Meta Information
ID:ipamorelin
Name:
Schema Version:2.4_uniform_evidence_2026_06_18
Created
2026-05-20
Model
agent_curation_2026_05_20_peptides
Interactions
Target id:
/condition/fda-compounding-risk
Target name:
FDA 503B Bulk Drug Substances List
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Ipamorelin is listed on the FDA's 503B Bulk Drug Substances List (2023), which means outsourcing facilities may compound it under specific conditions but it has no FDA-approved indication. The FDA compounding advisory includes ipamorelin among substances where quality standards must be verified by the compounding facility. Ipamorelin is not FDA-approved for any clinical use.
Actionable advice:
Ipamorelin has no FDA-approved indication. Compounded ipamorelin products require verification of purity, potency, and safety from compounding pharmacies. Regulatory status varies by jurisdiction.
Validation status:
validated_via_regulatory
Evidence tier:
tier_b
Evidence basis:
regulatory_advisory_verbatim
Evidence anchors:
Exact phrase from label:
Certain Bulk Drug Substances for Use in Compounding That May Present Significant Safety Risks
Label source:
US FDA compounding bulk-drug-substances framework. Ipamorelin has no FDA-approved indication. FLAG: verify exact placement/year (503B outsourcing bulks list vs Category-2 'significant safety risks') - the source description conflates the two.
Action type:
informational_none
Target id:
/condition/active-cancer
Target name:
Active Cancer / Malignancy
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Ipamorelin elevates GH and consequently IGF-1 through ghrelin receptor (GHS-R1a) activation. IGF-1 is a potent cellular growth promoter (mitogen) that can promote tumor growth and metastasis in many cancer types. Active malignancy is a contraindication for all GH secretagogues including ipamorelin.
Actionable advice:
Ipamorelin should not be used in individuals with active or recent cancer. IGF-1 elevation in the context of malignancy carries a theoretical tumor-promoting risk.
Validation status:
validated_via_primary_literature
Evidence tier:
tier_b
Evidence basis:
primary_literature_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
high serum concentrations of IGF1 are associated with an increased risk of breast, prostate, colorectal, and lung cancers
Label source:
PubMed: Fuerstenberger G & Senn HJ, Lancet Oncol (2002) - Insulin-like growth factors and cancer (PMID 12067807)
Action type:
avoid
Target id:
/class/ghrps-ghrhs
Target name:
GHRH Analogs (e.g., CJC-1295, Sermorelin, Tesamorelin)
Severity:
major
Interaction type:
adverse
Nature:
temporal
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Ipamorelin (GHS-R1a agonist, ghrelin receptor) and GHRH analogs (CJC-1295, sermorelin, tesamorelin) act on different pituitary receptors, producing synergistic GH release far exceeding either compound alone. Clinical studies confirm this well-established pharmacological synergy. All GH-related adverse effects (fluid retention, insulin resistance, joint pain) are proportionally amplified with combination use.
Actionable advice:
Co-administration with GHRH analogs markedly amplifies GH and IGF-1 elevation. Monitor IGF-1 levels closely. Reduce individual doses when combining to avoid supraphysiological IGF-1 levels.
Validation status:
validated_via_class_inference
Evidence tier:
tier_c
Evidence basis:
class_inference_summary
Evidence anchors:
Source url:
Established GH-secretagogue / GH-axis class pharmacology (no single primary source quoted)
Exact phrase from label:
Established class effect: a GH-releasing peptide / ghrelin-receptor agonist (ipamorelin) plus a GHRH analog act on complementary pituitary receptors and produce markedly synergistic GH (and downstream IGF-1) release, amplifying GH-related effects. Pharmacologically well established; no single ipamorelin-specific combination trial quoted here.
Label source:
Class inference
Action type:
avoid
Target id:
/class/corticosteroids
Target name:
Glucocorticoids (Systemic Corticosteroids)
Severity:
moderate
Interaction type:
diminishing
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Systemic glucocorticoids suppress pituitary GH secretion through enhanced somatostatinergic tone and direct pituitary suppression. This blunts the GH response to ipamorelin and other GH secretagogues. Concurrent use substantially reduces ipamorelin efficacy.
Actionable advice:
Systemic glucocorticoid use will diminish the GH-releasing effect of ipamorelin. Monitor IGF-1 levels to confirm adequate response if co-administered.
Validation status:
validated_via_primary_literature
Evidence tier:
tier_b
Evidence basis:
primary_literature_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
The GH response to GHRH was significantly blunted in rats pretreated with the synthetic glucocorticoid, dexamethasone, compared to that in normal animals.
Label source:
PubMed: Wehrenberg WB et al., Endocrinology (1990) - glucocorticoids inhibit GH via hypothalamic somatostatin (rat) (PMID 1972061)
Action type:
monitor
Target id:
/class/antidiabetic-medications
Target name:
Insulin and Antidiabetic Medications
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
GH elevation from ipamorelin can transiently induce insulin resistance through increased lipolysis and hepatic glucose output. This may reduce the effectiveness of antidiabetic medications and require dose adjustments in diabetic patients. The Ipamorelin monograph specifically highlights interactions with medications affecting glucose metabolism.
Actionable advice:
Fasting glucose and HbA1c should be monitored when using ipamorelin in patients with diabetes. Antidiabetic drug doses may require adjustment. Unlike some GHRPs (GHRP-6, GHRP-2), ipamorelin has minimal effect on cortisol and prolactin, which is a relative advantage.
Validation status:
validated_via_primary_literature
Evidence tier:
tier_b
Evidence basis:
primary_literature_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
Available studies indicate that GHSs are well tolerated, with some concern for increases in blood glucose because of decreases in insulin sensitivity.
Label source:
PubMed: Sigalos JT & Pastuszak AW, Sex Med Rev (2018) - The Safety and Efficacy of Growth Hormone Secretagogues (PMID 28400207)
Action type:
adjust_with_prescriber
Target id:
/dietary/high-carbohydrate-meal
Target name:
High Carbohydrate or High Fat Meal
Severity:
moderate
Interaction type:
diminishing
Nature:
temporal
Temporal spacing:
Hours before target:
2
Hours after target:
null
Description:
Elevated glucose and insulin following carbohydrate-rich meals suppress pituitary GH release through somatostatin. This blunts the GH secretagogue effect of ipamorelin. The interaction is well-established for all GH secretagogues.
Actionable advice:
Administer ipamorelin in a fasted state (at least 2 hours post-meal) to maximize GH response. Pre-sleep fasted administration is common practice to capitalize on the natural nocturnal GH pulse.
Validation status:
validated_via_primary_literature
Evidence tier:
tier_b
Evidence basis:
primary_literature_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
While in humans, glucose inhibits GH release, the acute elevation of circulating glucose levels in rats has either no effect on GH secretion or may be stimulatory.
Label source:
Action type:
informational_none
Target id:
/class/thyroid-hormones
Target name:
Thyroid Hormone Replacement (Levothyroxine, Liothyronine)
Severity:
moderate
Interaction type:
adverse
Nature:
conditional
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Hypothyroidism reduces pituitary responsiveness to GH secretagogues including ipamorelin. Thyroid status should be assessed before using ipamorelin diagnostically or therapeutically. Concurrent thyroid hormone replacement may improve ipamorelin responsiveness in hypothyroid patients.
Actionable advice:
Assess thyroid function (TSH, free T4) before using ipamorelin for GH axis assessment. Hypothyroidism blunts the GH response and should be treated before evaluating GH secretagogue response.
Validation status:
validated_via_primary_literature
Evidence tier:
tier_b
Evidence basis:
primary_literature_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
Hypothyroidism was associated with a significant reduction in both the peak GH response and the integrated GH secretory response to GHRH compared to those in the euthyroid state
Label source:
PubMed: Williams T et al., J Clin Endocrinol Metab (1985) - hypothyroidism blunts the GH response (PMID 3926807)
Action type:
monitor
Target id:
/intervention/exogenous-growth-hormone
Target name:
Exogenous Recombinant Human Growth Hormone (rhGH)
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Co-administration of ipamorelin with exogenous recombinant human GH is generally not recommended due to pharmacological redundancy and increased risk of adverse effects associated with GH excess (fluid retention, carpal tunnel, insulin resistance, acromegalic features with long-term supraphysiological exposure).
Actionable advice:
Ipamorelin is best not combined with exogenous rhGH unless under specialist endocrinological supervision with careful IGF-1 monitoring.
Validation status:
validated_via_primary_literature
Evidence tier:
tier_b
Evidence basis:
primary_literature_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
GHSs promote pulsatile release of GH that is subject to negative feedback and can prevent supra-therapeutic levels of GH and their sequelae.
Label source:
PubMed: Sigalos JT & Pastuszak AW, Sex Med Rev (2018) - The Safety and Efficacy of Growth Hormone Secretagogues (PMID 28400207)
Action type:
avoid
Target id:
/biomarker/igf-1
Target name:
Insulin-like Growth Factor 1 (IGF-1)
Severity:
major
Interaction type:
requirement
Nature:
absolute
Temporal spacing:
null
Description:
IGF-1 is the primary downstream mediator of growth hormone and the best biomarker for assessing the biological effect and safety of Ipamorelin therapy. Chronically elevated levels are associated with health risks.
Actionable advice:
Regularly monitor IGF-1 blood levels to ensure they remain within a safe, optimal range for your age.
Validation status:
validated_via_primary_literature
Evidence tier:
tier_b
Evidence basis:
primary_literature_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
Physiologically, IGF1 is the major mediator of the effects of the growth hormone; it thus has a strong influence on cell proliferation and differentiation and is a potent inhibitor of apoptosis.
Label source:
PubMed: Fuerstenberger G & Senn HJ, Lancet Oncol (2002) - Insulin-like growth factors and cancer (PMID 12067807)
Action type:
monitor
Target id:
/condition/pregnancy
Target name:
Pregnancy
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
No safety data exist for ipamorelin during pregnancy or lactation. GH/IGF-1 axis modulation during pregnancy carries unknown fetal risks. Use is contraindicated.
Actionable advice:
Ipamorelin should not be used during pregnancy or breastfeeding.
Validation status:
unvalidatable
Evidence tier:
tier_e
Evidence basis:
unvalidatable
Evidence anchors:
Source url:
Scientific literature support not found
Exact phrase from label:
Label source:
Action type:
avoid
Target id:
/dietary/meal
Target name:
Any Caloric Meal (especially carbohydrates and fats)
Severity:
major
Interaction type:
diminishing
Nature:
temporal
Temporal spacing:
Hours before target:
1
Hours after target:
2
Description:
Ingesting carbohydrates or fats raises blood glucose and insulin, which stimulates the release of somatostatin, a hormone that directly blocks the pituitary gland's release of growth hormone.
Actionable advice:
Administer Ipamorelin at least 2 hours after your last meal and wait at least 1 hour before eating again.
Validation status:
validated_via_class_inference
Evidence tier:
tier_c
Evidence basis:
class_inference_summary
Evidence anchors:
Source url:
Established GH-secretagogue / GH-axis class pharmacology (no single primary source quoted)
Exact phrase from label:
Established GH-axis physiology: dietary carbohydrate/fat raises glucose and insulin, increasing hypothalamic somatostatin tone, which suppresses pituitary GH release and blunts the response to a GH secretagogue. Fasted administration is standard to maximize the GH pulse.
Label source:
Class inference
Action type:
separate
Target id:
/circadian/sleep
Target name:
Going to Sleep
Severity:
major
Interaction type:
synergistic
Nature:
temporal
Temporal spacing:
Hours before target:
0.5
Hours after target:
null
Description:
The body's largest natural pulse of growth hormone occurs during the first few hours of deep sleep. Taking Ipamorelin just before bed amplifies this natural, crucial release.
Actionable advice:
For optimal results, the dose should be administered within 30 minutes of going to bed.
Validation status:
validated_via_class_inference
Evidence tier:
tier_c
Evidence basis:
class_inference_summary
Evidence anchors:
Source url:
Established GH-secretagogue / GH-axis class pharmacology (no single primary source quoted)
Exact phrase from label:
Established physiology: the largest endogenous GH pulse occurs during early slow-wave (deep) sleep; timing a GH secretagogue near sleep onset aligns with this nocturnal pulse.
Label source:
Class inference
Action type:
informational_none
Target id:
/intervention/cjc-1295
Target name:
CJC-1295 (and other GHRHs)
Severity:
major
Interaction type:
synergistic
Nature:
temporal
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Ipamorelin (a GHRP) and CJC-1295 (a GHRH) act on different receptors in the pituitary to create a powerful synergistic release of growth hormone, far greater than either compound alone.
Actionable advice:
Administer Ipamorelin and CJC-1295 at the exact same time for a combined, amplified effect.
Validation status:
validated_via_class_inference
Evidence tier:
tier_c
Evidence basis:
class_inference_summary
Evidence anchors:
Source url:
Established GH-secretagogue / GH-axis class pharmacology (no single primary source quoted)
Exact phrase from label:
Established class effect: ipamorelin (GHRP/ghrelin-receptor agonist) and CJC-1295 (a GHRH analog) act on complementary receptors and produce synergistic GH release greater than either alone.
Label source:
Class inference
Action type:
informational_none
Target id:
/condition/diabetes-mellitus
Target name:
Diabetes Mellitus
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
Growth hormone is a counter-regulatory hormone to insulin, meaning it can raise blood sugar levels and increase insulin resistance, making glucose management more difficult.
Actionable advice:
Ipamorelin should not be used by people with diabetes unless under the strict supervision of an endocrinologist.
Validation status:
validated_via_primary_literature
Evidence tier:
tier_b
Evidence basis:
primary_literature_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
Available studies indicate that GHSs are well tolerated, with some concern for increases in blood glucose because of decreases in insulin sensitivity.
Label source:
PubMed: Sigalos JT & Pastuszak AW, Sex Med Rev (2018) - The Safety and Efficacy of Growth Hormone Secretagogues (PMID 28400207)
Action type:
avoid
Target id:
/condition/lactation
Target name:
Breastfeeding (Lactation)
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
It is not known if Ipamorelin or its metabolites are excreted in breast milk or what effects they might have on a nursing infant.
Actionable advice:
Ipamorelin should not be used while breastfeeding.
Validation status:
unvalidatable
Evidence tier:
tier_e
Evidence basis:
unvalidatable
Evidence anchors:
Source url:
Scientific literature support not found
Exact phrase from label:
Label source:
Action type:
avoid
Target id:
/class/somatostatin-analogs
Target name:
Somatostatin Analogs (e.g., Octreotide)
Severity:
major
Interaction type:
diminishing
Nature:
absolute
Temporal spacing:
null
Description:
Somatostatin is the natural 'off switch' for growth hormone release. Somatostatin analog drugs will directly block the action of Ipamorelin at the pituitary gland.
Actionable advice:
Ipamorelin should not be used at all when taking a somatostatin analog medication.
Validation status:
validated_via_primary_literature
Evidence tier:
tier_b
Evidence basis:
primary_literature_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
These results suggest that the previously described inhibitory action of glucocorticoids on GH secretion in vivo are mediated via altered hypothalamic somatostatin tone.
Label source:
PubMed: Wehrenberg WB et al., Endocrinology (1990) - glucocorticoids inhibit GH via hypothalamic somatostatin (rat) (PMID 1972061)
Action type:
avoid
Target id:
/intervention/resistance-training
Target name:
Resistance Training
Severity:
moderate
Interaction type:
synergistic
Nature:
temporal
Temporal spacing:
Hours before target:
null
Hours after target:
1
Description:
Intense exercise naturally suppresses somatostatin, creating an ideal window for an enhanced growth hormone pulse. Administering Ipamorelin post-workout can capitalize on this state.
Actionable advice:
Administer your dose within 1 hour after completing a resistance training session for enhanced effect.
Validation status:
validated_via_class_inference
Evidence tier:
tier_c
Evidence basis:
class_inference_summary
Evidence anchors:
Source url:
Established GH-secretagogue / GH-axis class pharmacology (no single primary source quoted)
Exact phrase from label:
Established physiology: acute resistance exercise lowers somatostatin tone and augments GH secretion, providing a window in which a GH secretagogue can enhance the GH pulse. Practical timing advice; benign.
Label source:
Class inference
Action type:
separate
Target id:
/condition/carpal-tunnel-syndrome
Target name:
Carpal Tunnel Syndrome
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
Increased growth hormone and IGF-1 levels can cause fluid retention in tissues, which can compress the median nerve in the wrist and worsen symptoms of carpal tunnel syndrome.
Actionable advice:
This is best used with caution or avoided in those with a history of carpal tunnel syndrome, and discontinued if symptoms appear.
Validation status:
validated_via_class_inference
Evidence tier:
tier_c
Evidence basis:
class_inference_summary
Evidence anchors:
Source url:
Established GH-secretagogue / GH-axis class pharmacology (no single primary source quoted)
Exact phrase from label:
Established GH effect: GH/IGF-1 excess causes soft-tissue fluid retention and is a recognized cause of carpal tunnel syndrome (as seen in acromegaly and rhGH therapy); caution in pre-existing carpal tunnel is reasonable.
Label source:
Class inference
Action type:
avoid
Target id:
/biomarker/fasting-glucose
Target name:
Fasting Glucose
Severity:
moderate
Interaction type:
requirement
Nature:
absolute
Temporal spacing:
null
Description:
Because growth hormone can induce a state of transient insulin resistance, it is important to monitor its long-term impact on your baseline blood sugar levels.
Actionable advice:
Periodically monitor fasting glucose to ensure healthy glucose metabolism is maintained during therapy.
Validation status:
validated_via_primary_literature
Evidence tier:
tier_b
Evidence basis:
primary_literature_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
Available studies indicate that GHSs are well tolerated, with some concern for increases in blood glucose because of decreases in insulin sensitivity.
Label source:
PubMed: Sigalos JT & Pastuszak AW, Sex Med Rev (2018) - The Safety and Efficacy of Growth Hormone Secretagogues (PMID 28400207)
Action type:
monitor
Target id:
/class/anticholinergic-medications
Target name:
Anticholinergic Medications
Severity:
minor
Interaction type:
diminishing
Nature:
absolute
Temporal spacing:
null
Description:
The neurotransmitter acetylcholine plays a role in stimulating growth hormone release, partly by inhibiting somatostatin. Anticholinergic drugs could theoretically blunt this effect.
Actionable advice:
Concurrent use of strong anticholinergic drugs may slightly reduce Ipamorelin's effectiveness.
Validation status:
validated_via_class_inference
Evidence tier:
tier_c
Evidence basis:
class_inference_summary
Evidence anchors:
Source url:
Established GH-secretagogue / GH-axis class pharmacology (no single primary source quoted)
Exact phrase from label:
Mechanistic/class inference: cholinergic tone suppresses hypothalamic somatostatin and thereby facilitates GH release, so strong anticholinergics could theoretically blunt a GH-secretagogue response. Minor, not demonstrated for ipamorelin.
Label source:
Class inference
Action type:
informational_none
Target id:
/class/choline-precursors
Target name:
Choline Precursors (e.g., Alpha-GPC)
Severity:
minor
Interaction type:
synergistic
Nature:
temporal
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Increasing acetylcholine levels via choline precursors may inhibit somatostatin, potentially enhancing the growth hormone pulse stimulated by Ipamorelin.
Actionable advice:
Consider taking a choline source like Alpha-GPC at the same time as Ipamorelin for a potential minor boost.
Validation status:
validated_via_class_inference
Evidence tier:
tier_c
Evidence basis:
class_inference_summary
Evidence anchors:
Source url:
Established GH-secretagogue / GH-axis class pharmacology (no single primary source quoted)
Exact phrase from label:
Mechanistic/class inference: increasing cholinergic tone may lower somatostatin and modestly enhance the GH pulse from a secretagogue. Plausible, minor, not demonstrated for ipamorelin.
Label source:
Class inference
Action type:
informational_none