Which is better, sermorelin or ipamorelin?
Sermorelin is graded human_rct on small studies (a 19 person, 16 week adult trial and pediatric growth data behind its former approval) and has a defensible compounding pathway, while ipamorelin is graded animal_only for its marketed uses and sits outside every FDA compounding category after its nomination was withdrawn. Neither has evidence for adult fat loss, muscle gain, or anti-aging, so the win is about evidence quality and legality, not a proven benefit. [1] [2] [6] [7] [9] [10] [12]
How do sermorelin and ipamorelin compare?
| Dimension | SermorelinFavored | Ipamorelin |
|---|---|---|
| Mechanism [3] [7] [8] | GHRH receptor agonist: the first 29 amino acids of growth hormone releasing hormone, acting upstream on pituitary somatotrophs. | Ghrelin receptor (GHS-R1a) agonist: a five amino acid growth hormone secretagogue acting through a separate pathway from GHRH. |
| Note: Because the receptors differ, the two are often marketed together, but no human trial has tested the combination. | ||
| Evidence grade [1] [6] [7] | Human RCT (small): single blind, placebo controlled 16 week trial in 19 adults aged 55 to 71 raised nocturnal GH and IGF-1. | Animal only for marketed uses: GH release in rats and pigs; the only human RCT (117 adults, intravenous, postoperative ileus) found no significant benefit. |
| Human outcomes measured [1] [2] [6] | Higher IGF-1 and skin thickness in both sexes; lean mass and insulin sensitivity gains in men only; sleep unchanged. Children with short stature grew 7.2 versus 4.8 cm per year. | Time to first tolerated meal after bowel surgery 25.3 versus 32.6 hours on placebo (p = 0.15). No human GH, IGF-1, or body composition outcome published for subcutaneous use. |
| Hormonal selectivity [5] [7] | Response limited by somatostatin tone and pituitary capacity, so GH cannot reach levels seen with injected recombinant GH. | In animals it released GH without raising ACTH, cortisol, prolactin, LH, FSH, or TSH, even at 200 times the GH ED50. |
| Regulatory history [9] [10] | Approved as Geref (diagnostic 1990, pediatric GH deficiency 1997); discontinued, approvals withdrawn in 2009; FDA determined in 2013 the withdrawal was not for safety or effectiveness. | Never approved anywhere. Placed on the 503A Category 2 list in September 2023; nominations withdrawn in 2024 and listed as a withdrawn nomination in the April 2026 update. |
| Compounding status [9] [10] | Not on Category 2 or the bulks list; many 503A pharmacies compound it on the basis of the former approval, a reading that depends on the state board. | No active nomination, not on the bulks list, not an approved drug component: no lawful basis for 503A or 503B compounding. |
| Literature dosing [1] [4] [6] | Geref label: 30 ug/kg subcutaneously at bedtime in children; adult trial used 10 ug/kg nightly for 16 weeks. | Not established for GH use; the only human trial used 0.03 mg/kg intravenously twice daily for up to 7 days after surgery. |
| Typical cost [9] [10] | Compounded only, paid in cash through telehealth clinics that include the visit; there is no branded product. Dated prices are on the sermorelin cost page. | Not available through licensed channels; ipamorelin is not on the 503A bulks list. |
| Note: Prices at the verification date. Products sold as research chemicals are not lawful for human use and are not verified for identity or purity. | ||
Evidence grade and regulatory status
Pulled from each peptide’s own record, so it stays in step with the peptide pages.
| Attribute | Sermorelin | Ipamorelin |
|---|---|---|
| Class | Synthetic 29 amino acid N-terminal fragment of human growth hormone releasing hormone (GHRH 1-29), the shortest fragment with full GHRH receptor activity | Synthetic pentapeptide growth hormone secretagogue; selective agonist at the ghrelin receptor (GHS-R1a) |
| What it is | Formerly FDA approved piece of growth hormone releasing hormone (Geref, withdrawn 2009 for business reasons); small trials show higher GH and IGF-1. | Growth hormone releaser acting on the hunger hormone (ghrelin) receptor; raised GH in animals and one small study in men; its only randomized trial failed. |
| Evidence | Evidence: Human RCT evidence | Evidence: Animal-only evidence |
| FDA status | Regulatory: Regulatory status unknown | Regulatory: Removed from Category 2 (Apr 2026) |
| Compounding | There is no currently approved sermorelin product in the United States. Geref (sermorelin acetate) was approved as a diagnostic on December 28, 1990 (NDA 19-863) and for treatment of idiopathic growth hormone deficiency in children on September 26, 1997 (NDA 20-443); the sponsor discontinued both in 2008 and FDA withdrew the approvals effective June 18, 2009. In March 2013 FDA determined in the Federal Register that Geref was not withdrawn for reasons of safety or effectiveness, which allows generic applications. Sermorelin was not placed on the 503A Category 2 list in 2023 and is not on the 503A bulks list; many 503A pharmacies compound it on the basis of the former approval, and whether that satisfies the component of an approved drug condition depends on how a state board and the pharmacy read it. Compounded sermorelin for adult anti-aging, fat loss, or sleep is an unapproved use with no supporting trial. | Not FDA approved for any use and never approved anywhere. FDA placed ipamorelin (free base and acetate) on the 503A Category 2 list on September 29, 2023, citing immunogenicity risk, peptide related impurities, and lack of safety data for the compounded routes. The nominators withdrew the 503A nominations in September 2024 and FDA's April 2026 update moved it to the list of nominated but withdrawn substances rather than Category 1 or the bulks list. Ipamorelin acetate also remains in 503B Category 2 (added September 29, 2023) on the FDA page current as of April 22, 2026. It was not among the peptides the Pharmacy Compounding Advisory Committee reviewed in July 2026. Because it has no active nomination, is not on the 503A bulks list, and is not a component of an approved drug, licensed 503A pharmacies and 503B outsourcing facilities have no lawful basis to compound it. |
| WADA | WADA: WADA prohibited | WADA: WADA prohibited |
| Routes | Subcutaneous injection, usually at bedtime (approved and trial use), Intravenous bolus (former diagnostic use), Intranasal (research only, lower bioavailability), Oral tablets and troches sold by some compounders have no published pharmacokinetic data | Subcutaneous injection (as sold, no human pharmacokinetic publication), Intravenous infusion (human ileus trial), Intranasal (anti-doping metabolite study only) |
| Typical cost | About 105 to 180 USD per month for compounded sermorelin through licensed telehealth programs, including the consultation and medication. Research chemical listings are not lawful for human use. Prices checked 2026-09-22 on published provider and pharmacy price pages. | Not available through licensed channels. Products sold as research chemicals are not lawful for human use and are not verified for identity or purity. |
| Last verified |
Has sermorelin been tested directly against ipamorelin?
No published trial has compared sermorelin and ipamorelin directly. The dimensions above come from separate studies and labels, and cross-trial comparisons are less reliable than a direct trial.
What do sermorelin and ipamorelin cost?
| Dimension | Sermorelin | Ipamorelin |
|---|---|---|
| Typical cost | $105 to $180 per month | Not available through licensed channels. Products sold as research chemicals are not lawful for human use and are not verified for identity or purity. |
| Price detail | Sermorelin price by channel | Ipamorelin price by channel |
Where a price index exists, the range is the cash price per month across branded, compounded, and telehealth channels, without insurance. The cost pages give each channel separately with its sources. Otherwise the typical cost from the peptide record is shown. Legal access depends on your state: see peptide legality by state.
Are sermorelin and ipamorelin combined?
Sermorelin and ipamorelin are sold together in the premixed blend below. No study has tested the combination, and a mix is only as lawful as its least lawful ingredient. The blend page covers what is in each product, the evidence for each ingredient, and legal status.
- Sermorelin and ipamorelin: No lawful path.
Frequently asked questions
Which has better evidence, sermorelin or ipamorelin?
Sermorelin. It has small human trials showing higher GH and IGF-1 (including a 16 week adult trial) and pediatric growth data that supported its former FDA approval. Ipamorelin has no human trial for any GH related use, only one small IV pharmacology study showing growth hormone release in healthy men; its only randomized human trial, for postoperative ileus, was negative. [1] [2] [6] [12]
Can a pharmacy legally compound either one?
Sermorelin is widely compounded by 503A pharmacies on the basis of its former approval, which FDA confirmed was not withdrawn for safety reasons, though acceptability depends on the state board. Ipamorelin has no lawful basis: its nomination was withdrawn after a 2023 Category 2 listing and it is not on the bulks list. [9] [10]
Does either help with fat loss or muscle gain?
Not on current evidence. Sermorelin's adult trial found a small lean mass gain in men only and no change in women; ipamorelin has never been tested for body composition in humans. [1] [6]
Why are they often sold together?
They stimulate GH through different receptors (GHRH versus ghrelin), and reviews of the GHRP class describe synergy with GHRH on GH release. No trial has tested sermorelin and ipamorelin together, so the benefit and safety of the combination are unknown. [7] [8]
Are they allowed in sport?
No. Both are prohibited at all times under WADA section S2: sermorelin as a GHRH analog and ipamorelin as a growth hormone secretagogue. [11]
Conditions studied
From the blog
- Tesamorelin vs sermorelin vs ipamorelin: evidence and legality
Tesamorelin, sermorelin, and ipamorelin compared in one table: mechanism, FDA approval, compounding status, human evidence, and WADA status, with links to each pairwise comparison.
- Sermorelin vs HGH: mechanism, evidence, and legal status
Sermorelin signals the pituitary to release growth hormone; HGH (somatropin) is the hormone itself. Only somatropin is FDA approved today, and anti-aging use of either is off-label.
Sources
Numbered citations above point to these primary sources. PubMed entries link to the indexed abstract.
- [1]Khorram O, Laughlin GA, Yen SS. Endocrine and metabolic effects of long-term administration of [Nle27]growth hormone-releasing hormone-(1-29)-NH2 in age-advanced men and women. J Clin Endocrinol Metab 1997PubMed 9141536, 1997
- [2]Kirk JM et al. Treatment with GHRH(1-29)NH2 in children with idiopathic short stature induces a sustained increase in growth velocity. Clin Endocrinol (Oxf) 1994PubMed 7955460, 1994
- [3]Vance ML et al. The effect of intravenous, subcutaneous, and intranasal GH-RH analog, [Nle27]GHRH(1-29)-NH2, on growth hormone secretion in normal men: dose-response relationships. Clin Pharmacol Ther 1986PubMed 3096623, 1986
- [4]Prakash A, Goa KL. Sermorelin: a review of its use in the diagnosis and treatment of children with idiopathic growth hormone deficiency. BioDrugs 1999PubMed 18031173, 1999
- [5]Walker RF. Sermorelin: a better approach to management of adult-onset growth hormone insufficiency? Clin Interv Aging 2006PubMed 18046908, 2006
- [6]Beck DE, Sweeney WB, McCarter MD; Ipamorelin 201 Study Group. Prospective, randomized, controlled, proof-of-concept study of the ghrelin mimetic ipamorelin for the management of postoperative ileus in bowel resection patients. Int J Colorectal Dis 2014PubMed 25331030, 2014
- [7]Raun K et al. Ipamorelin, the first selective growth hormone secretagogue. Eur J Endocrinol 1998PubMed 9849822, 1998
- [8]Camanni F, Ghigo E, Arvat E. Growth hormone-releasing peptides and their analogs. Front Neuroendocrinol 1998PubMed 9465289, 1998
- [9]Federal Register, March 4, 2013: Determination that Geref (sermorelin acetate) injection was not withdrawn from sale for reasons of safety or effectiveness (NDA 19-863 and NDA 20-443)Federal Register, 2013
- [10]FDA: Bulk drug substances used in compounding under section 503A of the FD&C Act (503A bulks list, Category 1, 2, and 3 lists, and withdrawn nominations)FDA
- [11]WADA Prohibited List, section S2 (growth hormone releasing hormone and its analogues, and growth hormone secretagogues)WADA
- [12]Gobburu JV et al. Pharmacokinetic-pharmacodynamic modeling of ipamorelin, a growth hormone releasing peptide, in human volunteers. Pharm Res 1999PubMed 10496658, 1999
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