Side-by-side · Research reference

SermorelinvsVIP

Side-by-side comparison across mechanism, dosage, evidence, side effects, administration, and stack synergies. Citations on every claim where available.

APhase 3HUMAN-REVIEWED14/43 cited

BPhase 3HUMAN-REVIEWED9/42 cited

Sermorelin

GHRH 1-29 fragment · Short-acting

100–500 mcgPer doseMolteno 2013

Phase 3Evidence levelWalker 1994 Molteno 2013

~12 minHalf-lifeMolteno 2013

SQ · Pre-sleep · 1×/day

VIP

Neuropeptide · VPAC1/VPAC2 Agonist · Emergency Use Authorization (COVID-19 ARDS)

IntravenousPrimary routeBrown 2023

ARDSLead indicationUdupa 2025

Phase 3Development stage

IV infusion · Inhaled (investigational)Brown 2023 Boesing 2022

01Mechanism of Action

Parameter

Sermorelin

VIP

Primary target

Pituitary GHRH receptorWalker 1994

VPAC1 and VPAC2 G-protein-coupled receptorsUdupa 2025

Pathway

GHRH-R → Gαs → cAMP → PKA → GH vesicle exocytosisWalker 1994

VIP → VPAC1/VPAC2 activation → cAMP elevation → Pulmonary vasodilation + epithelial protection

Downstream effect

Pulsatile GH release; subsequent IGF-1 elevationMolteno 2013

Anti-inflammatory cytokine modulation, alveolar-capillary membrane stabilization, pulmonary smooth muscle relaxation, reduced neutrophil infiltration

Feedback intact?

Yes — short pulse preserves feedback

Yes — exogenous VIP acts as physiological agonist

Origin

Unmodified active 29-AA fragment of human GHRH (1-44)Walker 1994

Endogenous 28-amino-acid neuropeptide; synthetic analogue (aviptadil) identical to natural VIP

Antibody development

—

02Dosage Protocols

Parameter

Sermorelin

VIP

Standard dose

100–500 mcg per injectionMolteno 2013

—

Frequency

Once daily, pre-sleep

—

Lower / starter dose

100 mcg per dose

—

Evidence basis

Phase 3 (Geref pediatric); clinical practiceWalker 1994 Molteno 2013

Phase 3 RCT (TESICO)Brown 2023

816-patient randomized controlled trial in COVID-19 ARDS.

Duration

8–12 weeks per cycle

—

Reconstitution

Bacteriostatic water

Lyophilized powder reconstituted with sterile diluent per protocol

Timing

Pre-sleep, fasted preferred

—

Half-life

~12 min (plasma)Molteno 2013

Shorter than tesamorelin (~26 min) — simpler GHRH analogue.

~2 minutes (plasma)

Rapid clearance necessitates continuous infusion.

Intravenous (ARDS protocol)

—

60–90 mcg/kg/day via continuous infusion

TESICO trial protocol for COVID-19 ARDS.

Infusion duration

—

12-hour continuous IV infusion dailyBrown 2023

Inhaled (investigational)

—

Variable dosing under clinical trial protocolsBoesing 2022

Delivered via nebulizer for direct pulmonary deposition.

Treatment duration

—

3–14 days (acute ARDS)

04Side Effects & Safety

Parameter

Sermorelin

VIP

Injection site reaction

Mild erythema, transient pain

—

Flushing / headache

Common transient effect

—

IGF-1 elevation

Modest at standard doses

—

Cancer risk

Contraindicated in active malignancy (GH/IGF-1 axis)

—

Pregnancy / OB

Avoid

—

Glucose handling

Generally neutral

—

Hypotension

—

Transient vasodilation-related blood pressure drop

Tachycardia

—

Reflex tachycardia secondary to vasodilation

Infusion site reactions

—

Erythema, phlebitis (IV administration)

GI symptoms

—

Nausea, diarrhea (VIP is endogenous GI peptide)

Overall tolerability

—

Well-tolerated in Phase 3 trials; adverse event profile comparable to placebo

Absolute Contraindications

Sermorelin

·Active malignancy
·Pregnancy / breastfeeding
·Disrupted hypothalamic-pituitary axis

VIP

·Known hypersensitivity to aviptadil or formulation components

Relative Contraindications

Sermorelin

·Untreated diabetes

VIP

·Severe hypotension or shock states (monitor blood pressure)
·Pregnancy — insufficient safety data

05Administration Protocol

Parameter

Sermorelin

VIP

1. Reconstitution

Add 2 mL bacteriostatic water to 5 mg vial → 2.5 mg/mL = 250 mcg per 0.1 mL.

Reconstitute lyophilized aviptadil powder with sterile diluent per manufacturer protocol. Inspect solution for particulates — should be clear and colorless.

2. Injection site

SQ — abdomen or thigh. Rotate sites.

Administer as continuous 12-hour intravenous infusion via central or peripheral line. Use infusion pump for precise dosing (60–90 mcg/kg/day divided over infusion duration).

3. Timing

Pre-sleep, fasted.

Monitor blood pressure, heart rate, and oxygenation continuously during first infusion. Assess for hypotension and adjust infusion rate if needed.

4. Storage

Lyophilised: room temp, light-protected. Reconstituted: refrigerate ≤30 days.

Deliver via jet or mesh nebulizer per clinical trial protocol. Patient seated upright, normal tidal breathing for 10–15 minutes.

5. Needle

29–31G, 4–8 mm insulin syringe.

Store lyophilized powder at 2–8 °C, light-protected. Reconstituted solution: use immediately or within 24 hours if refrigerated.

06Stack Synergy

Sermorelin

+ Ipamorelin

Strong

View Ipamorelin →

Sermorelin (GHRH analogue) and ipamorelin (selective GHRP) form the prototypical GHRH+GHRP dual-axis stack at the lowest cost. Both peak within 30 min and produce a sharp physiological GH pulse without cortisol/prolactin elevation.

Sermorelin: 200–300 mcg SQ · pre-sleep
Ipamorelin: 200–300 mcg SQ · same injection
Primary benefit: Pulsatile GH stimulation, recovery, body composition

Raun 1998 Walker 1994

VIP

— no documented stacks