Short answer: They raise growth hormone through different receptors. Ipamorelin mimics ghrelin at the growth hormone secretagogue receptor;1 sermorelin is the first 29 amino acids of GHRH and acts on the GHRH receptor. Sermorelin was FDA approved as Geref, then discontinued, not for safety reasons.2 Ipamorelin has never been approved. Both are short-acting.
| Ipamorelin | Sermorelin | |
|---|---|---|
| Mechanism | Ghrelin receptor (GHS-R) agonist; selective GH release in animal studies1 | GHRH analog (GHRH 1-29); acts on the GHRH receptor |
| Approval status | Never FDA approved | Approved as Geref (diagnostic 1990; pediatric GH deficiency 1997); discontinued 2008; FDA found it was not withdrawn for safety or effectiveness2 |
| Dosing in studies | Phase 2 postoperative ileus trial: 0.03 mg/kg IV twice daily3 | Former Geref label dosing not confirmed in an available source, so not shown |
| Half-life | about 2 hours (IV, healthy volunteers)4 | About 4 minutes after IV injection;5 no confirmed value under the skin |
| Time to peak (Tmax) | GH peak about 0.67 hours after IV dosing4 | Not confirmed for injection under the skin |
| Dosing frequency | Twice daily in the ileus trial (IV) | Not shown (label text not confirmed) |
| Typical vial sizes | 2, 5 or 10 mg powder | 2, 6 or 9 mg powder |
| Notable warnings | No label. Prohibited in sport (WADA) | No current label. Prohibited in sport (WADA) |
Growth hormone is controlled by two signals: GHRH, which tells the pituitary to release it, and ghrelin, which amplifies that release through a separate receptor. Sermorelin copies GHRH. Ipamorelin copies ghrelin's effect, and in the original animal work it was described as the first selective growth hormone secretagogue.1 Because they work on different receptors, they are often discussed together.