 2.3 plus or minus 0.03 nmol/kg in conscious swine. The distinguishing finding was selectivity: unlike growth hormone-releasing peptide-6 and growth hormone-releasing peptide-2, ipamorelin did not raise plasma ACTH or cortisol above GHRH-stimulated levels even at exposures more than 200-fold above the ED50 for growth hormone release, and no effect on FSH, LH, prolactin or TSH was observed in swine; on that basis the authors described it as the first growth hormone-releasing peptide receptor agonist whose growth hormone selectivity was comparable to GHRH 1.
In rats, intravenous ipamorelin showed a systemic plasma clearance about five-fold lower than growth hormone-releasing peptide-6, was excreted mainly in urine with 60 to 80 per cent of the administered material recovered in bile and urine as the intact peptide, and had a nasal bioavailability of approximately 20 per cent 18. In healthy male volunteers, intravenous kinetics were dose-proportional, with a terminal half-life of about two hours, a clearance of 0.078 L/h/kg and a steady-state volume of distribution of 0.22 L/kg 4.
Further nonclinical findings concern bone, body composition and gastrointestinal motility. In adult female rats the longitudinal bone growth rate increased in proportion to exposure 19, bone mineral content rose in a way attributable to larger bone dimensions rather than higher volumetric density 20, and a glucocorticoid-induced reduction in periosteal bone formation was partly reversed 21. Body fat, serum leptin and food intake increased in growth hormone-deficient lit/lit mice as well as in intact mice, indicating a growth hormone-independent component 22. Gastric emptying was accelerated in a rodent model after abdominal surgery 23.
FDA's nonclinical assessment records that no acute, repeat-dose, genotoxicity, reproductive or carcinogenicity study of either form was identified in the public literature, and raises two class-level concerns: possible reinforcing properties from ghrelin receptor activation in reward-processing regions, and possible effects on fertilisation and embryofetal development inferred from studies of ghrelin and a ghrelin receptor antagonist in mice 2.
Clinical and preclinical evidence
The human programme is small enough to tabulate in full. Helsinn Therapeutics ran two phase 2 trials in postoperative ileus; one was published with a negative primary endpoint, and the larger carries no posted results and no located publication 675. The phase 1 study and the two most relevant nonclinical studies are tabulated alongside them.
| Study | Design | n | Intervention | Comparator | Duration | Primary endpoint | Result |
|---|---|---|---|---|---|---|---|
| Beck et al. 2014, Ipamorelin 201NCT00672074 | Phase 2, multicentre, randomised, quadruple-masked, placebo-controlled, parallel-group proof of concept in hospitalised adults undergoing small or large bowel resection | 117 | Ipamorelin 0.03 mg/kg intravenously twice daily from postoperative day 1 (n = 56) | matching intravenous placebo twice daily (n = 58) | until postoperative day 7 or hospital discharge, whichever came first | Time from first dose to tolerance of a standardised solid meal without nausea or vomiting | Median 25.3 h versus 32.6 h, p = 0.15; no significant difference in the key or secondary efficacy analyses. Treatment-emergent adverse events in 87.5% versus 94.8%; hypokalaemia 12.5% versus 3.4%; insomnia 10.7% versus 5.2%; hyperglycaemia at discharge 14.3% versus 8.6%; serious adverse events in 17.9% versus 15.5%. [beck-2014-int-j-colorectal-dis] |
| HT-IPAM-202 dose findingNCT01280344 | Phase 2, multicentre, randomised, quadruple-masked, placebo-controlled, parallel-group dose finding in patients aged 18 to 85 after small or large bowel resection with primary anastomosis | 320 | Ipamorelin 0.03 mg/kg intravenously twice daily, 0.06 mg/kg twice daily, or 0.06 mg/kg three times daily | matching saline placebo three times daily | up to 10 days or until hospital discharge | Recovery of gastrointestinal function | No posted results. The registry record, completed May 2014 and last updated April 2017, carries no results and no primary publication was identified in PubMed. A peer-reviewed review states that a multicentre placebo-controlled trial found no significant difference in measurable motility parameters, but cites a malformed registry identifier, so the statement cannot be tied to this record with confidence. [ct-nct01280344] |
| Gobburu et al. 1999none | Phase 1, randomised, placebo-controlled dose escalation in healthy men with population pharmacokinetic and pharmacodynamic modelling | 48 | Ipamorelin 4.21, 14.02, 42.13, 84.27 or 140.45 nmol/kg infused intravenously over 15 minutes | placebo | single infusion with serial post-infusion sampling | Plasma ipamorelin and growth hormone concentrations | Dose-proportional kinetics; terminal half-life about 2 h, clearance 0.078 L/h/kg, steady-state volume of distribution 0.22 L/kg. A single episode of growth hormone release peaked at 0.67 h; SC50 214 nmol/L and maximal growth hormone production rate 694 mIU/L/h. FDA notes the publication reported no adverse events attributed to ipamorelin. [gobburu-1999-pharm-res] |
| Raun et al. 1998none | Nonclinical: primary rat pituitary cell assay and in vivo dose-response studies in anaesthetised rats and conscious swine, with growth hormone-releasing peptide and GHRH antagonist profiling | — | Ipamorelin (NNC 26-0161) | growth hormone-releasing peptide-6, growth hormone-releasing peptide-2 and GHRH | acute administration | Growth hormone release and specificity for other pituitary hormones | EC50 1.3 nmol/L in vitro with Emax 85% of the growth hormone-releasing peptide-6 response; ED50 80 nmol/kg in rats and 2.3 nmol/kg in swine. No ACTH or cortisol release above GHRH-stimulated levels at exposures more than 200-fold above the ED50, and no effect on FSH, LH, prolactin or TSH. [raun-1998-eur-j-endocrinol] |
| Venkova et al. 2009none | Nonclinical rodent model of postoperative ileus after laparotomy and intestinal manipulation, with single and two-day repeated intravenous dosing | — | Ipamorelin 0.01 to 1 mg/kg intravenously | growth hormone-releasing peptide-6 20 mcg/kg and saline vehicle | 48 h observation; repeated dosing four times daily at 3 h intervals over 2 days | Time to first bowel movement; faecal pellet output, food intake and body weight | A single dose of 1 mg/kg or of growth hormone-releasing peptide-6 shortened the time to first bowel movement without affecting cumulative faecal output, food intake or weight gain; repeated dosing significantly increased cumulative faecal pellet output, food intake and body weight gain. [venkova-2009-j-pharmacol-exp-ther] |
Nonclinical in vitro and in vivo characterisation; one phase 1 intravenous study in 48 healthy men; one published phase 2 trial that missed its primary endpoint; one phase 2 trial with no posted results and no located publication 1457.
Deaths reported in the published trial
In its briefing document FDA reviewed the published proof-of-concept trial and recorded two fatal serious adverse events among ipamorelin-treated subjects, both following anastomotic leak after resection for colon cancer, with a stated primary cause of hyperkalaemia with sepsis in one case and renal failure with sepsis in the other; the agency states that it is unclear whether the deaths were related to ipamorelin 2. The same finding appears among the agency's stated concerns on its page for bulk drug substances that may present significant safety risks, as a published study identifying serious adverse events including death when ipamorelin was given intravenously to improve gastric motility 24. Both statements are recorded here as FDA's own account of the published record; the trial publication reports serious adverse events in 17.9 per cent of ipamorelin-treated and 15.5 per cent of placebo-treated subjects 5.
Development is reported to have been discontinued after those results, but only at second hand: the FDA briefing document quotes a 2020 review to that effect, and no developer statement was retrieved 2.
Analytical characterisation
There is no United States Pharmacopeia or National Formulary drug substance monograph for the free base or the acetate, and FDA's searches of the European, Chinese, Indian and Japanese pharmacopoeias returned no monograph either, so published characterisation rests on the original synthesis description and on vendor certificates 2.
The original preparation used Fmoc solid-phase chemistry with HBTU-mediated couplings in N-methylpyrrolidone, purification by semi-preparative reversed-phase high-performance liquid chromatography to greater than 95 per cent purity, and characterisation by amino acid analysis, analytical reversed-phase high-performance liquid chromatography, plasma desorption mass spectrometry and proton nuclear magnetic resonance 21. The expected impurities are those of solid-phase peptide synthesis: truncation and deletion sequences, side-reaction products, isomeric impurities, free and protected amino acids, residual solvents, coupling reagents, activators, catalysts and scavengers, together with peptide aggregates. FDA found no impurity limits and no aggregate or endotoxin testing in the certificates available to it, and noted that aggregate detection may require size exclusion chromatography or field flow fractionation 2. Less is generally known about the chromatographic behaviour of unnatural residues during purification and about their effect on a peptide's propensity to aggregate, which is why their presence adds to the difficulty of characterising this molecule 2.
The most detailed published analytical work comes from doping control. Ipamorelin is determined in urine by solid-phase extraction with liquid chromatography coupled to high-resolution or tandem mass spectrometry, with reported detection limits of 0.2 to 1 ng/mL for the intact peptides of this family 25. A metabolism study of the class identified at least three metabolites per peptide 26, and a human nasal administration study found ipamorelin to be extensively metabolised, with ipamorelin (1-4) free acid detectable after the parent compound had cleared 27. N-terminally glycine-extended analogues have been identified in seized doping material and in black-market growth-promoting products 2829.
Certificates of analysis, identity data and lot verification for the research material characterised on this page.
View analytical data · CJC-1295 / Ipamorelin / Sermorelin blend →Stability and handling
Laboratory handling data only. Every figure below is reported by FDA from supplier documentation rather than from a pharmacopoeial or peer-reviewed determination 2.
- Free base, lyophilised: reported stable at room temperature for about three weeks, with desiccated storage below −18 °C recommended because moisture greatly reduces the long-term stability of lyophilised peptides 2.
- Free base, in solution: reported stable for two to three weeks at 4 °C and for three to four months at −20 °C 2.
- Acetate: long-term storage in a sealed container at 2 to 8 °C per the nominator's certificate of analysis, and reported to remain stable for up to four years at −20 °C. No in-solution data for the acetate were found 2.
- Solubility in water: the free base is reported as slightly soluble at 0.0032 mg/mL and the acetate as soluble at 5 mg/mL, a difference of three orders of magnitude between two non-pharmacopoeial figures. FDA observes that the free-base value makes the nominated 2 mg/mL injectable formulation difficult to rationalise 2.
- Peptides of this type are sensitive to formulation, process and environmental conditions such as pH, temperature and concentration, which may cause aggregation and degradation with loss of biological activity 2.
Regulatory status
The dated per-jurisdiction rows below are rendered from the database and cover the United Kingdom, the European Union, the United States and the WADA Prohibited List 8102413.
No medicine containing this compound is authorised in any jurisdiction checked. It has no established safety profile in humans outside registered clinical research. It is supplied for laboratory research only.
The rows below record the absence of authorisation and any compounding, evaluation or anti-doping status found on the date checked.
- United Kingdom
- No record of any ipamorelin medicine was found in the MHRA products register or the eMC on 2026-09-21.Checked 2026-09-21 · Medicines and Healthcare products Regulatory Agency
- European Union
- No entry for ipamorelin was found in the EU Union Register of medicinal products for human use on 2026-09-21.Checked 2026-09-21 · European Commission, DG Health and Food Safety
- United States
- Ipamorelin is not an approved drug substance; ipamorelin acetate sits in category 2 of the FDA 503B interim policy for significant safety risks, and in October 2024 the Pharmacy Compounding Advisory Committee voted against adding either form to the 503A Bulks List.Checked 2026-09-21 · US Food and Drug Administration
- WADA Prohibited List
- Ipamorelin is named in the Prohibited List in force under S2.2.4, growth hormone releasing factors, and is prohibited at all times.Checked 2026-09-21 · World Anti-Doping Agency
Advisory committee history
FDA's page on bulk drug substances that may present significant safety risks, content current as of 22 April 2026, lists ipamorelin acetate in category 2 under the 503B interim policy, added 29 September 2023, and repeats the entry in the table of substances previously in category 2 whose nominations were withdrawn 24. The stated concerns are a risk of immunogenicity for certain routes arising from potential aggregation or peptide-related impurities; unnatural amino acids adding to the complexity of peptide characterisation; the published study identifying serious adverse events including death; and an absence of safety information for certain other injectable routes 24. The 503B category list updated 21 March 2025 carries ipamorelin acetate in category 2; the 503A category list updated 14 May 2026 does not name ipamorelin in any category 3031.
Two nominations for the 503A bulks list, from Wells Pharmacy Network for the acetate and from LDT Health Solutions for the free base, were withdrawn on 19 September 2024, and FDA stated that it continued its evaluation on its own initiative 322. At the Pharmacy Compounding Advisory Committee meeting of 29 October 2024 the committee agreed by 12 votes to 1 to consider the two forms as a group, then voted 0 yes, 12 no and 1 abstention against placing each of them on the 503A bulks list, members citing a lack of information supporting safety and efficacy for growth hormone deficiency and for postoperative ileus 12. Ipamorelin was not on the agenda of the subsequent meeting of 23 and 24 July 2026, which considered BPC-157, KPV, TB-500, MOTs-C, emideltide, semax and epitalon 3334.
Anti-doping
The Prohibited List in force names ipamorelin in section S2.2.4, growth hormone releasing factors, among growth hormone secretagogues and their mimetics, alongside anamorelin, capromorelin, ibutamoren (MK-677), lenomorelin (ghrelin), macimorelin and tabimorelin. Class S2 is prohibited at all times 13.
Open questions
- The phase 2 dose-finding trial NCT01280344, completed in May 2014 with 320 participants, has no posted results and no primary publication was found, so the outcome of the larger trial is unverified 7.
- Discontinuation of development is stated only at second hand, in a 2020 review quoted by FDA 2.
- The acetate CAS number rests on a supplier catalogue entry footnoted by FDA and on PubChem, no UNII exists for the acetate, and FDA warns that public references also apply the free-base number to it 217.
- Reported water solubility of the free base and of the acetate differ by three orders of magnitude, and both figures come from non-pharmacopoeial sources quoted by FDA 2.
- No pharmacopoeial monograph exists, so there are no official assay, impurity or endotoxin limits for either form 2.
- No nonclinical acute, repeat-dose, genotoxicity, reproductive or carcinogenicity study was identified by FDA, and no subcutaneous-route human data were identified for either form 2.
- The European finding rests on the Union Register and on FDA's account of its own EMA and European Pharmacopoeia searches, because the EMA website returned a bot-verification page 102.
- The free base appears in no current 503A or 503B category list although the acetate does, so its interim-policy status after the October 2024 vote is not stated on the pages retrieved 313024.
