VIP

What VIP does

VIP is a natural blood-vessel and immune signal; aviptadil is its synthetic form. The largest COVID-19 infusion trial found no benefit; small nasal studies in chronic inflammatory response syndrome lack blinded placebo comparisons. Low blood pressure, diarrhea and headache are key risks.

• Combined with phentolamine, it is approved in the UK and Finland as a penile injection for erectile problems in adult men. (Drug label)
• In trials of that combination, 75% of men responded, compared with 12% on placebo. (Studied in a trial)
• In small studies without a placebo group, people with chronic inflammatory response syndrome had fewer symptoms on a nasal spray. (Studied in a trial)
• People report using the nose spray for brain fog and long COVID; some injection users report deeper sleep or less joint pain. (Reported by users)

Uses in the sources

• Studied by IV infusion for COVID-19 lung failure; the largest trial found no recovery or survival benefit. (Studied in a trial) (source)
• Studied by inhalation for sarcoidosis, pulmonary hypertension and COVID-19. Findings do not establish routine use. (Studied in a trial) (source)
• Nasal VIP was studied in small uncontrolled CIRS cohorts after several earlier interventions. (Studied in a trial) (source)
• VIP plus phentolamine is licensed in the UK and Finland for adult male erectile dysfunction, by injection into penile erectile tissue. (Drug label) (source)
• Users report nasal use for brain fog and long COVID. Controlled evidence for these community goals was not found. (Reported by users) (source)

VIP dosage

Typical reported dose: One 50 mcg spray in one nostril, four times a day

• Three monitored IV infusion days: Day 1: 50 pmol/kg/hour for 12 hours, then Day 2: 100 pmol/kg/hour for 12 hours, then Day 3: 150 pmol/kg/hour for 12 hours one 12-hour infusion daily for 3 successive days, into a vein. Studied in a trial. Studied in: Adults in the cited study. (source)
• Three monitored IV infusion days: Day 1: 50 pmol/kg/hour for 12 hours, then Day 2: 100 pmol/kg/hour for 12 hours, then Day 3: 150 pmol/kg/hour for 12 hours one 12-hour infusion daily for 3 successive days, into a vein. Studied in a trial. Studied in: Adults in the cited study. (source)
• India trial: three infusion days: Day 1: 0.166 mcg/kg/hour for 12 hours, then Day 2: 0.332 mcg/kg/hour for 12 hours, then Day 3: 0.498 mcg/kg/hour for 12 hours one 12-hour infusion daily for 3 successive days, into a vein. Studied in a trial. Studied in: Adults in the cited study. (source)
• Two inhalations 30 minutes apart: 100 mcg in 1 mL, then another 100 mcg in 1 mL after 30 minutes; total 200 mcg/day one daily session with two inhalations, inhaled. Studied in a trial. Studied in: Adults in the cited study. (source)
• Sarcoidosis: 50 mcg four times daily: 50 mcg by ultrasonic nebulizer four times daily four times daily, inhaled. Studied in a trial. Studied in: Adults in the cited study. (source)
• Pulmonary hypertension: four inhalations: 50 mcg per inhalation, four times daily; total 200 mcg/day four times daily, inhaled. Studied in a trial. Studied in: Adults in the cited study. (source)

These are doses reported in labels, trials or user reports, not a personal plan. Check the source behind each one.

Work out syringe units with the dosing calculator

How to mix VIP

Comes as: Community reports describe freeze-dried powder vials and nasal spray bottles., Published nasal studies used a prepared liquid; this does not validate home-made products..

Mixed with: Users report bacteriostatic water. The 2017 study used sterile saline plus 1% glycerin; these preparations are not interchangeable..

Common vial sizes: 5, 10 mg. Common water amounts: 2, 10 mL.

• One forum example mixed 5 or 10 mg into 10 mL total, assuming a 0.1 mL spray. Actual spray delivery and drug content were untested.
• The same report used 2 mL first, then 8 mL more. These are community practices, not validated compounding instructions.
• Bacteriostatic water does not establish sterility, nasal compatibility or product shelf life.
• The 2017 study reported 500 mcg/mL, delivering 50 mcg per 0.1 mL spray. Its device and formulation were controlled.

Before mixing: A validated shelf life and storage temperature for unverified powder vials were not found.

After mixing: Home-mixed VIP has no verified stability or sterility period. The 2017 study’s refrigerated 60-day limit applied to its specific nasal formulation.

VIP side effects and risks

Reported side effects

• Low blood pressure: IV TESICO: 58.4% versus 41.3% placebo during infusions. Nasal frequency is unknown., serious. Fainting or chest pain needs urgent care; IV trials used infusion pauses or slower rates. (source)
• Diarrhea: IV TESICO: 39.8% versus 11.3% placebo. US trial: 32.8% versus 1.5%., moderate. Persistent watery stools, poor fluid intake or dizziness need prompt assessment. (source)
• Flushing: IV TESICO: 14.7% versus 6.1% placebo during infusions., mild (source)
• Fast heart rate: IV TESICO: 9.5% versus 4.8% placebo during infusions., moderate. A sustained racing or irregular heartbeat, chest pain or faintness needs care. (source)
• Migraine or headache: Two hour IV challenge in migraine: 15/21, 71%, versus 1/21, 5%, with placebo. Nasal rate is unknown., moderate (source)
• Raised pancreatic enzyme: Nasal CIRS study: 1/20 had a transient lipase rise without belly pain. This is not a reliable population rate., moderate (source)
• Nasal fatigue, lightheadedness or no benefit: Mixed forum reports; no denominator or verified product identity., moderate (source)
• Priapism with the ED combination: VIP–phentolamine cohort: 1/308, 0.3%. This risk concerns penile injections., serious. An erection lasting 4 hours needs emergency care. (source)
• Severe immune or allergic reactions: FDA’s 2019 review noted severe immune reactions; no reliable rate or route specific denominator was supplied., serious. Swelling of the mouth or throat, wheezing or breathing trouble needs emergency care. (source)

Stop and get help if

• Fainting, chest pain or severe breathlessness: Stop exposure and seek emergency care.
• Face or tongue swelling, wheezing or trouble breathing: Seek emergency care for a possible severe allergic reaction.
• Severe persistent belly pain, repeated vomiting or inability to keep fluids down: Stop exposure and get urgent assessment.
• An erection lasting 4 hours after penile injection: Seek emergency care immediately; delayed care can damage penile tissue.
• A sudden severe headache, weakness, speech trouble or vision loss: Seek emergency care immediately.

Who should avoid it

• pregnant: Pregnancy safety is unproven; trials excluded pregnancy. One favorable case report cannot establish fetal safety.
• breastfeeding: Breast-milk transfer and infant effects are unknown; clinical trial eligibility excluded breastfeeding.
• tryingToConceive: Conception safety is unproven. A planned sarcoidosis trial excluded planned pregnancy and required contraception; no tested washout interval is established.
• under18: Adult trial evidence does not establish child safety. A small CIRS cohort including a minor is insufficient.
• other: Do not repeat dosing after a serious allergic reaction to VIP or its formulation.
• other: VIP can lower blood pressure. Existing symptomatic low pressure, fainting or dehydration raises immediate risk.
• heartCondition: Low blood pressure and faster heart rate can stress the heart; review cardiac status and medicines.
• uncontrolledBloodPressure: Large blood-pressure changes and interacting medicines need assessment before exposure.
• pancreatitisHistory: One nasal-study patient had raised lipase. Pancreatitis risk and safe use after pancreatitis are unknown.
• activeCancer: VIP supports blood-vessel and tumor signaling in lab models. This is a precaution; human cancer risk is unknown.
• cancerHistory: Discuss prior cancer with the treating team; human recurrence data for added VIP are lacking.
• other: Two-hour IV exposure provoked migraine; nasal and subcutaneous headache risk is not quantified.
• kidneyDisease: Dose adjustments are not established. Low pressure or diarrhea may worsen fluid and kidney problems.
• liverDisease: Formal dose-adjustment studies in liver impairment were not identified.
• diabetes: VIP can alter glucose and insulin signaling. Glucose response to community schedules is unpredictable.
• testedAthlete: No VIP-specific anti-doping decision was found; obtain a ruling for the exact substance and product.
• other: For intracavernosal VIP–phentolamine only: block with sickle-cell disease or trait, multiple myeloma, leukemia, or another condition predisposing to prolonged erections.
• other: For intracavernosal VIP–phentolamine only: block with penile angulation, cavernosal fibrosis or Peyronie's disease.
• other: For intracavernosal VIP–phentolamine only: a penile implant is a label contraindication.
• other: For intracavernosal VIP–phentolamine only: block when an underlying physical disease makes sexual activity inadvisable or contraindicated.
• other: TESICO IV exclusion: end-stage liver disease prevented enrollment. This trial restriction does not establish a contraindication for nasal or subcutaneous VIP.
• other: TESICO IV exclusion: severe diarrhea prevented enrollment. Infusion was withheld with more than 3 liquid stools in 24 hours; this restriction is not established for other routes.
• other: TESICO IV exclusion: current C. difficile infection prevented enrollment. This trial restriction does not establish a contraindication for nasal or subcutaneous VIP.

Interactions

• Blood-pressure medicines and vasodilators: Nasal VIP interactions are unstudied. Additive blood-pressure lowering is a theoretical concern; intracavernosal VIP–phentolamine has a separate label prohibition on other ED medicines.
• Insulin and sulfonylureas: VIP affects glucose and insulin biology. A clinical interaction size or routine adjustment is unknown; review glucose monitoring.
• Anticoagulants: The ED-combination label cautions about bleeding with penile injections. A systemic interaction with nasal VIP has not been established.
• Other VIP products or analogues: Duplicate VIP exposure can add vascular effects. Long-acting analogues have different kinetics; no dose conversion is established.
• Other ED medicines with intracavernosal VIP–phentolamine: For intracavernosal VIP–phentolamine only: do not combine with other ED medicines, including oral PDE5 inhibitors or penile injections, because erections may be prolonged.

Product quality risks

• No independent survey of online VIP products was found. General unauthorized-peptide warnings cannot establish a VIP-specific contamination rate.
• Unauthorized peptides may contain the wrong amount, the wrong ingredient, microbes, endotoxin or residual chemicals.
• A research-use label and a high purity percentage do not establish identity, dose accuracy or injection quality.
• The 2017 authors reported HPLC purity, stability, sterility and endotoxin testing of their nasal formulation; this does not certify other products.
• FDA’s 2019 review noted risks from wrong-length or wrong-sequence peptides when VIP synthesis is poorly controlled.

What to expect

TESICO tested one 12-hour aviptadil infusion daily for three days in hospital patients with severe COVID-19, without improving clinical outcomes.

The largest COVID-19 infusion trial found no benefit; small nasal studies lack blinded placebo comparisons. Reports may include the same participants.

Key studies

• TESICO: IV aviptadil: OR 1.11, 95% CI 0.80–1.55; p=0.54. No improvement versus placebo. (source)
• US COVID-19 trial: 196 patients: 72/131, 55.0%, versus 34/65, 52.3%; adjusted OR 1.6, 95% CI 0.86–3.11. Primary outcome was not significant. (source)
• India COVID-19 trial: Median 7 days with aviptadil versus 14 days with placebo. (source)
• Inhaled COVID-19 trial: 80 patients: Mean 7.8±4.0 days versus 10±5.0 days; p=0.049. (source)
• Nasal VIP for CIRS: 20 patients: Symptoms reportedly reached historical-control levels; exercise pressure rise fell below 8 mmHg in all patients within 2 months. (source)
• Nasal VIP and gene activity: 14 patients: Mean fell from 12.9 before VIP to 3.3 after VIP; no placebo group. (source)

VIP FAQ

• Is VIP FDA-approved? No FDA-approved product found. PCAC voted against 503A listing on November 3, 2016; FDA proposed exclusion in 2019. VIP remains on the May 2026 Category 1 interim list.
• How do people take it? Nasal spray, four times daily. Source: reported by users, not an established dose.
• What's the difference between VIP and KPV? VIP: a blood-vessel and immune signal studied in lung disease; nasal CIRS benefits remain unproven. KPV: an alpha-MSH fragment studied for gut inflammation in animals, with no human dosing trial. Why people pair them: a forum user reports overlapping low-dose VIP while finishing KPV. No human combination trial was found.
• Can I take it with KPV? A forum user reports overlapping low-dose VIP while finishing KPV. No human combination trial was found. Adds another unapproved exposure; no validated timing or interaction data. Source: reported by users. Ask a doctor before combining anything.
• Is it banned in sport? It is unclear (WADA 2026). VIP is not named. S0 concerns substances lacking any governmental human-use approval; licensed VIP combinations complicate that inference. No VIP-specific ruling was found.
• How long does a mixed vial last? Home-mixed VIP has no verified stability or sterility period. The 2017 study’s refrigerated 60-day limit applied to its specific nasal formulation.