Sermorelin: research

An experimental short-acting peptide that triggers growth hormone release, with limited evidence of adult benefits.

Also called: Sermorelin acetate, Geref, GHRH(1-29)-NH2, GRF(1-29)-NH2, Groliberin.

GHRH analogues · Growth hormone-releasing hormone receptor agonist.

35 human reports include two spontaneous safety reports, excluding a duplicate substudy and two registry records. The full count and participant overlap remain uncertain.

Studies

Geref: daily pediatric treatment. open-label, n=110, Previously untreated, prepubertal children with GH deficiency. Growth speed rose in some children with GH deficiency; this does not establish adult wellness benefits. (source)
Children: 30 or 60 mcg/kg/day. rct, n=60, Children with hypothalamic GH deficiency. Doubling the GHRH infusion dose did not improve growth. (source)
Children: three daily injections. rct, n=43, Prepubertal children with hypothalamic GH deficiency. Split-dose GHRH promoted growth, but the findings apply to GH-deficient children. (source)
IV and nasal dose finding. pk-study, n=30, Healthy men aged 19–43. Nasal delivery required far higher doses and had low absorption. (source)
Nasal treatment lost effect. single-arm, n=8, Short, prepubertal children with GH deficiency. This nasal formulation did not sustain growth benefits. (source)
Six-month infusion: fading GH response. single-arm, n=6, Children with partial GH deficiency. The hormone response weakened during prolonged infusion. (source)
Short stature: 20 mcg/kg twice daily. single-arm, n=18, Prepubertal children with idiopathic short stature. Growth increased during treatment, with catch-down growth after stopping. (source)
One-year continuous infusion. single-arm, n=8, Prepubertal children with partial GH insufficiency. Some children grew faster during infusion; growth returned to baseline after stopping. (source)
Three-week infusion dose finding. single-arm, n=6, Short children with low 24-hour GH secretion. A higher infusion dose increased hormone responses in a very small group. (source)
Early pediatric twice-daily treatment. single-arm, n=18, Prepubertal children with GH deficiency. Some children responded, while several grew more slowly than on prior GH therapy. (source)
Children: once versus twice daily. open-label, n=9, Boys with short stature and partial GH deficiency. This small dosing comparison did not show a significant overall height-growth change. (source)
Short stature: 5 mcg/kg nightly. single-arm, n=11, Short children with normal GH stimulation tests. Growth increased in this small study without a clear rise in IGF-I. (source)
Low-dose GHRH versus later GH. single-arm, n=7, Children with hypothalamic GH deficiency. Low-dose GHRH was less effective than the subsequent GH regimen. (source)
Short stature: two-year follow-up. single-arm, n=7, Children with marked idiopathic short stature and normal GH. Some children continued growing well, but poor responders were removed. (source)
Growth after stopping nightly treatment. single-arm, n=24, 16 children with idiopathic short stature; 8 with GH neurosecretory dysfunction. There was no sustained group-wide growth increase after treatment stopped. (source)
Children with kidney failure. single-arm, n=9, Children with chronic kidney failure, dialysis or kidney transplant. Growth responses varied and kidney safety remains uncertain. (source)
Children after cranial radiation. single-arm, n=9, Children with radiation-induced GH deficiency. Growth improved, but less than during the following year on GH. (source)
Older men: 0.5 or 1 mg twice daily. open-label, n=19, 10 older men, mean 68 years; 9 young men as baseline comparators. The higher twice-daily dose raised hormone levels; long-term functional benefit was not tested. (source)
Older men: 2 mg nightly. single-arm, n=11, Healthy non-obese men aged 64–76 with low IGF-I. A higher GH pulse did not produce measurable body-composition change. (source)
Older adults: sleep preliminary results. rct, n=75, Healthy older men and women; preliminary report within a review. These preliminary controlled results did not show better sleep. (source)
Six-month cognition study. rct, n=89, Healthy older adults, mean age 68 years. Some thinking tests improved; prevention of dementia was not demonstrated. (source)
HIV fat changes: 1 mg twice daily. rct, n=31, Men aged 18–60 with HIV-associated lipodystrophy. Small changes in lean and trunk fat occurred; visceral-fat reduction was not statistically clear. (source)
HIV trial: bone turnover substudy. rct, n=31, Same cohort as the 2004 HIV trial. Bone-turnover markers rose; stronger bones were not demonstrated. (source)
IV: 1, 10 or 100 mcg. crossover-rct, n=10, Adult male volunteers; median weight 68 kg. The larger bolus prolonged GH release more than it increased the peak. (source)
IV clearance and analogue comparison. pk-study, n=10, Healthy men. The modified analogue lasted longer; it cannot be treated as sermorelin. (source)
Acute GHRP-2 pairing. crossover-rct, n=8, Healthy non-obese men aged 25–34. The combination raised GH more than either alone, but synergy was not demonstrated. (source)
Children: acute GHRP-2 pairing. crossover-rct, n=15, 10 children with GH insufficiency and 5 with idiopathic short stature. The hormone response depended strongly on the underlying GH disorder. (source)
Early fragment comparison. open-label, n=5, Healthy adult volunteers. The shorter 29-amino-acid fragment retained GH-releasing activity. (source)
IV: 0.015–0.5 mcg/kg. pk-study, n=5, Healthy men. Both peptides stimulated GH, but they had different potencies. (source)
Nasal: single 100 mcg/kg dose. single-arm, n=5, Healthy prepubertal children with short stature. A large nasal dose stimulated GH but does not establish a chronic nasal protocol. (source)
Acute comparison with GHRH1-40. open-label, n=20, Short prepubertal children with pulsatile GH secretion. Both forms produced similar GH peaks. (source)
Single-dose short-term memory test. open-label, n=23, Healthy young adults. An acute word-recall signal does not establish long-term cognitive benefit. (source)
Clinician series: three secretagogues. cohort, n=14, Hypogonadal men on testosterone, selected from 105 records. IGF-I increased, but effects of sermorelin alone cannot be separated. (source)
Long-term mixed GH use: swallowing trouble. case-report, n=1, 62-year-old man with remote neck injury and years of GH-axis drug use. New swallowing trouble during long-term GH-axis use deserves assessment. (source)
Tumor-cell growth signal. in-vitro, Human bronchial neuroendocrine tumor cells NCI-H727. A cell-growth signal supports caution in active cancer, without proving clinical cancer causation. (source)
Elderly pulse study: terminated. single-arm, n=13, Older adults. This registry does not establish an effective or safe dosing schedule. (source)
Heart-failure study: missing results. crossover-rct, n=3, Adults with congestive heart failure. This registry does not establish an effective or safe dosing schedule. (source)
FDA report: elbow pain on a blend. case-report, n=1, 46-year-old man using a compounded ipamorelin/sermorelin blend. A blend safety report cannot establish which ingredient caused the symptom. (source)
2025 serious allergy safety report. case-report, n=1, Adult in an openFDA spontaneous adverse-event report. Serious allergy has been reported; spontaneous reports cannot measure its frequency. (source)

Sermorelin dosage

Typical reported dose: Historical pediatric label: 30 mcg per kg at bedtime

Historical Geref pediatric label: A dosage of 0.03 mg (30 mcg) per kg of body weight once daily at bedtime by subcutaneous injection is recommended. once daily, under the skin. Drug label. Studied in: Prepubertal children with growth failure from idiopathic GH deficiency and adequate Geref stimulation response; historical exclusion: peak GH < 2 ng/mL. (source)
Specialist GH stimulation test: 1 mcg/kg IV once, with arginine under a specialist testing protocol. single supervised diagnostic dose, into a vein. Clinician-published. Studied in: Adults being assessed for GH deficiency. (source)
Geref study: 30 mcg/kg nightly: 30 mcg/kg SC at bedtime once daily, under the skin. Studied in a trial. Studied in: Previously untreated, prepubertal children with GH deficiency. (source)
Older men: 0.5 mg twice daily: 0.5 mg SC per injection twice daily, under the skin. Studied in a trial. Studied in: 10 older men, mean 68 years; 9 young men as baseline comparators. (source)
Older men: 1 mg twice daily: 1 mg SC per injection twice daily, under the skin. Studied in a trial. Studied in: 10 older men, mean 68 years; 9 young men as baseline comparators. (source)
Older men: 2 mg nightly: 2 mg SC nightly once daily, under the skin. Studied in a trial. Studied in: Healthy non-obese men aged 64–76 with low IGF-I. (source)

Highest studied: 2 mg SC nightly studied for 6 weeks in 11 older men; not a safety ceiling.; 1 mg SC twice daily studied for 12 weeks in HIV lipodystrophy..

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

Sermorelin side effects and risks

Reported side effects

Injection-site pain, redness or swelling: Historical US label: about 1 in 6; 3/350 stopped because of injection reactions., mild. Rotate injection sites; persistent or spreading redness needs assessment. (source)
Low thyroid function: Historical pediatric label: 6.5%; this is not an established adult rate., moderate. Check thyroid tests before use and during follow-up. (source)
Headache, flushing, dizziness or hives: Historical SC label: each <1%. Acute IV flushing also reported; route specific rates differ., mild (source)
Anti-GHRH antibodies: Continuous infusion trial: 19/20 at 30 mcg/kg/day and 20/20 at 60 mcg/kg/day., moderate. Clinical meaning and relevance to current compounded adult regimens are uncertain. (source)
Nasal burning, sneezing or runny nose: Most children in an 8 child chronic nasal study reported local reactions; exact counts absent., mild (source)
Blood sugar increase: Glucose and insulin rose in one pediatric study; the small HIV trial found no significant glucose change., moderate. Monitor glucose, especially with diabetes or glucose-lowering drugs. (source)
Fluid retention, joint pain or tingling: One FDA blend report described elbow pain. No edema or joint pain occurred in the small HIV trial; adult incidence remains unknown., moderate. Review new swelling, numb hands or joint pain; check for other causes. (source)
Serious allergic reaction: A 2025 spontaneous report named anaphylactic shock and hospitalization; causation and incidence cannot be established., serious. Stop and get emergency help for breathing trouble or facial swelling. (source)
Sleep disruption: Forum reports include early waking. A preliminary trial found a small worsening in the average sleep score., moderate (source)

Stop and get help if

Breathing trouble, throat swelling or widespread hives: Stop and get emergency help now.
Chest pain, fainting or severe shortness of breath: Get emergency care now.
New severe headache, vision loss or confusion: Stop and seek urgent medical assessment.
Fever with spreading redness, pus or worsening pain at an injection site: Get urgent care for possible infection.
Extreme thirst or urination with vomiting, deep breathing or confusion: Get urgent care for possible severe high blood sugar.
Persistent or worsening difficulty swallowing: Seek prompt assessment; choking or trouble breathing needs emergency care.

Who should avoid it

pregnant: No adequate pregnancy safety evidence; the Irish diagnostic label contraindicated pregnancy.
breastfeeding: Milk transfer and infant effects are unknown; the Irish label contraindicated breastfeeding.
tryingToConceive: Early-pregnancy and fertility safety are not established. Avoid while trying to conceive.
under18: Historical pediatric GH-deficiency treatment was a separate specialist indication.
activeCancer: GH and IGF-I can support cell growth. Avoid in active cancer; this is a GH-axis precaution, not proof sermorelin causes cancer.
cancerHistory: Review prior cancer and pituitary tumors with the treating specialist; long-term adult sermorelin safety is uncertain.
other: Known allergy to sermorelin or its excipients was a label contraindication.
other: Do not add GH stimulation when GH or IGF-I is already abnormally high; evaluate the cause first.
other: A pituitary or intracranial lesion needs specialist assessment; the historical therapeutic label did not recommend use in this group.
other: Untreated low thyroid function can alter response; check and address it before use.
diabetes: GH signaling can change glucose control. Small studies in people without diabetes do not establish safety in diabetes.
diabeticRetinopathy: A GH-axis precaution based on GH guidance; direct sermorelin safety data in diabetic retinopathy are lacking.
kidneyDisease: No established adult dose adjustment or safety data. Kidney disease can also complicate interpretation of fluid retention.
liverDisease: Adult dose adjustment is unknown; liver disease can change IGF-I levels and fluid balance.
heartCondition: New fluid retention or shortness of breath needs review. The tiny heart-failure registry has no usable outcomes.
sleepApnea: Review untreated sleep apnea and new snoring; better sleep from sermorelin has not been established.
seizureDisorder: The historical Irish diagnostic label called for particular caution in epilepsy.
testedAthlete: WADA prohibits sermorelin at all times under S2.2.4.

Interactions

Glucocorticoids: Can blunt the GH response. Never stop prescribed steroids to improve a peptide response.
Somatostatin analogues: These suppress GH release and can reduce the response or change diagnostic test results.
Insulin and sulfonylureas: GH-axis stimulation can worsen glucose control; diabetes drugs may need review. Direct sermorelin interaction trials are lacking.
Other GH-releasing drugs: Stacking can amplify GH/IGF-I exposure. Long-term combination benefits and harms are not established.
Growth hormone or IGF-I: Adds overlapping GH/IGF-I effects and complicates safety monitoring.
Oral estrogen or anti-estrogens: Oral estrogen or anti-estrogen therapy can change the IGF-I response. This does not justify increasing the peptide dose.
Anticoagulants: Anticoagulants increase bleeding and bruising risk around injections. No specific sermorelin drug-level interaction is established.
Drugs affecting diagnostic GH release: These may alter a GHRH test response. A testing clinician should review medicines; do not stop them yourself.

Product quality risks

FDA documented a recall of a sermorelin/ipamorelin injectable for lack of sterility assurance.
European seized injectables included sermorelin and products with no active ingredient; this was not a prevalence survey of sermorelin vials.
Research-use labeling does not establish human drug quality or approval. Compounded drugs also lack FDA premarket approval.

How Sermorelin works

It copies the first 29 amino acids of a brain hormone called GHRH. It tells the pituitary to release growth hormone, which can raise IGF-I. A working pituitary is needed; a higher hormone level does not guarantee better health.

GHRH receptor: Triggers growth hormone release from pituitary cells.
GH–IGF-I pathway: Released GH can increase IGF-I production and growth signals in other tissues.

Half-life: Short and method-dependent: 4.3 ± 1.4 minutes after IV infusion; an old Irish diagnostic label reports 6–7 minutes IV.

Gaps: No large long-term trial establishes healthy-adult muscle, recovery, sleep or longevity benefits. Complete human-study count is unknown; 35 detailed human reports include two spontaneous safety reports. Some historical cohorts may overlap. Historical US label PDF was not recovered. Its reproduced schedule matches the pediatric trial and review; the draft still needs archival label review. The common 200–500 mcg wellness range has not been established by a dedicated adult dose-finding trial. No validated universal adult titration, five-on/two-off cycle or optimal washout period was found. No controlled chronic SC trial of sermorelin plus ipamorelin or BPC-157 was found. Cancer, cardiovascular and metabolic risks after years of adult use are not quantified. Reliable sublingual absorption and efficacy trials, and universal mixed-vial stability data, were not found. Some historical papers lack accessible full dosing and adverse-event tables. Related studies and duplicate cohorts are identified in notes. No representative independent survey of the purity, dose accuracy or sterility of current online sermorelin vials was found. No sermorelin-specific PCAC listing vote was found. The 2024 ipamorelin review mentions sermorelin blends but does not approve them.

Related to Sermorelin

CJC-1295 without DAC: A peptide intended to trigger growth hormone release, with no human dosing study found.
Tesamorelin: A peptide approved for deep abdominal fat in adults with HIV lipodystrophy.
CJC-1295 with DAC: An experimental long-acting peptide that triggers growth hormone release, with no proven muscle or recovery benefit.
Tirzepatide: A weekly GIP/GLP-1 injection with strong diabetes and weight-loss evidence and common stomach side effects.
BPC-157: An experimental repair peptide with mostly animal evidence and a few small human reports.
Ipamorelin: An experimental peptide that triggers growth hormone release.

Sermorelin: the short version

Sources

503B Bulk Drug Substances List, FDA · FDA · 2026
Bulk Drug Substances Nominated for Use in Compounding Under Section 503A of the Federal Food, Drug, and Cosmetic Act, FDA · FDA · 2026
Bulk Drug Substances Used in Compounding Under Section 503A of the FD&C Act, FDA · FDA · 2026
Compounding and the FDA: Questions and Answers, FDA · FDA · 2026
Search Results - (emc), 2026
The 2026 Prohibited List, World Anti-Doping Agency · WADA · 2026
Therapeutic Goods (Poisons Standard—October 2026) Instrument 2026, Australian Government · Australian Government · 2026
Bulk Drug Substances Nominated for Use in Compounding Under Section 503B of the Federal Food, Drug, and Cosmetic Act, FDA · FDA · 2025
Unauthorized injectable peptide drugs seized and sold by Canada Peptide may pose serious health risks, 2025
October 29, 2024 Meeting of the Pharmacy Compounding Advisory Committee, FDA · 2024
Xcel Research LLC - 694608 - 12/10/2024, 2024
Innoveix Pharmaceuticals Inc - 624782 - 01/26/2022, 2022
Determination That GEREF (Sermorelin Acetate) Injection, 0.5 Milligrams Base/Vial and 1.0 Milligrams Base/Vial, and GEREF (Sermorelin Acetate) Injection, 0.05 Milligrams Base/Amp, Were Not Withdrawn From Sale for Reasons of Safety or Effectiveness, 2013
Evaluation and treatment of adult growth hormone deficiency: an Endocrine Society clinical practice guideline., Molitch ME et al. · The Journal of clinical endocrinology and metabolism · 2011
Geref (Seristim), 2005

Sources checked: 2026-10-18.

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