[ { "slug": "5-amino-1mq", "name": "5-Amino-1MQ", "aliases": "5-amino-1-methylquinolinium; 5-Amino 1MQ; longevity peptide; anti-ageing peptide; nootropic peptide", "class": "Small-molecule NNMT inhibitor", "body_system": "Gut and weight", "families": "Longevity and brain peptides", "uses": "fat loss; weight loss", "route": "Oral", "evidence_grade": "C", "grade_meaning": "Animal and cell studies", "human_studies_cited": 0, "animal_or_cell_studies_cited": 2, "fda_status": "Not approved", "fda_as_of": "2026-10-26", "fda_statement": "5-Amino-1MQ is not approved by the FDA for any use. It is sold online as a research chemical and by some wellness clinics as a metabolism or fat-loss supplement; no new drug application has been filed for it.", "sold_for": "5-Amino-1MQ is sold as an oral fat-loss and muscle-preserving compound that blocks the NNMT enzyme, with claims that it raises NAD+ and shrinks fat cells without affecting appetite.", "studies_say": "Two mouse studies show reduced fat mass and better glucose handling in diet-induced obese animals, but no human data exist, so the fat-loss claim rests entirely on preclinical work (grade C).", "grade_reasoning": "The evidence for fat loss comes from two mouse studies and cultured fat cells; no human trial of 5-Amino-1MQ has been published, so the largest human sample is zero. The remaining citations are human trials of different NAD+ precursors (NR and NMN) that showed no metabolic benefit, which says nothing direct about this compound.", "citations": "https://doi.org/10.1016/j.bcp.2017.11.007 | https://doi.org/10.1038/s41598-021-03670-5 | https://pubmed.ncbi.nlm.nih.gov/29155147/ | https://pubmed.ncbi.nlm.nih.gov/39161060/ | https://www.accessdata.fda.gov/scripts/cder/daf/index.cfm?event=overview.process&ApplNo=213051 | https://www.accessdata.fda.gov/scripts/cder/daf/index.cfm?event=overview.process&ApplNo=215866 | https://pubmed.ncbi.nlm.nih.gov/39531138/ | https://pubmed.ncbi.nlm.nih.gov/29992272/ | https://pubmed.ncbi.nlm.nih.gov/35338115/", "page": "https://peptidegraded.com/p/5-amino-1mq/" }, { "slug": "abaloparatide", "name": "Abaloparatide", "aliases": "Tymlos; BA058; PTHrP(1-34) analog; Eladynos", "class": "PTHrP analog", "body_system": "Muscle and bone", "families": "", "uses": "bone density", "route": "Injection", "evidence_grade": "A", "grade_meaning": "Strong human evidence", "human_studies_cited": 2, "animal_or_cell_studies_cited": 0, "fda_status": "FDA approved", "fda_as_of": "2026-10-26", "fda_statement": "Abaloparatide is FDA-approved and sold as Tymlos, a once-daily subcutaneous injection. It was approved in April 2017 for postmenopausal women with osteoporosis at high risk of fracture and in December 2022 to increase bone density in men with osteoporosis at high risk of fracture.", "sold_for": "Abaloparatide is a prescription bone-building drug, and online discussion of it centres on whether it builds bone faster than teriparatide with less hypercalcemia.", "studies_say": "A large randomized trial showed fewer new spine and non-spine fractures over 18 months compared with placebo, which meets the bar for grade A for postmenopausal osteoporosis.", "grade_reasoning": "Approval for osteoporosis rests on ACTIVE, a randomized, double-blind, placebo- and active-controlled phase 3 trial in 2,463 postmenopausal women with fracture endpoints, plus the ATOM trial in 228 men with a bone-density endpoint. Fracture reduction in women was shown directly; the men's approval relies on bone density as a surrogate.", "citations": "https://www.ncbi.nlm.nih.gov/books/NBK587447/ | https://pmc.ncbi.nlm.nih.gov/articles/PMC6182596/ | https://www.ncbi.nlm.nih.gov/books/NBK499863/ | https://www.niams.nih.gov/health-topics/bone-mineral-density-tests-what-numbers-mean | https://jamanetwork.com/journals/jama/fullarticle/2544640 | https://www.accessdata.fda.gov/drugsatfda_docs/label/2024/208743Orig1s015lbl.pdf | https://www.tymlos.com/ | http://sciencedirect.com/science/article/abs/pii/S0006295219302126", "page": "https://peptidegraded.com/p/abaloparatide/" }, { "slug": "acetyl-hexapeptide-8", "name": "Acetyl hexapeptide-8", "aliases": "Argireline; Acetyl hexapeptide-3; Argireline peptide; Ac-EEMQRR; cosmetic peptide; skincare peptide; Matrixyl", "class": "Neurotransmitter-inhibiting peptide", "body_system": "Skin", "families": "Cosmetic skin peptides", "uses": "skin and hair; anti-ageing", "route": "Topical", "evidence_grade": "B", "grade_meaning": "Some human evidence", "human_studies_cited": 5, "animal_or_cell_studies_cited": 4, "fda_status": "Cosmetic ingredient", "fda_as_of": "2026-10-26", "fda_statement": "Acetyl hexapeptide-8 (Argireline) is a cosmetic ingredient, and the FDA does not approve cosmetic ingredients before sale; products containing it are regulated as cosmetics so long as they claim only to improve appearance. It is not an approved drug for any use.", "sold_for": "Argireline is marketed as a needle-free alternative to Botox that relaxes expression lines when applied as a cream or serum.", "studies_say": "One small randomized trial found a measurable reduction in eye-area wrinkles and another found none, while penetration studies show almost none of the peptide reaches the muscle layer, so the evidence supports a modest surface effect at best (grade B).", "grade_reasoning": "For wrinkle reduction there is one randomized placebo-controlled trial in 60 Chinese adults showing a benefit, a 19-person split-face double-blind study showing none, a 26-patient uncontrolled series and the manufacturer's original volunteer study. Skin penetration work in human and animal skin finds very little of the peptide reaches the dermis, which leaves the mechanism in doubt. Small samples and conflicting results keep this at B.", "citations": "https://doi.org/10.1007/s40257-013-0009-9 | https://pmc.ncbi.nlm.nih.gov/articles/PMC12193160/ | https://www.fda.gov/cosmetics/cosmetics-laws-regulations/fda-authority-over-cosmetics-how-cosmetics-are-not-fda-approved-are-fda-regulated | https://www.fda.gov/cosmetics/cosmetics-laws-regulations/it-cosmetic-drug-or-both-or-it-soap | https://www.cir-safety.org/sites/default/files/acetyl122020revTR.pdf | https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=485d9b71-6881-42c5-a620-a4360c7192ab | https://pubmed.ncbi.nlm.nih.gov/23417317/ | https://pubmed.ncbi.nlm.nih.gov/38024099/ | https://pubmed.ncbi.nlm.nih.gov/29371611/ | https://pubmed.ncbi.nlm.nih.gov/24754410/ | https://pubmed.ncbi.nlm.nih.gov/40673537/ | https://pubmed.ncbi.nlm.nih.gov/18498523/ | https://pubmed.ncbi.nlm.nih.gov/33482052/ | https://pubmed.ncbi.nlm.nih.gov/33151254/ | https://pubmed.ncbi.nlm.nih.gov/35950860/ | https://pubmed.ncbi.nlm.nih.gov/18492182/ | https://pubmed.ncbi.nlm.nih.gov/25497319/", "page": "https://peptidegraded.com/p/acetyl-hexapeptide-8/" }, { "slug": "acetyl-octapeptide-3", "name": "Acetyl octapeptide-3", "aliases": "SNAP-8; SNAP8; Acetyl glutamyl heptapeptide-3; cosmetic peptide; skincare peptide; Matrixyl; Argireline", "class": "Neurotransmitter-inhibiting peptide", "body_system": "Skin", "families": "Cosmetic skin peptides", "uses": "skin and hair", "route": "Topical", "evidence_grade": "C", "grade_meaning": "Animal and cell studies", "human_studies_cited": 1, "animal_or_cell_studies_cited": 0, "fda_status": "Cosmetic ingredient", "fda_as_of": "2026-10-26", "fda_statement": "Acetyl octapeptide-3 (SNAP-8) is a cosmetic ingredient. The FDA does not approve cosmetic ingredients before sale and regulates products containing it as cosmetics provided they claim only to improve appearance; it is not an approved drug for any use.", "sold_for": "SNAP-8 is sold as a longer, stronger version of Argireline that relaxes expression lines around the eyes and forehead when applied topically.", "studies_say": "The mechanism is borrowed from Argireline and the clinical support is one 24-person study of a microneedle patch that mixed SNAP-8 with other actives, which is too little to say SNAP-8 itself reduces wrinkles (grade C).", "grade_reasoning": "The only peer-reviewed human study found that tests a product containing SNAP-8 is a 2024 split-face study in 24 people, in which a microneedle patch carrying SNAP-8 together with other actives was compared with a plain hyaluronic acid patch for 28 days. SNAP-8 has not been tested on its own against placebo, and the claim that it beats Argireline comes from the manufacturer. That is grade C.", "citations": "https://doi.org/10.1007/s40257-013-0009-9 | https://www.fda.gov/cosmetics/cosmetics-laws-regulations/fda-authority-over-cosmetics-how-cosmetics-are-not-fda-approved-are-fda-regulated | https://www.fda.gov/cosmetics/cosmetics-laws-regulations/it-cosmetic-drug-or-both-or-it-soap | https://pubmed.ncbi.nlm.nih.gov/39082657/", "page": "https://peptidegraded.com/p/acetyl-octapeptide-3/" }, { "slug": "acetyl-tetrapeptide-5", "name": "Acetyl tetrapeptide-5", "aliases": "Eyeseryl; cosmetic peptide; skincare peptide; Matrixyl; Argireline", "class": "Signal peptide", "body_system": "Skin", "families": "Cosmetic skin peptides", "uses": "skin and hair", "route": "Topical", "evidence_grade": "D", "grade_meaning": "No meaningful data", "human_studies_cited": 0, "animal_or_cell_studies_cited": 0, "fda_status": "Cosmetic ingredient", "fda_as_of": "2026-10-26", "fda_statement": "Acetyl tetrapeptide-5 (Eyeseryl) is a cosmetic ingredient. The FDA does not approve cosmetic ingredients before sale and regulates eye creams containing it as cosmetics as long as they claim only to improve appearance; it is not an approved drug for any use.", "sold_for": "Eyeseryl is sold as an eye-cream peptide that reduces under-eye bags and puffiness by draining fluid and blocking glycation.", "studies_say": "There is no published, peer-reviewed evidence for any effect; the supporting data are the manufacturer's own tests (grade D).", "grade_reasoning": "The claims for reducing under-eye puffiness come from the manufacturer's product documentation and ingredient databases that repeat it. No peer-reviewed human trial, animal study or cell study of acetyl tetrapeptide-5 could be found, so the largest human sample is zero.", "citations": "https://www.lubrizol.com/Personal-Care/Products/Product-Finder/Products-Data/Eyeseryl-peptide-solution-G | https://incidecoder.com/ingredients/acetyl-tetrapeptide-5 | https://www.fda.gov/cosmetics/cosmetics-laws-regulations/fda-authority-over-cosmetics-how-cosmetics-are-not-fda-approved-are-fda-regulated | https://www.fda.gov/cosmetics/cosmetics-laws-regulations/it-cosmetic-drug-or-both-or-it-soap", "page": "https://peptidegraded.com/p/acetyl-tetrapeptide-5/" }, { "slug": "afamelanotide", "name": "Afamelanotide", "aliases": "Scenesse; Melanotan I; Melanotan 1; MT-1; MT-I; CUV1647; NDP-alpha-MSH; [Nle4-D-Phe7]-alpha-MSH; melanotan; tanning peptide; barbie peptide", "class": "MC1R agonist", "body_system": "Skin", "families": "Tanning and libido peptides", "uses": "skin and hair; rare disease; tanning", "route": "Implant", "evidence_grade": "A", "grade_meaning": "Strong human evidence", "human_studies_cited": 3, "animal_or_cell_studies_cited": 0, "fda_status": "FDA approved", "fda_as_of": "2026-10-26", "fda_statement": "Afamelanotide is FDA-approved and sold as Scenesse, a subcutaneous implant, approved in October 2019 to increase pain-free light exposure in adults with a history of phototoxic reactions from erythropoietic protoporphyria (EPP). The European Medicines Agency authorised it for the same disease in 2014.", "sold_for": "Afamelanotide is best known as the first drug for EPP, a rare disease in which sunlight causes burning pain, and in its earlier life as a candidate 'sunless tan' because it darkens skin.", "studies_say": "Randomized trials show it lengthens the time EPP patients can spend in sunlight without pain, which earns grade A for that indication; there are no trials supporting cosmetic tanning.", "grade_reasoning": "Two randomized, double-blind, placebo-controlled trials in 168 adults with EPP (94 in the United States, 74 in the European Union) showed more pain-free hours in sunlight, and a 117-patient post-authorisation cohort followed for about two years confirmed the effect in routine practice. Consensus guidelines recommend it for preventing phototoxic symptoms. The evidence is strong for EPP and nonexistent for the tanning use the compound is also known for.", "citations": "https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/210797s000lbl.pdf | https://www.mcgill.ca/oss/article/medical-critical-thinking-student-contributors-pseudoscience/barbie-drug-your-dermatologist-has-never-heard | https://www.ema.europa.eu/en/medicines/human/EPAR/scenesse | https://www.biospace.com/fda-approves-first-treatment-to-increase-pain-free-light-exposure-in-patients-with-a-rare-disorder | https://pubmed.ncbi.nlm.nih.gov/26132941/ | https://pubmed.ncbi.nlm.nih.gov/32186677/ | https://pubmed.ncbi.nlm.nih.gov/36041558/ | https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=94f53286-11dd-7fbb-e053-2a95a90a7c48 | https://doi.org/10.1056/NEJMoa1411481", "page": "https://peptidegraded.com/p/afamelanotide/" }, { "slug": "albiglutide", "name": "Albiglutide", "aliases": "Tanzeum; Eperzan; GSK716155; GLP-1; GLP1; GLP-1 agonist; weight loss shot", "class": "GLP-1 receptor agonist", "body_system": "Hormones", "families": "GLP-1 drugs and successors", "uses": "blood sugar; heart and vessels", "route": "Injection", "evidence_grade": "A", "grade_meaning": "Strong human evidence", "human_studies_cited": 2, "animal_or_cell_studies_cited": 0, "fda_status": "FDA approved", "fda_as_of": "2026-10-26", "fda_statement": "Albiglutide was FDA-approved in April 2014 as Tanzeum, a once-weekly injection for adults with type 2 diabetes. GlaxoSmithKline withdrew it from the market in 2018 for commercial reasons, not safety, so the approval exists but no product is sold.", "sold_for": "Albiglutide is talked about mainly as the GLP-1 drug that proved cardiovascular benefit and was then pulled from the market anyway.", "studies_say": "Large randomized trials showed it lowered blood glucose and cut major cardiovascular events by about a fifth in people with type 2 diabetes and heart disease, which is grade A evidence for a drug nobody can buy.", "grade_reasoning": "Approval for type 2 diabetes rested on the HARMONY phase 3 programme of randomized trials, and the HARMONY OUTCOMES trial later randomized 9,463 patients with diabetes and cardiovascular disease, showing fewer major cardiovascular events than placebo. Those are large randomized trials with hard endpoints, which is grade A for glucose control and cardiovascular risk reduction.", "citations": "https://pmc.ncbi.nlm.nih.gov/articles/PMC4665069/ | https://doi.org/10.1016/S0140-6736(18)32261-X | https://www.drugs.com/tanzeum.html", "page": "https://peptidegraded.com/p/albiglutide/" }, { "slug": "amycretin", "name": "Amycretin", "aliases": "Zenagamtide; NN9487; NNC0487-0111; GLP-1; GLP1; GLP-1 agonist; weight loss shot", "class": "Amylin + GLP-1 co-agonist", "body_system": "Gut and weight", "families": "GLP-1 drugs and successors", "uses": "weight loss; blood sugar", "route": "Several routes", "evidence_grade": "B", "grade_meaning": "Some human evidence", "human_studies_cited": 3, "animal_or_cell_studies_cited": 0, "fda_status": "In clinical trials", "fda_as_of": "2026-10-26", "fda_statement": "Amycretin (international nonproprietary name zenagamtide) is an investigational drug from Novo Nordisk and is not approved by the FDA or any other regulator. It entered phase 3 trials for weight management in 2026.", "sold_for": "Amycretin is talked about as Novo Nordisk's next step after semaglutide and CagriSema: one molecule that hits both the GLP-1 and amylin receptors, available as a pill or a weekly injection.", "studies_say": "Early randomized trials show large, dose-dependent weight loss over up to 36 weeks with the usual gastrointestinal side effects, but the trials were small and many participants dropped out, so the evidence is grade B pending phase 3.", "grade_reasoning": "The published human data are a first-in-human phase 1 trial of the oral tablet in 144 people, a 125-participant phase 1b/2a trial of the weekly injection, and a 186-participant phase 2 trial of the oral form in type 2 diabetes published in 2026, all randomized and placebo-controlled. In the obesity trials weight change was a secondary or exploratory endpoint and dropout was high, so the weight-loss use is grade B until the phase 3 programme reports.", "citations": "https://doi.org/10.1016/S0140-6736(26)01247-X | https://www.ncbi.nlm.nih.gov/books/NBK551568/ | https://doi.org/10.1016/S0140-6736(25)01185-7 | https://clinicaltrials.gov/study/NCT07339423 | https://doi.org/10.1016/S0140-6736(25)01176-6", "page": "https://peptidegraded.com/p/amycretin/" }, { "slug": "angiotensin-ii", "name": "Angiotensin II", "aliases": "Giapreza; Angiotensin 2; Ang II; LJPC-501", "class": "Vasopressor peptide", "body_system": "Circulation", "families": "", "uses": "other", "route": "Intravenous", "evidence_grade": "A", "grade_meaning": "Strong human evidence", "human_studies_cited": 1, "animal_or_cell_studies_cited": 0, "fda_status": "FDA approved", "fda_as_of": "2026-10-26", "fda_statement": "Synthetic human angiotensin II is FDA-approved and sold as Giapreza, approved in December 2017 as an intravenous infusion to raise blood pressure in adults with septic or other distributive shock.", "sold_for": "Angiotensin II is an intensive-care drug, and discussion of it concerns whether it saves lives in septic shock when norepinephrine is not enough.", "studies_say": "A 344-patient randomized trial showed it raises blood pressure in shock patients who are not responding to other vasopressors, which earned approval, but it did not show that patients live longer.", "grade_reasoning": "Approval rests on ATHOS-3, a randomized, double-blind, placebo-controlled trial in 344 adults with vasodilatory shock that met its blood-pressure endpoint. That is one trial with a surrogate endpoint, but a regulator accepted it for approval and it is the use the drug is known for, which fits grade A as defined here; no survival benefit has been shown.", "citations": "https://www.ncbi.nlm.nih.gov/books/NBK470410/ | https://www.giapreza.com/ | https://pubmed.ncbi.nlm.nih.gov/11751697/ | https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/209360s000lbl.pdf | https://doi.org/10.1056/NEJMoa1704154", "page": "https://peptidegraded.com/p/angiotensin-ii/" }, { "slug": "aod-9604", "name": "AOD-9604", "aliases": "AOD9604; AOD 9604; HGH Fragment 176-191; Fragment 176-191; Tyr-hGH 177-191; growth hormone secretagogue; GH secretagogue; GHRP; GHRH", "class": "GH fragment (lipolytic)", "body_system": "Gut and weight", "families": "Growth hormone boosters", "uses": "fat loss; weight loss", "route": "Injection", "evidence_grade": "C", "grade_meaning": "Animal and cell studies", "human_studies_cited": 0, "animal_or_cell_studies_cited": 2, "fda_status": "Not approved", "fda_as_of": "2026-10-27", "fda_statement": "AOD-9604 is not approved by the FDA for any use and is sold online as a research chemical. The FDA placed it in category 2 of bulk substances nominated for compounding in 2023, citing possible safety risks; its nomination was later withdrawn, and in December 2024 the FDA's Pharmacy Compounding Advisory Committee voted 12-0 against adding it to the list of substances pharmacies may compound.", "sold_for": "AOD-9604 is sold as the fat-burning piece of growth hormone, promising lipolysis without the blood-sugar and growth effects of the full hormone.", "studies_say": "Mouse studies showed increased fat breakdown, but the one sizeable human obesity programme failed to show weight loss and was abandoned, so the fat-loss claim rests on animal data (grade C).", "grade_reasoning": "Fat loss is the claimed use. The supporting data are two mouse studies from around 2001 showing lipolytic effects of the growth hormone fragment. A manufacturer-run obesity trial in the mid-2000s found no significant weight loss, and it was never published in full, so no citable human trial exists; the largest published human study is zero.", "citations": "https://doi.org/10.1159/000053183 | https://doi.org/10.1038/sj.ijo.0801740 | https://pubmed.ncbi.nlm.nih.gov/23092275/ | https://pubmed.ncbi.nlm.nih.gov/25208511/ | https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=1058e17c-9261-459c-a3e6-fae38d196c14 | https://pubmed.ncbi.nlm.nih.gov/24124033/ | https://www.fda.gov/drugs/human-drug-compounding/certain-bulk-drug-substances-use-compounding-may-present-significant-safety-risks | https://www.wada-ama.org/sites/default/files/2025-09/2026list_en_final_clean_september_2025.pdf | https://www.fda.gov/media/174456/download | https://www.accessdata.fda.gov/scripts/cder/daf/index.cfm?event=overview.process&ApplNo=022505 | https://pubmed.ncbi.nlm.nih.gov/18057338/", "page": "https://peptidegraded.com/p/aod-9604/" }, { "slug": "apraglutide", "name": "Apraglutide", "aliases": "FE 203799; FE203799", "class": "GLP-2 analog", "body_system": "Gut and weight", "families": "", "uses": "gut health; rare disease", "route": "Injection", "evidence_grade": "B", "grade_meaning": "Some human evidence", "human_studies_cited": 2, "animal_or_cell_studies_cited": 0, "fda_status": "In clinical trials", "fda_as_of": "2026-10-27", "fda_statement": "Apraglutide is an investigational GLP-2 analogue developed by VectivBio and now owned by Ironwood Pharmaceuticals, and is not approved by the FDA or any other regulator. Ironwood did not file a new drug application after the phase 3 STARS trial; a second placebo-controlled phase 3 trial in short bowel syndrome with intestinal failure started in August 2026 and is recruiting, with primary completion expected in October 2028.", "sold_for": "Apraglutide is discussed as a once-weekly alternative to daily teduglutide for people with short bowel syndrome who depend on intravenous feeding.", "studies_say": "One 163-patient randomized trial showed a larger reduction in weekly intravenous nutrition volume than placebo over 24 weeks, with a clear effect in patients with a stoma and a non-significant one in those with colon in continuity (grade B).", "grade_reasoning": "The main evidence is STARS, a randomized, double-blind, placebo-controlled phase 3 trial in 163 adults with short bowel syndrome dependent on intravenous nutrition, which met its primary endpoint on a surrogate measure (volume of parenteral support); a 9-patient open-label phase 2 study adds absorption data. One phase 3 trial with a surrogate endpoint, a non-significant result in patients with colon in continuity, and no approval yet is grade B.", "citations": "https://doi.org/10.1016/j.cgh.2026.08.026 | https://doi.org/10.1016/j.clnu.2024.10.011 | https://clinicaltrials.gov/study/NCT07742735", "page": "https://peptidegraded.com/p/apraglutide/" }, { "slug": "aviptadil", "name": "Aviptadil", "aliases": "Vasoactive intestinal peptide; VIP; Zyesami; RLF-100; Invicorp; Aviptadil acetate", "class": "Vasoactive intestinal peptide", "body_system": "Immunity", "families": "", "uses": "infection; sexual function", "route": "Intravenous", "evidence_grade": "B", "grade_meaning": "Some human evidence", "human_studies_cited": 1, "animal_or_cell_studies_cited": 3, "fda_status": "In clinical trials", "fda_as_of": "2026-10-26", "fda_statement": "Aviptadil is not approved by the FDA for any use. The FDA declined requests for emergency use authorisation in critical COVID-19 in 2021 and 2022, and the investigational product has not been approved since. A combination of aviptadil with phentolamine (Invicorp) is approved in the United Kingdom and some other countries as an injection for erectile dysfunction, but not in the United States.", "sold_for": "Aviptadil drew attention in 2020 and 2021 as a proposed rescue treatment for COVID-19 respiratory failure, promoted by its sponsor as protecting the lung's surfactant-producing cells.", "studies_say": "A randomized trial of roughly 460 critically ill COVID-19 patients found no benefit on recovery or survival, so the respiratory claim is not supported despite a plausible mechanism (grade B, negative).", "grade_reasoning": "For the use it became known for, respiratory failure in COVID-19, the decisive evidence is TESICO, a randomized placebo-controlled trial of about 460 patients that was stopped for futility with no difference in recovery or 90-day mortality. A properly conducted negative randomized trial is grade B evidence against the claimed benefit; the immunology citations are reviews of the natural peptide, not studies of the drug.", "citations": "https://pubmed.ncbi.nlm.nih.gov/5450698/ | https://pmc.ncbi.nlm.nih.gov/articles/PMC10527239/ | https://pmc.ncbi.nlm.nih.gov/articles/PMC8630992 | https://pubmed.ncbi.nlm.nih.gov/12409234/ | https://pubmed.ncbi.nlm.nih.gov/21951273/ | https://pubmed.ncbi.nlm.nih.gov/22139413/ | https://thepharmaletter.com/pharmaceutical/fda-declines-eua-for-aviptadil-for-patients-with-critical-covid-19-at-immediate-risk | https://www.globenewswire.com/news-release/2020/06/24/2052448/0/en/NeuroRx-and-Relief-Therapeutics-Announce-Fast-Track-Designation-Granted-by-the-FDA-to-RLF-100-Aviptadil-for-the-Treatment-of-Respiratory-Distress-in-COVID-19.html | https://www.sec.gov/Archives/edgar/data/1719406/000155837022008948/nrxp-20220331x10q.htm | https://awttc.nhs.wales/files/appraisals-asar-far/final-recommendation-aviptadil-phentolamine-invicorp-3435/ | https://doi.org/10.1016/S2213-2600(23)00147-9", "page": "https://peptidegraded.com/p/aviptadil/" }, { "slug": "bacitracin", "name": "Bacitracin", "aliases": "Baciguent; Neosporin (component); Polysporin (component); Bacitracin zinc; Triple antibiotic ointment", "class": "Polypeptide antibiotic", "body_system": "Skin", "families": "", "uses": "infection; wound healing", "route": "Topical", "evidence_grade": "B", "grade_meaning": "Some human evidence", "human_studies_cited": 1, "animal_or_cell_studies_cited": 0, "fda_status": "FDA approved", "fda_as_of": "2026-10-26", "fda_statement": "Bacitracin is FDA-approved and sold over the counter as a topical first-aid antibiotic ointment, alone and combined with neomycin and polymyxin B, for preventing infection in minor cuts, scrapes and burns. The injectable form, once used for staphylococcal pneumonia in infants, was withdrawn at the FDA's request in 2020 because of kidney toxicity.", "sold_for": "Bacitracin is the antibiotic in the first-aid kit, applied to scrapes and surgical wounds on the assumption that it prevents infection.", "studies_say": "In a 922-patient randomized trial, wounds treated with bacitracin got infected at the same low rate as wounds treated with plain petroleum jelly, and bacitracin caused allergic reactions that petrolatum did not (grade B).", "grade_reasoning": "Bacitracin's approval predates modern trial requirements. The best modern evidence for its everyday use, preventing infection in minor wounds, is a randomized double-blind trial of 922 dermatologic surgery patients in which bacitracin was no better than plain petrolatum on overall infection rate. One large trial with a null primary result for the popular use is grade B.", "citations": "https://go.drugbank.com/drugs/DB00626 | https://www.statpearls.com/point-of-care/18087 | https://reference.medscape.com/drug/baciguent-bacitracin-topical-343464 | https://pubmed.ncbi.nlm.nih.gov/8805732/ | https://www.pharmacytimes.com/view/bacitracin-and-boo-boos-becoming-a-no-no", "page": "https://peptidegraded.com/p/bacitracin/" }, { "slug": "balixafortide", "name": "Balixafortide", "aliases": "POL6326; POL-6326", "class": "CXCR4 antagonist peptide", "body_system": "Circulation", "families": "", "uses": "cancer", "route": "Intravenous", "evidence_grade": "B", "grade_meaning": "Some human evidence", "human_studies_cited": 2, "animal_or_cell_studies_cited": 0, "fda_status": "In clinical trials", "fda_as_of": "2026-10-27", "fda_statement": "Balixafortide is an investigational peptide developed by Polyphor and is not approved by the FDA or any other regulator. Its phase 3 trial in breast cancer (FORTRESS) failed in 2021 and the sponsor closed the study without seeking approval. The only trial registered since then is an investigator-led phase 1 study combining it with cosibelimab in metastatic pancreatic cancer, posted in 2025 and not yet recruiting at its last update.", "sold_for": "Balixafortide was pitched as a drug that would stop breast cancer cells hiding in protective niches by blocking the CXCR4 receptor, making chemotherapy work better.", "studies_say": "An encouraging uncontrolled early trial was followed by a 432-patient randomized trial that showed no benefit when balixafortide was added to eribulin (grade B, negative).", "grade_reasoning": "A 56-patient single-arm phase 1 trial with eribulin in metastatic breast cancer suggested a higher response rate than eribulin alone, but the randomized phase 3 FORTRESS trial in 432 patients found no improvement in response rate, progression-free survival or overall survival. A negative randomized trial is grade B evidence against the claimed benefit.", "citations": "https://pubmed.ncbi.nlm.nih.gov/29706375/ | https://www.clinicaltrialsarena.com/news/polyphor-balixafortide-fails-breast-cancer-study/ | https://www.onclive.com/view/balixafortide-plus-eribulin-fails-to-improve-orr-in-advanced-her2-negative-breast-cancer | https://clinicaltrials.gov/study/NCT06981806", "page": "https://peptidegraded.com/p/balixafortide/" }, { "slug": "bivalirudin", "name": "Bivalirudin", "aliases": "Angiomax; Angiox; Hirulog; Bivalirudin trifluoroacetate", "class": "Direct thrombin inhibitor", "body_system": "Circulation", "families": "", "uses": "heart and vessels", "route": "Intravenous", "evidence_grade": "A", "grade_meaning": "Strong human evidence", "human_studies_cited": 1, "animal_or_cell_studies_cited": 0, "fda_status": "FDA approved", "fda_as_of": "2026-10-26", "fda_statement": "Bivalirudin is FDA-approved and sold as Angiomax and generics, given intravenously as an anticoagulant during percutaneous coronary intervention (angioplasty and stenting), including in patients with heparin-induced thrombocytopenia. It was first approved in December 2000.", "sold_for": "Bivalirudin is a hospital anticoagulant, and the argument around it has been whether it beats heparin during stenting by causing less bleeding without more clots.", "studies_say": "In a 3,602-patient randomized trial of heart attack patients undergoing stenting, bivalirudin reduced major bleeding and 30-day cardiac death compared with heparin plus a platelet blocker, at the cost of more stent thrombosis in the first 24 hours (grade A).", "grade_reasoning": "Approval and guideline use rest on several randomized trials in coronary intervention; the largest cited here is HORIZONS-AMI, which randomized 3,602 heart attack patients and found less major bleeding and lower cardiac mortality than heparin plus a glycoprotein IIb/IIIa inhibitor. Multiple large randomized trials with clinical endpoints is grade A.", "citations": "https://www.drugs.com/monograph/bivalirudin.html | https://link.springer.com/article/10.2165/00003495-200565130-00010 | https://doi.org/10.1056/NEJMoa0708191 | https://www.accessdata.fda.gov/scripts/cder/daf/index.cfm?event=overview.process&ApplNo=020873", "page": "https://peptidegraded.com/p/bivalirudin/" }, { "slug": "bpc-157", "name": "BPC-157", "aliases": "BPC157; BPC 157; Body Protection Compound 157; Body Protective Compound-157; Pentadecapeptide BPC 157; PL 14736; Bepecin; PL-10; healing peptide; recovery peptide; injury peptide", "class": "Synthetic pentadecapeptide (gastric-derived)", "body_system": "Gut and weight", "families": "Healing and recovery peptides", "uses": "tendon and ligament injury; gut health; wound healing", "route": "Several routes", "evidence_grade": "C", "grade_meaning": "Animal and cell studies", "human_studies_cited": 1, "animal_or_cell_studies_cited": 35, "fda_status": "Not approved", "fda_as_of": "2026-10-27", "fda_statement": "BPC-157 is not approved by the FDA for any use and is sold as a research chemical. The FDA put it in Category 2 of substances nominated for compounding in 2023 over safety concerns; the nominators later withdrew it, and the agency's Category 2 page now lists it as nominated but withdrawn. In July 2026 the Pharmacy Compounding Advisory Committee voted 8 to 6 to recommend adding it to the 503A bulks list, but the FDA has not proposed a rule to do so, so it still cannot be lawfully compounded.", "sold_for": "BPC-157 is sold as a healing peptide for tendons, ligaments, muscle and gut, taken by injection or orally, and is one of the most popular compounds in the grey-market peptide trade.", "studies_say": "Dozens of rat studies, nearly all from one laboratory, show faster tendon, ligament and gut healing, but the only human data are a 12-patient uncontrolled series, so nothing is established in people (grade C).", "grade_reasoning": "A 2025 systematic review found 36 studies of BPC-157 for musculoskeletal injury: 35 preclinical, almost all in rats from one Zagreb research group, and one retrospective human series of 12 patients with knee pain. No randomized or controlled human trial has been published, so the healing claims rest on animal data (grade C).", "citations": "https://doi.org/10.3390/ijms27062876 | https://doi.org/10.3390/ph18060928 | https://www.statnews.com/2026/06/01/bpc-157-researcher-predrag-sikiric-addesses-skeptics-questions/ | https://doi.org/10.1177/15563316251355551 | https://clinicaltrials.gov/study/NCT02637284 | https://www.fda.gov/drugs/human-drug-compounding/bulk-drug-substances-used-compounding-under-section-503a-fdc-act | https://www.fda.gov/drugs/human-drug-compounding/certain-bulk-drug-substances-use-compounding-may-present-significant-safety-risks | https://www.statnews.com/2026/07/24/fda-peptide-compounding-panel-backs-epitalon-rejects-emideltide/ | https://www.usada.org/spirit-of-sport/bpc-157-peptide-prohibited/ | https://doi.org/10.1007/s00441-019-03016-8 | https://pubmed.ncbi.nlm.nih.gov/14554208/ | https://clinicaltrials.gov/ | https://pubmed.ncbi.nlm.nih.gov/40756949/ | https://www.wada-ama.org/en/prohibited-list", "page": "https://peptidegraded.com/p/bpc-157/" }, { "slug": "bremelanotide", "name": "Bremelanotide", "aliases": "Vyleesi; PT-141; PT141; PT 141; Rekynda; melanotan; tanning peptide; barbie peptide", "class": "MC4R agonist", "body_system": "Nervous system", "families": "Tanning and libido peptides", "uses": "sexual function", "route": "Injection", "evidence_grade": "B", "grade_meaning": "Some human evidence", "human_studies_cited": 2, "animal_or_cell_studies_cited": 0, "fda_status": "FDA approved", "fda_as_of": "2026-10-26", "fda_statement": "Bremelanotide is FDA-approved and sold as Vyleesi, a self-administered subcutaneous autoinjector, approved in June 2019 for premenopausal women with acquired, generalised hypoactive sexual desire disorder (HSDD). It is not approved for men or for postmenopausal women.", "sold_for": "Bremelanotide is marketed as an on-demand injection for low sexual desire in women and is sold online, often as PT-141, as a libido booster for anyone.", "studies_say": "Two randomized trials in 1,267 women showed statistically significant but small improvements in questionnaire scores for desire and distress, no increase in satisfying sexual events, and nausea in about 40% of users (grade B).", "grade_reasoning": "Approval rests on the two RECONNECT phase 3 trials, which randomized 1,267 premenopausal women and met their co-primary endpoints on desire and distress questionnaires. The effect sizes were small, the number of satisfying sexual events did not increase, dropout for nausea was high, and an independent reanalysis questioned the validity of the outcome questionnaires. Approved on RCTs but with surrogate questionnaire endpoints and contested benefit is grade B.", "citations": "https://www.sciencedirect.com/topics/medicine-and-dentistry/bremelanotide | https://palatin.com/press_releases/fda-approves-new-drug-application-for-vyleesi-bremelanotide-injection-2/ | https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/210557s000lbl.pdf | https://doi.org/10.1097/AOG.0000000000003500 | https://doi.org/10.1080/00224499.2023.2175192", "page": "https://peptidegraded.com/p/bremelanotide/" }, { "slug": "brilacidin", "name": "Brilacidin", "aliases": "PMX-30063; PMX30063", "class": "Defensin-mimetic host-defense peptide", "body_system": "Gut and weight", "families": "", "uses": "infection; other", "route": "Several routes", "evidence_grade": "C", "grade_meaning": "Animal and cell studies", "human_studies_cited": 0, "animal_or_cell_studies_cited": 2, "fda_status": "In clinical trials", "fda_as_of": "2026-10-26", "fda_statement": "Brilacidin is an investigational compound from Innovation Pharmaceuticals and is not approved by the FDA for any use. It has been tested in phase 2 trials for skin infections, oral mucositis, ulcerative proctitis and COVID-19, none of which has led to a marketing application.", "sold_for": "Brilacidin is promoted as a synthetic mimic of the body's own defensin peptides that could kill drug-resistant bacteria and, during the pandemic, block SARS-CoV-2.", "studies_say": "Cell-culture studies show it disrupts viral particles and infected cells at low concentrations, but no peer-reviewed human trial has been published for any use (grade C).", "grade_reasoning": "The two citable studies are laboratory experiments showing brilacidin inhibits SARS-CoV-2 and other viruses in cell culture. The company has run phase 2 trials in skin infection and COVID-19, but those results exist only as press releases and conference material, not peer-reviewed publications, so the antiviral and antibacterial claims rest on in vitro data (grade C).", "citations": "https://doi.org/10.3390/v13020271 | https://doi.org/10.1002/jmv.27616 | https://markets.financialcontent.com/pennwell.pennenergy/article/accesswire-2021-11-11-innovation-pharmaceuticals-announces-topline-results-from-phase-2-clinical-trial-of-brilacidin-for-covid-19", "page": "https://peptidegraded.com/p/brilacidin/" }, { "slug": "cagrilintide", "name": "Cagrilintide", "aliases": "AM833; NN9838; NNC0174-0833; Cagri; GLP-1; GLP1; GLP-1 agonist; weight loss shot", "class": "Long-acting amylin analog", "body_system": "Gut and weight", "families": "GLP-1 drugs and successors", "uses": "weight loss", "route": "Injection", "evidence_grade": "B", "grade_meaning": "Some human evidence", "human_studies_cited": 5, "animal_or_cell_studies_cited": 0, "fda_status": "In clinical trials", "fda_as_of": "2026-10-27", "fda_statement": "Cagrilintide is an investigational long-acting amylin analogue from Novo Nordisk and is not approved by the FDA or any other regulator on its own. Novo Nordisk submitted its fixed-dose combination with semaglutide (CagriSema) to the FDA in December 2025, and no FDA decision had been announced by late October 2026. A standalone phase 3 trial of cagrilintide started in November 2025.", "sold_for": "Cagrilintide is talked about as the amylin half of CagriSema, Novo Nordisk's attempt to beat tirzepatide on weight loss, and as a weekly injection that could work on its own.", "studies_say": "Randomized trials show cagrilintide alone produces about 6% to 11% weight loss at 26 weeks depending on dose, and with semaglutide about 20% at 68 weeks, with mainly gastrointestinal side effects (grade B pending standalone phase 3).", "grade_reasoning": "For weight loss, cagrilintide alone has a 706-participant randomized phase 2 dose-finding trial and a 96-participant phase 1b combination trial; the 3,417-participant REDEFINE 1 phase 3 trial tested it mainly in combination with semaglutide, with a 302-person cagrilintide-alone arm. Randomized trials exist but the standalone drug has no completed phase 3 and no approval, which is grade B.", "citations": "https://doi.org/10.1016/S0140-6736(21)01751-7 | https://www.ncbi.nlm.nih.gov/books/NBK551568/ | https://doi.org/10.1056/NEJMoa2502081 | https://clinicaltrials.gov/study/NCT07220642 | https://www.fda.gov/drugs/drug-alerts-and-statements/fdas-concerns-unapproved-glp-1-drugs-used-weight-loss | https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=4aea30ff-eb0d-45c1-b114-3127966328ff | https://pubmed.ncbi.nlm.nih.gov/34798060/ | https://pubmed.ncbi.nlm.nih.gov/40544433/ | https://pubmed.ncbi.nlm.nih.gov/33567185/ | https://pubmed.ncbi.nlm.nih.gov/35658024/ | https://pubmed.ncbi.nlm.nih.gov/33894838/ | https://pubmed.ncbi.nlm.nih.gov/40550231/ | https://pubmed.ncbi.nlm.nih.gov/39279639/ | https://pubmed.ncbi.nlm.nih.gov/41207310/ | https://www.sec.gov/Archives/edgar/data/353278/000035327826000006/caq42025.htm", "page": "https://peptidegraded.com/p/cagrilintide/" }, { "slug": "cagrisema", "name": "CagriSema", "aliases": "Cagri-Sema; Cagrilintide + semaglutide; Cagrilintide/semaglutide; NN9388; GLP-1; GLP1; GLP-1 agonist; weight loss shot", "class": "Amylin + GLP-1 combination", "body_system": "Gut and weight", "families": "GLP-1 drugs and successors", "uses": "weight loss; blood sugar", "route": "Injection", "evidence_grade": "A", "grade_meaning": "Strong human evidence", "human_studies_cited": 4, "animal_or_cell_studies_cited": 0, "fda_status": "In clinical trials", "fda_as_of": "2026-10-26", "fda_statement": "CagriSema is not approved by the FDA for any use as of 2026-10-26. Novo Nordisk reported submitting it to the FDA for weight management, and the application is under review; no product name has been approved.", "sold_for": "CagriSema is talked about as the next step after semaglutide: a weekly injection combining two hormones that early company statements suggested could beat tirzepatide on weight loss.", "studies_say": "Published phase 3 trials show roughly 20% body-weight loss over 68 weeks against 3% on placebo, which earns an A for the weight-loss use, but the head-to-head trial against tirzepatide missed its primary goal.", "grade_reasoning": "Two large phase 3 randomized placebo-controlled trials support the weight-loss use: REDEFINE 1 randomized 3,417 adults with overweight or obesity and REDEFINE 2 randomized 1,206 adults with type 2 diabetes, both over 68 weeks. A thorough QT study (105 participants) and a phase 2 trial of cagrilintide alone round out the human data. What is missing is regulatory approval and long-term outcome data beyond 68 weeks.", "citations": "https://www.ncbi.nlm.nih.gov/books/NBK551568/ | https://doi.org/10.1016/S0140-6736(21)01751-7 | https://www.sec.gov/Archives/edgar/data/353278/000035327826000006/caq42025.htm | https://pubmed.ncbi.nlm.nih.gov/40544433/ | https://pubmed.ncbi.nlm.nih.gov/40544432/ | https://www.fda.gov/drugs/drug-alerts-and-statements/fdas-concerns-unapproved-glp-1-drugs-used-weight-loss | https://pubmed.ncbi.nlm.nih.gov/35658024/ | https://www.sec.gov/Archives/edgar/data/353278/000117184326000996/f6k_022326.htm | https://www.sec.gov/Archives/edgar/data/353278/000117184324007023/f6k_122024.htm | https://pubmed.ncbi.nlm.nih.gov/39279639/ | https://pubmed.ncbi.nlm.nih.gov/38937282/ | https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=ee06186f-2aa3-4990-a760-757579d8f77b", "page": "https://peptidegraded.com/p/cagrisema/" }, { "slug": "calcitonin-salmon", "name": "Calcitonin-salmon", "aliases": "Miacalcin (injection); nasal spray sold as a generic; Miacalcin; Fortical; Salmon calcitonin; Calcitonin salmon; Calcitonin; sCT; Calcimar", "class": "Calcitonin receptor agonist", "body_system": "Muscle and bone", "families": "", "uses": "bone density; pain; other", "route": "Several routes", "evidence_grade": "B", "grade_meaning": "Some human evidence", "human_studies_cited": 1, "animal_or_cell_studies_cited": 0, "fda_status": "FDA approved", "fda_as_of": "2026-10-26", "fda_statement": "Calcitonin-salmon is FDA-approved. The injection (Miacalcin) is labeled for Paget's disease of bone, hypercalcemia and postmenopausal osteoporosis; the nasal spray, now sold as a generic, is labeled only for postmenopausal osteoporosis in women more than five years past menopause when alternatives are not suitable.", "sold_for": "Calcitonin-salmon is an older bone drug, and online it is sometimes presented as a gentle alternative to bisphosphonates for osteoporosis or for bone pain after fractures.", "studies_say": "One large trial showed a vertebral-fracture reduction at a single dose level with an inconsistent dose response, regulators in Europe pulled the osteoporosis indication over a small cancer signal, and the FDA label now says fracture benefit is not established, so the evidence sits at B.", "grade_reasoning": "The osteoporosis use rests mainly on the PROOF trial, a five-year randomized placebo-controlled study of 1,255 postmenopausal women in which only the middle of three nasal doses reduced new vertebral fractures, with no clear dose response. The current injection label states that fracture-reduction efficacy has not been demonstrated, and a 21-trial meta-analysis cited on the label found more malignancies with calcitonin than placebo. That combination keeps the grade at B despite approval.", "citations": "https://www.drugs.com/monograph/calcitonin-salmon.html | https://go.drugbank.com/drugs/DB00017 | https://doi.org/10.1016/s0002-9343(00)00490-3 | https://www.ema.europa.eu/en/medicines/human/referrals/calcitonin | https://www.drugs.com/pro/miacalcin.html | https://www.drugs.com/pro/miacalcin-nasal-spray.html", "page": "https://peptidegraded.com/p/calcitonin-salmon/" }, { "slug": "carnosine", "name": "Carnosine", "aliases": "L-carnosine; Beta-alanyl-L-histidine; longevity peptide; anti-ageing peptide; nootropic peptide", "class": "Antioxidant dipeptide", "body_system": "Skin", "families": "Longevity and brain peptides", "uses": "skin and hair; anti-ageing; muscle growth", "route": "Topical", "evidence_grade": "C", "grade_meaning": "Animal and cell studies", "human_studies_cited": 1, "animal_or_cell_studies_cited": 2, "fda_status": "Cosmetic ingredient", "fda_as_of": "2026-10-27", "fda_statement": "Carnosine in skincare is a cosmetic ingredient and sits outside FDA drug approval; no carnosine product is approved by the FDA as a drug for any use.", "sold_for": "Carnosine is marketed in serums and creams as an antioxidant and anti-glycation ingredient that protects skin from sun damage and ageing.", "studies_say": "Lab models of human skin show carnosine lowers oxidative stress markers after UV exposure, but nobody has shown a visible benefit in a controlled trial on people, so the evidence is C.", "grade_reasoning": "For the skin anti-ageing use, the available data are an ex vivo study of human skin explants exposed to simulated sunlight and a 3D fibroblast spheroid model under UVA. No randomized trial on living volunteers is in the citations, so the grade is C. A 2026 randomized trial of oral carnosine in 299 adults measured exercise performance, not skin, and found mostly no effect, so it does not change the skin grade.", "citations": "https://doi.org/10.1111/php.13850 | https://www.mdpi.com/2076-3921/12/2/300 | https://pubmed.ncbi.nlm.nih.gov/42308284/", "page": "https://peptidegraded.com/p/carnosine/" }, { "slug": "cerebrolysin", "name": "Cerebrolysin", "aliases": "Cerebrolysine; FPF 1070; FPF-1070; Porcine brain peptides; longevity peptide; anti-ageing peptide; nootropic peptide", "class": "Neuropeptide preparation (porcine brain)", "body_system": "Nervous system", "families": "Longevity and brain peptides", "uses": "cognition; other", "route": "Intravenous", "evidence_grade": "B", "grade_meaning": "Some human evidence", "human_studies_cited": 9, "animal_or_cell_studies_cited": 3, "fda_status": "Not approved", "fda_as_of": "2026-10-26", "fda_statement": "Cerebrolysin is not approved by the FDA for any use. It is a licensed medicine in more than 50 other countries, mainly in Eastern Europe, Russia and Asia, for stroke, dementia and brain injury.", "sold_for": "Cerebrolysin is promoted in nootropic and longevity circles as a brain-repair injection that speeds stroke recovery, sharpens cognition and treats dementia.", "studies_say": "Randomized trials exist, which earns a B, but the largest independent synthesis found no effect on death or dependence after stroke and a rise in serious adverse events, while smaller manufacturer-backed trials found small functional gains.", "grade_reasoning": "For the stroke-recovery use there are randomized placebo-controlled trials, but they point in different directions. A Cochrane review pooled six RCTs with 1,501 participants and found no reduction in deaths and more non-fatal serious adverse events; the CARS trial (208 patients) and the two CAPTAIN trials in brain injury (185 patients pooled) reported modest functional benefits. Several trials were manufacturer-supported and had high risk of bias, so the grade stops at B.", "citations": "https://pubmed.ncbi.nlm.nih.gov/33515100/ | https://pubmed.ncbi.nlm.nih.gov/33620612/ | https://pubmed.ncbi.nlm.nih.gov/28430363/ | https://doi.org/10.1002/14651858.CD007026.pub7 | https://doi.org/10.1002/14651858.CD008900.pub3 | https://pmc.ncbi.nlm.nih.gov/articles/PMC4689177/ | https://doi.org/10.1016/j.kjms.2014.02.009 | https://doi.org/10.1007/s00401-006-0166-5 | https://doi.org/10.1007/978-3-7091-6781-6_29", "page": "https://peptidegraded.com/p/cerebrolysin/" }, { "slug": "cetrorelix", "name": "Cetrorelix", "aliases": "Cetrotide; Cetrorelix acetate; SB-75; Cetrorelix pamoate", "class": "GnRH antagonist", "body_system": "Reproduction", "families": "", "uses": "fertility", "route": "Injection", "evidence_grade": "A", "grade_meaning": "Strong human evidence", "human_studies_cited": 2, "animal_or_cell_studies_cited": 0, "fda_status": "FDA approved", "fda_as_of": "2026-10-26", "fda_statement": "Cetrorelix is FDA-approved as Cetrotide (cetrorelix acetate for injection), first approved in August 2000, for the inhibition of premature LH surges in women undergoing controlled ovarian stimulation.", "sold_for": "Cetrorelix is a routine IVF drug and carries little hype; where it appears outside fertility clinics it is discussed as a way to switch off sex-hormone production quickly.", "studies_say": "Dozens of randomized trials show GnRH antagonist protocols give the same live-birth rate as agonist protocols with fewer cases of ovarian hyperstimulation, which supports an A for the fertility use.", "grade_reasoning": "The approved IVF use rests on randomized trials of cetrorelix itself plus a Cochrane review of GnRH antagonists in assisted reproduction that pooled 73 randomized trials with 12,212 women. The review found live-birth rates equal to the older agonist protocols and a lower rate of ovarian hyperstimulation syndrome. The single cetrorelix trial in the citations is a multicentre randomized study from 2000 in 154 women, which compared one late-follicular injection with a depot GnRH agonist.", "citations": "https://www.accessdata.fda.gov/drugsatfda_docs/label/2023/021197s017s022lbl.pdf | https://go.drugbank.com/drugs/DB00050 | https://doi.org/10.1016/s0015-0282(99)00524-5 | https://doi.org/10.1002/14651858.CD001750.pub4", "page": "https://peptidegraded.com/p/cetrorelix/" }, { "slug": "cjc-1295", "name": "CJC-1295", "aliases": "CJC1295; CJC 1295; CJC-1295 DAC; CJC-1295 no DAC; Modified GRF 1-29; Mod GRF 1-29; DAC:GRF; Mod GRF (1-29); growth hormone secretagogue; GH secretagogue; GHRP; GHRH", "class": "GHRH analog (secretagogue)", "body_system": "Muscle and bone", "families": "Growth hormone boosters", "uses": "muscle growth; anti-ageing; fat loss", "route": "Injection", "evidence_grade": "B", "grade_meaning": "Some human evidence", "human_studies_cited": 3, "animal_or_cell_studies_cited": 1, "fda_status": "Not approved", "fda_as_of": "2026-10-26", "fda_statement": "CJC-1295 is not approved by the FDA for any use and is sold as a research chemical. Its nominations for the compounding bulks list were withdrawn in September 2024, and in December 2024 the FDA's Pharmacy Compounding Advisory Committee voted against adding it, so it is not eligible for pharmacy compounding either.", "sold_for": "CJC-1295 is sold as a long-acting growth-hormone booster for muscle gain, fat loss, sleep and recovery, usually paired with ipamorelin.", "studies_say": "Small trials in healthy volunteers confirm that it raises GH and IGF-1 for a week or more per injection, which is a real pharmacological effect measured on blood tests, but no study has shown it changes body composition or any health outcome.", "grade_reasoning": "Two randomized placebo-controlled dose-ranging trials and one overnight sampling study, all in healthy adults, show CJC-1295 raises growth hormone and IGF-1 for days after a single injection. The largest enrolled a few dozen volunteers, measured hormone levels only, and lasted 49 days. No trial has measured muscle, fat, recovery or ageing outcomes, which are the uses it is sold for, so the grade is B on surrogate endpoints only.", "citations": "https://pubmed.ncbi.nlm.nih.gov/16352683/ | https://pubmed.ncbi.nlm.nih.gov/17018654/ | https://pubmed.ncbi.nlm.nih.gov/15817669/ | https://pubmed.ncbi.nlm.nih.gov/42395176/ | https://www.fda.gov/drugs/human-drug-compounding/certain-bulk-drug-substances-use-compounding-may-present-significant-safety-risks | https://pubmed.ncbi.nlm.nih.gov/7962295/ | https://www.lexology.com/library/detail.aspx?g=2e55b76a-3173-4e04-beda-bf021202f18d | https://www.fda.gov/media/183819/download", "page": "https://peptidegraded.com/p/cjc-1295/" }, { "slug": "copper-tripeptide-1", "name": "Copper tripeptide-1", "aliases": "GHK-Cu; Copper peptide; Copper peptides; GHK copper; Cu-GHK; Glycyl-L-histidyl-L-lysine copper; Copper tripeptide; GHK Cu; healing peptide; recovery peptide; injury peptide; cosmetic peptide; skincare peptide; Matrixyl; Argireline", "class": "Carrier/copper peptide", "body_system": "Skin", "families": "Healing and recovery peptides; Cosmetic skin peptides", "uses": "skin and hair; wound healing", "route": "Topical", "evidence_grade": "C", "grade_meaning": "Animal and cell studies", "human_studies_cited": 1, "animal_or_cell_studies_cited": 3, "fda_status": "Cosmetic ingredient", "fda_as_of": "2026-10-26", "fda_statement": "Copper tripeptide-1 is a cosmetic ingredient and sits outside FDA drug approval; no copper tripeptide-1 or GHK-Cu product is approved by the FDA as a drug for any use. Injectable GHK-Cu sold online is not approved and is sold as a research chemical.", "sold_for": "Copper tripeptide-1 is marketed in serums as a collagen-building, wound-healing peptide that firms skin, softens wrinkles and regrows hair.", "studies_say": "Cell and animal studies show it switches on repair genes and speeds wound closure, but the one blinded human trial found no measurable skin benefit over the control regimen, so the evidence is C.", "grade_reasoning": "For the skin anti-ageing use, the controlled human evidence is a single randomized trial of 13 patients after CO2 laser resurfacing, which found no objective difference in redness or wrinkles. The rest is gene-expression work in cultured cells, animal wound and lung-injury models, and cosmetic-company studies summarized in reviews written by the peptide's discoverer.", "citations": "https://doi.org/10.1155/2015/648108 | https://doi.org/10.3390/brainsci7020020 | https://doi.org/10.1163/156856208784909435 | https://doi.org/10.1001/archfaci.8.4.252 | https://doi.org/10.18632/oncotarget.11168", "page": "https://peptidegraded.com/p/copper-tripeptide-1/" }, { "slug": "corticotropin", "name": "Corticotropin", "aliases": "ACTH; Acthar Gel; Acthar; H.P. Acthar Gel; Adrenocorticotropic hormone; Adrenocorticotropin; Purified Cortrophin Gel; Cortrophin; Repository corticotropin injection", "class": "Melanocortin / ACTH", "body_system": "Hormones", "families": "", "uses": "rare disease; other", "route": "Injection", "evidence_grade": "B", "grade_meaning": "Some human evidence", "human_studies_cited": 1, "animal_or_cell_studies_cited": 0, "fda_status": "FDA approved", "fda_as_of": "2026-10-27", "fda_statement": "Corticotropin is FDA-approved as Acthar Gel (repository corticotropin injection), first approved in 1952. The current label lists infantile spasms in children under two, acute exacerbations of multiple sclerosis in adults, and a set of older indications in rheumatic, collagen, dermatologic, allergic, ophthalmic, respiratory and edematous conditions. ANI Pharmaceuticals' Purified Cortrophin Gel, approved in 1954, is a second FDA-approved corticotropin product.", "sold_for": "Corticotropin is less a wellness peptide than a controversy over price: a 1952 hormone extract that became one of the most expensive drugs in the United States while being prescribed for conditions where cheap steroids are the usual choice.", "studies_say": "In infantile spasms, a small randomized trial found high-dose corticotropin stopped spasms and normalized the EEG in 87% of infants against 29% on prednisone, which supports that use; for most other labeled conditions the evidence is old and uncontrolled.", "grade_reasoning": "The use corticotropin is best known for today, infantile spasms, is supported by randomized trials, but they are small: the trial in the citations randomized 29 infants. Most of the other labeled indications were approved in the 1950s on uncontrolled experience and the label itself says controlled trials in multiple sclerosis showed faster recovery from attacks without changing the disease course. That earns a B and not an A.", "citations": "https://pubmed.ncbi.nlm.nih.gov/8604274/ | https://www.acthar.com/Static/pdf/Acthar-PI.pdf | https://www.accessdata.fda.gov/drugsatfda_docs/label/2021/008372s071lbl.pdf | https://www.accessdata.fda.gov/scripts/cder/daf/index.cfm?event=overview.process&ApplNo=008372", "page": "https://peptidegraded.com/p/corticotropin/" }, { "slug": "cosyntropin", "name": "Cosyntropin", "aliases": "Cortrosyn; Synacthen; Tetracosactide; Tetracosactrin; ACTH 1-24; ACTH(1-24)", "class": "ACTH(1-24) analog", "body_system": "Hormones", "families": "", "uses": "other", "route": "Injection", "evidence_grade": "A", "grade_meaning": "Strong human evidence", "human_studies_cited": 1, "animal_or_cell_studies_cited": 0, "fda_status": "FDA approved", "fda_as_of": "2026-10-26", "fda_statement": "Cosyntropin is FDA-approved as Cortrosyn (cosyntropin for injection), a diagnostic agent for screening patients presumed to have adrenocortical insufficiency; it is not approved as a treatment for anything.", "sold_for": "Cosyntropin carries no wellness hype; it is a hospital and clinic diagnostic, and the only online debate is whether the standard or low-dose test is more accurate.", "studies_say": "Pooled data from 679 patients show the cosyntropin stimulation test reliably separates adrenal insufficiency from normal function, which supports an A for its diagnostic use.", "grade_reasoning": "The use cosyntropin is known for is the ACTH stimulation test, and the evidence is diagnostic-accuracy data, with no treatment trials. A meta-analysis pooled patient-level data from 13 studies with 679 subjects and found the test discriminates adrenal insufficiency well, with the low-dose version performing better than the standard dose for chronic pituitary-related insufficiency. Decades of routine clinical use rest on this kind of validation.", "citations": "https://doi.org/10.1210/jc.2008-0710 | https://www.accessdata.fda.gov/drugsatfda_docs/label/2023/016750s033lbl.pdf", "page": "https://peptidegraded.com/p/cosyntropin/" }, { "slug": "cyclosporine", "name": "Cyclosporine", "aliases": "Ciclosporin; Cyclosporin; Cyclosporin A; Sandimmune; Neoral; Gengraf; Restasis; Cequa; Verkazia; CsA", "class": "Cyclic peptide immunosuppressant", "body_system": "Immunity", "families": "", "uses": "immune support; other", "route": "Several routes", "evidence_grade": "A", "grade_meaning": "Strong human evidence", "human_studies_cited": 1, "animal_or_cell_studies_cited": 0, "fda_status": "FDA approved", "fda_as_of": "2026-10-26", "fda_statement": "Cyclosporine is FDA-approved: Sandimmune (1983) for preventing rejection of kidney, liver and heart transplants; Neoral and generics for transplant rejection, rheumatoid arthritis and psoriasis; and Restasis eye drops (2002) for increasing tear production in dry eye. The systemic products carry boxed warnings for immunosuppression-related infection and malignancy, kidney toxicity and hypertension.", "sold_for": "Cyclosporine is not sold as a wellness peptide; its reputation is as the drug that made organ transplantation routine, and its online discussion is mostly patients comparing it with tacrolimus or asking about the eye drops.", "studies_say": "A randomized trial in 1983 showed a 16-percentage-point gain in one-year kidney graft survival, and the drug's approval and decades of use rest on that class of evidence, which is an A.", "grade_reasoning": "The transplant use was established by randomized trials, including the Canadian Multicentre Transplant Study in the citations, which randomized 209 recipients of cadaveric kidneys and found one-year graft survival of 80% with cyclosporine against 64% with azathioprine and prednisone. Forty years of subsequent trials and registry data confirm it.", "citations": "https://doi.org/10.1056/NEJM198310063091401 | https://www.drugs.com/pro/sandimmune.html | https://www.drugs.com/pro/neoral.html | https://www.drugs.com/pro/restasis.html", "page": "https://peptidegraded.com/p/cyclosporine/" }, { "slug": "dalbavancin-oritavancin-telavancin", "name": "Dalbavancin / Oritavancin / Telavancin", "aliases": "Dalbavancin; Oritavancin; Telavancin; Dalvance; Orbactiv; Kimyrsa; Vibativ; Xydalba; Lipoglycopeptides", "class": "Lipoglycopeptide antibiotics", "body_system": "Skin", "families": "", "uses": "infection", "route": "Intravenous", "evidence_grade": "A", "grade_meaning": "Strong human evidence", "human_studies_cited": 1, "animal_or_cell_studies_cited": 0, "fda_status": "FDA approved", "fda_as_of": "2026-10-26", "fda_statement": "All three lipoglycopeptides are FDA-approved for skin and skin-structure infections caused by susceptible Gram-positive bacteria: telavancin as Vibativ for complicated skin and skin-structure infections (2009, with hospital-acquired and ventilator-associated pneumonia due to S. aureus added in 2013 when alternatives are unsuitable), dalbavancin as Dalvance (2014, extended to children in 2021) and oritavancin as Orbactiv (2014) and Kimyrsa (2021), both for acute bacterial skin and skin-structure infections.", "sold_for": "These antibiotics attract little consumer hype; the clinical interest is in dalbavancin and oritavancin as one- or two-dose treatments that let patients skip a hospital stay or a PICC line.", "studies_say": "Large randomized trials show once-weekly dalbavancin and single-dose oritavancin match daily vancomycin for skin infections, and telavancin is non-inferior for skin infections and pneumonia, which supports an A for the approved uses.", "grade_reasoning": "Each drug was approved on randomized double-blind non-inferiority trials against vancomycin-based standard therapy. The trial in the citations, the pooled DISCOVER 1 and 2 programme for dalbavancin, randomized 1,312 patients and found early clinical response in 79.7% with dalbavancin against 79.8% with vancomycin followed by linezolid.", "citations": "https://doi.org/10.1056/NEJMoa1310480 | https://www.drugs.com/pro/dalvance.html | https://www.drugs.com/pro/orbactiv.html | https://www.drugs.com/pro/vibativ.html", "page": "https://peptidegraded.com/p/dalbavancin-oritavancin-telavancin/" }, { "slug": "daptomycin", "name": "Daptomycin", "aliases": "Cubicin; Cubicin RF; LY146032; Daptomycin for injection", "class": "Cyclic lipopeptide antibiotic", "body_system": "Skin", "families": "", "uses": "infection", "route": "Intravenous", "evidence_grade": "A", "grade_meaning": "Strong human evidence", "human_studies_cited": 2, "animal_or_cell_studies_cited": 0, "fda_status": "FDA approved", "fda_as_of": "2026-10-27", "fda_statement": "Daptomycin is FDA-approved as Cubicin (2003) and generics for complicated skin and skin-structure infections caused by susceptible Gram-positive bacteria and for Staphylococcus aureus bloodstream infections, including right-sided infective endocarditis. It is not approved for pneumonia.", "sold_for": "Daptomycin is a hospital antibiotic with no wellness market; its reputation is as a reliable option for MRSA bloodstream infections when vancomycin fails or cannot be used.", "studies_say": "A 246-patient randomized trial showed daptomycin cures S. aureus bacteremia and right-sided endocarditis about as often as standard therapy with less kidney damage, which with the skin-infection trials behind its approval supports an A.", "grade_reasoning": "Approval rested on randomized trials against standard antibiotics. The bacteremia and endocarditis trial in the citations randomized 246 patients and found daptomycin non-inferior to standard therapy, with success in 44.2% versus 41.7% at 42 days after treatment, a low absolute rate that reflects how hard these infections are to cure.", "citations": "https://doi.org/10.1056/NEJMoa053783 | https://www.merck.com/product/usa/pi_circulars/c/cubicin/cubicin_pi.pdf | https://pubmed.ncbi.nlm.nih.gov/42097302/", "page": "https://peptidegraded.com/p/daptomycin/" }, { "slug": "dasiglucagon", "name": "Dasiglucagon", "aliases": "Zegalogue; ZP4207; ZP-4207", "class": "Glucagon analog", "body_system": "Gut and weight", "families": "", "uses": "blood sugar", "route": "Injection", "evidence_grade": "A", "grade_meaning": "Strong human evidence", "human_studies_cited": 1, "animal_or_cell_studies_cited": 0, "fda_status": "FDA approved", "fda_as_of": "2026-10-26", "fda_statement": "Dasiglucagon is FDA-approved as Zegalogue, approved in March 2021 for severe hypoglycemia in people with diabetes. The June 2026 label replaced the original age cutoff of six years with a weight cutoff, so it now covers adults and children who weigh at least 20 kg. It comes as an autoinjector and a prefilled syringe.", "sold_for": "Dasiglucagon has no wellness market; the pitch is practical, a glucagon rescue pen that does not need mixing and works as fast as the powder-and-syringe kits it replaces.", "studies_say": "A 170-person randomized trial showed glucose recovered within 10 minutes in half the participants and within 15 minutes in 99%, matching conventional glucagon, which supports an A for the approved rescue use.", "grade_reasoning": "Approval rested on randomized double-blind trials in which hypoglycemia was induced with insulin under supervision and the time to blood-glucose recovery was measured. The adult trial in the citations randomized 170 people with type 1 diabetes and found a median recovery time of 10 minutes with dasiglucagon against 40 minutes with placebo and 12 minutes with reconstituted glucagon.", "citations": "https://doi.org/10.2337/dc20-2995 | https://www.accessdata.fda.gov/drugsatfda_docs/label/2026/214231s004lbl.pdf", "page": "https://peptidegraded.com/p/dasiglucagon/" }, { "slug": "davunetide", "name": "Davunetide", "aliases": "NAP; AL-108; AL108; NAPVSIPQ; NAP peptide", "class": "Neuroprotective peptide", "body_system": "Nervous system", "families": "", "uses": "cognition; rare disease", "route": "Nasal", "evidence_grade": "B", "grade_meaning": "Some human evidence", "human_studies_cited": 1, "animal_or_cell_studies_cited": 1, "fda_status": "In clinical trials", "fda_as_of": "2026-10-27", "fda_statement": "Davunetide is not approved by the FDA for any use. It is an investigational peptide whose phase 2/3 trial in progressive supranuclear palsy failed in 2012; no new trial of it has been registered since, and vials sold online are research chemicals.", "sold_for": "Davunetide circulates in nootropic forums as a nasal spray that protects neurons and stabilizes microtubules, pitched for memory, autism and neurodegeneration.", "studies_say": "The one phase 2/3 trial, 313 patients over a year, found davunetide no better than placebo on movement or daily-function scores in progressive supranuclear palsy, so the human evidence is a well-conducted negative result.", "grade_reasoning": "There is one large randomized placebo-controlled trial: 313 people with progressive supranuclear palsy treated for 52 weeks, with no difference from placebo on either primary endpoint. The trial exists and was well run, which by our definitions is B, but it is negative for the use davunetide is known for. Everything else is cell and animal work on microtubule stabilization.", "citations": "https://doi.org/10.2174/138161211795589373 | https://doi.org/10.1016/S1474-4422(14)70088-2 | https://pubmed.ncbi.nlm.nih.gov/42399413/", "page": "https://peptidegraded.com/p/davunetide/" }, { "slug": "degarelix", "name": "Degarelix", "aliases": "Firmagon; FE200486; Degarelix acetate", "class": "GnRH antagonist", "body_system": "Reproduction", "families": "", "uses": "cancer; hormone replacement", "route": "Injection", "evidence_grade": "A", "grade_meaning": "Strong human evidence", "human_studies_cited": 1, "animal_or_cell_studies_cited": 0, "fda_status": "FDA approved", "fda_as_of": "2026-10-27", "fda_statement": "Degarelix is FDA-approved as Firmagon (degarelix for injection), approved in December 2008 for the treatment of advanced prostate cancer.", "sold_for": "Degarelix has no wellness following; in oncology its selling point is speed, since it switches off testosterone in days without the initial flare that older hormone shots produce.", "studies_say": "A 610-man randomized trial showed degarelix matches leuprolide at suppressing testosterone over a year and gets there faster, which with approval supports an A.", "grade_reasoning": "Approval rested on the CS21 trial, a 12-month randomized open-label phase 3 study of 610 men with prostate cancer, which showed degarelix kept testosterone at castrate levels in over 97% of men, non-inferior to leuprolide, and did so within three days without the testosterone surge that agonists cause.", "citations": "https://doi.org/10.1111/j.1464-410X.2008.08183.x | https://ferringusa.com/PI/Firmagon | https://pubmed.ncbi.nlm.nih.gov/42154420/", "page": "https://peptidegraded.com/p/degarelix/" }, { "slug": "desirudin", "name": "Desirudin", "aliases": "Iprivask; Revasc; Recombinant hirudin; r-hirudin", "class": "Direct thrombin inhibitor", "body_system": "Circulation", "families": "", "uses": "heart and vessels; other", "route": "Injection", "evidence_grade": "A", "grade_meaning": "Strong human evidence", "human_studies_cited": 2, "animal_or_cell_studies_cited": 0, "fda_status": "FDA approved", "fda_as_of": "2026-10-26", "fda_statement": "Desirudin was FDA-approved in 2003 as Iprivask for preventing deep vein thrombosis in patients undergoing elective hip replacement. Iprivask has been discontinued in the United States and no generic is sold, so the approval stands but no product is available.", "sold_for": "Desirudin has no consumer following; it is a footnote in anticoagulation, a leech-derived thrombin blocker that beat enoxaparin in a large trial and then disappeared from the market for commercial reasons.", "studies_say": "A 2,079-patient randomized trial showed desirudin prevented more clots after hip replacement than enoxaparin with similar bleeding, which earns an A for the approved use even though the product is no longer sold.", "grade_reasoning": "Approval rested on randomized double-blind trials in hip replacement. The larger one randomized 2,079 patients across 31 European centres and found fewer proximal deep vein thromboses with desirudin (4.5%) than with enoxaparin (7.5%), with venography confirming every diagnosis; a 445-patient trial found a larger advantage over unfractionated heparin.", "citations": "https://pubmed.ncbi.nlm.nih.gov/9358126/ | https://www.drugs.com/mtm/iprivask.html | https://doi.org/10.2106/00004623-199703000-00002", "page": "https://peptidegraded.com/p/desirudin/" }, { "slug": "desmopressin", "name": "Desmopressin", "aliases": "DDAVP; Nocdurna; Noctiva; Stimate; Minirin; Desmopressin acetate; 1-deamino-8-D-arginine vasopressin", "class": "Vasopressin V2 analog", "body_system": "Circulation", "families": "", "uses": "rare disease; other", "route": "Several routes", "evidence_grade": "A", "grade_meaning": "Strong human evidence", "human_studies_cited": 0, "animal_or_cell_studies_cited": 0, "fda_status": "FDA approved", "fda_as_of": "2026-10-26", "fda_statement": "Desmopressin is FDA-approved, first in 1978 as DDAVP, for central diabetes insipidus, for temporary excessive urination after pituitary surgery or head injury, for bleeding control in mild hemophilia A and type 1 von Willebrand disease, and for primary nocturnal enuresis (bedwetting) in children; Nocdurna, a sublingual tablet approved in 2018, treats nocturia due to nocturnal polyuria in adults. The Noctiva nasal spray approved in 2017 for nocturia has been discontinued, and the Stimate nasal spray for bleeding disorders was recalled in 2020 and was still off the market in 2023.", "sold_for": "Desmopressin surfaces online as a memory booster and a nootropic because vasopressin acts in the brain, and as a shortcut for night-time urination; none of that is on the label.", "studies_say": "Approval for diabetes insipidus, bleeding disorders and nocturia rests on controlled trials and decades of use, an A for those indications, while the only consistent safety story is dangerously low sodium when fluid intake is not restricted.", "grade_reasoning": "Desmopressin has been the standard treatment for central diabetes insipidus for nearly fifty years, and the nocturia indications were approved in 2017 and 2018 on randomized placebo-controlled trials summarized on their labels. The citations here are labels and regulatory records, not primary trial papers; the largest trial they describe is Nocdurna's three-month study in 237 women.", "citations": "https://drugs.com/cons/noctiva.html | https://www.drugs.com/pro/ddavp.html | https://www.drugs.com/pro/nocdurna.html | https://www.bleeding.org/news/updates-on-generic-desmopressin-product", "page": "https://peptidegraded.com/p/desmopressin/" }, { "slug": "difelikefalin", "name": "Difelikefalin", "aliases": "Korsuva; Kapruvia; CR845; CR-845; Difelikefalin acetate", "class": "Kappa-opioid agonist peptide", "body_system": "Skin", "families": "", "uses": "pain; other", "route": "Intravenous", "evidence_grade": "A", "grade_meaning": "Strong human evidence", "human_studies_cited": 1, "animal_or_cell_studies_cited": 0, "fda_status": "FDA approved", "fda_as_of": "2026-10-26", "fda_statement": "Approved. Difelikefalin is sold as Korsuva, approved by the FDA in August 2021 for moderate-to-severe pruritus (itch) associated with chronic kidney disease in adults on hemodialysis. It is given intravenously through the dialysis circuit.", "sold_for": "Difelikefalin is talked about as an itch drug that works without the sedation or dependence risk of conventional opioids.", "studies_say": "Two placebo-controlled trials in dialysis patients support the approved use, so the grade is A for uremic pruritus and nothing else.", "grade_reasoning": "Approval rests on two randomized, double-blind, placebo-controlled phase 3 trials (KALM-1 and KALM-2) in hemodialysis patients with uremic itch. KALM-1, the trial cited here, randomized 378 patients and met its primary endpoint over 12 weeks. Nothing is missing for the approved use; what is missing is any controlled evidence for itch in people who are not on dialysis, which is where most online interest lies.", "citations": "https://doi.org/10.1056/NEJMoa1912770 | https://www.drugs.com/pro/korsuva.html", "page": "https://peptidegraded.com/p/difelikefalin/" }, { "slug": "dihexa", "name": "Dihexa", "aliases": "Dihexa acetate; PNB-0408; N-hexanoic-Tyr-Ile-(6) aminohexanoic amide; Di-hexa; longevity peptide; anti-ageing peptide; nootropic peptide", "class": "Angiotensin IV-derived peptide", "body_system": "Nervous system", "families": "Longevity and brain peptides", "uses": "cognition", "route": "Oral", "evidence_grade": "C", "grade_meaning": "Animal and cell studies", "human_studies_cited": 0, "animal_or_cell_studies_cited": 4, "fda_status": "Not approved", "fda_as_of": "2026-10-27", "fda_statement": "Not approved by the FDA for any use and sold as a research chemical. In September 2023 the FDA placed dihexa acetate in Category 2 of bulk substances that may present significant safety risks for compounding, citing the absence of any human exposure data. The FDA now lists it among substances whose nominations were withdrawn, which takes it out of Category 2 but does not approve it or make it eligible for compounding.", "sold_for": "Dihexa is sold online as a nootropic claimed to be millions of times more potent than BDNF at growing new synapses.", "studies_say": "A handful of rodent studies, two of them now retracted, show reversal of drug-induced memory deficits; there is no human data at all, so the grade is C.", "grade_reasoning": "The evidence for the use dihexa is sold for, memory and cognition, consists of rat and mouse behavioral studies and cell culture work. No human trial exists and none is registered. Two of the foundational papers from the originating laboratory were retracted in April 2025 and the third carries an expression of concern, so even the animal literature is weaker than it looks.", "citations": "https://doi.org/10.1124/jpet.112.199497 | https://doi.org/10.1124/jpet.114.218735 | https://doi.org/10.5435/JAAOSGlobal-D-25-00236 | https://www.fda.gov/drugs/human-drug-compounding/certain-bulk-drug-substances-use-compounding-may-present-significant-safety-risks | https://pmc.ncbi.nlm.nih.gov/articles/PMC3533412/ | https://pubmed.ncbi.nlm.nih.gov/40312092/ | https://pubmed.ncbi.nlm.nih.gov/40312093/ | https://pubmed.ncbi.nlm.nih.gov/23055539/ | https://pubmed.ncbi.nlm.nih.gov/30352967/ | https://clinicaltrials.gov/search?term=dihexa | https://pubmed.ncbi.nlm.nih.gov/34827486/", "page": "https://peptidegraded.com/p/dihexa/" }, { "slug": "dipeptide-diaminobutyroyl-benzylamide-diacetate", "name": "Dipeptide diaminobutyroyl benzylamide diacetate", "aliases": "Syn-Ake; Synake; Snake venom peptide; Waglerin-1 mimetic; cosmetic peptide; skincare peptide; Matrixyl; Argireline", "class": "Neuromuscular-relaxing peptide", "body_system": "Skin", "families": "Cosmetic skin peptides", "uses": "skin and hair", "route": "Topical", "evidence_grade": "D", "grade_meaning": "No meaningful data", "human_studies_cited": 1, "animal_or_cell_studies_cited": 0, "fda_status": "Cosmetic ingredient", "fda_as_of": "2026-10-26", "fda_statement": "A cosmetic ingredient, not a drug. It is used in creams and serums marketed in the US under cosmetic rules, which do not require FDA approval before sale, and it has never been reviewed or approved by the FDA for any therapeutic use.", "sold_for": "Sold as 'Syn-Ake', a synthetic snake-venom peptide claimed to relax expression lines the way a muscle-blocking injection would, but in a cream.", "studies_say": "The only human evidence is manufacturer testing and a combination-product study, which is a D on our scale.", "grade_reasoning": "The human data for wrinkle reduction are a supplier-run test of a cream in small volunteer groups (15 per arm, by the manufacturer's own brochure) and one peer-reviewed study of a serum that combined this peptide with acetyl hexapeptide-8, so the ingredient's own effect cannot be isolated. No independent trial of the peptide alone has been published.", "citations": "https://www.happi.com/contents/view_suppliers-corner/2005-12-09/pentapharm-introduces-anti-wrinkle-active/ | https://cosmeticsdesign-europe.com/Article/2007/12/14/snake-venom-based-anti-ageing-cream-launched-in-uk | https://doi.org/10.1111/ics.70087 | https://dsm.com/content/dam/protected/personal-care/en_US/peptides/peptides_distributor/syn-ake_brochure_2020.pdf", "page": "https://peptidegraded.com/p/dipeptide-diaminobutyroyl-benzylamide-diacetate/" }, { "slug": "dsip", "name": "DSIP", "aliases": "Delta sleep-inducing peptide; Delta sleep inducing peptide; Emideltide; DSIP peptide; Deltaran; longevity peptide; anti-ageing peptide; nootropic peptide", "class": "Neuromodulatory nonapeptide", "body_system": "Nervous system", "families": "Longevity and brain peptides", "uses": "sleep; pain", "route": "Injection", "evidence_grade": "C", "grade_meaning": "Animal and cell studies", "human_studies_cited": 4, "animal_or_cell_studies_cited": 1, "fda_status": "Not approved", "fda_as_of": "2026-10-26", "fda_statement": "Not approved by the FDA for any use and sold as a research chemical. In July 2026 the FDA's Pharmacy Compounding Advisory Committee voted against adding DSIP (reviewed under the name emideltide) to the list of substances pharmacies may compound.", "sold_for": "DSIP is sold as a natural sleep peptide that deepens slow-wave sleep and is also claimed to help with pain and withdrawal.", "studies_say": "Small, old human studies with mixed results and no modern trial, so the grade is C.", "grade_reasoning": "For sleep, the use DSIP is sold for, the human evidence is a cluster of small studies from the late 1970s and 1980s, mostly from the group that discovered the peptide, plus one later double-blind trial in 16 chronic insomniacs whose authors called the effect weak. There has been no adequately powered trial in the past 30 years, and no study of the injectable products now sold online.", "citations": "https://pubmed.ncbi.nlm.nih.gov/862769/ | https://doi.org/10.1007/BF01971753 | https://doi.org/10.1159/000115716 | https://doi.org/10.1159/000115715 | https://doi.org/10.5435/JAAOSGlobal-D-25-00236 | https://pubmed.ncbi.nlm.nih.gov/1299794/ | https://www.raps.org/resource/fda-advisory-committee-backs-two-more-peptides-rejects-one-for-compounding-list.html", "page": "https://peptidegraded.com/p/dsip/" }, { "slug": "dulaglutide", "name": "Dulaglutide", "aliases": "Trulicity; LY2189265; GLP-1; GLP1; GLP-1 agonist; weight loss shot", "class": "GLP-1 receptor agonist", "body_system": "Hormones", "families": "GLP-1 drugs and successors", "uses": "blood sugar; heart and vessels", "route": "Injection", "evidence_grade": "A", "grade_meaning": "Strong human evidence", "human_studies_cited": 3, "animal_or_cell_studies_cited": 0, "fda_status": "FDA approved", "fda_as_of": "2026-10-27", "fda_statement": "Approved. Dulaglutide is sold as Trulicity (Eli Lilly), approved by the FDA in 2014 as an adjunct to diet and exercise to improve glycemic control in type 2 diabetes in adults and, since 2022, in children aged 10 and older, and to reduce the risk of major cardiovascular events in adults with type 2 diabetes who have cardiovascular disease or multiple risk factors. It is not approved for weight loss.", "sold_for": "Dulaglutide is talked about as a once-weekly GLP-1 injection that lowers blood sugar, protects the heart and helps with weight.", "studies_say": "Large randomized trials support the diabetes and cardiovascular indications, which earns an A for those uses; weight loss is a side effect of a few kilograms, not a tested indication.", "grade_reasoning": "The glucose-lowering use is supported by the AWARD program of randomized trials, of which AWARD-5 (n=1,098, 52 weeks against sitagliptin) is cited here, and the cardiovascular claim by REWIND, a placebo-controlled trial of 9,901 patients followed for a median of 5.4 years. Weight loss with dulaglutide is modest and it has no obesity indication, so that off-label use would grade lower.", "citations": "https://www.accessdata.fda.gov/drugsatfda_docs/label/2026/125469s065lbl.pdf | https://doi.org/10.2337/dc13-2761 | https://doi.org/10.1016/S0140-6736(19)31149-3 | https://pubmed.ncbi.nlm.nih.gov/42618811/", "page": "https://peptidegraded.com/p/dulaglutide/" }, { "slug": "ecallantide", "name": "Ecallantide", "aliases": "Kalbitor; DX-88; DX88", "class": "Plasma kallikrein inhibitor", "body_system": "Skin", "families": "", "uses": "rare disease", "route": "Injection", "evidence_grade": "A", "grade_meaning": "Strong human evidence", "human_studies_cited": 1, "animal_or_cell_studies_cited": 0, "fda_status": "FDA approved", "fda_as_of": "2026-10-26", "fda_statement": "Approved. Ecallantide is sold as Kalbitor, approved by the FDA in December 2009 for acute attacks of hereditary angioedema, originally in patients 16 and older and extended in 2014 to patients 12 and older. It carries a boxed warning for anaphylaxis and must be given by a healthcare professional.", "sold_for": "Ecallantide is an on-demand treatment for hereditary angioedema attacks that blocks the enzyme driving the swelling.", "studies_say": "Two placebo-controlled trials support the approved use, so the grade is A, with the caveat that about 4% of treated patients in trials had anaphylaxis.", "grade_reasoning": "Approval was based on two randomized, double-blind, placebo-controlled trials, EDEMA3 (n=72, cited here) and EDEMA4 (n=96), both showing faster symptom relief than placebo during acute attacks. The trials were small by the standards of common diseases, but hereditary angioedema is rare and two consistent placebo-controlled trials meet the bar for A.", "citations": "https://doi.org/10.1056/NEJMoa0905079 | https://www.drugs.com/pro/kalbitor.html", "page": "https://peptidegraded.com/p/ecallantide/" }, { "slug": "echinocandins", "name": "Echinocandins", "aliases": "Caspofungin; Micafungin; Anidulafungin; Rezafungin; Cancidas; Mycamine; Eraxis; Rezzayo; Echinocandin", "class": "Lipopeptide antifungals", "body_system": "Circulation", "families": "", "uses": "infection", "route": "Intravenous", "evidence_grade": "A", "grade_meaning": "Strong human evidence", "human_studies_cited": 2, "animal_or_cell_studies_cited": 0, "fda_status": "FDA approved", "fda_as_of": "2026-10-26", "fda_statement": "Approved. Four echinocandins are FDA-approved antifungals: caspofungin (Cancidas, 2001), micafungin (Mycamine, 2005), anidulafungin (Eraxis, 2006) and rezafungin (Rezzayo, 2023). Their indications center on candidemia, invasive and esophageal candidiasis, with caspofungin also approved for empiric therapy in febrile neutropenia and for aspergillosis refractory to other drugs, and micafungin for prophylaxis in stem-cell transplant recipients.", "sold_for": "Echinocandins are hospital antifungals, not wellness products; the interest is clinical, as the preferred first drugs for bloodstream Candida infections.", "studies_say": "Randomized trials showed each echinocandin at least as effective as amphotericin B or fluconazole with fewer toxic effects than amphotericin B, which is an A for invasive candidiasis.", "grade_reasoning": "Each echinocandin was approved on randomized, double-blind trials against an established antifungal. The two cited here are caspofungin versus amphotericin B in 224 patients with invasive candidiasis and anidulafungin versus fluconazole in 245 patients with invasive candidiasis, 89% of them candidemia only. Rezafungin was approved in 2023 on a noninferiority trial against caspofungin.", "citations": "https://doi.org/10.1056/NEJMoa021585 | https://doi.org/10.1056/NEJMoa066906 | https://www.drugs.com/pro/rezzayo.html", "page": "https://peptidegraded.com/p/echinocandins/" }, { "slug": "efpeglenatide", "name": "Efpeglenatide", "aliases": "HM11260C; LAPS-Exendin; LAPS-Exendin-4 analog; GLP-1; GLP1; GLP-1 agonist; weight loss shot", "class": "Long-acting GLP-1 agonist", "body_system": "Hormones", "families": "GLP-1 drugs and successors", "uses": "blood sugar; heart and vessels", "route": "Injection", "evidence_grade": "B", "grade_meaning": "Some human evidence", "human_studies_cited": 1, "animal_or_cell_studies_cited": 0, "fda_status": "In clinical trials", "fda_as_of": "2026-10-27", "fda_statement": "Not approved by the FDA. Efpeglenatide is a once-weekly GLP-1 receptor agonist developed by Hanmi Pharmaceutical; Sanofi licensed it, ran a phase 3 program in type 2 diabetes, and returned the rights in 2020 before any filing. South Korea's Ministry of Food and Drug Safety approved it on October 7, 2026 for chronic weight management in adults with obesity or overweight who do not have diabetes, and no US marketing application has been reported.", "sold_for": "Efpeglenatide is discussed as a weekly GLP-1 drug with proven heart and kidney benefits that got shelved for business reasons.", "studies_say": "A single 4,076-patient outcomes trial showed cardiovascular and kidney benefit comparable to approved GLP-1 drugs, which is strong but orphaned evidence, hence B.", "grade_reasoning": "One large randomized, placebo-controlled cardiovascular outcomes trial, AMPLITUDE-O (n=4,076), showed a 27% reduction in major cardiovascular events in high-risk type 2 diabetes, and a prespecified analysis confirmed the effect regardless of SGLT2 inhibitor use. The evidence is of high quality but the drug was never approved for diabetes and no second outcomes trial exists, so it stays at B.", "citations": "https://www.ncbi.nlm.nih.gov/books/NBK551568/ | https://doi.org/10.1056/NEJMoa2108269 | https://doi.org/10.1161/CIRCULATIONAHA.121.057934 | https://www.mfds.go.kr/brd/m_99/view.do?seq=50399", "page": "https://peptidegraded.com/p/efpeglenatide/" }, { "slug": "elamipretide", "name": "Elamipretide", "aliases": "Forzinity; SS-31; SS31; Bendavia; MTP-131; Elamipretide hydrochloride", "class": "Mitochondria-targeting tetrapeptide", "body_system": "Hormones", "families": "", "uses": "rare disease", "route": "Injection", "evidence_grade": "B", "grade_meaning": "Some human evidence", "human_studies_cited": 3, "animal_or_cell_studies_cited": 0, "fda_status": "FDA approved", "fda_as_of": "2026-10-27", "fda_statement": "Approved under the accelerated pathway. On September 19, 2025 the FDA approved elamipretide as Forzinity (Stealth BioTherapeutics) to improve muscle strength in adults and children weighing at least 30 kg who have Barth syndrome, a rare mitochondrial disease. The approval rests on a surrogate measure, knee extensor strength, and a confirmatory trial is required. It is not approved for any other condition.", "sold_for": "Elamipretide is talked about as a mitochondria-targeting peptide for energy, aging and muscle, and as the first drug for Barth syndrome.", "studies_say": "A tiny crossover trial plus open-label follow-up earned a conditional approval in Barth syndrome, while the one large randomized trial in mitochondrial myopathy was negative, which lands at B for the approved use and lower for everything else.", "grade_reasoning": "The Barth syndrome approval is based on TAZPOWER, a 12-patient randomized crossover trial that missed its primary endpoints, followed by a 168-week open-label extension in which walking distance and strength improved against the natural history of the disease. The largest trial of elamipretide, MMPOWER-3 in 218 people with primary mitochondrial myopathy, failed both primary endpoints, so for the broader mitochondrial-health claims found online the evidence is negative.", "citations": "https://doi.org/10.1016/j.gim.2024.101138 | https://www.drugs.com/pro/forzinity.html | https://pubmed.ncbi.nlm.nih.gov/40281531/ | https://pubmed.ncbi.nlm.nih.gov/37268435/", "page": "https://peptidegraded.com/p/elamipretide/" }, { "slug": "enfuvirtide", "name": "Enfuvirtide", "aliases": "Fuzeon; T-20; T20; Pentafuside; DP-178", "class": "HIV fusion inhibitor peptide", "body_system": "Immunity", "families": "", "uses": "infection", "route": "Injection", "evidence_grade": "A", "grade_meaning": "Strong human evidence", "human_studies_cited": 1, "animal_or_cell_studies_cited": 0, "fda_status": "FDA approved", "fda_as_of": "2026-10-26", "fda_statement": "Approved but discontinued. Enfuvirtide was approved by the FDA in March 2003 as Fuzeon (Roche/Genentech) for HIV-1 infection in treatment-experienced patients with ongoing viral replication despite antiretroviral therapy. Genentech discontinued Fuzeon in the US effective February 28, 2025, citing declining need; the approval stands but the product is no longer sold.", "sold_for": "Enfuvirtide was the first HIV fusion inhibitor, a twice-daily injection that rescued patients whose virus had outrun every oral drug.", "studies_say": "Two randomized trials in multidrug-resistant HIV showed clear virologic benefit, an A for its approved use, though newer oral and long-acting drugs have made it obsolete.", "grade_reasoning": "Approval rested on two randomized open-label phase 3 trials, TORO 1 (n=501, cited here) and TORO 2, in heavily treatment-experienced patients, both showing a larger drop in viral load when enfuvirtide was added to an optimized regimen. That is an A for salvage HIV therapy; the drug has no other use.", "citations": "https://doi.org/10.1056/NEJMoa035026 | https://gene.com/media/statements/ps_081924", "page": "https://peptidegraded.com/p/enfuvirtide/" }, { "slug": "enlicitide", "name": "Enlicitide", "aliases": "Lipfendra; Enlicitide decanoate; MK-0616; MK0616; Oral PCSK9 inhibitor", "class": "Oral macrocyclic PCSK9 inhibitor peptide", "body_system": "Gut and weight", "families": "", "uses": "heart and vessels", "route": "Oral", "evidence_grade": "A", "grade_meaning": "Strong human evidence", "human_studies_cited": 2, "animal_or_cell_studies_cited": 0, "fda_status": "FDA approved", "fda_as_of": "2026-10-27", "fda_statement": "On July 15, 2026 the FDA approved enlicitide as Lipfendra (Merck), the first oral PCSK9 inhibitor, as an adjunct to diet and exercise to reduce LDL cholesterol in adults with hypercholesterolemia, including heterozygous familial hypercholesterolemia. Approval was based on LDL lowering; the cardiovascular outcomes trial is still running.", "sold_for": "Enlicitide is talked about as the pill that does what PCSK9 antibody injections do, cutting LDL cholesterol by more than half.", "studies_say": "Multiple large placebo-controlled trials show LDL reductions of 56 to 59%, with no event-reduction data yet, which is an A for LDL lowering.", "grade_reasoning": "Approval rests on the CORALreef phase 3 program of randomized, double-blind, placebo-controlled trials. CORALreef Lipids (n=2,909) showed a 56% placebo-adjusted LDL reduction at 24 weeks, and CORALreef HeFH showed 59% in familial hypercholesterolemia. The endpoint is a surrogate, LDL cholesterol, but it is a validated one for this drug class, and the outcomes trial is ongoing.", "citations": "https://doi.org/10.1056/NEJMoa2511002 | https://www.merck.com/product/usa/pi_circulars/l/lipfendra/lipfendra_pi.pdf | https://www.merck.com/news/mercks-lipfendra-enlicitide-is-the-first-and-only-once-daily-oral-pcsk9-inhibitor-approved-by-the-u-s-fda-to-reduce-ldl-c-in-adults-with-hypercholesterolemia/ | https://doi.org/10.1016/j.jacc.2026.03.036 | https://www.fda.gov/drugs/novel-drug-approvals-fda/novel-drug-approvals-2026", "page": "https://peptidegraded.com/p/enlicitide/" }, { "slug": "epitalon", "name": "Epitalon", "aliases": "Epithalon; Epithalone; Epitalone; Epithalamin; Epithalamine; Ala-Glu-Asp-Gly; AEDG peptide; Epitalon peptide; longevity peptide; anti-ageing peptide; nootropic peptide", "class": "Pineal tetrapeptide (Ala-Glu-Asp-Gly)", "body_system": "Nervous system", "families": "Longevity and brain peptides", "uses": "anti-ageing; sleep", "route": "Injection", "evidence_grade": "C", "grade_meaning": "Animal and cell studies", "human_studies_cited": 1, "animal_or_cell_studies_cited": 3, "fda_status": "Not approved", "fda_as_of": "2026-10-26", "fda_statement": "Not approved by the FDA for any use and sold as a research chemical. In July 2026 the FDA's Pharmacy Compounding Advisory Committee voted, over the objection of FDA staff, to recommend adding epitalon to the list of substances pharmacies may compound for insomnia; that recommendation is advisory and the FDA had not acted on it as of October 2026.", "sold_for": "Epitalon is sold as a telomerase-activating longevity peptide that resets the pineal gland and extends lifespan.", "studies_say": "Animal and cell studies from a single research school plus one weak human study of a different preparation put this at C.", "grade_reasoning": "The anti-aging claim rests on rodent and fruit-fly lifespan studies, monkey hormone-rhythm studies and cell-culture telomerase work, nearly all from the St Petersburg group that designed the peptide. The only human mortality data concern Epithalamin, a crude pineal extract, in a 266-person study without a described randomization or blinding, so human evidence for epitalon itself is essentially absent.", "citations": "https://pubmed.ncbi.nlm.nih.gov/12374906/ | https://doi.org/10.1023/a:1025493705728 | https://doi.org/10.1023/a:1021104819170 | https://www.ajmc.com/view/fda-panel-backs-6-peptides-for-compounding | https://pubmed.ncbi.nlm.nih.gov/40908429/ | https://www.fda.gov/media/193345/download | https://pubmed.ncbi.nlm.nih.gov/14523363/ | https://www.deadiversion.usdoj.gov/schedules/orangebook/c_cs_alpha.pdf | https://www.fda.gov/media/94155/download | https://www.statnews.com/2026/07/24/fda-peptide-compounding-panel-backs-epitalon-rejects-emideltide/ | https://pubmed.ncbi.nlm.nih.gov/38160808/", "page": "https://peptidegraded.com/p/epitalon/" }, { "slug": "eptifibatide", "name": "Eptifibatide", "aliases": "Integrilin; Eptifibatide injection", "class": "GPIIb/IIIa inhibitor", "body_system": "Circulation", "families": "", "uses": "heart and vessels", "route": "Intravenous", "evidence_grade": "A", "grade_meaning": "Strong human evidence", "human_studies_cited": 1, "animal_or_cell_studies_cited": 1, "fda_status": "FDA approved", "fda_as_of": "2026-10-26", "fda_statement": "Approved. Eptifibatide was approved by the FDA in 1998 as Integrilin for acute coronary syndrome, including patients managed medically and those undergoing percutaneous coronary intervention, and for patients undergoing PCI. It is given intravenously in hospital. Generic eptifibatide is available.", "sold_for": "Eptifibatide is a hospital anticlotting drug, derived from rattlesnake venom, used during heart attacks and stent procedures.", "studies_say": "A 10,948-patient placebo-controlled trial showed a modest reduction in death or heart attack with more bleeding, which is an A for its approved use.", "grade_reasoning": "The acute coronary syndrome indication rests on PURSUIT, a randomized, double-blind, placebo-controlled trial of 10,948 patients, with supporting trials in PCI (IMPACT-II, ESPRIT) summarized in the label. The absolute benefit is small, about 1.5 percentage points fewer deaths or heart attacks at 30 days, and comes at the cost of more bleeding.", "citations": "https://pubmed.ncbi.nlm.nih.gov/2033037/ | https://doi.org/10.1056/NEJM199808133390704 | https://www.merck.com/product/usa/pi_circulars/i/integrilin/integrilin_pi.pdf", "page": "https://peptidegraded.com/p/eptifibatide/" }, { "slug": "etelcalcetide", "name": "Etelcalcetide", "aliases": "Parsabiv; AMG 416; AMG416; Velcalcetide; KAI-4169", "class": "Calcimimetic peptide", "body_system": "Muscle and bone", "families": "", "uses": "bone density; other", "route": "Intravenous", "evidence_grade": "A", "grade_meaning": "Strong human evidence", "human_studies_cited": 1, "animal_or_cell_studies_cited": 0, "fda_status": "FDA approved", "fda_as_of": "2026-10-26", "fda_statement": "Approved. Etelcalcetide was approved by the FDA in February 2017 as Parsabiv (Amgen) for secondary hyperparathyroidism in adults with chronic kidney disease on hemodialysis. It is given intravenously through the dialysis circuit at the end of a session.", "sold_for": "Etelcalcetide is an intravenous calcimimetic that lets dialysis units control parathyroid hormone without relying on patients to take pills.", "studies_say": "Three randomized trials show it lowers parathyroid hormone more than placebo and more than oral cinacalcet, an A for the approved biochemical indication.", "grade_reasoning": "Approval rests on two placebo-controlled phase 3 trials (1,023 patients combined) and a head-to-head trial against cinacalcet in 683 patients, all randomized and double-blind, all showing larger reductions in parathyroid hormone. The endpoint is a laboratory marker; no trial has shown that lowering PTH with etelcalcetide reduces fractures or deaths.", "citations": "https://doi.org/10.1001/jama.2016.19468 | https://www.pi.amgen.com/united_states/parsabiv/parsabiv_pi.pdf", "page": "https://peptidegraded.com/p/etelcalcetide/" }, { "slug": "exenatide", "name": "Exenatide", "aliases": "Byetta; Bydureon; Bydureon BCise; Exendin-4; Exendin 4; Synthetic exendin-4; AC2993; GLP-1; GLP1; GLP-1 agonist; weight loss shot", "class": "GLP-1 receptor agonist", "body_system": "Hormones", "families": "GLP-1 drugs and successors", "uses": "blood sugar; weight loss", "route": "Injection", "evidence_grade": "A", "grade_meaning": "Strong human evidence", "human_studies_cited": 2, "animal_or_cell_studies_cited": 0, "fda_status": "FDA approved", "fda_as_of": "2026-10-26", "fda_statement": "Approved, with the brand products discontinued. Exenatide was approved by the FDA in 2005 as Byetta (twice-daily) and in 2012 as Bydureon (weekly; later Bydureon BCise) for glycemic control in type 2 diabetes. AstraZeneca discontinued Bydureon BCise and Byetta in the US in 2024 for business reasons; the approvals remain in force and generic exenatide is available. Exenatide has never been approved for weight loss.", "sold_for": "Exenatide was the first GLP-1 drug, a lizard-venom peptide that opened the door to the weight-loss injectables that followed it.", "studies_say": "Randomized trials support its use in type 2 diabetes, an A for that indication, while for weight loss it is a weak relative of the drugs that replaced it.", "grade_reasoning": "The diabetes indication rests on a long program of randomized trials summarized in the label and on EXSCEL, a placebo-controlled cardiovascular safety trial of 14,752 patients that showed no increase in cardiovascular events over a median 3.2 years. Weight loss with exenatide averages a few kilograms, well below the 15% and 22.5% seen with semaglutide and tirzepatide in their obesity trials, and it has no obesity indication.", "citations": "https://www.accessdata.fda.gov/drugsatfda_docs/label/2024/209210s024lbl.pdf | https://pubmed.ncbi.nlm.nih.gov/21194543/ | https://www.uhcprovider.com/en/resource-library/news/2024/discontinuation-bydureon-bcise-byetta.html | https://doi.org/10.1056/NEJMoa1411892 | https://doi.org/10.1056/NEJMoa2032183 | https://doi.org/10.1056/NEJMoa2206038 | https://www.accessdata.fda.gov/drugsatfda_docs/label/2025/215866s031lbl.pdf | https://doi.org/10.1056/NEJMoa1612917", "page": "https://peptidegraded.com/p/exenatide/" }, { "slug": "follistatin-344", "name": "Follistatin-344", "aliases": "Follistatin 344; FS-344; FST-344; Follistatin; FS344", "class": "Myostatin-inhibiting peptide", "body_system": "Muscle and bone", "families": "", "uses": "muscle growth; rare disease", "route": "Injection", "evidence_grade": "C", "grade_meaning": "Animal and cell studies", "human_studies_cited": 2, "animal_or_cell_studies_cited": 1, "fda_status": "Not approved", "fda_as_of": "2026-10-27", "fda_statement": "Not approved by the FDA for any use and sold as a research chemical. Follistatin has been given to people only as a gene therapy, first in two small academic trials of the follistatin-344 gene and since 2022 in a few small company-run early-phase studies. The injectable protein sold online has never been tested in people.", "sold_for": "Follistatin-344 is sold to bodybuilders as a myostatin blocker that unlocks muscle growth beyond natural limits.", "studies_say": "Two six-patient gene therapy trials, a few small company-run gene therapy studies and myostatin-knockout mice are the whole evidence base. None of it involves injecting the protein, so the grade is C.", "grade_reasoning": "For muscle growth, the use follistatin-344 is sold for, the human evidence is two open-label gene therapy trials of six patients each, in Becker muscular dystrophy and inclusion body myositis, with no placebo arm. The dramatic muscle phenotypes come from mice lacking myostatin, not from giving follistatin to anyone. Since 2022 a few small company-run early-phase studies have also given the gene therapy to people. No study has tested the injected peptide in humans.", "citations": "https://doi.org/10.1038/387083a0 | https://doi.org/10.1038/mt.2014.200 | https://doi.org/10.3233/jnd-150083 | https://pubmed.ncbi.nlm.nih.gov/25322757/ | https://pubmed.ncbi.nlm.nih.gov/28279643/ | https://clinicaltrials.gov/api/v2/studies?query.intr=follistatin", "page": "https://peptidegraded.com/p/follistatin-344/" }, { "slug": "fragment-176-191", "name": "Fragment 176-191", "aliases": "HGH Fragment 176-191; hGH Frag 176-191; Frag 176-191; GH Fragment 176-191; HGH Frag; AOD-9604; AOD9604; Fragment 176 191; growth hormone secretagogue; GH secretagogue; GHRP; GHRH", "class": "GH C-terminal fragment", "body_system": "Gut and weight", "families": "Growth hormone boosters", "uses": "fat loss; weight loss", "route": "Injection", "evidence_grade": "C", "grade_meaning": "Animal and cell studies", "human_studies_cited": 0, "animal_or_cell_studies_cited": 3, "fda_status": "Not approved", "fda_as_of": "2026-10-26", "fda_statement": "Not approved by the FDA for any use and sold as a research chemical. The same molecule was developed as AOD9604 by an Australian company, which stopped the program after phase 2 obesity trials failed to show weight loss; no application was ever filed.", "sold_for": "Fragment 176-191 is sold as the fat-burning piece of growth hormone, with none of growth hormone's effects on blood sugar or growth.", "studies_say": "Rodent studies support a fat-mobilizing effect, and the human obesity trials run under the name AOD9604 failed, which puts it at C.", "grade_reasoning": "The published evidence for fat loss is three rodent studies showing reduced weight gain and increased fat breakdown in obese rats and mice. Human trials of the identical compound (AOD9604) were run by its developer in the 2000s, with the largest reported at about 500 participants, but they did not meet their weight-loss endpoints and were never published, so for the claimed use there is no positive human evidence.", "citations": "https://pubmed.ncbi.nlm.nih.gov/8358331/ | https://pubmed.ncbi.nlm.nih.gov/11146367/ | https://pubmed.ncbi.nlm.nih.gov/11673763/ | https://pubmed.ncbi.nlm.nih.gov/23092275/ | https://doi.org/10.1159/000053183", "page": "https://peptidegraded.com/p/fragment-176-191/" }, { "slug": "ga-68-dotatate", "name": "Ga-68 dotatate", "aliases": "NETSPOT; Gallium Ga 68 dotatate; 68Ga-DOTATATE; Gallium-68 dotatate; DOTA-TATE; DOTA-Tyr3-octreotate; Ga68 dotatate", "class": "SSTR imaging radiopeptide", "body_system": "Gut and weight", "families": "", "uses": "cancer; other", "route": "Intravenous", "evidence_grade": "B", "grade_meaning": "Some human evidence", "human_studies_cited": 1, "animal_or_cell_studies_cited": 0, "fda_status": "FDA approved", "fda_as_of": "2026-10-26", "fda_statement": "Approved. Gallium Ga-68 dotatate was approved by the FDA on June 1, 2016 as NETSPOT (Advanced Accelerator Applications, now Novartis), a kit for preparing a PET imaging agent to localize somatostatin receptor-positive neuroendocrine tumors in adults and children. It is a single intravenous injection given before a PET scan, not a treatment.", "sold_for": "Ga-68 dotatate PET is the scan that finds neuroendocrine tumors the older octreotide scan missed and decides who is eligible for radioligand therapy.", "studies_say": "Head-to-head imaging studies show higher accuracy than the older scan and frequent changes in management, which supports its approved diagnostic use at a B.", "grade_reasoning": "As a diagnostic, Ga-68 dotatate was approved on accuracy studies, not randomized trials. The study cited here, 78 patients with known or suspected neuroendocrine tumors imaged with both Ga-68 dotatate PET and the older In-111 pentetreotide scan, found the PET scan more accurate and changed management in 36% of patients. Multiple consistent studies exist and the scan is now standard practice, but the evidence type keeps it at B under our definitions.", "citations": "https://doi.org/10.2967/jnumed.115.163865 | https://www.novartis.com/us-en/sites/novartis_us/files/netspot.pdf", "page": "https://peptidegraded.com/p/ga-68-dotatate/" }, { "slug": "ganirelix", "name": "Ganirelix", "aliases": "Antagon; Fyremadel; Orgalutran; Ganirelix acetate; Org 37462", "class": "GnRH antagonist", "body_system": "Reproduction", "families": "", "uses": "fertility", "route": "Injection", "evidence_grade": "A", "grade_meaning": "Strong human evidence", "human_studies_cited": 1, "animal_or_cell_studies_cited": 0, "fda_status": "FDA approved", "fda_as_of": "2026-10-26", "fda_statement": "Approved. Ganirelix acetate injection was approved by the FDA in 1999 (originally as Antagon, Organon) for inhibiting premature LH surges in women undergoing controlled ovarian stimulation for fertility treatment. It is sold in the US as ganirelix acetate injection by Organon and others, and as Fyremadel (Ferring); the Antagon name is no longer used.", "sold_for": "Ganirelix is the IVF injection that stops the body ovulating before egg retrieval, replacing weeks of agonist down-regulation with a few days of antagonist.", "studies_say": "Randomized trials show pregnancy rates similar to the older leuprolide protocol with fewer injections, an A for its approved use.", "grade_reasoning": "Approval rested on randomized phase 3 trials against the standard long GnRH agonist protocol, including the North American trial cited here (313 women, ganirelix versus leuprolide), which found similar pregnancy rates with a shorter, simpler course. The label adds a 332-patient dose-finding trial and a larger open-label randomized trial against a GnRH agonist in which 463 women received ganirelix.", "citations": "https://www.drugs.com/pro/fyremadel.html | https://doi.org/10.1016/s0015-0282(00)01638-1 | https://organonpro.com/en-us/product/ganirelix-acetate-injection/ | https://www.organon.com/product/usa/pi_circulars/g/ganirelix/ganirelix_pi.pdf", "page": "https://peptidegraded.com/p/ganirelix/" }, { "slug": "ghk-cu", "name": "GHK-Cu", "aliases": "GHK Cu; GHKCu; GHK-Cu peptide; Copper peptide; Copper peptides; Copper tripeptide-1; Cu-GHK; Glycyl-L-histidyl-L-lysine copper; GHK; healing peptide; recovery peptide; injury peptide", "class": "Copper-binding tripeptide", "body_system": "Skin", "families": "Healing and recovery peptides", "uses": "skin and hair; wound healing; anti-ageing", "route": "Several routes", "evidence_grade": "C", "grade_meaning": "Animal and cell studies", "human_studies_cited": 0, "animal_or_cell_studies_cited": 8, "fda_status": "Not approved", "fda_as_of": "2026-10-27", "fda_statement": "GHK-Cu is not approved by the FDA for any use. As copper tripeptide-1 it is sold in cosmetics, which sit outside FDA drug approval. The FDA placed the injectable form in Category 2 of its compounding list in 2023 over safety risks, and the agency now lists that nomination as withdrawn; it plans to bring GHK-Cu before its Pharmacy Compounding Advisory Committee by the end of February 2027.", "sold_for": "GHK-Cu is sold as an anti-aging and wound-healing peptide, in serums for wrinkles and hair thinning and as an injectable for recovery.", "studies_say": "Cell and animal work shows that GHK-Cu raises collagen production and speeds wound closure in rats, but the human evidence is limited to cosmetic tests reported inside reviews, which is why the grade is C.", "grade_reasoning": "For skin repair and wound healing, the use GHK-Cu is best known for, the primary studies in hand are cell cultures, rat and mouse experiments and one macaque hair model. The human cosmetic results that reviews describe come from manufacturer-run tests that are summarised and not published in full, so no controlled human trial with a known sample size can be named.", "citations": "https://doi.org/10.3390/brainsci7020020 | https://doi.org/10.1002/jor.22831 | https://doi.org/10.18632/oncotarget.11168 | https://pmc.ncbi.nlm.nih.gov/articles/PMC6073405/ | https://pubmed.ncbi.nlm.nih.gov/26236730/ | https://pubmed.ncbi.nlm.nih.gov/3169264/ | https://pubmed.ncbi.nlm.nih.gov/8227353/ | https://pubmed.ncbi.nlm.nih.gov/14648529/ | https://pubmed.ncbi.nlm.nih.gov/8326148/ | https://pubmed.ncbi.nlm.nih.gov/17703734/ | https://pubmed.ncbi.nlm.nih.gov/1809108/ | https://pubmed.ncbi.nlm.nih.gov/15773538/ | https://pubmed.ncbi.nlm.nih.gov/7544967/ | https://www.accessdata.fda.gov/scripts/cder/daf/index.cfm?event=overview.process&ApplNo=021108 | https://pmc.ncbi.nlm.nih.gov/articles/PMC3359723/ | https://pmc.ncbi.nlm.nih.gov/articles/PMC4180391/ | https://www.fda.gov/media/94155/download | https://www.fda.gov/drugs/human-drug-compounding/certain-bulk-drug-substances-use-compounding-may-present-significant-safety-risks", "page": "https://peptidegraded.com/p/ghk-cu/" }, { "slug": "ghrp-2", "name": "GHRP-2", "aliases": "Pralmorelin; GHRP2; GHRP 2; Growth hormone releasing peptide-2; Growth hormone-releasing peptide 2; KP-102; KP102; GPA-748; growth hormone secretagogue; GH secretagogue; GHRP; GHRH", "class": "GHRP / ghrelin agonist", "body_system": "Muscle and bone", "families": "Growth hormone boosters", "uses": "muscle growth; anti-ageing", "route": "Injection", "evidence_grade": "C", "grade_meaning": "Animal and cell studies", "human_studies_cited": 3, "animal_or_cell_studies_cited": 0, "fda_status": "Not approved", "fda_as_of": "2026-10-26", "fda_statement": "GHRP-2, also called pralmorelin, is not approved by the FDA for any use and is sold online as a research chemical. It has been used in Japan as a diagnostic test for growth hormone deficiency, which is a separate regulatory system. In Japan the GHRP-2 test is still used to assess pituitary function.", "sold_for": "GHRP-2 is sold as a growth hormone booster for muscle, fat loss and recovery, often stacked with a GHRH analog.", "studies_say": "In small human studies GHRP-2 does release growth hormone and increases appetite, but repeated dosing attenuates the response without raising IGF-1, and no trial has measured a body-composition or health outcome, so the grade is C.", "grade_reasoning": "For the muscle-building and anti-aging use GHRP-2 is sold for, the cited human work is a 7-man appetite study and a 9-man five-day dosing study in which the growth hormone response faded and IGF-1 did not rise. The largest human study, 65 elderly patients, used GHRP-2 only as a diagnostic test. None measured body composition, strength or any health outcome.", "citations": "https://doi.org/10.1210/jc.2004-1719 | https://doi.org/10.1016/j.ghir.2023.101545 | https://pubmed.ncbi.nlm.nih.gov/9820615/", "page": "https://peptidegraded.com/p/ghrp-2/" }, { "slug": "ghrp-6", "name": "GHRP-6", "aliases": "GHRP6; GHRP 6; Growth hormone releasing peptide-6; Growth hormone-releasing peptide 6; SKF-110679; His-D-Trp-Ala-Trp-D-Phe-Lys-NH2; growth hormone secretagogue; GH secretagogue; GHRP; GHRH", "class": "GHRP / ghrelin agonist", "body_system": "Muscle and bone", "families": "Growth hormone boosters", "uses": "muscle growth; fat loss", "route": "Injection", "evidence_grade": "C", "grade_meaning": "Animal and cell studies", "human_studies_cited": 1, "animal_or_cell_studies_cited": 1, "fda_status": "Not approved", "fda_as_of": "2026-10-26", "fda_statement": "GHRP-6 is not approved by the FDA for any use and is sold online as a research chemical. No company has filed for approval in any indication.", "sold_for": "GHRP-6 is sold as a growth hormone releaser for muscle gain, fat loss and injury recovery, and sometimes as an appetite stimulant.", "studies_say": "GHRP-6 does raise growth hormone and IGF-1 in healthy men over a day and a half of infusion, but there is no human trial measuring muscle, fat or recovery, and the heart findings are from rodents given a related peptide, which is the C grade.", "grade_reasoning": "For the muscle and recovery use GHRP-6 is sold for, the cited human evidence is a 1993 study in nine healthy men who received a 34-hour intravenous infusion of GHRP-6 or saline, measuring growth hormone and IGF-1 with no body-composition or health endpoint. The cardiovascular claims rest on rat and mouse heart experiments with hexarelin, a related peptide, and on a review of animal work.", "citations": "https://doi.org/10.1161/01.res.0000016164.02525.b4 | https://doi.org/10.1210/jcem.77.6.7903313 | https://doi.org/10.1016/j.tem.2005.11.004", "page": "https://peptidegraded.com/p/ghrp-6/" }, { "slug": "glepaglutide", "name": "Glepaglutide", "aliases": "ZP1848; ZP-1848", "class": "GLP-2 analog", "body_system": "Gut and weight", "families": "", "uses": "gut health; rare disease", "route": "Injection", "evidence_grade": "B", "grade_meaning": "Some human evidence", "human_studies_cited": 2, "animal_or_cell_studies_cited": 0, "fda_status": "In clinical trials", "fda_as_of": "2026-10-26", "fda_statement": "Glepaglutide is not approved by the FDA. Zealand Pharma filed a new drug application for short bowel syndrome and received a complete response letter in December 2024 asking for more evidence on the intended dose; a further phase 3 trial began enrolling in 2026. It is an investigational drug, not a research chemical.", "sold_for": "Glepaglutide is discussed as a long-acting GLP-2 analog that could reduce the hours patients with short bowel syndrome spend on intravenous nutrition.", "studies_say": "The phase 3 trial showed that glepaglutide at the trial dose cut parenteral support volume per week more than placebo, a real but single-trial result that regulators have not yet accepted, which is grade B.", "grade_reasoning": "One randomised placebo-controlled phase 3 trial in 106 patients with short bowel syndrome met its primary endpoint in the more frequent dosing arm but not the less frequent one, and the FDA judged that insufficient for approval. That is one positive trial with a split result, so the grade is B.", "citations": "https://doi.org/10.1053/j.gastro.2024.11.023 | https://doi.org/10.1016/j.clnesp.2025.08.006", "page": "https://peptidegraded.com/p/glepaglutide/" }, { "slug": "glucagon", "name": "Glucagon", "aliases": "Gvoke; Baqsimi; GlucaGen; GlucaGen HypoKit; Glucagon Emergency Kit; Gvoke HypoPen; Glucagon for injection", "class": "Glucagon receptor agonist", "body_system": "Gut and weight", "families": "", "uses": "blood sugar", "route": "Several routes", "evidence_grade": "A", "grade_meaning": "Strong human evidence", "human_studies_cited": 1, "animal_or_cell_studies_cited": 0, "fda_status": "FDA approved", "fda_as_of": "2026-10-26", "fda_statement": "Glucagon is FDA-approved for severe hypoglycemia and as a diagnostic aid to relax the gut during imaging. Current products include glucagon for injection kits, Gvoke (ready-to-use injection, approved 2019) and Baqsimi (nasal powder, approved 2019); Novo Nordisk discontinued GlucaGen HypoKit in the US on July 1, 2024.", "sold_for": "Glucagon is the emergency treatment for severe low blood sugar in people who use insulin, now available as a nasal powder and an autoinjector as well as the older mix-it-yourself kit.", "studies_say": "Randomised trials show that nasal and ready-to-use glucagon raise blood glucose as reliably as the injected kit within minutes, supporting the approvals and the A grade.", "grade_reasoning": "Glucagon's approval for severe hypoglycemia rests on decades of clinical use plus randomised trials of the newer formulations. The cited trial, 75 adults with type 1 diabetes in a randomised crossover design, showed nasal glucagon reversed insulin-induced hypoglycemia at 98.7% of visits against 100% for intramuscular glucagon.", "citations": "https://www.novomedlink.com/diabetes/products/treatments/glucagen-hypokit.html | https://doi.org/10.2337/dc15-1498 | https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/212097s000lbl.pdf | https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/210134s000lbl.pdf | https://www.novo-pi.com/glucagenhypokit.pdf", "page": "https://peptidegraded.com/p/glucagon/" }, { "slug": "glutathione", "name": "Glutathione", "aliases": "GSH; L-glutathione; Reduced glutathione; Glutathione IV; Gamma-glutamyl-cysteinyl-glycine; Tationil; Liposomal glutathione; longevity peptide; anti-ageing peptide; nootropic peptide", "class": "Antioxidant tripeptide", "body_system": "Skin", "families": "Longevity and brain peptides", "uses": "skin and hair; anti-ageing", "route": "Several routes", "evidence_grade": "B", "grade_meaning": "Some human evidence", "human_studies_cited": 4, "animal_or_cell_studies_cited": 0, "fda_status": "Not approved", "fda_as_of": "2026-10-26", "fda_statement": "Glutathione is not approved by the FDA as a drug for any indication. Oral glutathione is sold as a dietary supplement, intravenous and inhaled forms are made by compounding pharmacies, and glutathione sits in Category 1 of the FDA's list of nominated compounding substances, meaning it may be compounded while the agency evaluates it.", "sold_for": "Glutathione is sold as a master antioxidant, for skin whitening by intravenous drip, for detox and for Parkinson's disease.", "studies_say": "Oral glutathione does raise body stores and produced a modest, site-specific lightening in one small trial, while inhaled glutathione failed in cystic fibrosis and intravenous glutathione showed no clear benefit in a Parkinson's pilot, so the grade is B for the skin claim and lower for the others.", "grade_reasoning": "For skin lightening, the use glutathione is most often sold for, there is one randomised placebo-controlled trial of oral glutathione in 60 healthy students that found a small drop in melanin index at two of six skin sites. The larger trials in hand were for other purposes: a 153-patient inhaled trial in cystic fibrosis that missed its primary endpoint, a 54-adult trial showing oral glutathione raises blood levels, and a 21-patient Parkinson's pilot. No trial of intravenous glutathione for skin exists.", "citations": "https://www.fda.gov/media/94155/download | https://doi.org/10.3109/09546631003801619 | https://doi.org/10.1002/mds.22401 | https://pubmed.ncbi.nlm.nih.gov/24791752/ | https://pubmed.ncbi.nlm.nih.gov/23631796/", "page": "https://peptidegraded.com/p/glutathione/" }, { "slug": "compounded-gonadorelin", "name": "Gonadorelin (compounded)", "aliases": "Compounded gonadorelin; GnRH; Gonadotropin-releasing hormone; LHRH; Factrel; Lutrepulse; Kryptocur; Gonadorelin acetate", "class": "GnRH (native)", "body_system": "Reproduction", "families": "", "uses": "fertility; hormone replacement", "route": "Injection", "evidence_grade": "C", "grade_meaning": "Animal and cell studies", "human_studies_cited": 1, "animal_or_cell_studies_cited": 0, "fda_status": "Not approved", "fda_as_of": "2026-10-26", "fda_statement": "Gonadorelin was once sold as the FDA-approved products Factrel (a diagnostic) and Lutrepulse (a pump-delivered fertility treatment), both now discontinued in the United States, and no FDA-approved gonadorelin product is marketed as of 2026-10-26. The gonadorelin used alongside testosterone therapy is compounded and has no approved indication for that use.", "sold_for": "Compounded gonadorelin is sold by men's-health clinics as an injection taken alongside testosterone to prevent testicular shrinkage and preserve fertility, a role hCG used to fill.", "studies_say": "Pulsatile GnRH works in men whose pituitary is intact but unstimulated, but no trial has tested intermittent gonadorelin injections in men on testosterone therapy, so the grade is C.", "grade_reasoning": "For the use it is compounded for, keeping testicular size and fertility during testosterone replacement, there are no controlled trials. The human evidence in the citations is a meta-analysis of seven studies (420 men) of pulsatile GnRH pumps in congenital hypogonadotropic hypogonadism, a different condition treated with a different delivery method.", "citations": "https://pubmed.ncbi.nlm.nih.gov/32777865/ | https://doi.org/10.1159/000057944 | https://www.drugs.com/mtm/gonadorelin.html", "page": "https://peptidegraded.com/p/compounded-gonadorelin/" }, { "slug": "goserelin", "name": "Goserelin", "aliases": "Zoladex; Goserelin acetate; ICI 118630; Zoladex LA", "class": "GnRH agonist", "body_system": "Reproduction", "families": "", "uses": "cancer; hormone replacement", "route": "Implant", "evidence_grade": "A", "grade_meaning": "Strong human evidence", "human_studies_cited": 1, "animal_or_cell_studies_cited": 0, "fda_status": "FDA approved", "fda_as_of": "2026-10-26", "fda_statement": "Goserelin is FDA-approved as Zoladex, a subcutaneous implant first approved in 1989. Its labelled indications are palliative treatment of advanced prostate cancer, use with flutamide and radiotherapy in locally advanced prostate cancer, endometriosis, thinning of the uterine lining before ablation surgery, and palliative treatment of advanced breast cancer in pre- and perimenopausal women.", "sold_for": "Goserelin is a hormone-suppressing implant used in prostate cancer, premenopausal breast cancer and endometriosis, sometimes discussed as a way to protect ovaries during chemotherapy.", "studies_say": "Randomised trials show goserelin lowers sex hormones to post-menopausal or castrate levels and matches chemotherapy for survival in hormone-sensitive premenopausal breast cancer, which supports the approvals and the A grade.", "grade_reasoning": "Goserelin's approvals rest on randomised trials in prostate and breast cancer and endometriosis. The cited ZEBRA trial randomised 1,640 premenopausal women with node-positive early breast cancer to goserelin or CMF chemotherapy and found equivalent disease-free and overall survival in those with hormone-receptor-positive tumours.", "citations": "https://doi.org/10.1016/s0959-8049(03)00392-7 | https://www.accessdata.fda.gov/drugsatfda_docs/label/2026/019726s076lbl020515s013lbl.pdf", "page": "https://peptidegraded.com/p/goserelin/" }, { "slug": "hexapeptide-9", "name": "Hexapeptide-9", "aliases": "Collaxyl; Collaxyl IS; Hexapeptide 9; cosmetic peptide; skincare peptide; Matrixyl; Argireline", "class": "Signal peptide", "body_system": "Skin", "families": "Cosmetic skin peptides", "uses": "skin and hair; anti-ageing", "route": "Topical", "evidence_grade": "C", "grade_meaning": "Animal and cell studies", "human_studies_cited": 2, "animal_or_cell_studies_cited": 1, "fda_status": "Cosmetic ingredient", "fda_as_of": "2026-10-26", "fda_statement": "Hexapeptide-9 is a cosmetic ingredient. Cosmetics do not go through FDA drug approval, so it has no approved indication and makes no drug claims; it is listed under its INCI name in skincare formulations.", "sold_for": "Hexapeptide-9 is marketed in anti-aging serums as a collagen fragment that signals skin cells to rebuild the dermis and smooth wrinkles.", "studies_say": "The only controlled human trial tested a modified molecule and was run by the manufacturer, and the data for standard hexapeptide-9 are laboratory assays, so the grade is C.", "grade_reasoning": "For wrinkle reduction, the evidence for standard hexapeptide-9 is unpublished supplier data, lab and mouse work, and a small split-face volunteer test of a delivery carrier. The one randomised double-blind trial, published in 2025 by employees of a cosmetics company, enrolled 96 adults but tested a chemically modified cyclised version against a low-concentration retinol and vehicle over 56 days, so the standard ingredient stays at C.", "citations": "https://ashland.com/industries/personal-and-home-care/skin-and-sun-care/collaxyl-ng-biofunctional | https://www.specialchem.com/cosmetics/inci-ingredients/hexapeptide-9 | https://doi.org/10.1111/jocd.70290 | https://doi.org/10.1016/j.mtbio.2025.101527", "page": "https://peptidegraded.com/p/hexapeptide-9/" }, { "slug": "hexarelin", "name": "Hexarelin", "aliases": "Examorelin; Hexarelin acetate; EP 23905; EP-23905; Hexarelin peptide; growth hormone secretagogue; GH secretagogue; GHRP; GHRH", "class": "GHRP / ghrelin agonist", "body_system": "Muscle and bone", "families": "Growth hormone boosters", "uses": "muscle growth; heart and vessels", "route": "Injection", "evidence_grade": "C", "grade_meaning": "Animal and cell studies", "human_studies_cited": 1, "animal_or_cell_studies_cited": 1, "fda_status": "Not approved", "fda_as_of": "2026-10-26", "fda_statement": "Hexarelin, also called examorelin, is not approved by the FDA for any use and is sold online as a research chemical. It was studied in the 1990s as a growth hormone test and therapy but never reached the market anywhere.", "sold_for": "Hexarelin is sold as the most potent of the growth hormone-releasing peptides, for muscle gain and for heart protection.", "studies_say": "Hexarelin produces a larger growth hormone pulse than GHRH in healthy adults but also raises cortisol and prolactin, and its cardiac effects have been shown only in animals, so the grade is C.", "grade_reasoning": "For the muscle-building use hexarelin is sold for, the cited human evidence is an acute hormone study in six young and six elderly adults showing a growth hormone pulse along with rises in prolactin, ACTH and cortisol. The heart claims come from rodent and cell work on the CD36 receptor. No trial has measured body composition or any clinical outcome.", "citations": "https://doi.org/10.1161/01.res.0000016164.02525.b4 | https://pubmed.ncbi.nlm.nih.gov/9285939/ | https://pubmed.ncbi.nlm.nih.gov/9186261/", "page": "https://peptidegraded.com/p/hexarelin/" }, { "slug": "histrelin", "name": "Histrelin", "aliases": "Supprelin LA; Supprelin; Vantas; Histrelin acetate; Histrelin implant", "class": "GnRH agonist", "body_system": "Reproduction", "families": "", "uses": "hormone replacement; rare disease", "route": "Implant", "evidence_grade": "B", "grade_meaning": "Some human evidence", "human_studies_cited": 1, "animal_or_cell_studies_cited": 0, "fda_status": "FDA approved", "fda_as_of": "2026-10-26", "fda_statement": "Histrelin is FDA-approved as Supprelin LA, a 12-month subcutaneous implant for central precocious puberty in children, approved in 2007. The prostate cancer implant Vantas, approved in 2004, was discontinued by its manufacturer in 2021, so Supprelin LA is the only histrelin product on the US market.", "sold_for": "Histrelin is a once-a-year implant that pauses early puberty in children, and is sometimes discussed as a hormone blocker in other settings.", "studies_say": "A 36-child open-label trial showed the implant suppressed puberty hormones in every child for a year, which supports the approval, though no randomised comparison against monthly injections exists.", "grade_reasoning": "Supprelin LA was approved on the basis of open-label single-arm trials using hormone suppression as the endpoint; the cited study followed 36 children with central precocious puberty for 12 months and found luteinising hormone suppressed in all of them. Suppression of puberty is well established for the GnRH agonist class, but the histrelin-specific evidence is uncontrolled and uses surrogate endpoints, which is B.", "citations": "https://doi.org/10.1210/jc.2006-2479 | https://www.endodocuments.com/supprelin-la/pi | https://mdedge.com/content/hormone-blocker-sticker-shock-again-patients-lose-cheaper-drug-option", "page": "https://peptidegraded.com/p/histrelin/" }, { "slug": "human-chorionic-gonadotropin", "name": "Human chorionic gonadotropin", "aliases": "hCG; Pregnyl; Novarel; Ovidrel; Choriogonadotropin alfa; Chorionic gonadotropin; Chorex; Profasi; Gonasi", "class": "Glycoprotein gonadotropin", "body_system": "Reproduction", "families": "", "uses": "fertility; hormone replacement; weight loss", "route": "Injection", "evidence_grade": "A", "grade_meaning": "Strong human evidence", "human_studies_cited": 3, "animal_or_cell_studies_cited": 0, "fda_status": "FDA approved", "fda_as_of": "2026-10-26", "fda_statement": "Human chorionic gonadotropin (hCG) is FDA-approved as an injectable, under brand names including Pregnyl and Novarel, for inducing ovulation in women, for hypogonadotropic hypogonadism in men and for prepubertal cryptorchidism. It is not approved for weight loss, and the FDA has stated that over-the-counter \"homeopathic\" hCG weight-loss products are illegal and that hCG has not been shown to cause weight loss.", "sold_for": "hCG is used in fertility clinics to trigger ovulation, prescribed off-label to men to maintain testosterone and fertility, and sold illegally as a weight-loss injection or drops.", "studies_say": "Randomised trials support hCG for ovulation triggering and for raising testosterone in hypogonadal men, which earns the A grade for those uses; the weight-loss claim has no trial support and the FDA has said so.", "grade_reasoning": "For its approved reproductive uses, hCG is supported by decades of randomised trials, including a Cochrane review of hCG as the trigger for final egg maturation in IVF. For testosterone restoration in hypogonadal men who want to preserve fertility, a 282-man randomised trial found hCG as effective as clomiphene, and a systematic review pooled 196 hCG-treated patients. The weight-loss use has no supporting evidence.", "citations": "https://doi.org/10.1002/14651858.CD003719.pub4 | https://www.fda.gov/drugs/medication-health-fraud/questions-and-answers-hcg-products-weight-loss | https://www.organon.com/product/usa/pi_circulars/p/pregnyl/pregnyl_pi.pdf | https://pubmed.ncbi.nlm.nih.gov/33933392/ | https://pubmed.ncbi.nlm.nih.gov/29772111/", "page": "https://peptidegraded.com/p/human-chorionic-gonadotropin/" }, { "slug": "humanin", "name": "Humanin", "aliases": "HN; Humanin peptide; HNG; Humanin G; S14G-humanin; MTRNR2L; longevity peptide; anti-ageing peptide; nootropic peptide", "class": "Mitochondrial-derived peptide", "body_system": "Hormones", "families": "Longevity and brain peptides", "uses": "anti-ageing; cognition; blood sugar", "route": "Injection", "evidence_grade": "C", "grade_meaning": "Animal and cell studies", "human_studies_cited": 3, "animal_or_cell_studies_cited": 4, "fda_status": "Not approved", "fda_as_of": "2026-10-27", "fda_statement": "Humanin is not approved by the FDA for any use and is sold online as a research chemical. It is not a controlled substance under the DEA schedules. It does not appear in any of the FDA's three categories of substances nominated for compounding under section 503A, so the FDA's interim compounding policy does not cover it.", "sold_for": "Humanin is sold as a mitochondrial longevity peptide for brain protection, insulin sensitivity and healthy aging.", "studies_say": "Humanin protects neurons and improves insulin action in animals and tracks with age and disease in human blood samples, but it has never been administered to people in a trial, which is grade C.", "grade_reasoning": "For the longevity and metabolic use humanin is sold for, no human has been given humanin in a published trial. The human data are observational: a 693-person study of plasma mitokines across ages, a disease-comparison study in diabetes and Alzheimer's, and a genetic association with cognitive aging. Effects on insulin sensitivity, synapse loss and lifespan come from rats, mice, cultured neurons and worms.", "citations": "https://doi.org/10.1371/journal.pone.0006334 | https://doi.org/10.3389/fnagi.2019.00123 | https://doi.org/10.18632/aging.103534 | https://www.deadiversion.usdoj.gov/schedules/orangebook/c_cs_alpha.pdf | https://pubmed.ncbi.nlm.nih.gov/35499074/ | https://pubmed.ncbi.nlm.nih.gov/29955888/ | https://pubmed.ncbi.nlm.nih.gov/33131010/ | https://pubmed.ncbi.nlm.nih.gov/30242290/ | https://pubmed.ncbi.nlm.nih.gov/21510972/ | https://www.fda.gov/drugs/human-drug-compounding/certain-bulk-drug-substances-use-compounding-may-present-significant-safety-risks | https://www.fda.gov/media/94155/download | https://www.accessdata.fda.gov/scripts/cder/daf/index.cfm?event=overview.process&ApplNo=210557 | https://www.accessdata.fda.gov/scripts/cder/daf/index.cfm?event=overview.process&ApplNo=022505", "page": "https://peptidegraded.com/p/humanin/" }, { "slug": "icatibant", "name": "Icatibant", "aliases": "Firazyr; Sajazir; HOE 140; HOE-140; Icatibant acetate; JE049", "class": "Bradykinin B2 antagonist", "body_system": "Skin", "families": "", "uses": "rare disease", "route": "Injection", "evidence_grade": "A", "grade_meaning": "Strong human evidence", "human_studies_cited": 1, "animal_or_cell_studies_cited": 0, "fda_status": "FDA approved", "fda_as_of": "2026-10-26", "fda_statement": "Icatibant is FDA-approved as Firazyr, approved August 25, 2011, for treating acute attacks of hereditary angioedema in adults, given by subcutaneous self-injection. Generic icatibant injections have been approved since 2020.", "sold_for": "Icatibant is the on-demand injection that people with hereditary angioedema carry to stop a swelling attack.", "studies_say": "Placebo-controlled trials show icatibant shortens attacks from about 20 hours to about 2 hours, which supports the approval and the A grade.", "grade_reasoning": "Approval rested on three randomised phase 3 trials (FAST-1, FAST-2 and FAST-3). The cited FAST-3 trial randomised 88 patients with moderate to very severe attacks to icatibant or placebo and found median time to symptom relief of 2 hours against 20 hours.", "citations": "https://doi.org/10.1016/j.anai.2011.08.015 | https://ndclist.com/ndc/54092-702/label", "page": "https://peptidegraded.com/p/icatibant/" }, { "slug": "igf-1-des", "name": "IGF-1 DES", "aliases": "IGF-1 DES(1-3); DES(1-3) IGF-1; des(1-3)IGF-1; IGF1 DES; IGF-1 DES 1-3; Des IGF-1; Truncated IGF-1; growth hormone secretagogue; GH secretagogue; GHRP; GHRH", "class": "IGF-1 analog", "body_system": "Muscle and bone", "families": "Growth hormone boosters", "uses": "muscle growth", "route": "Injection", "evidence_grade": "C", "grade_meaning": "Animal and cell studies", "human_studies_cited": 0, "animal_or_cell_studies_cited": 2, "fda_status": "Not approved", "fda_as_of": "2026-10-26", "fda_statement": "IGF-1 DES, the des(1-3) fragment of insulin-like growth factor 1, is not approved by the FDA for any use and is sold online as a research chemical.", "sold_for": "IGF-1 DES is sold as a fast-acting, locally injected form of IGF-1 for muscle growth at the injection site.", "studies_say": "Cell studies explain why des(1-3)IGF-1 is more potent than IGF-1 in a dish, but there are no human studies at all, so the grade is C.", "grade_reasoning": "For the muscle-growth use it is sold for, the cited evidence is biochemical: cell assays showing des(1-3)IGF-1 escapes the binding proteins that restrain normal IGF-1, and one rat study in kidney insufficiency. No human has been given des(1-3)IGF-1 in a published study.", "citations": "https://doi.org/10.1042/bj2580267 | https://doi.org/10.1152/ajprenal.1991.261.4.F626 | https://doi.org/10.3389/fendo.2026.1822475", "page": "https://peptidegraded.com/p/igf-1-des/" }, { "slug": "igf-1-lr3", "name": "IGF-1 LR3", "aliases": "IGF1 LR3; LR3 IGF-1; Long R3 IGF-1; Long R3 IGF-I; LR3-IGF-1; IGF-1 Long R3; LongR3; growth hormone secretagogue; GH secretagogue; GHRP; GHRH", "class": "IGF-1 analog", "body_system": "Muscle and bone", "families": "Growth hormone boosters", "uses": "muscle growth; fat loss", "route": "Injection", "evidence_grade": "C", "grade_meaning": "Animal and cell studies", "human_studies_cited": 0, "animal_or_cell_studies_cited": 1, "fda_status": "Not approved", "fda_as_of": "2026-10-26", "fda_statement": "IGF-1 LR3 is not approved by the FDA for any use. It is manufactured as a cell-culture reagent and sold online as a research chemical.", "sold_for": "IGF-1 LR3 is sold as a long-acting IGF-1 for muscle growth and fat loss, with claims that it outlasts natural IGF-1 by a day.", "studies_say": "IGF-1 LR3 is a well characterised laboratory reagent that activates the IGF-1 receptor in cell culture, but it has never been studied in humans, so the grade is C.", "grade_reasoning": "For the muscle-growth use IGF-1 LR3 is sold for, no human study exists. The cited material is a review of IGF-1 receptor signalling, a 2019 animal or cell study and a 2026 review of IGF-1 analogs; the compound's documented use is as a growth supplement in laboratory cell culture.", "citations": "https://pubmed.ncbi.nlm.nih.gov/29535161/ | https://doi.org/10.1038/s41598-019-46178-9 | https://doi.org/10.3389/fendo.2026.1822475", "page": "https://peptidegraded.com/p/igf-1-lr3/" }, { "slug": "insulin-analogs-multiple", "name": "Insulin analogs", "aliases": "Insulin analogues; Insulin lispro; Insulin aspart; Insulin glulisine; Insulin glargine; Insulin detemir; Insulin degludec; Humalog; Novolog; NovoRapid; Apidra; Lantus; Basaglar; Toujeo; Levemir; Tresiba; Semglee; Fiasp; Lyumjev; Admelog", "class": "Insulin receptor agonist", "body_system": "Hormones", "families": "", "uses": "blood sugar", "route": "Injection", "evidence_grade": "A", "grade_meaning": "Strong human evidence", "human_studies_cited": 1, "animal_or_cell_studies_cited": 0, "fda_status": "FDA approved", "fda_as_of": "2026-10-26", "fda_statement": "Insulin analogs are FDA-approved to improve glycaemic control in diabetes: rapid-acting lispro (Humalog, 1996), aspart and glulisine, and long-acting glargine (2000), detemir and degludec, among others, with biosimilar and interchangeable versions now on the market. Novo Nordisk discontinued Levemir (insulin detemir) in the US at the end of 2024.", "sold_for": "Insulin analogs are the modified insulins that act faster at meals or last longer overnight than the human insulin they replaced, and they dominate diabetes treatment.", "studies_say": "Randomised trials show analogs match human insulin on blood glucose and reduce hypoglycaemia, particularly at night, which is the basis of their approvals and the A grade.", "grade_reasoning": "Every insulin analog was approved on randomised trials against human insulin. The cited Treat-to-Target trial randomised 756 adults with type 2 diabetes to glargine or NPH insulin added to oral drugs for 24 weeks and found the same glucose control with fewer night-time lows on glargine.", "citations": "https://www.novocare.com/levemir.html | https://doi.org/10.2337/diacare.26.11.3080 | https://uspl.lilly.com/humalog/humalog.html", "page": "https://peptidegraded.com/p/insulin-analogs-multiple/" }, { "slug": "ipamorelin", "name": "Ipamorelin", "aliases": "Ipamoreline; Ipamorelin acetate; NNC 26-0161; NNC26-0161; Ipamorelin peptide; Ipamorlin; Ipamoralin; CJC-1295/Ipamorelin; growth hormone secretagogue; GH secretagogue; GHRP; GHRH", "class": "GHRP / ghrelin receptor agonist", "body_system": "Muscle and bone", "families": "Growth hormone boosters", "uses": "muscle growth; anti-ageing", "route": "Injection", "evidence_grade": "C", "grade_meaning": "Animal and cell studies", "human_studies_cited": 3, "animal_or_cell_studies_cited": 2, "fda_status": "Not approved", "fda_as_of": "2026-10-27", "fda_statement": "Ipamorelin is not approved by the FDA for any use and is sold online as a research chemical; its development for post-operative ileus was abandoned after a negative phase 2 trial. In 2023 the FDA placed it in Category 2 of its compounding lists, the category for substances with significant safety risks, and it remains there for outsourcing facilities (503B) although the nominations for pharmacy compounding (503A) were withdrawn in 2024. In October 2024 the Pharmacy Compounding Advisory Committee voted 12 to 0, with one abstention, against adding it to the 503A bulks list.", "sold_for": "Ipamorelin is sold as the cleanest growth hormone secretagogue, for anti-aging, fat loss and muscle, usually paired with CJC-1295.", "studies_say": "Ipamorelin releases growth hormone in humans without the cortisol rise seen with GHRP-2 and GHRP-6, but the only outcome trial, in bowel surgery patients, was negative, and no study has measured body composition or aging, so the grade is C.", "grade_reasoning": "For the anti-aging and body-composition use ipamorelin is sold for, no human trial exists. The human data are a 40-volunteer dose-escalation pharmacokinetic study showing a single growth hormone pulse, a 114-patient randomised phase 2 trial in post-operative ileus that found no benefit, and a comparative hormone study of related peptides. The selectivity claim comes from rats and swine.", "citations": "https://my.clevelandclinic.org/health/body/22804-ghrelin | https://pubmed.ncbi.nlm.nih.gov/9849822/ | https://doi.org/10.1054/ghir.2001.0239 | https://pubmed.ncbi.nlm.nih.gov/10496658/ | https://doi.org/10.1124/jpet.108.149211 | https://pubmed.ncbi.nlm.nih.gov/25331030/ | https://www.fda.gov/drugs/human-drug-compounding/certain-bulk-drug-substances-use-compounding-may-present-significant-safety-risks | https://pubmed.ncbi.nlm.nih.gov/9186261/ | https://pubmed.ncbi.nlm.nih.gov/9285939/ | https://www.fda.gov/media/94155/download | https://pubmed.ncbi.nlm.nih.gov/22901302/", "page": "https://peptidegraded.com/p/ipamorelin/" }, { "slug": "kisspeptin-10", "name": "Kisspeptin-10", "aliases": "Kisspeptin; Kisspeptin 10; KP-10; KP10; Metastin; Metastin (45-54); KISS1", "class": "Reproductive peptide", "body_system": "Reproduction", "families": "", "uses": "sexual function; fertility", "route": "Intravenous", "evidence_grade": "B", "grade_meaning": "Some human evidence", "human_studies_cited": 4, "animal_or_cell_studies_cited": 0, "fda_status": "Not approved", "fda_as_of": "2026-10-26", "fda_statement": "Kisspeptin-10 is not approved by the FDA for any use. Kisspeptin peptides remain investigational, studied mainly at Imperial College London, and are sold online as research chemicals.", "sold_for": "Kisspeptin-10 is sold as a natural libido and testosterone booster that works upstream of the hormones themselves.", "studies_say": "In small controlled trials kisspeptin raises luteinising hormone and testosterone and increases sexual brain responses, with the largest trial in 32 men, which earns a B; online products are the 10-amino-acid fragment, while most of the trial evidence used kisspeptin-54.", "grade_reasoning": "For stimulating reproductive hormones and sexual response, the use kisspeptin is best known for, there are several small controlled human studies, the largest a 32-man double-blind placebo-controlled crossover trial in hypoactive sexual desire disorder. Most of the brain and libido work used kisspeptin-54, the longer natural form; kisspeptin-10 itself has been tested for hormone release in 12 men. Samples are small and endpoints are hormonal or imaging-based, so the grade is B.", "citations": "https://wada-ama.org/en/prohibited-list | https://doi.org/10.1172/JCI89519 | https://doi.org/10.1172/jci.insight.121958 | https://doi.org/10.1001/jamanetworkopen.2022.36131 | https://doi.org/10.1210/endrev/bnad023 | https://pubmed.ncbi.nlm.nih.gov/23153270/", "page": "https://peptidegraded.com/p/kisspeptin-10/" }, { "slug": "kpv", "name": "KPV", "aliases": "KPV peptide; Lys-Pro-Val; Alpha-MSH 11-13; α-MSH(11-13); KPV tripeptide; healing peptide; recovery peptide; injury peptide", "class": "Anti-inflammatory tripeptide", "body_system": "Gut and weight", "families": "Healing and recovery peptides", "uses": "gut health; skin and hair", "route": "Several routes", "evidence_grade": "C", "grade_meaning": "Animal and cell studies", "human_studies_cited": 0, "animal_or_cell_studies_cited": 2, "fda_status": "Not approved", "fda_as_of": "2026-10-27", "fda_statement": "KPV is not approved by the FDA for any use and is sold online as a research chemical, in oral, topical and injectable forms. The FDA moved it out of its category 2 safety-risk list in April 2026 after the nomination was withdrawn, and in July 2026 the FDA's Pharmacy Compounding Advisory Committee voted 8-6 to recommend adding it to the list of substances pharmacies may compound. That vote is advisory and does not by itself allow compounding.", "sold_for": "KPV is sold as an anti-inflammatory peptide for gut problems, skin conditions and general inflammation.", "studies_say": "KPV reduces colitis in mice when given systemically or in oral nanoparticles, but there is no human data at all, so the grade is C.", "grade_reasoning": "For gut inflammation, the use KPV is best known for, the evidence is two mouse colitis studies and a review of the alpha-MSH peptide family. No human study of KPV has been published for any indication.", "citations": "https://doi.org/10.1002/ibd.20334 | https://doi.org/10.1016/j.ymthe.2016.11.020 | https://doi.org/10.1136/ard.2007.079780 | https://www.fda.gov/advisory-committees/advisory-committee-calendar/july-23-24-2026-meeting-pharmacy-compounding-advisory-committee-07232026", "page": "https://peptidegraded.com/p/kpv/" }, { "slug": "lanreotide", "name": "Lanreotide", "aliases": "Somatuline Depot; Somatuline; Somatuline Autogel; Lanreotide acetate; BIM 23014; BIM-23014; Angiopeptin", "class": "Somatostatin analog", "body_system": "Gut and weight", "families": "", "uses": "cancer; rare disease; other", "route": "Injection", "evidence_grade": "A", "grade_meaning": "Strong human evidence", "human_studies_cited": 1, "animal_or_cell_studies_cited": 0, "fda_status": "FDA approved", "fda_as_of": "2026-10-26", "fda_statement": "Approved. Lanreotide is marketed in the US as Somatuline Depot for acromegaly (first approved 2007), for unresectable or metastatic gastroenteropancreatic neuroendocrine tumors, and for carcinoid syndrome. A therapeutically equivalent lanreotide injection from Cipla is also approved.", "sold_for": "Lanreotide is a prescription cancer and acromegaly drug, and it is not a wellness-market peptide; the talk about it is clinical, mostly about slowing neuroendocrine tumors.", "studies_say": "A placebo-controlled trial in 204 patients and the acromegaly trials behind the label support both approved uses, which is why it grades A.", "grade_reasoning": "The neuroendocrine tumor indication rests on CLARINET, a randomized, double-blind, placebo-controlled trial in 204 patients that showed longer progression-free survival. The acromegaly approval rests on earlier controlled trials summarized in the label. The citations here include one trial and the prescribing information; the open question is how lanreotide compares head to head with octreotide in tumor control, which CLARINET did not test.", "citations": "https://doi.org/10.1056/NEJMoa1316158 | https://www.drugs.com/pro/somatuline-depot.html", "page": "https://peptidegraded.com/p/lanreotide/" }, { "slug": "larazotide-acetate", "name": "Larazotide acetate", "aliases": "Larazotide; AT-1001; AT1001; INN-202; Zonulin inhibitor", "class": "Zonulin antagonist (tight-junction regulator)", "body_system": "Gut and weight", "families": "", "uses": "gut health", "route": "Oral", "evidence_grade": "B", "grade_meaning": "Some human evidence", "human_studies_cited": 2, "animal_or_cell_studies_cited": 0, "fda_status": "In clinical trials", "fda_as_of": "2026-10-26", "fda_statement": "Not approved by the FDA for any use. Larazotide acetate reached a phase 3 trial for celiac disease, which 9 Meters Biopharma stopped in June 2022 after an interim analysis found it unlikely to show a difference from placebo.", "sold_for": "Larazotide is talked about as a pill that would let people with celiac disease tolerate accidental gluten by tightening the gut barrier, and some wellness sites extend that to 'leaky gut' in general.", "studies_say": "Randomized trials in celiac patients were run and pooled, but the phase 3 was stopped for lack of effect, so the controlled human evidence (grade B) does not support the claimed benefit.", "grade_reasoning": "Larazotide was tested in four randomized placebo-controlled trials in celiac disease with 626 patients in total, pooled in a 2021 meta-analysis, and in a phase 3 trial planned for 525 patients that was stopped at the halfway point. Human controlled data exist, which keeps it at B, but symptom benefit appeared only during deliberate gluten challenge, the permeability measure did not change, and the program ended.", "citations": "https://doi.org/10.1152/ajpgi.00386.2020 | https://www.beyondceliac.org/research-news/phase-3-study-discontinued/ | https://doi.org/10.1016/j.clinre.2021.101782", "page": "https://peptidegraded.com/p/larazotide-acetate/" }, { "slug": "leuprolide", "name": "Leuprolide", "aliases": "Lupron; Lupron Depot; Lupron Depot-Ped; Eligard; Camcevi; Fensolvi; Leuprorelin; Leuprolide acetate; Viadur; Prostap; Leuprorelin acetate", "class": "GnRH agonist", "body_system": "Reproduction", "families": "", "uses": "hormone replacement; cancer; fertility", "route": "Injection", "evidence_grade": "A", "grade_meaning": "Strong human evidence", "human_studies_cited": 1, "animal_or_cell_studies_cited": 0, "fda_status": "FDA approved", "fda_as_of": "2026-10-26", "fda_statement": "Approved. Leuprolide acetate was first approved in 1985 for advanced prostate cancer and is sold as Lupron Depot, Eligard, Camcevi, and generics for prostate cancer, endometriosis, and uterine fibroids, and as Lupron Depot-Ped and Fensolvi for central precocious puberty in children.", "sold_for": "Leuprolide is a mainstream hormone-suppressing drug; outside clinics it comes up mostly in debates about puberty blockers and in bodybuilding forums as a way to shut down natural testosterone.", "studies_say": "Controlled trials and 40 years of clinical use support the approved indications, so it grades A for prostate cancer and precocious puberty.", "grade_reasoning": "Leuprolide has four decades of controlled trials behind its prostate cancer, endometriosis, and precocious puberty indications, summarized in the adult and pediatric labels. The cited 2012 study is a randomized phase 3 trial in 84 children with precocious puberty comparing two strengths of the three-month depot, which is also the largest trial cited. The citations are thin on the original randomized prostate cancer trials, but the approvals and the labels rest on them.", "citations": "https://doi.org/10.1210/jc.2011-2704 | https://www.rxabbvie.com/pdf/lupronuro_pi.pdf | https://www.rxabbvie.com/pdf/lupronpediatric.pdf", "page": "https://peptidegraded.com/p/leuprolide/" }, { "slug": "linaclotide", "name": "Linaclotide", "aliases": "Linzess; Constella; MD-1100; MM-416775", "class": "Guanylate cyclase-C agonist", "body_system": "Gut and weight", "families": "", "uses": "gut health", "route": "Oral", "evidence_grade": "A", "grade_meaning": "Strong human evidence", "human_studies_cited": 1, "animal_or_cell_studies_cited": 0, "fda_status": "FDA approved", "fda_as_of": "2026-10-26", "fda_statement": "Approved. Linaclotide (Linzess) was approved in 2012 for irritable bowel syndrome with constipation and chronic idiopathic constipation in adults. The current label also covers IBS with constipation in children 7 and older and functional constipation in children 2 and older, the latter extended from age 6 in May 2026. It is contraindicated in children under 2.", "sold_for": "Linaclotide is a prescription constipation drug; the only hype around it is marketing to IBS-C patients, and it is not sold in the gray peptide market.", "studies_say": "Multiple large randomized placebo-controlled trials met their FDA-set endpoints, which is why it grades A.", "grade_reasoning": "The adult IBS-C approval rests on two phase 3 randomized placebo-controlled trials with about 800 patients each (1,604 in total, per the label); the cited 2012 paper reports the 26-week trial of 804 patients. Two further trials support chronic constipation, and the pediatric extensions rest on additional randomized trials. Head-to-head comparisons with other secretagogues such as plecanatide are missing.", "citations": "https://doi.org/10.1038/ajg.2012.254 | https://www.rxabbvie.com/pdf/linzess_pi.pdf", "page": "https://peptidegraded.com/p/linaclotide/" }, { "slug": "liraglutide", "name": "Liraglutide", "aliases": "Victoza; Saxenda; Xultophy (component); NN2211; Liraglutide injection; Generic liraglutide; GLP-1; GLP1; GLP-1 agonist; weight loss shot", "class": "GLP-1 receptor agonist", "body_system": "Gut and weight", "families": "GLP-1 drugs and successors", "uses": "weight loss; blood sugar; heart and vessels", "route": "Injection", "evidence_grade": "A", "grade_meaning": "Strong human evidence", "human_studies_cited": 3, "animal_or_cell_studies_cited": 0, "fda_status": "FDA approved", "fda_as_of": "2026-10-27", "fda_statement": "Approved. Liraglutide is sold as Victoza (approved 2010) for type 2 diabetes in adults and children aged 10 and older and to reduce major cardiovascular events in adults with type 2 diabetes and heart disease, and as Saxenda (approved 2014) for chronic weight management in adults and adolescents aged 12 and older. Generic liraglutide for both indications has been approved since December 2024 and August 2025.", "sold_for": "Liraglutide was the first daily GLP-1 drug to be approved for weight loss and is now marketed as the cheaper generic alternative to semaglutide for people who want a GLP-1 but cannot get or afford the newer ones.", "studies_say": "Trials in nearly 10,000 diabetic patients and 3,700 adults with obesity showed fewer heart events and about 8 percent body weight loss respectively, which earns an A for both approved uses.", "grade_reasoning": "Both uses rest on large randomized placebo-controlled trials: LEADER (9,340 patients with type 2 diabetes, cardiovascular outcomes) and the SCALE obesity trial (3,731 adults, 56 weeks of weight loss). Multiple other phase 3 trials sit behind the labels. What the citations do not cover is how liraglutide compares with the newer weekly GLP-1 drugs, which outperform it on weight.", "citations": "https://www.accessdata.fda.gov/drugsatfda_docs/label/2025/022341s044lbl.pdf | https://www.drugs.com/liraglutide.html | https://www.sciencedirect.com/science/article/pii/S1043661825004700 | https://doi.org/10.1056/NEJMoa1603827 | https://www.accessdata.fda.gov/drugsatfda_docs/label/2025/206321s022lbl.pdf | https://doi.org/10.1056/NEJMoa1411892 | https://pubmed.ncbi.nlm.nih.gov/42595732/", "page": "https://peptidegraded.com/p/liraglutide/" }, { "slug": "lixisenatide", "name": "Lixisenatide", "aliases": "Adlyxin; Lyxumia; Soliqua (component); Soliqua 100/33; AVE0010; ZP10; GLP-1; GLP1; GLP-1 agonist; weight loss shot", "class": "GLP-1 receptor agonist", "body_system": "Hormones", "families": "GLP-1 drugs and successors", "uses": "blood sugar; heart and vessels", "route": "Injection", "evidence_grade": "A", "grade_meaning": "Strong human evidence", "human_studies_cited": 1, "animal_or_cell_studies_cited": 0, "fda_status": "FDA approved", "fda_as_of": "2026-10-26", "fda_statement": "Approved. Lixisenatide was approved in 2016 as Adlyxin for type 2 diabetes in adults. Sanofi withdrew standalone Adlyxin from the US market effective January 1, 2023 for commercial reasons; the molecule remains available in Soliqua 100/33, a fixed combination with insulin glargine.", "sold_for": "Lixisenatide gets almost no consumer attention; it is a shorter-acting GLP-1 drug that lost out commercially to weekly rivals and now survives mainly as the GLP-1 half of Soliqua.", "studies_say": "Phase 3 glycemic trials and a 6,068-patient cardiovascular trial support its approval for type 2 diabetes (grade A), with the cardiovascular trial showing neither harm nor benefit.", "grade_reasoning": "The glucose-lowering indication rests on the GetGoal phase 3 program summarized in the label, and ELIXA, a randomized placebo-controlled cardiovascular outcomes trial in 6,068 patients after an acute coronary syndrome, established cardiovascular safety. The gap is that lixisenatide showed no cardiovascular benefit and only modest weight loss, so its evidence supports safety and glycemic control, not the outcomes that newer GLP-1 drugs achieved.", "citations": "https://www.accessdata.fda.gov/drugsatfda_docs/label/2024/208471s009lbl.pdf | https://doi.org/10.1056/NEJMoa1509225 | https://www.rxless.com/resources/adlyxin-lixisenatide-will-no-longer-be-available-in-the-us", "page": "https://peptidegraded.com/p/lixisenatide/" }, { "slug": "ll-37", "name": "LL-37", "aliases": "LL37; LL 37; Cathelicidin; hCAP18; hCAP-18; CAMP; Cathelicidin antimicrobial peptide; LL-37 peptide; healing peptide; recovery peptide; injury peptide", "class": "Host-defense antimicrobial peptide", "body_system": "Immunity", "families": "Healing and recovery peptides", "uses": "wound healing; immune support", "route": "Injection", "evidence_grade": "C", "grade_meaning": "Animal and cell studies", "human_studies_cited": 6, "animal_or_cell_studies_cited": 6, "fda_status": "Not approved", "fda_as_of": "2026-10-26", "fda_statement": "Not approved by the FDA for any use and sold as a research chemical. LL-37 was nominated for the FDA's compounding bulk-substances list and placed in Category 2 (significant safety risk); the nomination was withdrawn, the FDA removed it from the category in April 2026, and a Pharmacy Compounding Advisory Committee review is planned before the end of February 2027.", "sold_for": "LL-37 is sold as an injectable 'natural antibiotic' that fights infections, breaks up biofilms, heals wounds, and modulates immunity.", "studies_say": "Topical LL-37 has two small wound-healing trials with mixed results, the body's own LL-37 is well studied and drives inflammation in psoriasis and rosacea, and there are no human data on injecting it, so the evidence for the marketed use is grade C.", "grade_reasoning": "Two randomized placebo-controlled trials exist, both of LL-37 applied topically to chronic wounds: 148 patients with venous leg ulcers (negative on the primary endpoint) and a smaller diabetic foot ulcer trial. The injected 'immune support' use sold online has no human data at all. The rest of the human literature is observational work on the body's own LL-37 in wounds, psoriasis, and rosacea, plus cell and mouse mechanism studies. For the use it is sold for, that is C.", "citations": "https://doi.org/10.1016/j.bbrc.2020.03.162 | https://www.fda.gov/drugs/human-drug-compounding/certain-bulk-drug-substances-use-compounding-may-present-significant-safety-risks | https://www.fda.gov/media/94155/download | https://www.fda.gov/advisory-committees/pharmacy-compounding-advisory-committee/meeting-pharmacy-compounding-advisory-committee | https://pubmed.ncbi.nlm.nih.gov/11015447/ | https://pubmed.ncbi.nlm.nih.gov/11389039/ | https://pubmed.ncbi.nlm.nih.gov/12603850/ | https://pubmed.ncbi.nlm.nih.gov/23766266/ | https://pubmed.ncbi.nlm.nih.gov/15985530/ | https://pubmed.ncbi.nlm.nih.gov/16497887/ | https://pubmed.ncbi.nlm.nih.gov/40270954/ | https://pubmed.ncbi.nlm.nih.gov/17873860/ | https://pubmed.ncbi.nlm.nih.gov/17676051/ | https://pubmed.ncbi.nlm.nih.gov/16215847/ | https://pubmed.ncbi.nlm.nih.gov/34687253/ | https://pubmed.ncbi.nlm.nih.gov/37480520/", "page": "https://peptidegraded.com/p/ll-37/" }, { "slug": "ltx-315", "name": "LTX-315", "aliases": "LTX315; LTX 315; Oncopore; Ruxotemitide", "class": "Oncolytic peptide", "body_system": "Skin", "families": "", "uses": "cancer", "route": "Injection", "evidence_grade": "C", "grade_meaning": "Animal and cell studies", "human_studies_cited": 1, "animal_or_cell_studies_cited": 0, "fda_status": "In clinical trials", "fda_as_of": "2026-10-27", "fda_statement": "Not approved by the FDA for any use. LTX-315 (ruxotemitide, developed by Verrica Pharmaceuticals as VP-315) is an investigational oncolytic peptide, and the FDA accepted Verrica's IND application for basal cell carcinoma in November 2021. Verrica's phase 2 basal cell carcinoma trial (NCT05188729) finished in April 2024 and posted results on ClinicalTrials.gov in June 2025; no phase 3 trial is registered.", "sold_for": "LTX-315 is described as a first-in-class 'oncolytic peptide' that bursts tumor cells from the inside and turns a tumor into its own vaccine, a story that outruns the single phase 1 trial published so far.", "studies_say": "A 39-patient uncontrolled phase 1 trial showed injected tumors regressing in some patients and immune cells moving in, which is grade C evidence until a controlled trial reports.", "grade_reasoning": "The only published human data in the citations are a phase 1 dose-escalation study of intratumoral injection in 39 patients with accessible solid tumors, uncontrolled and designed for safety. Earlier animal work established the mechanism. No randomized trial exists, so the grade is C despite the drug reaching phase 2.", "citations": "https://pubmed.ncbi.nlm.nih.gov/33542073/ | https://verrica.com/press_release/verrica-pharmaceuticals-announces-fda-acceptance-of-its-ind-application-for-ltx-315-a-potential-first-in-class-oncolytic-peptide-based-immunotherapy-for-the-treatment-of-basal-cell-carcinoma/ | https://clinicaltrials.gov/study/NCT05188729", "page": "https://peptidegraded.com/p/ltx-315/" }, { "slug": "lutetium-lu-177-dotatate", "name": "Lutetium Lu-177 dotatate", "aliases": "Lutathera; Lu-177 dotatate; 177Lu-DOTATATE; Lutetium-177 dotatate; Lu177 dotatate; 177Lu-DOTA-TATE; PRRT; Lutetium oxodotreotide; Oxodotreotide", "class": "SSTR-targeted radiopeptide", "body_system": "Gut and weight", "families": "", "uses": "cancer", "route": "Intravenous", "evidence_grade": "A", "grade_meaning": "Strong human evidence", "human_studies_cited": 1, "animal_or_cell_studies_cited": 0, "fda_status": "FDA approved", "fda_as_of": "2026-10-26", "fda_statement": "Approved. Lutetium Lu-177 dotatate (Lutathera, Novartis) was approved in January 2018 for somatostatin receptor-positive gastroenteropancreatic neuroendocrine tumors in adults, and in 2024 the indication was extended to patients aged 12 and older.", "sold_for": "Lutathera is discussed in oncology circles, with no wellness market, as the first radioactive peptide drug to win FDA approval and the model for the targeted radioligand drugs that followed.", "studies_say": "A 229-patient randomized trial showed a 79 percent reduction in progression or death versus octreotide, which supports an A grade for its approved use.", "grade_reasoning": "Approval rests on NETTER-1, a randomized open-label phase 3 trial in 229 patients with progressive midgut neuroendocrine tumors, which showed a large improvement in progression-free survival over high-dose octreotide, supported by a Dutch single-center series of more than 1,200 patients. The remaining gap is overall survival, where the final NETTER-1 analysis showed no statistically significant difference.", "citations": "https://doi.org/10.1056/NEJMoa1607427 | https://www.novartis.com/us-en/sites/novartis_us/files/lutathera.pdf", "page": "https://peptidegraded.com/p/lutetium-lu-177-dotatate/" }, { "slug": "lutetium-lu-177-vipivotide-tetraxetan", "name": "Lutetium Lu-177 vipivotide tetraxetan", "aliases": "Pluvicto; Lu-177 PSMA-617; 177Lu-PSMA-617; PSMA-617; Lutetium-177 PSMA; Lu-PSMA; Vipivotide tetraxetan; Lu177 PSMA", "class": "PSMA-targeted radioligand", "body_system": "Reproduction", "families": "", "uses": "cancer", "route": "Intravenous", "evidence_grade": "A", "grade_meaning": "Strong human evidence", "human_studies_cited": 1, "animal_or_cell_studies_cited": 0, "fda_status": "FDA approved", "fda_as_of": "2026-10-26", "fda_statement": "Approved. Lutetium Lu-177 vipivotide tetraxetan (Pluvicto, Novartis) was approved in March 2022 for PSMA-positive metastatic castration-resistant prostate cancer after androgen receptor pathway inhibition and taxane chemotherapy, extended in March 2025 to patients who have not had chemotherapy, and extended again in mid-2026 to PSMA-positive metastatic hormone-sensitive prostate cancer in combination with an androgen receptor pathway inhibitor and androgen deprivation therapy.", "sold_for": "Pluvicto is talked about as the proof that radioligand therapy works in a common cancer, and as a multibillion-dollar product that keeps moving earlier in prostate cancer treatment.", "studies_say": "An 831-patient randomized trial showed a four-month survival gain, and further randomized trials supported earlier use, which is an A for its approved indications.", "grade_reasoning": "The original approval rests on VISION, a randomized open-label phase 3 trial in 831 men that showed longer overall survival and progression-free survival over standard care alone. Later expansions rest on PSMAfore and PSMAddition, randomized trials summarized in the label. The open question is overall survival in the earlier settings: PSMAfore showed no significant survival difference, with most control patients crossing over to the radioligand, and PSMAddition survival data are immature.", "citations": "https://doi.org/10.1056/NEJMoa2107322 | https://www.novartis.com/us-en/sites/novartis_us/files/pluvicto.pdf | https://www.accessdata.fda.gov/drugsatfda_docs/label/2026/215833s037lbl.pdf", "page": "https://peptidegraded.com/p/lutetium-lu-177-vipivotide-tetraxetan/" }, { "slug": "mazdutide", "name": "Mazdutide", "aliases": "IBI362; IBI-362; LY3305677; LY-3305677; OXM3; Xinermei; GLP-1; GLP1; GLP-1 agonist; weight loss shot", "class": "GLP-1 / glucagon dual agonist", "body_system": "Gut and weight", "families": "GLP-1 drugs and successors", "uses": "weight loss; blood sugar", "route": "Injection", "evidence_grade": "A", "grade_meaning": "Strong human evidence", "human_studies_cited": 7, "animal_or_cell_studies_cited": 1, "fda_status": "In clinical trials", "fda_as_of": "2026-10-27", "fda_statement": "Not approved by the FDA for any use. Mazdutide is approved in China, where the NMPA cleared it in June 2025 for chronic weight management in adults with overweight or obesity and in September 2025 for glycemic control in type 2 diabetes. In the US it is investigational, with Eli Lilly holding the rights, one US phase 2 trial published and no phase 3 result or FDA filing reported.", "sold_for": "Mazdutide is pitched as the next step after tirzepatide: a weekly dual agonist that adds glucagon receptor activity to GLP-1 for more weight loss and liver fat reduction, and it is already being sold by gray-market peptide vendors in the US.", "studies_say": "Two phase 3 trials in more than a thousand Chinese adults produced about 15 percent weight loss versus placebo over 48 to 60 weeks and led to approval in China, which grades A, although no US trial has finished and no outcomes trial exists.", "grade_reasoning": "Mazdutide has completed multiple phase 3 randomized placebo-controlled trials in China: GLORY-1 in 610 adults with overweight or obesity and GLORY-2 in 461 adults with obesity, plus the DREAMS trials in type 2 diabetes, and it won two approvals on that basis. That meets the A definition. The limits are that nearly all trial participants were Chinese, no cardiovascular outcomes trial has reported, and US data are limited to one phase 2 trial of 179 people.", "citations": "https://www.ncbi.nlm.nih.gov/books/NBK551568/ | https://doi.org/10.1001/jama.2026.8142 | https://doi.org/10.1007/s40265-025-02249-y | https://doi.org/10.1056/NEJMoa2411528 | https://doi.org/10.1111/dom.71058 | https://clinicaltrials.gov/study/NCT06124807 | https://doi.org/10.3390/ijms232314631 | https://doi.org/10.1111/dom.15693 | https://doi.org/10.1136/bmj-2026-372161 | https://pubmed.ncbi.nlm.nih.gov/42251595/ | https://doi.org/10.3389/fendo.2024.1309118 | https://pubmed.ncbi.nlm.nih.gov/42628555/", "page": "https://peptidegraded.com/p/mazdutide/" }, { "slug": "mecasermin", "name": "Mecasermin", "aliases": "Increlex; rhIGF-1; Recombinant IGF-1; Recombinant human IGF-1; Iplex (mecasermin rinfabate); Mecasermin rinfabate; Myotrophin", "class": "IGF-1 (recombinant)", "body_system": "Hormones", "families": "", "uses": "rare disease", "route": "Injection", "evidence_grade": "B", "grade_meaning": "Some human evidence", "human_studies_cited": 1, "animal_or_cell_studies_cited": 0, "fda_status": "FDA approved", "fda_as_of": "2026-10-26", "fda_statement": "Approved. Mecasermin (Increlex) was approved in 2005 for growth failure in children with severe primary IGF-1 deficiency, or with growth hormone gene deletion who have developed neutralizing antibodies to growth hormone. It is not approved for any adult use or for muscle building.", "sold_for": "Mecasermin is pharmaceutical IGF-1, and in bodybuilding circles it is treated as a muscle-building hormone, even though its only approved use is to make very short children grow.", "studies_say": "Uncontrolled follow-up of 76 children with IGF-1 deficiency showed growth velocity roughly tripling in the first year, enough for approval in a rare disease but not for an A, and there are no trials for any other use.", "grade_reasoning": "The approval rests on open-label, uncontrolled studies: the cited 2007 report followed 76 children with severe primary IGF-1 deficiency for up to 12 years, using each child's pre-treatment growth rate as the comparison. No placebo-controlled trial exists, which is defensible for a rare pediatric disease but keeps the grade at B. The off-label uses promoted online (muscle growth, recovery) have no human trials at all.", "citations": "https://doi.org/10.1210/jc.2006-1610 | https://www.accessdata.fda.gov/drugsatfda_docs/label/2025/021839s033lbl.pdf", "page": "https://peptidegraded.com/p/mecasermin/" }, { "slug": "mechano-growth-factor", "name": "Mechano growth factor", "aliases": "MGF; MGF peptide; PEG-MGF; PEG MGF; IGF-1Ec; IGF-1 Ec; Mechano-growth factor; MGF Peg; healing peptide; recovery peptide; injury peptide", "class": "IGF-1 splice variant", "body_system": "Muscle and bone", "families": "Healing and recovery peptides", "uses": "muscle growth", "route": "Injection", "evidence_grade": "C", "grade_meaning": "Animal and cell studies", "human_studies_cited": 1, "animal_or_cell_studies_cited": 2, "fda_status": "Not approved", "fda_as_of": "2026-10-26", "fda_statement": "Not approved by the FDA for any use. Mechano growth factor has never entered a registered clinical trial as a drug; it is sold online as a research chemical and used as a performance drug.", "sold_for": "Mechano growth factor is sold as a muscle-repair peptide that mimics what exercise does, promising faster hypertrophy and recovery after injury.", "studies_say": "Exercise raises MGF expression in young muscle and the E-domain peptide activates muscle stem cells in a dish, but no one has published a trial of injecting it into people, so the evidence is grade C.", "grade_reasoning": "The human evidence is a 2003 biopsy study in 15 volunteers showing that resistance exercise raises MGF gene expression in muscle, which says nothing about injecting the peptide. The rest is cell culture: a 2011 study of human muscle progenitor cells and a 2008 bacterial expression and osteoblast study. No human has received MGF in a published trial, so C.", "citations": "https://doi.org/10.1016/j.mad.2011.02.007 | https://pubmed.ncbi.nlm.nih.gov/18837392/ | https://pubmed.ncbi.nlm.nih.gov/21354439/ | https://pubmed.ncbi.nlm.nih.gov/12562960/", "page": "https://peptidegraded.com/p/mechano-growth-factor/" }, { "slug": "melanotan-i", "name": "Melanotan I", "aliases": "Melanotan 1; Melanotan-1; MT-1; MT-I; MT1; Afamelanotide; Scenesse; NDP-MSH; NDP-alpha-MSH; [Nle4-D-Phe7]-alpha-MSH; melanotan; tanning peptide; barbie peptide", "class": "MC1R agonist", "body_system": "Skin", "families": "Tanning and libido peptides", "uses": "tanning; skin and hair", "route": "Injection", "evidence_grade": "B", "grade_meaning": "Some human evidence", "human_studies_cited": 2, "animal_or_cell_studies_cited": 0, "fda_status": "Not approved", "fda_as_of": "2026-10-26", "fda_statement": "Melanotan I is the same molecule as afamelanotide, which the FDA approved in 2019 as the Scenesse implant for adults with erythropoietic protoporphyria. Injectable 'Melanotan I' sold online for tanning is not approved by the FDA for any use and is sold as a research chemical.", "sold_for": "Melanotan I is sold as the 'safer' tanning peptide, the one that became a real drug, promising a tan without sun and protection against burning.", "studies_say": "A 65-person placebo-controlled trial showed more melanin and less UV damage in fair skin, and two trials in 168 porphyria patients led to approval of the implant, so the evidence is grade B for tanning and the approved product is a different formulation for a rare disease.", "grade_reasoning": "For the tanning use it is sold for, the evidence is one placebo-controlled trial in 65 fair-skinned volunteers that measured melanin density and UV damage markers, a surrogate for sunburn protection. The approved use in erythropoietic protoporphyria rests on two randomized placebo-controlled trials totaling 168 patients. The tanning use has one trial with surrogate endpoints, which is B; no trial has tested cosmetic tanning in the general population or compared it with sunscreen.", "citations": "https://pubmed.ncbi.nlm.nih.gov/16763547/ | https://pubmed.ncbi.nlm.nih.gov/26132941/ | https://doi.org/10.1016/j.jpba.2012.11.040", "page": "https://peptidegraded.com/p/melanotan-i/" }, { "slug": "melanotan-ii", "name": "Melanotan II", "aliases": "Melanotan 2; Melanotan-2; MT-2; MT-II; MT2; MTII; Melanotan; Barbie peg; Barbie drug; Tanning peptide; Ac-Nle-cyclo[Asp-His-D-Phe-Arg-Trp-Lys]-NH2; melanotan; tanning peptide; barbie peptide", "class": "Melanocortin agonist (MC1R/MC3R/MC4R)", "body_system": "Skin", "families": "Tanning and libido peptides", "uses": "tanning; sexual function", "route": "Injection", "evidence_grade": "C", "grade_meaning": "Animal and cell studies", "human_studies_cited": 1, "animal_or_cell_studies_cited": 0, "fda_status": "Not approved", "fda_as_of": "2026-10-26", "fda_statement": "Not approved by the FDA for any use and sold as an unregulated gray-market product. Melanotan II was nominated for the FDA's list of substances compounding pharmacies may use and placed in Category 2 (significant safety risk); the nomination was withdrawn and the FDA removed it from that category in April 2026, with an advisory committee review planned, which does not make it legal to compound or sell.", "sold_for": "Melanotan II is the 'Barbie drug' of gym and tanning culture, sold online as an injectable that gives a deep tan, suppresses appetite, and improves erections.", "studies_say": "A three-man pilot study in 1996 showed it darkens skin and causes erections and nausea, and the rest of the literature is case reports of harm, which is grade C evidence.", "grade_reasoning": "The human evidence is a 1996 pilot phase 1 study in three men, plus case reports of melanoma and changing moles in users. No controlled trial of Melanotan II has been published for tanning or any other use.", "citations": "https://www.fda.gov/drugs/human-drug-compounding/certain-bulk-drug-substances-use-compounding-may-present-significant-safety-risks | https://pubmed.ncbi.nlm.nih.gov/8637402/ | https://doi.org/10.1001/archdermatol.2008.623 | https://doi.org/10.1111/j.1365-2133.2009.09362.x | https://pubmed.ncbi.nlm.nih.gov/24355990/", "page": "https://peptidegraded.com/p/melanotan-ii/" }, { "slug": "mk-677-ibutamoren", "name": "MK-677 (ibutamoren)", "aliases": "Ibutamoren; MK-677; MK677; MK 677; Ibutamoren mesylate; Nutrobal; Oratrope; L-163,191; Ibutamoren MK-677; growth hormone secretagogue; GH secretagogue; GHRP; GHRH", "class": "Non-peptide ghrelin mimetic", "body_system": "Muscle and bone", "families": "Growth hormone boosters", "uses": "muscle growth; sleep; anti-ageing", "route": "Oral", "evidence_grade": "B", "grade_meaning": "Some human evidence", "human_studies_cited": 2, "animal_or_cell_studies_cited": 0, "fda_status": "Not approved", "fda_as_of": "2026-10-26", "fda_statement": "Not approved by the FDA for any use. MK-677 (ibutamoren) is an investigational compound that Merck and later Lumos Pharma studied but never submitted for approval. The FDA placed ibutamoren mesylate in Category 2 of its compounding bulk-substances list, meaning significant safety risks, and reviewed it at a Pharmacy Compounding Advisory Committee meeting in October 2024. It is sold online as a research chemical.", "sold_for": "MK-677 is sold in the bodybuilding market as an oral growth hormone booster that builds muscle, deepens sleep, and heals injuries without injections.", "studies_say": "Controlled trials confirm it raises growth hormone and IGF-1, but the body composition change in 65 older adults was small, strength did not improve, blood sugar rose, and a 563-patient Alzheimer's trial failed, so the evidence is grade B.", "grade_reasoning": "Two randomized placebo-controlled trials are cited: a two-year trial in 65 healthy older adults that raised growth hormone and IGF-1 and increased fat-free mass, and a 563-patient trial in Alzheimer's disease that raised IGF-1 but did not slow decline. Those are real controlled human data, which is B, but the muscle-building use it is sold for has only the 65-person trial, with modest body composition changes and no strength or function benefit.", "citations": "https://www.fda.gov/media/94155/download | https://doi.org/10.7326/0003-4819-149-9-200811040-00003 | https://doi.org/10.1212/01.wnl.0000335163.88054.e7 | https://pubmed.ncbi.nlm.nih.gov/19015485/ | https://pubmed.ncbi.nlm.nih.gov/18981485/", "page": "https://peptidegraded.com/p/mk-677-ibutamoren/" }, { "slug": "motixafortide", "name": "Motixafortide", "aliases": "Aphexda; BL-8040; BL8040; BKT140; 4F-benzoyl-TN14003; TN14003", "class": "CXCR4 antagonist peptide", "body_system": "Circulation", "families": "", "uses": "cancer; other", "route": "Injection", "evidence_grade": "A", "grade_meaning": "Strong human evidence", "human_studies_cited": 1, "animal_or_cell_studies_cited": 0, "fda_status": "FDA approved", "fda_as_of": "2026-10-26", "fda_statement": "Approved. Motixafortide (Aphexda) was approved in September 2023 for use with filgrastim to mobilize hematopoietic stem cells for collection and autologous transplantation in patients with multiple myeloma. It has no other approved indication as of the 2026 label revision.", "sold_for": "Motixafortide is a hospital drug with no consumer market; it is discussed as a stronger alternative to plerixafor for harvesting stem cells before a myeloma transplant.", "studies_say": "A 122-patient placebo-controlled trial showed 92.5 percent versus 26 percent of patients reaching the stem cell target in up to two collections, which is enough for an A for this single approved use.", "grade_reasoning": "Approval rests on GENESIS, a randomized, double-blind, placebo-controlled phase 3 trial in 122 patients with multiple myeloma in which motixafortide plus filgrastim mobilized the target stem cell dose in far more patients than filgrastim alone. One trial of moderate size supports a narrow indication; the FDA accepted it because the endpoint is objective and the effect was large. Uses in sickle cell disease and solid tumors are in early trials only.", "citations": "https://doi.org/10.1038/s41591-023-02273-z | https://www.accessdata.fda.gov/drugsatfda_docs/label/2026/217159s009lbl.pdf", "page": "https://peptidegraded.com/p/motixafortide/" }, { "slug": "mots-c", "name": "MOTS-c", "aliases": "MOTSc; MOTS c; Mitochondrial open reading frame of the 12S rRNA type-c; MOTS-c peptide; Mitochondrial-derived peptide; longevity peptide; anti-ageing peptide; nootropic peptide", "class": "Mitochondrial-derived peptide", "body_system": "Hormones", "families": "Longevity and brain peptides", "uses": "anti-ageing; weight loss; blood sugar", "route": "Injection", "evidence_grade": "C", "grade_meaning": "Animal and cell studies", "human_studies_cited": 1, "animal_or_cell_studies_cited": 2, "fda_status": "Not approved", "fda_as_of": "2026-10-26", "fda_statement": "Not approved by the FDA for any use and sold as a research chemical. MOTS-c was nominated for the FDA's compounding bulk-substances list and placed in Category 2 (significant safety risk); the nomination was withdrawn, the FDA removed it from that category in April 2026, and the Pharmacy Compounding Advisory Committee discussed it in July 2026. It is also on the 2026 WADA Prohibited List.", "sold_for": "MOTS-c is sold as an 'exercise mimetic', a mitochondrial peptide said to burn fat, improve insulin sensitivity, and boost endurance the way training does.", "studies_say": "Mice given MOTS-c resisted obesity and ran longer, and humans make more of it after exercise, but no trial has given it to people, so the evidence is grade C.", "grade_reasoning": "The efficacy data are in mice: the 2015 discovery paper showing protection from diet-induced obesity and insulin resistance, and a 2021 paper showing better physical performance in young and old mice. The only human data measure the body's own MOTS-c rising in muscle and blood after exercise. No human has received MOTS-c in a published trial, so C.", "citations": "https://doi.org/10.3389/fendo.2023.1120533 | https://doi.org/10.1016/j.bbagen.2021.130011 | https://pubmed.ncbi.nlm.nih.gov/25738459/ | https://www.fda.gov/drugs/human-drug-compounding/certain-bulk-drug-substances-use-compounding-may-present-significant-safety-risks | https://www.wada-ama.org/sites/default/files/2025-09/2026list_en_final_clean_september_2025.pdf | https://pubmed.ncbi.nlm.nih.gov/33473109/ | https://pubmed.ncbi.nlm.nih.gov/35499074/", "page": "https://peptidegraded.com/p/mots-c/" }, { "slug": "murepavadin", "name": "Murepavadin", "aliases": "POL7080; POL-7080; Murepavadin inhaled", "class": "Antimicrobial 'protegrin' peptidomimetic", "body_system": "Immunity", "families": "", "uses": "infection", "route": "Intravenous", "evidence_grade": "C", "grade_meaning": "Animal and cell studies", "human_studies_cited": 2, "animal_or_cell_studies_cited": 0, "fda_status": "In clinical trials", "fda_as_of": "2026-10-27", "fda_statement": "Not approved by the FDA for any use. Murepavadin is an investigational antibiotic; Polyphor stopped its two phase 3 trials of the intravenous form in 2019 after excess kidney injury. An inhaled formulation for cystic fibrosis lung infection was later developed by Spexis with Cystic Fibrosis Foundation funding, but the foundation now lists that program as discontinued, with no active development.", "sold_for": "Murepavadin is discussed as the first of a new antibiotic class that could kill drug-resistant Pseudomonas aeruginosa, the hospital pathogen behind many ventilator pneumonias.", "studies_say": "Phase 1 and small phase 2 data showed it reaches the blood and clears Pseudomonas in small uncontrolled series, but the phase 3 trials were stopped for kidney injury, leaving grade C evidence.", "grade_reasoning": "The cited human data are a randomized, placebo-controlled phase 1 pharmacokinetic and safety study in healthy men (10 single-dose cohorts of six plus three multiple-dose cohorts) and a small phase 2 study in ventilator-associated pneumonia summarized in a review. The two randomized phase 3 trials were halted early for kidney toxicity and never published as efficacy studies. Controlled human efficacy data therefore do not exist in the literature, so the grade is C despite a large development program.", "citations": "https://doi.org/10.1080/14787210.2018.1441024 | https://doi.org/10.1128/AAC.02355-17 | https://www.biospace.com/polyphor-temporarily-halts-enrollment-in-the-phase-iii-studies-of-murepavadin-for-the-treatment-of-patients-with-nosocomial-pneumonia | https://www.biospace.com/polyphor-closes-the-phase-iii-prism-studies-of-murepavadin-intravenous-formulation-and-evaluates-further-product-improvement-options | https://apps.cff.org/Trials/Pipeline/details/10181/Inhaled-Murepavadin", "page": "https://peptidegraded.com/p/murepavadin/" }, { "slug": "nafarelin", "name": "Nafarelin", "aliases": "Synarel; Nafarelin acetate; Synarel nasal spray; Synarela; RS-94991", "class": "GnRH agonist", "body_system": "Reproduction", "families": "", "uses": "hormone replacement; other", "route": "Nasal", "evidence_grade": "A", "grade_meaning": "Strong human evidence", "human_studies_cited": 1, "animal_or_cell_studies_cited": 0, "fda_status": "FDA approved", "fda_as_of": "2026-10-26", "fda_statement": "Approved. Nafarelin is sold as Synarel, a metered nasal spray, for the management of endometriosis and for central precocious puberty in children.", "sold_for": "Nafarelin is a prescription hormone suppressant for endometriosis and early puberty, with little of the online wellness market around it.", "studies_say": "Randomized trials showed nafarelin shrank endometriosis lesions and relieved pain about as well as danazol, with a different side effect profile, which is the basis of its approval and its A grade.", "grade_reasoning": "The approval rests on randomized double-blind trials against danazol, the standard endometriosis drug of the 1980s. The largest in these citations enrolled 213 women with laparoscopically confirmed endometriosis and judged lesions before and after treatment by repeat laparoscopy. What is missing is modern long-term data; the trials are old, and there is nothing here on use beyond the labeled indications.", "citations": "https://pubmed.ncbi.nlm.nih.gov/2963213/ | https://www.pfizermedical.com/synarel | https://www.pfizermedical.com/synarel/adverse-reactions", "page": "https://peptidegraded.com/p/nafarelin/" }, { "slug": "nangibotide", "name": "Nangibotide", "aliases": "LR12; LR-12; Nangibotide infusion", "class": "TREM-1 inhibitor peptide", "body_system": "Immunity", "families": "", "uses": "infection; other", "route": "Intravenous", "evidence_grade": "B", "grade_meaning": "Some human evidence", "human_studies_cited": 1, "animal_or_cell_studies_cited": 0, "fda_status": "In clinical trials", "fda_as_of": "2026-10-26", "fda_statement": "Not approved by the FDA for any use. Nangibotide is an investigational drug for septic shock; a phase 2b trial has been published, and its authors say a further trial is needed to confirm any benefit.", "sold_for": "Nangibotide is discussed as a possible first targeted immune therapy for septic shock, a condition where nearly every drug tried has failed.", "studies_say": "A single controlled trial missed its primary endpoint, with a post hoc hint of benefit in patients with high soluble TREM-1 levels, which is enough for B but not for a claim that it works.", "grade_reasoning": "One randomized, double-blind, placebo-controlled phase 2b trial in 355 patients with septic shock exists. It did not meet its primary endpoint, and the encouraging signal came from an exploratory analysis in patients with higher biomarker levels. A confirmatory trial is what is missing.", "citations": "https://doi.org/10.1016/S2213-2600(23)00158-3", "page": "https://peptidegraded.com/p/nangibotide/" }, { "slug": "nesiritide", "name": "Nesiritide", "aliases": "Natrecor; Noratak; Recombinant BNP; rhBNP; B-type natriuretic peptide; Brain natriuretic peptide; BNP", "class": "Natriuretic peptide", "body_system": "Circulation", "families": "", "uses": "heart and vessels", "route": "Intravenous", "evidence_grade": "B", "grade_meaning": "Some human evidence", "human_studies_cited": 1, "animal_or_cell_studies_cited": 0, "fda_status": "FDA approved", "fda_as_of": "2026-10-26", "fda_statement": "Approved in 2001 as Natrecor for acutely decompensated heart failure with shortness of breath at rest or with minimal activity. The product is now listed as discontinued in the United States, and the FDA has stated the discontinuation was not for safety or effectiveness reasons.", "sold_for": "Nesiritide was marketed in the 2000s as a modern hormone-based treatment for acute heart failure, replacing older drips.", "studies_say": "The largest heart failure drug trial of its era showed nesiritide neither helped nor clearly harmed, which is why its use faded and its approval is now mostly of historical interest.", "grade_reasoning": "Nesiritide was approved on short-term symptom trials, but the definitive outcome trial, ASCEND-HF with 7,141 patients, found no reduction in death or heart failure readmission and only a small, non-significant improvement in breathlessness. The approval exists, but the evidence for a meaningful clinical benefit is weak, which keeps it at B.", "citations": "https://doi.org/10.1056/NEJMoa1100171", "page": "https://peptidegraded.com/p/nesiritide/" }, { "slug": "nnz-2591", "name": "NNZ-2591", "aliases": "NNZ2591; NNZ 2591; Cyclic glycine-proline analog; cGP analog", "class": "IGF-1-related peptide", "body_system": "Nervous system", "families": "", "uses": "rare disease; cognition", "route": "Oral", "evidence_grade": "C", "grade_meaning": "Animal and cell studies", "human_studies_cited": 1, "animal_or_cell_studies_cited": 0, "fda_status": "In clinical trials", "fda_as_of": "2026-10-27", "fda_statement": "Not approved by the FDA for any use. NNZ-2591 is an investigational oral drug from Neuren Pharmaceuticals being tested in rare neurodevelopmental disorders, and the published human data are from an open-label phase 2 trial in Phelan-McDermid syndrome. A randomized, placebo-controlled phase 3 trial in children with Phelan-McDermid syndrome started in November 2025 and is recruiting.", "sold_for": "NNZ-2591 is talked about as a follow-on to trofinetide, a possible oral treatment for several genetic autism-related syndromes at once.", "studies_say": "One small uncontrolled trial found the drug was tolerated and that scores moved in a favorable direction, which is the kind of evidence that justifies a placebo-controlled trial but does not show the drug works.", "grade_reasoning": "The only published trial is a single-group, open-label phase 2 study in 18 children with Phelan-McDermid syndrome, designed mainly to test safety and drug levels. Without a placebo group, the reported improvements on caregiver and clinician scales cannot be separated from expectation effects. A placebo-controlled phase 3 trial in children started in November 2025. It is recruiting.", "citations": "https://doi.org/10.1212/NXG.0000000000200338 | https://clinicaltrials.gov/study/NCT05025241 | https://bioworld.com/articles/709208-neurens-nnz-2591-meets-phase-ii-endpoints-in-pitt-hopkins-syndrome | https://clinicaltrials.gov/study/NCT07281079", "page": "https://peptidegraded.com/p/nnz-2591/" }, { "slug": "nonapeptide-1", "name": "Nonapeptide-1", "aliases": "Melanostatine; Melanostatine-5; Melanostatine 5; Nonapeptide 1; Alpha-MSH antagonist peptide; cosmetic peptide; skincare peptide; Matrixyl; Argireline", "class": "Brightening peptide", "body_system": "Skin", "families": "Cosmetic skin peptides", "uses": "skin and hair", "route": "Topical", "evidence_grade": "C", "grade_meaning": "Animal and cell studies", "human_studies_cited": 0, "animal_or_cell_studies_cited": 1, "fda_status": "Cosmetic ingredient", "fda_as_of": "2026-10-26", "fda_statement": "Nonapeptide-1 is a cosmetic ingredient. Cosmetic ingredients do not go through FDA drug approval, and no nonapeptide-1 product is approved as a drug for any use.", "sold_for": "Nonapeptide-1 is sold in brightening serums and dark-spot creams as a peptide that stops melanin production at its source.", "studies_say": "Cell and receptor studies show it competes with alpha-MSH at the MC1R receptor, but no published human trial shows it lightens skin, so the grade is C.", "grade_reasoning": "The published work on nonapeptide-1 is receptor and cell culture data showing it blocks the melanocyte-stimulating hormone receptor. There is no published controlled human trial of a nonapeptide-1 skin product in these sources. The cell-level mechanism is plausible; the brightening effect on real skin is undocumented.", "citations": "https://doi.org/10.5114/ada.2022.115890 | https://www.fda.gov/cosmetics/cosmetics-laws-regulations/fda-authority-over-cosmetics-how-cosmetics-are-not-fda-approved-are-fda-regulated | https://file.medchemexpress.com/batch_PDF/HY-P0097/Nonapeptide-1-DataSheet-MedChemExpress.pdf", "page": "https://peptidegraded.com/p/nonapeptide-1/" }, { "slug": "octreotide", "name": "Octreotide", "aliases": "Sandostatin; Sandostatin LAR; Mycapssa; Bynfezia; Octreotide acetate; SMS 201-995; SMS201-995; Octreotide LAR", "class": "Somatostatin analog", "body_system": "Gut and weight", "families": "", "uses": "rare disease; cancer; other", "route": "Injection", "evidence_grade": "A", "grade_meaning": "Strong human evidence", "human_studies_cited": 1, "animal_or_cell_studies_cited": 0, "fda_status": "FDA approved", "fda_as_of": "2026-10-26", "fda_statement": "Approved. Octreotide is sold as Sandostatin injection for acromegaly, for the flushing and diarrhea of metastatic carcinoid tumors, and for the watery diarrhea of VIP-secreting tumors. Long-acting depot and oral formulations have followed the original 1988 approval.", "sold_for": "Octreotide is a workhorse hospital drug for hormone-secreting tumors and acromegaly, not a wellness peptide.", "studies_say": "Controlled trials show octreotide lowers growth hormone in acromegaly, controls carcinoid symptoms, and slows the growth of midgut neuroendocrine tumors, supporting an A grade for its approved uses.", "grade_reasoning": "Octreotide has nearly four decades of use and multiple controlled trials in acromegaly and neuroendocrine tumors behind its label. The trial cited here, PROMID, randomized 85 patients with midgut neuroendocrine tumors and showed a large delay in tumor progression. The label itself documents the symptom-control trials in acromegaly and carcinoid syndrome.", "citations": "https://doi.org/10.1200/JCO.2009.22.8510 | https://www.novartis.com/us-en/sites/novartis_us/files/sandostatin_inj.pdf", "page": "https://peptidegraded.com/p/octreotide/" }, { "slug": "oligopeptide-1", "name": "Oligopeptide-1", "aliases": "EGF; Epidermal growth factor; sh-Oligopeptide-1; rh-Oligopeptide-1; Human oligopeptide-1; Oligopeptide 1; Recombinant EGF; cosmetic peptide; skincare peptide; Matrixyl; Argireline", "class": "Growth-factor peptide", "body_system": "Skin", "families": "Cosmetic skin peptides", "uses": "skin and hair; anti-ageing", "route": "Topical", "evidence_grade": "C", "grade_meaning": "Animal and cell studies", "human_studies_cited": 1, "animal_or_cell_studies_cited": 0, "fda_status": "Cosmetic ingredient", "fda_as_of": "2026-10-26", "fda_statement": "Oligopeptide-1 is the cosmetic ingredient name for epidermal growth factor. In skincare it is regulated as a cosmetic and is not approved by the FDA as a drug for any use; the FDA does not approve cosmetic ingredients before sale.", "sold_for": "Oligopeptide-1 is sold in growth-factor serums promising faster skin renewal, firmer texture and fewer fine lines.", "studies_say": "EGF has a well-understood role in wound healing, but the cosmetic evidence is a handful of small, short, uncontrolled or industry-run studies, which is C-grade support.", "grade_reasoning": "The human evidence in these sources is an open pilot study of an EGF serum in 18 volunteers with no control group. Larger controlled trials of oligopeptide-1 as a cosmetic have not been identified, and those that exist test it inside multi-ingredient products. Uncontrolled series put it at C.", "citations": "https://pubmed.ncbi.nlm.nih.gov/25844616/ | https://www.fda.gov/cosmetics/cosmetics-laws-regulations/fda-authority-over-cosmetics-how-cosmetics-are-not-fda-approved-are-fda-regulated | https://www.fda.gov/cosmetics/cosmetics-laws-regulations/it-cosmetic-drug-or-both-or-it-soap", "page": "https://peptidegraded.com/p/oligopeptide-1/" }, { "slug": "oxytocin", "name": "Oxytocin", "aliases": "Pitocin; Syntocinon; Oxytocin nasal spray; Intranasal oxytocin; OXT; Oxytocin injection; Love hormone", "class": "Oxytocin receptor agonist", "body_system": "Reproduction", "families": "", "uses": "other; mood", "route": "Several routes", "evidence_grade": "A", "grade_meaning": "Strong human evidence", "human_studies_cited": 11, "animal_or_cell_studies_cited": 2, "fda_status": "FDA approved", "fda_as_of": "2026-10-26", "fda_statement": "Approved. Synthetic oxytocin is sold as Pitocin, an injection, for inducing labor when there is a medical reason, for strengthening contractions during labor, and for controlling bleeding after delivery. Its label carries a boxed warning that it is not indicated for elective induction. Intranasal oxytocin for anxiety, PTSD, autism, pain or intimacy is not approved by the FDA for any use.", "sold_for": "Oxytocin is sold as a nasal spray for anxiety, social connection, PTSD, pain and better orgasms, trading on its reputation as the love hormone.", "studies_say": "The childbirth uses are solidly proven, which earns the A, but randomized trials of intranasal oxytocin for psychiatric and pain conditions have mostly come back null or mixed.", "grade_reasoning": "For its obstetric uses, oxytocin is supported by decades of randomized trials; the Cochrane review cited here pooled nine trials with 2,391 women comparing dosing regimens for induction. The grade applies to childbirth. The popular intranasal uses are a different story: systematic reviews of randomized trials in anxiety, depression, PTSD and pain find no consistent effect on core symptoms, and the largest prevention trial in PTSD (120 patients) was negative on its primary outcome.", "citations": "https://doi.org/10.1002/14651858.CD009701.pub2 | https://www.drugs.com/pro/pitocin.html | https://doi.org/10.1152/physrev.2001.81.2.629 | https://doi.org/10.3389/fnbeh.2014.00031 | https://doi.org/10.9758/cpn.2019.17.1.1 | https://doi.org/10.1016/j.psyneuen.2014.07.014 | https://doi.org/10.1038/npp.2016.1 | https://doi.org/10.1016/j.biopsych.2016.11.012 | https://doi.org/10.1016/j.psyneuen.2020.104605 | https://doi.org/10.1097/PSY.0000000000000068 | https://doi.org/10.1016/j.neuropharm.2020.108105 | https://doi.org/10.1080/24740527.2023.2191114 | https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=6d4b2c25-2e5d-49b5-93bc-2ae8a20916d1 | https://doi.org/10.1038/s41380-020-00864-7 | https://doi.org/10.1016/j.esxm.2021.100370", "page": "https://peptidegraded.com/p/oxytocin/" }, { "slug": "palmitoyl-hexapeptide-12", "name": "Palmitoyl hexapeptide-12", "aliases": "Biopeptide EL; Pal-VGVAPG; Palmitoyl oligopeptide (former name); Palmitoyl hexapeptide 12; Pal-hexapeptide-12; cosmetic peptide; skincare peptide; Matrixyl; Argireline", "class": "Signal peptide", "body_system": "Skin", "families": "Cosmetic skin peptides", "uses": "skin and hair", "route": "Topical", "evidence_grade": "C", "grade_meaning": "Animal and cell studies", "human_studies_cited": 0, "animal_or_cell_studies_cited": 1, "fda_status": "Cosmetic ingredient", "fda_as_of": "2026-10-26", "fda_statement": "Palmitoyl hexapeptide-12 is a cosmetic ingredient and is not approved by the FDA as a drug for any use. Cosmetic ingredients are regulated but not pre-approved.", "sold_for": "Palmitoyl hexapeptide-12 is sold in anti-aging serums as a collagen-signaling peptide that firms skin and smooths wrinkles.", "studies_say": "The published evidence shows the peptide penetrates skin and interacts with its structural molecules in the laboratory; whether that changes how skin looks has not been tested in a published human trial.", "grade_reasoning": "The identifiable published work is a 2025 ex vivo study on excised human skin that tracked where the peptide goes and how it interacts with skin components, plus a 2018 industry safety review. No controlled trial in living people measuring wrinkles, firmness or hydration has been identified. That is laboratory evidence only.", "citations": "https://doi.org/10.1021/acsabm.4c01816 | https://pure.psu.edu/en/publications/safety-assessment-of-tripeptide-1-hexapeptide-12-their-metal-salt/ | https://www.fda.gov/cosmetics/cosmetics-laws-regulations/fda-authority-over-cosmetics-how-cosmetics-are-not-fda-approved-are-fda-regulated", "page": "https://peptidegraded.com/p/palmitoyl-hexapeptide-12/" }, { "slug": "palmitoyl-pentapeptide-4", "name": "Palmitoyl pentapeptide-4", "aliases": "Matrixyl; Palmitoyl pentapeptide-3; Pal-KTTKS; Palmitoyl-KTTKS; Matrixyl 3000 (component); Palmitoyl pentapeptide 4; Micro-collagen; cosmetic peptide; skincare peptide; Argireline", "class": "Signal (collagen) peptide", "body_system": "Skin", "families": "Cosmetic skin peptides", "uses": "skin and hair; anti-ageing", "route": "Topical", "evidence_grade": "B", "grade_meaning": "Some human evidence", "human_studies_cited": 1, "animal_or_cell_studies_cited": 1, "fda_status": "Cosmetic ingredient", "fda_as_of": "2026-10-26", "fda_statement": "Palmitoyl pentapeptide-4 is a cosmetic ingredient, sold under trade names such as Matrixyl. It is not approved by the FDA as a drug for any use; the FDA regulates cosmetics but does not approve their ingredients.", "sold_for": "Palmitoyl pentapeptide-4, better known as Matrixyl, is the peptide most anti-wrinkle creams point to when they say peptides work.", "studies_say": "A single sponsor-run randomized trial found modest wrinkle improvement versus the same moisturizer without the peptide, which is better evidence than most cosmetic peptides have and still short of independent confirmation.", "grade_reasoning": "One randomized, double-blind, placebo-controlled split-face trial in 93 women showed a measurable reduction in fine lines and wrinkles over 12 weeks, backed by a 1993 cell study identifying the five-amino-acid sequence as a stimulator of collagen production. The trial was run by the manufacturer and has not been independently replicated, which caps it at B.", "citations": "https://doi.org/10.1111/j.1467-2494.2005.00261.x | https://pubmed.ncbi.nlm.nih.gov/8486721/ | https://www.specialchem.com/cosmetics/inci-ingredients/palmitoyl-pentapeptide-4 | https://www.fda.gov/cosmetics/cosmetics-laws-regulations/fda-authority-over-cosmetics-how-cosmetics-are-not-fda-approved-are-fda-regulated | https://www.fda.gov/cosmetics/cosmetics-laws-regulations/it-cosmetic-drug-or-both-or-it-soap", "page": "https://peptidegraded.com/p/palmitoyl-pentapeptide-4/" }, { "slug": "palmitoyl-tetrapeptide-7", "name": "Palmitoyl tetrapeptide-7", "aliases": "Matrixyl 3000; Pal-GQPR; Palmitoyl tetrapeptide-3; Rigin; Palmitoyl tetrapeptide 7; Pal-tetrapeptide-7; cosmetic peptide; skincare peptide; Matrixyl; Argireline", "class": "Signal / anti-inflammatory peptide", "body_system": "Skin", "families": "Cosmetic skin peptides", "uses": "skin and hair; anti-ageing", "route": "Topical", "evidence_grade": "D", "grade_meaning": "No meaningful data", "human_studies_cited": 0, "animal_or_cell_studies_cited": 0, "fda_status": "Cosmetic ingredient", "fda_as_of": "2026-10-26", "fda_statement": "Palmitoyl tetrapeptide-7 is a cosmetic ingredient and is not approved by the FDA as a drug for any use. The FDA regulates cosmetics after they reach the market and does not approve their ingredients.", "sold_for": "Palmitoyl tetrapeptide-7 is one half of Matrixyl 3000 and is marketed as an anti-inflammatory peptide that calms skin and reduces wrinkles.", "studies_say": "The published record is a safety review and nothing on efficacy, so the claims rest on manufacturer data and the grade is D.", "grade_reasoning": "The only peer-reviewed publication identified is a 2018 industry safety assessment, which addresses toxicity, not benefit. The efficacy claims, including the widely quoted wrinkle reductions for the Matrixyl 3000 blend, come from the manufacturer's unpublished testing of a two-peptide combination. No independent human trial of palmitoyl tetrapeptide-7 alone exists in these sources.", "citations": "https://pure.psu.edu/en/publications/safety-assessment-of-tripeptide-1-hexapeptide-12-their-metal-salt/ | https://www.fda.gov/cosmetics/cosmetics-laws-regulations/fda-authority-over-cosmetics-how-cosmetics-are-not-fda-approved-are-fda-regulated", "page": "https://peptidegraded.com/p/palmitoyl-tetrapeptide-7/" }, { "slug": "palmitoyl-tripeptide-1", "name": "Palmitoyl tripeptide-1", "aliases": "Pal-GHK; Palmitoyl oligopeptide (former name); Matrixyl 3000 (component); Biopeptide CL; Palmitoyl tripeptide 1; Pal-tripeptide-1; cosmetic peptide; skincare peptide; Matrixyl; Argireline", "class": "Signal peptide", "body_system": "Skin", "families": "Cosmetic skin peptides", "uses": "skin and hair; anti-ageing", "route": "Topical", "evidence_grade": "D", "grade_meaning": "No meaningful data", "human_studies_cited": 0, "animal_or_cell_studies_cited": 0, "fda_status": "Cosmetic ingredient", "fda_as_of": "2026-10-26", "fda_statement": "Palmitoyl tripeptide-1 is a cosmetic ingredient and is not approved by the FDA as a drug for any use. Cosmetic ingredients are regulated but not pre-approved.", "sold_for": "Palmitoyl tripeptide-1 is marketed as a collagen-boosting signal peptide and is one of the two actives in Matrixyl 3000.", "studies_say": "Published data cover safety only; the wrinkle claims rest on unpublished manufacturer testing of a blend, which is a D.", "grade_reasoning": "The peer-reviewed record identified is a 2018 industry safety assessment covering toxicity, not benefit. Efficacy claims come from the manufacturer's testing of the Matrixyl 3000 blend, in which this peptide is combined with palmitoyl tetrapeptide-7, and have not been published in a form that isolates it. No independent human trial exists in these sources.", "citations": "https://pure.psu.edu/en/publications/safety-assessment-of-tripeptide-1-hexapeptide-12-their-metal-salt/ | https://www.fda.gov/cosmetics/cosmetics-laws-regulations/fda-authority-over-cosmetics-how-cosmetics-are-not-fda-approved-are-fda-regulated", "page": "https://peptidegraded.com/p/palmitoyl-tripeptide-1/" }, { "slug": "palmitoyl-tripeptide-38", "name": "Palmitoyl tripeptide-38", "aliases": "Matrixyl Synthe'6; Matrixyl Synthe 6; Matrixyl synthe6; Pal-KMO2K; Palmitoyl tripeptide 38; cosmetic peptide; skincare peptide; Matrixyl; Argireline", "class": "Signal peptide", "body_system": "Skin", "families": "Cosmetic skin peptides", "uses": "skin and hair", "route": "Topical", "evidence_grade": "C", "grade_meaning": "Animal and cell studies", "human_studies_cited": 1, "animal_or_cell_studies_cited": 0, "fda_status": "Cosmetic ingredient", "fda_as_of": "2026-10-26", "fda_statement": "Palmitoyl tripeptide-38 is a cosmetic ingredient, sold as Matrixyl Synthe'6, and is not approved by the FDA as a drug for any use. The FDA does not approve cosmetic ingredients before sale.", "sold_for": "Palmitoyl tripeptide-38 is sold as a next-generation Matrixyl that rebuilds six different skin matrix components to fill wrinkles from within.", "studies_say": "The only published human study is uncontrolled and tests a combination serum, so improvement cannot be attributed to the peptide; the vehicle-controlled data are the manufacturer's.", "grade_reasoning": "The one peer-reviewed human study is a two-month open-label trial in 35 women over 40 using a serum that combined the peptide with vitamins C and E, with no control group. The peptide's own contribution cannot be separated from the vitamins or from regular use of any serum. A vehicle-controlled trial cited in that paper comes from the manufacturer. Uncontrolled human data put it at C.", "citations": "https://doi.org/10.1111/jocd.13770 | https://www.fda.gov/cosmetics/cosmetics-laws-regulations/fda-authority-over-cosmetics-how-cosmetics-are-not-fda-approved-are-fda-regulated", "page": "https://peptidegraded.com/p/palmitoyl-tripeptide-38/" }, { "slug": "palopegteriparatide", "name": "Palopegteriparatide", "aliases": "Yorvipath; TransCon PTH; TransCon-PTH; Yorvipath injection; Long-acting PTH", "class": "Long-acting PTH prodrug", "body_system": "Muscle and bone", "families": "", "uses": "hormone replacement; bone density; rare disease", "route": "Injection", "evidence_grade": "A", "grade_meaning": "Strong human evidence", "human_studies_cited": 1, "animal_or_cell_studies_cited": 0, "fda_status": "FDA approved", "fda_as_of": "2026-10-26", "fda_statement": "Approved in 2024 as Yorvipath for the treatment of hypoparathyroidism in adults, given as a once-daily subcutaneous injection. The label carries a warning about a potential osteosarcoma risk based on rat studies of parathyroid hormone analogs.", "sold_for": "Palopegteriparatide is the first replacement therapy that lets most people with hypoparathyroidism stop taking handfuls of calcium and active vitamin D.", "studies_say": "A placebo-controlled phase 3 trial showed about four in five patients reached normal calcium without conventional supplements, versus one in twenty on placebo, which is A-grade support for the approved use.", "grade_reasoning": "Approval rests on the PaTHway phase 3 trial, a randomized, double-blind, placebo-controlled study in 84 adults with hypoparathyroidism, in which the composite endpoint of normal calcium without conventional therapy was met by a large majority on drug and almost none on placebo. The trial was short at 26 weeks and open-label extension data are what carry the long-term story.", "citations": "https://pubmed.ncbi.nlm.nih.gov/36271471/ | https://ascendispharma.us/products/pi/yorvipath/yorvipath_pi.pdf", "page": "https://peptidegraded.com/p/palopegteriparatide/" }, { "slug": "parathyroid-hormone", "name": "Parathyroid hormone", "aliases": "Natpara; PTH; rhPTH(1-84); rhPTH 1-84; Parathyroid hormone 1-84; Recombinant parathyroid hormone; Preotact; Parathormone", "class": "PTH (recombinant)", "body_system": "Muscle and bone", "families": "", "uses": "rare disease; bone density", "route": "Injection", "evidence_grade": "A", "grade_meaning": "Strong human evidence", "human_studies_cited": 1, "animal_or_cell_studies_cited": 0, "fda_status": "FDA approved", "fda_as_of": "2026-10-26", "fda_statement": "Recombinant parathyroid hormone was approved in 2015 as Natpara for hypocalcemia in hypoparathyroidism that cannot be controlled with calcium and active vitamin D alone, with a boxed warning for osteosarcoma and a restricted distribution program. Takeda recalled it in the United States in 2019 over particles from the cartridge septum and announced in 2022 that manufacturing would end globally at the end of 2024.", "sold_for": "Natpara was the first hormone replacement for hypoparathyroidism, promising freedom from the calcium and vitamin D pill burden.", "studies_say": "A 24-week placebo-controlled trial showed about half of patients could cut their supplements by half or more while keeping calcium normal, supporting the approval; supply problems ended the product, and efficacy was not the cause.", "grade_reasoning": "The approval rests on REPLACE, a randomized, double-blind, placebo-controlled phase 3 trial in 134 adults with hypoparathyroidism, which met its primary endpoint of reducing conventional therapy while holding calcium in range. The grade applies to that use. The drug's practical availability, not its evidence, is what has collapsed.", "citations": "https://doi.org/10.1016/S2213-8587(13)70106-2 | https://www.takeda.com/en-us/newsroom/statements/2022/takeda-to-discontinue-manufacturing-of-natpar-natpara/", "page": "https://peptidegraded.com/p/parathyroid-hormone/" }, { "slug": "pasireotide", "name": "Pasireotide", "aliases": "Signifor; Signifor LAR; SOM230; SOM 230; Pasireotide pamoate; Pasireotide diaspartate", "class": "Somatostatin analog", "body_system": "Hormones", "families": "", "uses": "rare disease; hormone replacement", "route": "Injection", "evidence_grade": "A", "grade_meaning": "Strong human evidence", "human_studies_cited": 1, "animal_or_cell_studies_cited": 0, "fda_status": "FDA approved", "fda_as_of": "2026-10-26", "fda_statement": "Approved. Pasireotide is sold as Signifor, a twice-daily subcutaneous injection, for adults with Cushing's disease for whom pituitary surgery is not an option or has not worked. A monthly long-acting form, Signifor LAR, is approved for acromegaly and for Cushing's disease.", "sold_for": "Pasireotide is the first drug approved specifically to treat the pituitary tumor behind Cushing's disease, where earlier drugs block cortisol downstream.", "studies_say": "In the phase 3 trial about one in four patients at the higher trial dose reached normal cortisol at six months, and most developed high blood sugar, which is an approvable but limited result.", "grade_reasoning": "Approval for Cushing's disease rests on a randomized, double-blind phase 3 trial in 162 patients that compared two doses, with normalization of urinary cortisol as the primary endpoint. The trial lacked a placebo arm, which is common in Cushing's because untreated disease is dangerous, and response rates were modest. It is the largest prospective drug trial in the disease.", "citations": "https://doi.org/10.1056/NEJMoa1105743 | https://www.recordatirarediseases.com/sites/www.recordatirarediseases.com/files/inline-files/SIGNIFOR_Prescribing_Information.pdf", "page": "https://peptidegraded.com/p/pasireotide/" }, { "slug": "pegcetacoplan", "name": "Pegcetacoplan", "aliases": "Empaveli; Syfovre; Aspaveli; APL-2; APL2", "class": "Complement C3 inhibitor (PEG peptide)", "body_system": "Circulation", "families": "", "uses": "rare disease; other", "route": "Several routes", "evidence_grade": "A", "grade_meaning": "Strong human evidence", "human_studies_cited": 1, "animal_or_cell_studies_cited": 0, "fda_status": "FDA approved", "fda_as_of": "2026-10-27", "fda_statement": "Approved under two brand names. Empaveli, a subcutaneous infusion, was approved in 2021 for paroxysmal nocturnal hemoglobinuria in adults and in July 2025 for C3 glomerulopathy and primary immune-complex membranoproliferative glomerulonephritis in patients 12 and older; it carries a boxed warning for serious infections with encapsulated bacteria. Syfovre, an injection into the eye, was approved in 2023 for geographic atrophy from age-related macular degeneration.", "sold_for": "Pegcetacoplan is a targeted complement blocker for rare blood, kidney and eye diseases, not a product with a consumer market.", "studies_say": "In a head-to-head trial it outperformed the previous standard drug on hemoglobin in PNH, and a placebo-controlled trial showed a large reduction in urinary protein in two rare kidney diseases, which supports an A for the approved uses.", "grade_reasoning": "The PNH approval rests on PEGASUS, a randomized open-label phase 3 trial in 80 patients comparing pegcetacoplan with eculizumab, which showed a large hemoglobin advantage at 16 weeks. The kidney approvals rest on the phase 3 VALIANT trial. The trials are small because the diseases are rare; the effects are large and on hard laboratory endpoints.", "citations": "https://doi.org/10.1056/NEJMoa2029073 | https://pi.apellis.com/files/PI_Empaveli.pdf | https://www.hcplive.com/view/fda-approves-pegcetacoplan-empaveli-for-c3-glomerulopathy-ic-mpgn | https://pubmed.ncbi.nlm.nih.gov/42472569/ | https://pubmed.ncbi.nlm.nih.gov/42627260/", "page": "https://peptidegraded.com/p/pegcetacoplan/" }, { "slug": "pegvisomant", "name": "Pegvisomant", "aliases": "Somavert; B2036-PEG; Pegvisomant for injection", "class": "GH receptor antagonist", "body_system": "Hormones", "families": "", "uses": "rare disease", "route": "Injection", "evidence_grade": "A", "grade_meaning": "Strong human evidence", "human_studies_cited": 1, "animal_or_cell_studies_cited": 0, "fda_status": "FDA approved", "fda_as_of": "2026-10-26", "fda_statement": "Approved in 2003 as Somavert, a daily subcutaneous injection, for acromegaly in patients who have had an inadequate response to surgery or radiation therapy, or for whom those therapies are not appropriate.", "sold_for": "Pegvisomant is the most effective drug for normalizing IGF-1 in acromegaly, and it is the reason bodybuilding forums sometimes discuss blocking growth hormone.", "studies_say": "A placebo-controlled trial normalized IGF-1 in nearly nine out of ten patients at the top trial dose, with symptom relief tracking the biochemistry, which is A-grade evidence for its approved use.", "grade_reasoning": "The trial was a randomized, double-blind, placebo-controlled study of 112 patients with acromegaly over 12 weeks, in which IGF-1 normalized in a large majority at the highest trial dose. The ACROSTUDY registry in the label followed 2,221 treated patients for a mean of 8.5 years for safety. The trial measured a biochemical endpoint, IGF-1, and not long-term outcomes, but IGF-1 is the accepted marker of disease activity.", "citations": "https://doi.org/10.1056/NEJM200004203421604 | https://labeling.pfizer.com/ShowLabeling.aspx?id=3213", "page": "https://peptidegraded.com/p/pegvisomant/" }, { "slug": "pemvidutide", "name": "Pemvidutide", "aliases": "ALT-801; ALT801; Pemvidutide injection; GLP-1; GLP1; GLP-1 agonist; weight loss shot", "class": "GLP-1 / glucagon dual agonist", "body_system": "Gut and weight", "families": "GLP-1 drugs and successors", "uses": "weight loss; other", "route": "Injection", "evidence_grade": "B", "grade_meaning": "Some human evidence", "human_studies_cited": 2, "animal_or_cell_studies_cited": 0, "fda_status": "In clinical trials", "fda_as_of": "2026-10-27", "fda_statement": "Not approved by the FDA or any other regulator for any use. Pemvidutide is an investigational once-weekly injection from Altimmune; after the phase 2b IMPACT trial in metabolic dysfunction-associated steatohepatitis (MASH), a phase 3 MASH trial (PERFORMA) began in July 2026. Phase 2 trials have also covered obesity, alcohol use disorder and alcohol-associated liver disease.", "sold_for": "Pemvidutide is pitched as a weight-loss injection that also clears fat from the liver, with the glucagon component sold as a way to lose fat while sparing muscle.", "studies_say": "Phase 2 trials show large reductions in liver fat and resolution of MASH in about half of treated patients versus a fifth on placebo, with moderate weight loss, which is B-grade evidence pending a confirmatory trial.", "grade_reasoning": "Two randomized, double-blind, placebo-controlled trials have been published: the IMPACT phase 2b trial in 212 patients with biopsy-confirmed MASH and a 64-patient fatty liver trial with 24 weeks of treatment. IMPACT met its MASH-resolution endpoint but not its co-primary fibrosis endpoint at 24 weeks; the smaller trial met its liver-fat endpoint. A phase 3 MASH trial (PERFORMA) began in July 2026. What is missing is phase 3 results, long-term safety data, and any peer-reviewed publication of the obesity trial.", "citations": "https://www.ncbi.nlm.nih.gov/books/NBK551568/ | https://doi.org/10.1016/S0140-6736(25)02114-2 | https://doi.org/10.1016/j.jhepr.2025.101483 | https://clinicaltrials.gov/study/NCT07795164", "page": "https://peptidegraded.com/p/pemvidutide/" }, { "slug": "pentapeptide-18", "name": "Pentapeptide-18", "aliases": "Leuphasyl; Pentapeptide 18; Leuphasyl peptide; cosmetic peptide; skincare peptide; Matrixyl; Argireline", "class": "Neurotransmitter-inhibiting peptide", "body_system": "Skin", "families": "Cosmetic skin peptides", "uses": "skin and hair; anti-ageing", "route": "Topical", "evidence_grade": "C", "grade_meaning": "Animal and cell studies", "human_studies_cited": 2, "animal_or_cell_studies_cited": 0, "fda_status": "Cosmetic ingredient", "fda_as_of": "2026-10-26", "fda_statement": "Pentapeptide-18 is a cosmetic ingredient, sold under the trade name Leuphasyl. Cosmetic ingredients in the United States are not reviewed or approved by the FDA before sale, so there is no FDA approval to cite for or against it.", "sold_for": "Pentapeptide-18 is sold as a topical alternative to botulinum toxin that softens expression lines, usually paired with acetyl hexapeptide-8 (Argireline).", "studies_say": "Two small uncontrolled studies in 20 volunteers each report shorter or fewer wrinkles after weeks of use, one of them with retinol in the same cream, which is grade C support at best.", "grade_reasoning": "The human evidence is two small uncontrolled studies: a 20-volunteer, two-month test of pentapeptide-18 creams at three strengths, in which only the strongest reduced measured wrinkle length, and an eight-week test in 20 women of a cream that also contained retinol. Neither had a vehicle or placebo control, and the manufacturer has not published its own trial data. Uncontrolled series put it at C for expression lines.", "citations": "https://www.mdpi.com/2079-9284/1/2/75 | https://www.specialchem.com/cosmetics/product/lubrizol-leuphasyl-peptide | https://doi.org/10.3390/life14101212", "page": "https://peptidegraded.com/p/pentapeptide-18/" }, { "slug": "petrelintide", "name": "Petrelintide", "aliases": "ZP8396; ZP-8396; Petrelintide injection; GLP-1; GLP1; GLP-1 agonist; weight loss shot", "class": "Long-acting amylin analog", "body_system": "Gut and weight", "families": "GLP-1 drugs and successors", "uses": "weight loss; blood sugar", "route": "Injection", "evidence_grade": "B", "grade_meaning": "Some human evidence", "human_studies_cited": 2, "animal_or_cell_studies_cited": 0, "fda_status": "In clinical trials", "fda_as_of": "2026-10-27", "fda_statement": "Petrelintide is an investigational drug in phase 3 development and is not approved by the FDA or any other regulator for any use. It is not legally available outside clinical trials.", "sold_for": "Petrelintide is talked about as the amylin-based weight loss drug that might match GLP-1 injections for weight loss with far fewer stomach side effects.", "studies_say": "One published phase 2 trial shows about a tenth of body weight lost over 42 weeks with gastrointestinal tolerability close to placebo apart from mild nausea, which earns a B; the phase 3 program that would settle efficacy and safety is only starting.", "grade_reasoning": "One randomized, placebo-controlled phase 2 trial (ZUPREME-1, 485 adults with overweight or obesity, 42 weeks) has been published, and a second phase 2 trial in people with type 2 diabetes has reported topline results by press release. That is enough for B but not A: there is no phase 3 data yet and no long-term safety follow-up.", "citations": "https://pubmed.ncbi.nlm.nih.gov/42810355/ | https://www.hcplive.com/view/zupreme-2-petrelintide-outperforms-placebo-for-weight-loss-in-t2d-and-obesity", "page": "https://peptidegraded.com/p/petrelintide/" }, { "slug": "plecanatide", "name": "Plecanatide", "aliases": "Trulance; SP-304; SP304; Plecanatide tablets", "class": "Guanylate cyclase-C agonist", "body_system": "Gut and weight", "families": "", "uses": "gut health", "route": "Oral", "evidence_grade": "A", "grade_meaning": "Strong human evidence", "human_studies_cited": 2, "animal_or_cell_studies_cited": 0, "fda_status": "FDA approved", "fda_as_of": "2026-10-26", "fda_statement": "Plecanatide is FDA-approved as Trulance for adults with chronic idiopathic constipation (January 2017) and irritable bowel syndrome with constipation (2018). The label carries a boxed warning about serious dehydration in children; it is contraindicated under age 6 and not recommended under 18.", "sold_for": "Plecanatide is prescribed as a once-daily pill for chronic constipation and constipation-type IBS that is meant to work like the gut's own fluid-regulating peptide.", "studies_say": "Large randomized trials show plecanatide roughly doubles the chance of a durable improvement in bowel movements compared with placebo, with diarrhea as the main side effect, which earns an A for its approved use.", "grade_reasoning": "Approval rested on randomized, placebo-controlled phase 3 trials; the published chronic constipation trial randomized 1,394 adults over 12 weeks, and companion trials covered IBS with constipation. The effect size is modest (roughly one in five responders versus one in ten on placebo), but the trial evidence for the approved use is as good as it gets.", "citations": "https://doi.org/10.1038/ajg.2016.611 | https://drugs.com/pro/trulance.html", "page": "https://peptidegraded.com/p/plecanatide/" }, { "slug": "pn-943", "name": "PN-943", "aliases": "PN943; PN 943; Oral alpha4beta7 antagonist", "class": "Oral α4β7 integrin antagonist peptide", "body_system": "Gut and weight", "families": "", "uses": "gut health", "route": "Oral", "evidence_grade": "C", "grade_meaning": "Animal and cell studies", "human_studies_cited": 2, "animal_or_cell_studies_cited": 1, "fda_status": "In clinical trials", "fda_as_of": "2026-10-27", "fda_statement": "PN-943 is an investigational oral peptide that is not approved by the FDA for any use. After the phase 2 IDEAL trial in ulcerative colitis reported in 2022, its sponsor, Protagonist Therapeutics, said it would put no further internal resources into the program and would look for a licensing partner. No phase 3 trial has been registered.", "sold_for": "PN-943 was pitched as an oral, gut-restricted pill that could do what vedolizumab infusions do for ulcerative colitis.", "studies_say": "The one controlled trial in ulcerative colitis failed its primary endpoint at the higher dose and showed only a borderline signal at the lower one, so the evidence does not support the claimed use.", "grade_reasoning": "PN-943 has been through phase 1 in healthy volunteers and one randomized, placebo-controlled phase 2 trial in 159 adults with ulcerative colitis, which missed its primary endpoint at the higher dose. A randomized trial exists, but it did not show benefit on its main outcome, so there is no controlled evidence supporting the intended use. The predecessor compound PTG-100 has separate preclinical and phase 2a data.", "citations": "https://doi.org/10.1053/j.gastro.2021.08.045 | https://www.hcplive.com/view/phase-2-data-positive-pn-943-ulcerative-colitis-treatment | https://www.biospace.com/protagonist-reports-third-quarter-2022-financial-results-and-provides-corporate-update", "page": "https://peptidegraded.com/p/pn-943/" }, { "slug": "polymyxin-b-colistin", "name": "Polymyxin B / Colistin", "aliases": "Polymyxin B; Colistin; Colistimethate; Colistimethate sodium; Coly-Mycin M; Coly-Mycin; Polymyxin E; Polymyxins; Polymyxin B sulfate; Colomycin; Promixin", "class": "Polymyxin antibiotic", "body_system": "Immunity", "families": "", "uses": "infection", "route": "Intravenous", "evidence_grade": "B", "grade_meaning": "Some human evidence", "human_studies_cited": 1, "animal_or_cell_studies_cited": 0, "fda_status": "FDA approved", "fda_as_of": "2026-10-27", "fda_statement": "Both are FDA-approved antibiotics. Injectable polymyxin B is approved for serious infections caused by susceptible Gram-negative bacteria, with a boxed warning about kidney toxicity, nerve toxicity and the risk of respiratory paralysis; colistimethate sodium for injection, first approved as Coly-Mycin M, is approved for acute or chronic infections due to susceptible Gram-negative bacilli, mainly Pseudomonas aeruginosa. Drugs@FDA lists the first polymyxin B injection approval in 1964 and Coly-Mycin M in 1970, and both drugs are now sold as generics.", "sold_for": "Polymyxin B and colistin are the antibiotics of last resort for Gram-negative bacteria that have beaten carbapenems.", "studies_say": "The polymyxins kill multidrug-resistant Gram-negative bacteria and remain in use for lack of alternatives, but their approvals predate controlled trials and the one large RCT showed that adding meropenem does not improve outcomes.", "grade_reasoning": "The polymyxins were approved decades before randomized trials were required, so their efficacy rests on bacteriology and observational experience. The modern controlled evidence is mostly about how to use them: the AIDA trial randomized 406 patients with carbapenem-resistant Gram-negative infections to colistin alone or colistin plus meropenem and found no difference in clinical failure. Last-resort use is well established; what is missing is trial-grade proof of benefit against modern comparators.", "citations": "https://doi.org/10.1016/S1473-3099(18)30099-9 | https://drugs.com/pro/polymyxin-b-injection.html | https://api.fda.gov/drug/drugsfda.json?search=application_number:NDA050108", "page": "https://peptidegraded.com/p/polymyxin-b-colistin/" }, { "slug": "pramlintide", "name": "Pramlintide", "aliases": "Symlin; SymlinPen; Pramlintide acetate; AC137; AC-137; GLP-1; GLP1; GLP-1 agonist; weight loss shot", "class": "Amylin analog", "body_system": "Hormones", "families": "GLP-1 drugs and successors", "uses": "blood sugar; weight loss", "route": "Injection", "evidence_grade": "A", "grade_meaning": "Strong human evidence", "human_studies_cited": 6, "animal_or_cell_studies_cited": 0, "fda_status": "FDA approved", "fda_as_of": "2026-10-26", "fda_statement": "Pramlintide is FDA-approved as Symlin (approved March 2005) for adults with type 1 or type 2 diabetes who use mealtime insulin and have not reached their glucose targets. The label carries a boxed warning about severe hypoglycemia, which is why insulin doses are reduced when it is started.", "sold_for": "Pramlintide is the only approved amylin drug, used as an add-on to mealtime insulin to blunt after-meal glucose spikes and help with weight.", "studies_say": "Randomized trials show pramlintide modestly lowers HbA1c and body weight when added to insulin, at the cost of nausea and a higher risk of insulin-related hypoglycemia, which supports its narrow approved use.", "grade_reasoning": "Approval rested on randomized, placebo-controlled trials in type 1 and type 2 diabetes lasting up to a year; the label summarizes six placebo-controlled trials (four in type 1 and two in type 2 diabetes), the largest with 480 type 1 patients, in which pramlintide lowered HbA1c by about 0.25 to 0.34 percentage points more than placebo and reduced weight. The effect is real but small, and the drug has largely been displaced by GLP-1 agonists.", "citations": "https://www.accessdata.fda.gov/drugsatfda_docs/label/2014/021332s007_S016.pdf", "page": "https://peptidegraded.com/p/pramlintide/" }, { "slug": "pt-141", "name": "PT-141", "aliases": "PT141; PT 141; Bremelanotide; Vyleesi; PT-141 peptide; Bremelanotide acetate; melanotan; tanning peptide; barbie peptide", "class": "MC4R agonist", "body_system": "Nervous system", "families": "Tanning and libido peptides", "uses": "sexual function", "route": "Injection", "evidence_grade": "B", "grade_meaning": "Some human evidence", "human_studies_cited": 7, "animal_or_cell_studies_cited": 0, "fda_status": "Not approved", "fda_as_of": "2026-10-26", "fda_statement": "PT-141 is the development code for bremelanotide, which the FDA approved in June 2019 as Vyleesi for premenopausal women with acquired, generalized hypoactive sexual desire disorder. Products sold online as PT-141 are not Vyleesi, are not approved by the FDA for any use, and are sold as research chemicals, most often to men, a population the drug was never approved for.", "sold_for": "PT-141 is sold on the gray market as a libido and erection booster for men and women that works through the brain instead of blood flow.", "studies_say": "Two phase 3 trials support a modest effect on sexual desire in premenopausal women with HSDD, which is what the FDA approved; the evidence in men is two small 2004 studies, one nasal and one injected, from a program that was abandoned, and nausea affects about 40 percent of users.", "grade_reasoning": "For the approved use there are two randomized, placebo-controlled phase 3 trials (RECONNECT, 1,267 women combined), which is A-level evidence, though a re-analysis argues the effect on desire is small. For the use PT-141 is actually sold for online, libido and erections in men, the evidence is two small 2004 studies, one of a nasal spray that was later abandoned and one of an injection, so the compound as marketed sits at B.", "citations": "https://doi.org/10.1007/s40265-019-01187-w | https://doi.org/10.1080/00224499.2023.2175192 | https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=f1d0c1b5-2f39-4bad-a6a4-0066e3ad5dcf | https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=0b0be196-0c62-461c-94f4-9a35339b4501 | https://doi.org/10.1097/AOG.0000000000003500 | https://doi.org/10.1097/AOG.0000000000003514 | https://www.accessdata.fda.gov/scripts/cder/daf/index.cfm?event=overview.process&ApplNo=210557 | https://doi.org/10.1177/10600280241253273 | https://doi.org/10.1172/JCI152341 | https://doi.org/10.1038/sj.ijir.3901139 | https://doi.org/10.1038/sj.ijir.3901200 | https://doi.org/10.2217/whe-2016-0018", "page": "https://peptidegraded.com/p/pt-141/" }, { "slug": "retatrutide", "name": "Retatrutide", "aliases": "LY3437943; LY-3437943; LY 3437943; Reta; Triple G; GGG tri-agonist; Retatrutide peptide; GLP-1; GLP1; GLP-1 agonist; weight loss shot", "class": "Triple GLP-1 / GIP / glucagon agonist", "body_system": "Gut and weight", "families": "GLP-1 drugs and successors", "uses": "weight loss; fat loss", "route": "Injection", "evidence_grade": "B", "grade_meaning": "Some human evidence", "human_studies_cited": 4, "animal_or_cell_studies_cited": 0, "fda_status": "In clinical trials", "fda_as_of": "2026-10-26", "fda_statement": "Retatrutide is an investigational drug and is not approved by the FDA for any use. Eli Lilly has said it plans to file for approval in the first quarter of 2027 after completing manufacturing data. Vials sold online as retatrutide are not a legal product; the FDA has stated that unapproved GLP-1 class drugs cannot be used in compounding.", "sold_for": "Retatrutide is talked about as the next step beyond tirzepatide, a triple-hormone injection that produced the largest weight loss yet seen in a drug trial.", "studies_say": "Randomized trials show about a quarter of body weight lost over 48 weeks and roughly a fifth over 80 weeks in people with diabetes, with gastrointestinal side effects and heart rate increases, which supports a B pending approval and full phase 3 publication.", "grade_reasoning": "There is one published randomized phase 2 trial in obesity (338 adults, 48 weeks), a 98-person liver fat substudy of that trial, and one published phase 3 trial, TRIUMPH-2, in 1,152 adults with obesity and type 2 diabetes over 80 weeks; other phase 3 results exist only as press releases. Multiple randomized trials point the same way, but the drug is not approved, most of the roughly 5,800-person TRIUMPH program is unpublished, and there is no long-term safety data, so the grade is B and not A.", "citations": "https://www.ncbi.nlm.nih.gov/books/NBK551568/ | https://pubmed.ncbi.nlm.nih.gov/37366315/ | https://pubmed.ncbi.nlm.nih.gov/38858523/ | https://doi.org/10.1016/S0140-6736(26)01861-1 | https://www.sec.gov/Archives/edgar/data/59478/000005947826000077/q226lillysalesandearningsp.htm | https://www.fda.gov/drugs/drug-alerts-and-statements/fdas-concerns-unapproved-glp-1-drugs-used-weight-loss | https://pubmed.ncbi.nlm.nih.gov/41090431/ | https://www.biospace.com/press-releases/lillys-triple-agonist-retatrutide-successful-in-two-additional-phase-3-obesity-trials-delivering-significant-improvements-in-weight-and-a1c | https://clinicaltrials.gov/search?term=retatrutide", "page": "https://peptidegraded.com/p/retatrutide/" }, { "slug": "rusfertide", "name": "Rusfertide", "aliases": "Mimrylo; PTG-300; PTG300; Hepcidin mimetic; Rusfertide injection", "class": "Hepcidin mimetic peptide", "body_system": "Circulation", "families": "", "uses": "rare disease", "route": "Injection", "evidence_grade": "A", "grade_meaning": "Strong human evidence", "human_studies_cited": 2, "animal_or_cell_studies_cited": 0, "fda_status": "FDA approved", "fda_as_of": "2026-10-26", "fda_statement": "Rusfertide was approved by the FDA on August 28, 2026, as Mimrylo (Takeda) for adults with polycythemia vera, to control red cell overproduction and reduce the need for therapeutic phlebotomy. It is the first hepcidin mimetic approved for any use.", "sold_for": "Rusfertide is talked about as the drug that lets people with polycythemia vera stop having blood drawn every few weeks.", "studies_say": "Two randomized trials show rusfertide keeps hematocrit below 45 percent and frees most patients from phlebotomy, with injection site reactions as the main side effect, which earns an A for its approved use.", "grade_reasoning": "Approval rested on the phase 3 VERIFY trial, a randomized, double-blind, placebo-controlled study of 293 adults with phlebotomy-dependent polycythemia vera, preceded by the phase 2 REVIVE trial of 70 patients with a randomized withdrawal phase. Both showed large, consistent reductions in phlebotomy need. Long-term data run to about four years in open-label follow-up; what is missing is evidence on thrombosis and survival.", "citations": "https://doi.org/10.1056/NEJMoa2308809 | https://www.drugs.com/pro/mimrylo.html | https://ascopost.com/news/august-2026/fda-approves-rusfertide-for-erythrocytosis-in-adults-with-polycythemia-vera/", "page": "https://peptidegraded.com/p/rusfertide/" }, { "slug": "secretin", "name": "Secretin", "aliases": "ChiRhoStim; Human secretin; Synthetic human secretin; SecreFlo; Porcine secretin; Secretin stimulation test", "class": "Secretin hormone", "body_system": "Hormones", "families": "", "uses": "other; rare disease", "route": "Intravenous", "evidence_grade": "B", "grade_meaning": "Some human evidence", "human_studies_cited": 2, "animal_or_cell_studies_cited": 0, "fda_status": "FDA approved", "fda_as_of": "2026-10-26", "fda_statement": "Synthetic human secretin is FDA-approved as ChiRhoStim (approved 2004) for three diagnostic uses: stimulating pancreatic secretions to diagnose exocrine pancreatic dysfunction, stimulating gastrin release to diagnose gastrinoma, and helping locate the pancreatic duct during ERCP. It is not approved as a treatment for any condition.", "sold_for": "Secretin is a century-old hormone used in hospitals to test the pancreas, and briefly, in the late 1990s, hyped as an autism cure.", "studies_say": "Secretin dependably stimulates pancreatic fluid and gastrin release, which is what its diagnostic approval requires; the randomized trial of secretin for autism found no benefit over placebo.", "grade_reasoning": "Secretin is a diagnostic agent whose approval rests on comparative studies showing the synthetic human form produces the same pancreatic and gastrin responses as the porcine hormone it replaced; those studies involved dozens, not hundreds, of patients. The cited randomized trial of secretin as a treatment, in 60 children with autism, was negative. Trial-grade evidence for the diagnostic uses themselves is thin by design.", "citations": "https://doi.org/10.1056/NEJM199912093412404 | https://www.drugs.com/pro/chirhostim.html", "page": "https://peptidegraded.com/p/secretin/" }, { "slug": "selank", "name": "Selank", "aliases": "Selank peptide; TP-7; TP7; Selanc; Selank nasal spray; Tuftsin analog; N-acetyl Selank; NA-Selank; longevity peptide; anti-ageing peptide; nootropic peptide", "class": "Anxiolytic peptide (Russian)", "body_system": "Nervous system", "families": "Longevity and brain peptides", "uses": "mood; cognition", "route": "Nasal", "evidence_grade": "B", "grade_meaning": "Some human evidence", "human_studies_cited": 2, "animal_or_cell_studies_cited": 2, "fda_status": "Not approved", "fda_as_of": "2026-10-26", "fda_statement": "Selank is not approved by the FDA for any use and is sold in the United States as a research chemical. It is registered as a prescription anxiolytic in Russia. It is not on the FDA's list of substances pharmacies may compound, and it was not among the peptides the FDA's compounding advisory committee reviewed in July 2026.", "sold_for": "Selank is sold as a nasal spray that calms anxiety without the sedation or dependence of benzodiazepines and sharpens focus at the same time.", "studies_say": "A single 62-patient Russian trial found anxiety relief comparable to a benzodiazepine, and animal work points to GABA and NMDA receptor effects, but there is no placebo-controlled human trial, so the claims rest on thin evidence.", "grade_reasoning": "There is one small randomized comparison in 62 patients with generalized anxiety disorder or neurasthenia, published in Russian without a placebo arm, plus a cytokine study in a subset of patients and two animal or in vitro studies on GABA and NMDA receptor binding. One randomized trial meets the letter of B, but it is tiny, unblinded as far as the abstract reports, and has never been replicated outside Russia.", "citations": "https://doi.org/10.17116/jnevro20151156133-40 | https://doi.org/10.1002/dta.2717 | https://doi.org/10.1007/s10571-009-9432-0 | https://www.statnews.com/2026/07/24/fda-peptide-compounding-panel-backs-epitalon-rejects-emideltide/ | https://pubmed.ncbi.nlm.nih.gov/18454096/ | https://www.fda.gov/drugs/human-drug-compounding/certain-bulk-drug-substances-use-compounding-may-present-significant-safety-risks | https://pubmed.ncbi.nlm.nih.gov/18577961/ | https://doi.org/10.3389/fphar.2016.00031 | https://pubmed.ncbi.nlm.nih.gov/29787664/ | https://www.fda.gov/media/94155/download | https://www.fda.gov/advisory-committees/advisory-committee-calendar/july-23-24-2026-meeting-pharmacy-compounding-advisory-committee-07232026", "page": "https://peptidegraded.com/p/selank/" }, { "slug": "selepressin", "name": "Selepressin", "aliases": "FE 202158; FE202158; Selepressin infusion", "class": "Selective vasopressin V1a agonist", "body_system": "Circulation", "families": "", "uses": "infection; heart and vessels", "route": "Intravenous", "evidence_grade": "C", "grade_meaning": "Animal and cell studies", "human_studies_cited": 1, "animal_or_cell_studies_cited": 0, "fda_status": "In clinical trials", "fda_as_of": "2026-10-26", "fda_statement": "Selepressin is an investigational drug that is not approved by the FDA or any regulator. Its phase 2b/3 trial in septic shock was stopped for futility in 2017 and development has not resumed.", "sold_for": "Selepressin was meant to be a cleaner vasopressin for septic shock: raise blood pressure without the fluid leak and clotting effects of the natural hormone.", "studies_say": "The one large randomized trial found selepressin did not increase ventilator- and vasopressor-free days or reduce mortality compared with placebo, so the evidence does not support it.", "grade_reasoning": "One large randomized, double-blind, placebo-controlled trial (SEPSIS-ACT, 868 adults with septic shock) tested selepressin and found no benefit on its primary endpoint or on mortality. A controlled trial exists, but it was negative, so there is no evidence supporting the use for which the drug was designed. Earlier phase 2a data were small and dose-finding.", "citations": "https://doi.org/10.1001/jama.2019.14607 | https://doi.org/10.1513/AnnalsATS.201708-669SD", "page": "https://peptidegraded.com/p/selepressin/" }, { "slug": "semaglutide", "name": "Semaglutide", "aliases": "Ozempic; Wegovy; Rybelsus; Sema; Compounded semaglutide; NN9535; Oral semaglutide; Semaglutide injection; GLP-1; GLP1; GLP-1 agonist; weight loss shot", "class": "GLP-1 receptor agonist", "body_system": "Gut and weight", "families": "GLP-1 drugs and successors", "uses": "weight loss; blood sugar; heart and vessels", "route": "Several routes", "evidence_grade": "A", "grade_meaning": "Strong human evidence", "human_studies_cited": 11, "animal_or_cell_studies_cited": 0, "fda_status": "FDA approved", "fda_as_of": "2026-10-26", "fda_statement": "Semaglutide is FDA-approved as Ozempic (weekly injection, type 2 diabetes, 2017; with later indications to reduce cardiovascular events and, since January 2025, kidney disease progression in type 2 diabetes), Rybelsus (daily tablet, type 2 diabetes, 2019), and Wegovy (weekly injection, chronic weight management, 2021; cardiovascular risk reduction in obesity, 2024; MASH with liver fibrosis, 2025; an oral Wegovy tablet, December 2025). Compounded semaglutide is not FDA-approved.", "sold_for": "Semaglutide is the GLP-1 injection behind Ozempic and Wegovy, the most talked-about weight loss drug of the decade.", "studies_say": "Randomized trials in tens of thousands of people show about 15 percent weight loss, roughly a 1 to 2 point HbA1c reduction, a 20 percent cut in major cardiovascular events and slower kidney decline, with gastrointestinal side effects and weight regain after stopping as the main caveats.", "grade_reasoning": "Semaglutide has one of the largest trial programs of any peptide: the STEP trials in obesity (STEP 1, 1,961 adults), the SUSTAIN trials in type 2 diabetes, SELECT (17,604 adults with cardiovascular disease and obesity, the largest), FLOW in kidney disease, and systematic reviews pooling tens of thousands of participants. Weight loss, glucose lowering and reductions in heart attack, stroke and kidney outcomes are all shown in randomized placebo-controlled trials. What remains open is what happens over decades and how to stop without regaining.", "citations": "https://www.accessdata.fda.gov/drugsatfda_docs/label/2023/209637s020s021lbl.pdf | https://pubmed.ncbi.nlm.nih.gov/33567185/ | https://pubmed.ncbi.nlm.nih.gov/37952131/ | https://pubmed.ncbi.nlm.nih.gov/34293304/ | https://pubmed.ncbi.nlm.nih.gov/37891683/ | https://pubmed.ncbi.nlm.nih.gov/35015037/ | https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=ee06186f-2aa3-4990-a760-757579d8f77b | https://pubmed.ncbi.nlm.nih.gov/33755728/ | https://pubmed.ncbi.nlm.nih.gov/39181597/ | https://doi.org/10.1056/NEJMoa2307563 | https://pubmed.ncbi.nlm.nih.gov/41138739/ | https://pubmed.ncbi.nlm.nih.gov/35441470/ | https://doi.org/10.1056/NEJMoa2403347 | https://www.ajmc.com/view/fda-approves-semaglutide-for-mash-with-fibrosis | https://www.healio.com/news/endocrinology/20260213/fda-approves-wegovy-pill-the-first-oral-glp1-to-treat-obesity | https://pubmed.ncbi.nlm.nih.gov/35658024/ | https://pubmed.ncbi.nlm.nih.gov/38613667/", "page": "https://peptidegraded.com/p/semaglutide/" }, { "slug": "semax", "name": "Semax", "aliases": "Semax peptide; NA-Semax; N-acetyl Semax; Semax amidate; Semax nasal; ACTH(4-7)PGP; Met-Glu-His-Phe-Pro-Gly-Pro; longevity peptide; anti-ageing peptide; nootropic peptide", "class": "Nootropic peptide (ACTH(4-10) analog)", "body_system": "Nervous system", "families": "Longevity and brain peptides", "uses": "cognition; other", "route": "Nasal", "evidence_grade": "B", "grade_meaning": "Some human evidence", "human_studies_cited": 5, "animal_or_cell_studies_cited": 2, "fda_status": "Not approved", "fda_as_of": "2026-10-26", "fda_statement": "Semax is not approved by the FDA for any use and is sold in the United States as a research chemical. It is registered as a prescription drug in Russia. In July 2026 the FDA's Pharmacy Compounding Advisory Committee voted to recommend adding semax to the list of substances pharmacies may compound, against the advice of FDA staff; that recommendation has no legal effect until the FDA acts on it.", "sold_for": "Semax is sold as a nasal nootropic that sharpens memory and attention and protects the brain after stroke.", "studies_say": "Russian clinical studies report faster recovery after stroke and fewer vascular events in chronic cerebrovascular disease, and a small imaging study shows it changes brain network activity in healthy people, but no blinded placebo-controlled trial has been published, so the cognitive claims are unproven.", "grade_reasoning": "Five Russian clinical studies cover stroke (30 patients versus 80 controls in 1997; 110 patients in 2018), chronic cerebrovascular insufficiency (187 patients), optic nerve disease and a 24-person imaging study in healthy volunteers. Several had control groups but none describes randomization and blinding in the way a modern trial would, and none has been replicated outside Russia. Controlled human studies exist, so B, but at the weak end.", "citations": "https://doi.org/10.1016/j.npep.2020.102114 | https://www.statnews.com/2026/07/24/fda-peptide-compounding-panel-backs-epitalon-rejects-emideltide/ | https://doi.org/10.1002/dta.2717 | https://doi.org/10.1007/s10571-009-9432-0 | https://www.fda.gov/media/193348/download | https://pubmed.ncbi.nlm.nih.gov/29798983/ | https://pubmed.ncbi.nlm.nih.gov/15792140/ | https://pubmed.ncbi.nlm.nih.gov/10741256/ | https://doi.org/10.1007/s11064-005-8826-8 | https://pubmed.ncbi.nlm.nih.gov/30225715/ | https://pubmed.ncbi.nlm.nih.gov/11517472/ | https://www.fda.gov/media/94155/download | https://www.healio.com/news/primary-care/20260724/fda-committee-recommends-looser-restrictions-for-several-peptides", "page": "https://peptidegraded.com/p/semax/" }, { "slug": "sermorelin", "name": "Sermorelin", "aliases": "Geref; Sermorelin acetate; GRF 1-29; GRF(1-29); GHRH 1-29; GHRH(1-29); Compounded sermorelin; Sermorelin peptide; growth hormone secretagogue; GH secretagogue; GHRP; GHRH", "class": "GHRH analog (secretagogue)", "body_system": "Muscle and bone", "families": "Growth hormone boosters", "uses": "anti-ageing; muscle growth; sleep", "route": "Injection", "evidence_grade": "C", "grade_meaning": "Animal and cell studies", "human_studies_cited": 10, "animal_or_cell_studies_cited": 0, "fda_status": "Not approved", "fda_as_of": "2026-10-27", "fda_statement": "Sermorelin was FDA-approved as Geref for diagnosing growth hormone deficiency and for treating growth failure in children with idiopathic growth hormone deficiency. EMD Serono discontinued Geref in 2008, and in 2013 the FDA determined it was not withdrawn for reasons of safety or effectiveness, which allows the agency to approve generic versions, though none has been approved. There is no FDA-approved sermorelin product on the market; what clinics prescribe is compounded, and the anti-aging and body composition uses it is prescribed for were never approved.", "sold_for": "Sermorelin is sold by anti-aging and men's health clinics as a gentler way to restore youthful growth hormone levels, promising fat loss, muscle, deeper sleep and recovery.", "studies_say": "Sermorelin does raise growth hormone and IGF-1, and small physiology studies show GHRH increases slow-wave sleep, but the fat loss and muscle data come from trials of tesamorelin in HIV patients, and no trial has tested sermorelin for anti-aging in healthy adults.", "grade_reasoning": "For the use sermorelin is sold for today, raising growth hormone in healthy middle-aged adults to lose fat, build muscle and sleep better, there is no randomized trial of sermorelin. The controlled human data are physiology experiments in 7 to 13 people using GHRH, a retrospective series of 14 men on a combination regimen, and randomized trials of a different GHRH analog, tesamorelin, in HIV-associated belly fat (806 patients pooled) and in 60 obese adults. Class evidence from another drug in another population does not lift sermorelin itself above C.", "citations": "https://pubmed.ncbi.nlm.nih.gov/42395176/ | https://pubmed.ncbi.nlm.nih.gov/18057338/ | https://pubmed.ncbi.nlm.nih.gov/20554713/ | https://pubmed.ncbi.nlm.nih.gov/23015655/ | https://pubmed.ncbi.nlm.nih.gov/2506218/ | https://pubmed.ncbi.nlm.nih.gov/28830317/ | https://pubmed.ncbi.nlm.nih.gov/1361964/ | https://pubmed.ncbi.nlm.nih.gov/8476038/ | https://pubmed.ncbi.nlm.nih.gov/9390775/ | https://www.federalregister.gov/documents/2013/03/04/2013-04827/determination-that-geref-sermorelin-acetate-injection-05-milligrams-basevial-and-10-milligrams | https://pubmed.ncbi.nlm.nih.gov/31237318/ | https://pubmed.ncbi.nlm.nih.gov/41545261/ | https://pubmed.ncbi.nlm.nih.gov/9354748/ | https://pubmed.ncbi.nlm.nih.gov/10522985/", "page": "https://peptidegraded.com/p/sermorelin/" }, { "slug": "setmelanotide", "name": "Setmelanotide", "aliases": "Imcivree; RM-493; RM493; BIM-22493; Setmelanotide injection", "class": "MC4R agonist", "body_system": "Gut and weight", "families": "", "uses": "weight loss; rare disease", "route": "Injection", "evidence_grade": "B", "grade_meaning": "Some human evidence", "human_studies_cited": 3, "animal_or_cell_studies_cited": 0, "fda_status": "FDA approved", "fda_as_of": "2026-10-26", "fda_statement": "Setmelanotide is FDA-approved as Imcivree for chronic weight management in patients aged 2 and older with obesity due to POMC, PCSK1 or LEPR deficiency (first approved November 2020), Bardet-Biedl syndrome (2022), and, since March 19, 2026, acquired hypothalamic obesity in patients aged 4 and older. It is not approved for common obesity.", "sold_for": "Setmelanotide is the drug that treats obesity caused by a broken appetite switch in the brain, in people whose hunger never turns off.", "studies_say": "In rare genetic and brain-injury forms of obesity, setmelanotide produces large sustained weight loss in trials ranging from 10 to 142 patients, with skin darkening and nausea as the trade-offs; it has not been tested as a treatment for ordinary obesity.", "grade_reasoning": "The original approvals rested on two open-label single-arm trials of 10 and 11 patients in which most lost more than a tenth of their weight, which is strong for diseases this rare but is not randomized evidence. The Bardet-Biedl approval added a placebo-controlled phase, and the 2026 hypothalamic obesity approval rests on TRANSCEND, a randomized placebo-controlled trial of 142 patients, the largest to date. One true RCT plus small single-arm trials in rare genetic conditions is B.", "citations": "https://doi.org/10.1016/S2213-8587(20)30364-8 | https://www.accessdata.fda.gov/drugsatfda_docs/label/2026/213793s009lbl.pdf | https://www.contemporarypediatrics.com/view/fda-approves-setmelanotide-for-acquired-hypothalmic-obesity-in-ages-4-years-and-older", "page": "https://peptidegraded.com/p/setmelanotide/" }, { "slug": "sincalide", "name": "Sincalide", "aliases": "Kinevac; Sincalide for injection; CCK-8; CCK8; Cholecystokinin octapeptide; Cholecystokinin 8", "class": "Cholecystokinin analog", "body_system": "Gut and weight", "families": "", "uses": "other", "route": "Intravenous", "evidence_grade": "B", "grade_meaning": "Some human evidence", "human_studies_cited": 1, "animal_or_cell_studies_cited": 0, "fda_status": "FDA approved", "fda_as_of": "2026-10-26", "fda_statement": "Sincalide is FDA-approved as Kinevac (approved 1976) as a diagnostic agent: to stimulate gallbladder contraction for imaging, to stimulate pancreatic secretion together with secretin for pancreatic function testing, and to speed the passage of barium through the small bowel during x-ray studies.", "sold_for": "Sincalide is the hospital drug that makes the gallbladder squeeze on cue so radiologists can measure how well it empties.", "studies_say": "Sincalide reliably contracts the gallbladder and stimulates pancreatic enzyme output, and a 60-person multicenter study standardized how to infuse it for imaging; that is solid for a diagnostic agent but is not outcome-trial evidence.", "grade_reasoning": "Sincalide is a diagnostic drug approved in 1976 on physiological studies, not outcome trials. The main modern evidence is a multicenter study of 60 healthy volunteers that compared infusion methods and set normal values for gallbladder ejection fraction. That is enough to establish it does what the label says, but there are no randomized trials showing that sincalide-based testing improves patient outcomes.", "citations": "https://doi.org/10.2967/jnumed.109.069393 | https://www.bracco.com/sites/default/files/2023-02/us-en-2023-02-27-spc-kinevac.pdf", "page": "https://peptidegraded.com/p/sincalide/" }, { "slug": "somapacitan", "name": "Somapacitan", "aliases": "Sogroya; Somapacitan-beco; NNC0195-0092; Sogroya injection; Long-acting growth hormone; growth hormone secretagogue; GH secretagogue; GHRP; GHRH", "class": "Long-acting GH analog", "body_system": "Hormones", "families": "Growth hormone boosters", "uses": "rare disease; other", "route": "Injection", "evidence_grade": "A", "grade_meaning": "Strong human evidence", "human_studies_cited": 2, "animal_or_cell_studies_cited": 0, "fda_status": "FDA approved", "fda_as_of": "2026-10-26", "fda_statement": "Somapacitan is FDA-approved as Sogroya (Novo Nordisk), a once-weekly injection, for adults with growth hormone deficiency (August 2020), children aged 2.5 and older with growth hormone deficiency (2023), and, since February 27, 2026, children aged 2.5 and older with idiopathic short stature, short stature after being born small for gestational age, or growth failure from Noonan syndrome.", "sold_for": "Somapacitan is the once-a-week growth hormone that replaces daily injections for children and adults who lack the hormone.", "studies_say": "Randomized trials show weekly somapacitan reduces body fat in adults with growth hormone deficiency as well as daily growth hormone does and produces equivalent growth in children, which supports an A for its approved uses.", "grade_reasoning": "The adult approval rested on REAL 1, a randomized, double-blind, placebo-controlled and active-controlled trial of 301 adults with growth hormone deficiency, and the pediatric approvals on randomized trials against daily somatropin, the most recent being the REAL8 basket trial across three indications. The question these trials answer is whether weekly somapacitan matches daily growth hormone, and they show it does.", "citations": "https://pubmed.ncbi.nlm.nih.gov/32022863/ | https://www.novo-pi.com/sogroya.pdf | https://www.hcplive.com/view/fda-approves-3-new-pediatric-indications-for-once-weekly-somapacitan-beco-sogroya-", "page": "https://peptidegraded.com/p/somapacitan/" }, { "slug": "somatropin-rhgh", "name": "Somatropin (rhGH)", "aliases": "rhGH; Somatropin; HGH; Growth hormone; Human growth hormone; Recombinant human growth hormone; Genotropin; Norditropin; Humatrope; Omnitrope; Zomacton; Nutropin; Saizen; Serostim; Zorbtive; Somatotropin; GH; growth hormone secretagogue; GH secretagogue; GHRP; GHRH", "class": "Growth hormone", "body_system": "Hormones", "families": "Growth hormone boosters", "uses": "hormone replacement; muscle growth; anti-ageing", "route": "Injection", "evidence_grade": "A", "grade_meaning": "Strong human evidence", "human_studies_cited": 0, "animal_or_cell_studies_cited": 0, "fda_status": "FDA approved", "fda_as_of": "2026-10-26", "fda_statement": "Somatropin, recombinant human growth hormone, has been FDA-approved since Humatrope in 1987 and is sold under several brands including Norditropin, Genotropin, Omnitrope and Zomacton, for growth hormone deficiency in children and adults and for a set of specific growth disorders. Two long-standing brands have left the market: Genentech discontinued Nutropin in 2024 and Lilly is ending Humatrope distribution at the end of 2026. Use for anti-aging or athletic performance is not an approved indication.", "sold_for": "Growth hormone is sold by anti-aging clinics and on the black market as the master hormone for youth, muscle and fat loss, well beyond the deficiency states it is approved to treat.", "studies_say": "Somatropin reliably restores growth in children who lack growth hormone and improves body composition in deficient adults, which is what it is approved for; the labels do not support use in healthy adults, and the market is shifting toward weekly long-acting versions as older daily brands exit.", "grade_reasoning": "The approved indications rest on four decades of randomized and controlled trials summarized in each product's label, including placebo-controlled trials in adult deficiency and growth velocity trials in children; the Norditropin label alone covers pediatric and adult deficiency, Turner syndrome, Noonan syndrome, Prader-Willi syndrome, small-for-gestational-age short stature and idiopathic short stature. Evidence for the uses it is sold for off-label, anti-aging and body composition in healthy adults, is a separate and much weaker question not covered by these citations.", "citations": "https://www.gene.com/media/statements/ps_031524 | https://humatrope.lilly.com/hcp | https://www.novo-pi.com/norditropin.pdf", "page": "https://peptidegraded.com/p/somatropin-rhgh/" }, { "slug": "survodutide", "name": "Survodutide", "aliases": "BI 456906; BI456906; BI-456906; Survodutide injection; GLP-1; GLP1; GLP-1 agonist; weight loss shot", "class": "GLP-1 / glucagon dual agonist", "body_system": "Gut and weight", "families": "GLP-1 drugs and successors", "uses": "weight loss; other", "route": "Injection", "evidence_grade": "B", "grade_meaning": "Some human evidence", "human_studies_cited": 3, "animal_or_cell_studies_cited": 0, "fda_status": "In clinical trials", "fda_as_of": "2026-10-26", "fda_statement": "Survodutide is not approved by the FDA or any other regulator. It is an investigational drug in phase 3 trials run by Boehringer Ingelheim and Zealand Pharma.", "sold_for": "Survodutide is talked about as the next-generation weight-loss injection that also burns liver fat, a possible rival to semaglutide and tirzepatide.", "studies_say": "Randomized trials show large placebo-adjusted weight loss and liver-fat reduction, but the drug is unapproved and long-term outcome data do not yet exist, which is why it grades B.", "grade_reasoning": "Survodutide has a published phase 2 randomized trial in metabolic dysfunction-associated steatohepatitis (293 participants), a 216-person phase 3 liver-fat trial published in Nature Medicine, and phase 3 obesity results (SYNCHRONIZE-1, 725 participants, the largest) reported by the sponsor in 2026. The obesity use it is best known for rests on randomized placebo-controlled data, but the drug has no approval and the full phase 3 program is still reading out, so it stops at B.", "citations": "https://doi.org/10.1056/NEJMoa2401755 | https://www.ncbi.nlm.nih.gov/books/NBK551568/ | https://doi.org/10.1038/s41591-026-04479-3 | https://www.boehringer-ingelheim.com/us/human-health/metabolic-diseases/results-phase-iii-synchronize-1-obesity-trial", "page": "https://peptidegraded.com/p/survodutide/" }, { "slug": "tb-500", "name": "TB-500", "aliases": "TB500; TB 500; Thymosin beta-4; Thymosin beta 4; Thymosin β4; Tβ4; TB4; Tb4 fragment; Thymosin beta-4 fragment 17-23; LKKTETQ; Ac-LKKTETQ; TB-500 peptide; healing peptide; recovery peptide; injury peptide", "class": "Synthetic Tβ4 fragment", "body_system": "Muscle and bone", "families": "Healing and recovery peptides", "uses": "tendon and ligament injury; wound healing", "route": "Injection", "evidence_grade": "C", "grade_meaning": "Animal and cell studies", "human_studies_cited": 0, "animal_or_cell_studies_cited": 2, "fda_status": "Not approved", "fda_as_of": "2026-10-26", "fda_statement": "TB-500 is not approved by the FDA for any use and is sold as a research chemical. In July 2026 an FDA advisory committee voted to recommend it for the list of substances pharmacies may compound, but that recommendation has not become a rule and is not an approval.", "sold_for": "TB-500 is sold online as an injectable healing peptide for torn muscles, tendons and ligaments, often paired with BPC-157.", "studies_say": "Nothing published tests TB-500 for injury in humans or animals; the evidence for its parent protein comes from small trials in wounds and the eye, so the grade is C.", "grade_reasoning": "There are no published human trials of TB-500 itself. The only TB-500-specific papers are doping-control chemistry studies that identified the peptide in gray-market and veterinary products and detected it in horses. Human trials exist for full-length thymosin beta-4 (a venous-ulcer safety study planned for 72 patients and an 18-patient eye-drop trial), but those tested a different, larger molecule.", "citations": "https://doi.org/10.1517/14712598.2012.634793 | https://www.mcdermottlaw.com/insights/bulk-list-bound-pcac-backs-majority-of-peptides-in-two-day-public-meeting/ | https://pubmed.ncbi.nlm.nih.gov/17495250/ | https://pubmed.ncbi.nlm.nih.gov/36613994/ | https://doi.org/10.1196/annals.1415.003 | https://pubmed.ncbi.nlm.nih.gov/22962027/ | https://www.fda.gov/drugs/human-drug-compounding/certain-bulk-drug-substances-use-compounding-may-present-significant-safety-risks | https://pubmed.ncbi.nlm.nih.gov/23084823/ | https://pubmed.ncbi.nlm.nih.gov/39314109/ | https://www.statnews.com/2026/07/24/fda-peptide-compounding-panel-backs-epitalon-rejects-emideltide/", "page": "https://peptidegraded.com/p/tb-500/" }, { "slug": "teduglutide", "name": "Teduglutide", "aliases": "Gattex; Revestive; ALX-0600; ALX0600; Teduglutide for injection", "class": "GLP-2 analog", "body_system": "Gut and weight", "families": "", "uses": "gut health; rare disease", "route": "Injection", "evidence_grade": "A", "grade_meaning": "Strong human evidence", "human_studies_cited": 2, "animal_or_cell_studies_cited": 0, "fda_status": "FDA approved", "fda_as_of": "2026-10-26", "fda_statement": "Teduglutide is approved by the FDA as Gattex for adults and children 1 year and older with short bowel syndrome who depend on parenteral support (intravenous nutrition or fluids). Approval came in 2012 for adults, with the pediatric indication added later.", "sold_for": "Teduglutide is prescribed to help people with very short intestines absorb enough on their own to cut back on intravenous feeding.", "studies_say": "Randomized and long-term extension data show meaningful reductions in parenteral support volume, with a minority of patients weaning off entirely, which supports the A grade for its approved indication.", "grade_reasoning": "Approval rests on the randomized placebo-controlled STEPS trial in adults with short bowel syndrome, followed by a two-year open-label extension (STEPS-2) in 88 patients that documented sustained reductions in parenteral support. The approved use matches the studied use, so it grades A. The outcome measured is volume of intravenous nutrition, not survival.", "citations": "https://doi.org/10.1038/ctg.2015.69 | https://www.accessdata.fda.gov/drugsatfda_docs/label/2021/203441s018lbl.pdf", "page": "https://peptidegraded.com/p/teduglutide/" }, { "slug": "teriparatide", "name": "Teriparatide", "aliases": "Forteo; Forsteo; Bonsity; PTH 1-34; PTH(1-34); rhPTH(1-34); Teriparatide injection; Parathyroid hormone 1-34; LY333334", "class": "PTH analog", "body_system": "Muscle and bone", "families": "", "uses": "bone density", "route": "Injection", "evidence_grade": "A", "grade_meaning": "Strong human evidence", "human_studies_cited": 1, "animal_or_cell_studies_cited": 0, "fda_status": "FDA approved", "fda_as_of": "2026-10-26", "fda_statement": "Teriparatide is approved by the FDA as Forteo (and as generic and follow-on products) to treat osteoporosis in postmenopausal women and men at high risk of fracture, and glucocorticoid-induced osteoporosis. Approved in 2002; the boxed warning about osteosarcoma and the two-year lifetime limit were removed from the label in November 2020.", "sold_for": "Teriparatide is the bone-building osteoporosis injection, the first drug that grows new bone instead of slowing its loss.", "studies_say": "A large randomized trial showed fewer spine and non-spine fractures in high-risk postmenopausal women, and two decades of use have not shown the bone cancer signal seen in rats, which is why it grades A.", "grade_reasoning": "The Fracture Prevention Trial randomized 1,637 postmenopausal women with prior vertebral fractures to teriparatide or placebo and showed fewer new vertebral and nonvertebral fractures over a median of 21 months. The approved use matches the trial population, and the label has since been expanded on further human data, so the grade is A.", "citations": "https://doi.org/10.1056/NEJM200105103441904 | https://uspl.lilly.com/forteo/forteo.html", "page": "https://peptidegraded.com/p/teriparatide/" }, { "slug": "terlipressin", "name": "Terlipressin", "aliases": "Terlivaz; Glypressin; Terlipressin acetate; Triglycyl-lysine vasopressin; Remestyp; Lucassin", "class": "Vasopressin analog", "body_system": "Gut and weight", "families": "", "uses": "other", "route": "Intravenous", "evidence_grade": "A", "grade_meaning": "Strong human evidence", "human_studies_cited": 1, "animal_or_cell_studies_cited": 0, "fda_status": "FDA approved", "fda_as_of": "2026-10-26", "fda_statement": "Terlipressin is approved by the FDA as Terlivaz (September 2022) to improve kidney function in adults with hepatorenal syndrome with rapid reduction in kidney function. The label carries a boxed warning for serious or fatal respiratory failure.", "sold_for": "Terlipressin is the hospital drug that can pull the kidneys back in people with cirrhosis whose kidneys are shutting down.", "studies_say": "A 300-patient randomized trial showed more reversals of hepatorenal syndrome than placebo, at the cost of more respiratory failure and no survival gain, which supports an A grade for the narrow approved use.", "grade_reasoning": "The CONFIRM trial randomized 300 patients with hepatorenal syndrome type 1 to terlipressin or placebo, both with albumin, and showed roughly double the rate of verified reversal of kidney failure. The label's efficacy section rests on CONFIRM, a double-blind randomized trial, so the approved use grades A, with the caveat that reversal of kidney injury did not translate into better 90-day survival.", "citations": "https://doi.org/10.1056/NEJMoa2008290 | https://drugs.com/pro/terlivaz.html", "page": "https://peptidegraded.com/p/terlipressin/" }, { "slug": "tesamorelin", "name": "Tesamorelin", "aliases": "Egrifta; Egrifta SV; Egrifta WR; TH9507; TH-9507; Tesamorelin acetate; Tesamorelin for injection; Compounded tesamorelin; growth hormone secretagogue; GH secretagogue; GHRP; GHRH", "class": "GHRH analog", "body_system": "Gut and weight", "families": "Growth hormone boosters", "uses": "fat loss; other", "route": "Injection", "evidence_grade": "B", "grade_meaning": "Some human evidence", "human_studies_cited": 6, "animal_or_cell_studies_cited": 1, "fda_status": "FDA approved", "fda_as_of": "2026-10-26", "fda_statement": "Tesamorelin is approved by the FDA as Egrifta (2010), Egrifta SV, and Egrifta WR (2025) to reduce excess abdominal fat in adults with HIV and lipodystrophy. It is not approved for weight loss, fat loss in people without HIV, or anti-aging.", "sold_for": "Tesamorelin is marketed by longevity and body-composition clinics as a growth-hormone-releasing injection that melts belly fat without the risks of growth hormone itself.", "studies_say": "In people with HIV it reliably cuts visceral fat by about 15 percent over six months, but the fat returns when the drug stops and the evidence in people without HIV is a single small trial, which is the logic of the B grade.", "grade_reasoning": "Two phase 3 randomized trials in HIV-associated abdominal fat, pooled at 806 patients, support the approved indication, which would be A for that use. The use tesamorelin is best known for outside clinics, trimming visceral fat in people without HIV, rests on one 60-person randomized trial in obese adults with reduced growth hormone and one 61-person trial in HIV-related fatty liver, so the popular use grades B.", "citations": "https://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=3d783378-b02d-4f19-99dd-0fc91a042224 | https://doi.org/10.1097/QAI.0b013e3181cbdaff | https://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=839334d3-8c1d-4c26-9036-2ab524a6ea75 | https://doi.org/10.1097/QAD.0b013e32830a5058 | https://doi.org/10.1097/QAI.0b013e3181cbdaff | https://www.accessdata.fda.gov/drugsatfda_docs/label/2025/022505s020lbl.pdf | https://pubmed.ncbi.nlm.nih.gov/23015655/ | https://pubmed.ncbi.nlm.nih.gov/31611038/ | https://pubmed.ncbi.nlm.nih.gov/18057338/ | https://pubmed.ncbi.nlm.nih.gov/20554713/ | https://pubmed.ncbi.nlm.nih.gov/20101189/ | https://pubmed.ncbi.nlm.nih.gov/28617838/ | https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=3d783378-b02d-4f19-99dd-0fc91a042224 | https://pubmed.ncbi.nlm.nih.gov/17214611/", "page": "https://peptidegraded.com/p/tesamorelin/" }, { "slug": "compounded-tesamorelin", "name": "Tesamorelin (compounded)", "aliases": "Compounded tesamorelin; Egrifta; Egrifta SV; Egrifta WR; TH9507; Tesamorelin acetate; growth hormone secretagogue; GH secretagogue; GHRP; GHRH", "class": "GHRH analog", "body_system": "Hormones", "families": "Growth hormone boosters", "uses": "fat loss; other", "route": "Injection", "evidence_grade": "B", "grade_meaning": "Some human evidence", "human_studies_cited": 7, "animal_or_cell_studies_cited": 1, "fda_status": "Not approved", "fda_as_of": "2026-10-26", "fda_statement": "Tesamorelin is FDA-approved as Egrifta (Egrifta SV, and since March 2025 Egrifta WR) only for reducing excess abdominal fat in adults with HIV who have lipodystrophy. Compounded tesamorelin sold for fat loss, muscle or anti-ageing in people without HIV is not an FDA-approved product and that use has no approved indication.", "sold_for": "Compounded tesamorelin is sold by longevity and body-composition clinics as the approved, cleaner alternative to CJC-1295 for burning visceral fat and raising growth hormone.", "studies_say": "It reliably cuts visceral fat by about 15% in HIV lipodystrophy, one 60-person trial suggests a similar selective effect in obese adults without HIV, and the fat returns within months of stopping, so the off-label use rests on a single small trial.", "grade_reasoning": "For the approved HIV indication the evidence would be A: two phase 3 placebo-controlled trials (412 and 404 patients, pooled 806) showed visceral fat fell about 15% over 26 weeks. For the use compounded tesamorelin is actually sold for, belly fat in people without HIV, there is one randomized trial of 60 abdominally obese adults with low GH secretion, and a 61-person trial in HIV-related fatty liver. That is B.", "citations": "https://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=3d783378-b02d-4f19-99dd-0fc91a042224 | https://pubmed.ncbi.nlm.nih.gov/20101189/ | https://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=839334d3-8c1d-4c26-9036-2ab524a6ea75 | https://doi.org/10.1097/QAD.0b013e32830a5058 | https://www.accessdata.fda.gov/drugsatfda_docs/label/2025/022505s020lbl.pdf | https://pubmed.ncbi.nlm.nih.gov/23015655/ | https://pubmed.ncbi.nlm.nih.gov/31611038/ | https://pubmed.ncbi.nlm.nih.gov/18057338/ | https://pubmed.ncbi.nlm.nih.gov/20554713/ | https://pubmed.ncbi.nlm.nih.gov/28617838/ | https://pubmed.ncbi.nlm.nih.gov/17214611/", "page": "https://peptidegraded.com/p/compounded-tesamorelin/" }, { "slug": "thymosin-alpha-1", "name": "Thymosin alpha-1", "aliases": "Thymalfasin; Zadaxin; Thymosin alpha 1; Thymosin α1; Tα1; TA1; TA-1; Thymosin alpha-1 acetate; Thymosin alpha1; longevity peptide; anti-ageing peptide; nootropic peptide", "class": "Immunomodulatory peptide", "body_system": "Immunity", "families": "Longevity and brain peptides", "uses": "immune support; infection", "route": "Injection", "evidence_grade": "B", "grade_meaning": "Some human evidence", "human_studies_cited": 6, "animal_or_cell_studies_cited": 2, "fda_status": "Not approved", "fda_as_of": "2026-10-27", "fda_statement": "Thymosin alpha-1 is not approved by the FDA for any use. It is approved as thymalfasin (Zadaxin) in more than 35 other countries for hepatitis B and C and as an immune adjuvant. In the United States it was taken off the FDA's Category 2 compounding list after its nominators withdrew it, and in December 2024 the Pharmacy Compounding Advisory Committee voted 17 to 4 against adding it to the 503A bulks list; it is sold online as a research chemical.", "sold_for": "Thymosin alpha-1 is sold by wellness clinics as an immune-system booster for infections, cancer support, autoimmune disease and long COVID.", "studies_say": "Randomized trials support a modest, delayed antiviral effect in chronic hepatitis B, a large trial found no benefit in sepsis, and there are no trials of the immune-boosting uses marketed in the US, which is why it grades B.", "grade_reasoning": "Thymosin alpha-1 has several randomized trials in chronic hepatitis B (98 and 316 patients) and a meta-analysis of five trials with 353 patients showing delayed viral suppression, which is the approved use abroad. The 1,106-patient TESTS phase 3 trial in sepsis found no mortality benefit. The general immune-boosting use it is sold for in the US has no controlled trials, so the compound grades B on its hepatitis B evidence and D on the wellness claims.", "citations": "https://pubmed.ncbi.nlm.nih.gov/19392576/ | https://pubmed.ncbi.nlm.nih.gov/9581695/ | https://doi.org/10.1186/cc11932 | https://doi.org/10.1136/bmj-2024-082583 | https://doi.org/10.1111/j.1365-2893.2005.00633.x | https://doi.org/10.3389/fcimb.2025.1673959 | https://www.fda.gov/drugs/human-drug-compounding/certain-bulk-drug-substances-use-compounding-may-present-significant-safety-risks | https://pubmed.ncbi.nlm.nih.gov/19405116/ | https://pubmed.ncbi.nlm.nih.gov/15482167/ | https://pubmed.ncbi.nlm.nih.gov/21513520/ | https://pubmed.ncbi.nlm.nih.gov/16741252/ | https://pubmed.ncbi.nlm.nih.gov/41570941/ | https://pubmed.ncbi.nlm.nih.gov/11736720/ | https://pubmed.ncbi.nlm.nih.gov/15850471/ | https://pubmed.ncbi.nlm.nih.gov/39814420/ | https://www.fda.gov/media/185642/download", "page": "https://peptidegraded.com/p/thymosin-alpha-1/" }, { "slug": "thymosin-beta-4", "name": "Thymosin beta-4", "aliases": "Thymosin beta 4; Thymosin β4; Tβ4; TB4; TB-4; TB-500; TB500; TMSB4X; RGN-259; Timbetasin; healing peptide; recovery peptide; injury peptide", "class": "Actin-regulating peptide", "body_system": "Muscle and bone", "families": "Healing and recovery peptides", "uses": "wound healing; tendon and ligament injury; cognition", "route": "Several routes", "evidence_grade": "B", "grade_meaning": "Some human evidence", "human_studies_cited": 5, "animal_or_cell_studies_cited": 3, "fda_status": "Not approved", "fda_as_of": "2026-10-27", "fda_statement": "Thymosin beta-4 is not approved by the FDA for any use. Injectable products sold online, often labeled TB-500 (which the FDA reviewed as a seven-amino-acid fragment), are research chemicals; the FDA found no human exposure data for TB-500, and the agency has not acted on its compounding advisory committee's July 2026 vote to recommend adding TB-500 to the 503A bulks list. RGN-259 eye drops are in a phase 3 trial for neurotrophic keratopathy, and a recombinant intravenous form has been tested in heart attack patients.", "sold_for": "Thymosin beta-4 is sold as a regenerative injection for tendon, muscle and joint injuries and promoted as the full-length version of TB-500.", "studies_say": "Small randomized trials show safety and signals of benefit in eye and heart disease, but the injected use for sports injuries has never been tested in people, which is why it grades B for the studied indications and no better.", "grade_reasoning": "Thymosin beta-4 has two phase 1 safety trials in healthy volunteers (40 and 84 subjects), an 18-patient phase 3 eye-drop trial, a 96-patient randomized trial after heart attack, and a venous ulcer study. All are small and most tested topical or intravenous full-length protein for specific diseases, not the injected wound-healing use it is sold for. Animal work in rats and mice supports wound and cardiac effects. Grade B for the clinical indications under study; the injury-recovery use sold online has no trial.", "citations": "https://doi.org/10.1517/14712598.2012.634793 | https://doi.org/10.1196/annals.1415.003 | https://clinicaltrials.gov/study/NCT03937882 | https://pubmed.ncbi.nlm.nih.gov/36613994/ | https://pubmed.ncbi.nlm.nih.gov/41570941/ | https://pubmed.ncbi.nlm.nih.gov/23084823/ | https://pubmed.ncbi.nlm.nih.gov/41229390/ | https://www.fda.gov/drugs/human-drug-compounding/certain-bulk-drug-substances-use-compounding-may-present-significant-safety-risks | https://clinicaltrials.gov/study/NCT05555589 | https://pubmed.ncbi.nlm.nih.gov/20536472/ | https://pubmed.ncbi.nlm.nih.gov/34346165/ | https://pubmed.ncbi.nlm.nih.gov/10469335/ | https://www.statnews.com/2026/04/15/peptides-fda-panel-to-discuss-broader-access-compounding/ | https://www.statnews.com/2026/07/24/fda-peptide-compounding-panel-backs-epitalon-rejects-emideltide/", "page": "https://peptidegraded.com/p/thymosin-beta-4/" }, { "slug": "thymulin", "name": "Thymulin", "aliases": "Facteur thymique serique; FTS; Serum thymic factor; Thymulin peptide; Zinc-thymulin; Zn-FTS; longevity peptide; anti-ageing peptide; nootropic peptide", "class": "Thymic immune peptide", "body_system": "Immunity", "families": "Longevity and brain peptides", "uses": "immune support; anti-ageing", "route": "Injection", "evidence_grade": "C", "grade_meaning": "Animal and cell studies", "human_studies_cited": 0, "animal_or_cell_studies_cited": 2, "fda_status": "Not approved", "fda_as_of": "2026-10-26", "fda_statement": "Thymulin is not approved by the FDA for any use and is sold as a research chemical. No pharmaceutical company has brought it through clinical development.", "sold_for": "Thymulin is sold as an anti-aging immune peptide that restores a shrinking thymus and rebalances T cells.", "studies_say": "Thymulin is a real thymic hormone whose biology is well described in animals, but no human trial has tested giving it as a drug, which puts it at C.", "grade_reasoning": "The literature on thymulin is physiological: how the thymus makes it, how zinc activates it, and what it does in rodent models of aging, inflammation and pain. Human data are limited to measurements of thymulin activity in blood as a marker of zinc status; there are no interventional trials of giving thymulin to people. Grade C for the immune-restoration use it is sold for.", "citations": "https://doi.org/10.1111/j.1749-6632.2008.03964.x | https://doi.org/10.1093/jn/137.5.1345", "page": "https://peptidegraded.com/p/thymulin/" }, { "slug": "tirzepatide", "name": "Tirzepatide", "aliases": "Mounjaro; Zepbound; Tirz; LY3298176; Compounded tirzepatide; GIP/GLP-1 dual agonist; Tirzepatide injection; GLP-1; GLP1; GLP-1 agonist; weight loss shot", "class": "Dual GIP + GLP-1 receptor agonist", "body_system": "Gut and weight", "families": "GLP-1 drugs and successors", "uses": "weight loss; blood sugar; sleep", "route": "Injection", "evidence_grade": "A", "grade_meaning": "Strong human evidence", "human_studies_cited": 8, "animal_or_cell_studies_cited": 0, "fda_status": "FDA approved", "fda_as_of": "2026-10-27", "fda_statement": "Tirzepatide is approved by the FDA as Mounjaro (2022) for type 2 diabetes in adults, extended to children 10 and older and to cardiovascular risk reduction in adults with type 2 diabetes and established cardiovascular disease, and as Zepbound (2023) for chronic weight management and for moderate to severe obstructive sleep apnea in adults with obesity.", "sold_for": "Tirzepatide is the weight-loss injection that outperformed semaglutide, cutting body weight by about a fifth in trials.", "studies_say": "Multiple large randomized trials show weight loss of 15 to 21 percent, better glucose control than other diabetes drugs, and improvement in sleep apnea, with weight regain after stopping, which is a clean A.", "grade_reasoning": "Tirzepatide's weight-loss use rests on the SURMOUNT program of randomized placebo-controlled trials, the largest being SURMOUNT-1 with 2,539 adults, plus trials in type 2 diabetes, sleep apnea, weight maintenance and diabetes prevention. Every approved indication was granted on randomized data, so it grades A.", "citations": "https://www.accessdata.fda.gov/drugsatfda_docs/label/2025/215866s031lbl.pdf | https://doi.org/10.1056/NEJMoa2206038 | https://www.accessdata.fda.gov/drugsatfda_docs/label/2025/217806s031lbl.pdf | https://www.fda.gov/news-events/press-announcements/fda-approves-first-medication-obstructive-sleep-apnea | https://doi.org/10.3390/ijms232314631 | https://doi.org/10.1007/s00125-024-06144-1 | https://doi.org/10.1001/jama.2023.24945 | https://doi.org/10.1016/S0140-6736(23)01200-X | https://www.accessdata.fda.gov/scripts/cder/daf/index.cfm?event=overview.process&ApplNo=215866 | https://www.accessdata.fda.gov/drugsatfda_docs/label/2026/215866s009lbl.pdf | https://www.accessdata.fda.gov/drugsatfda_docs/label/2026/215866s044s045lbl.pdf | https://www.accessdata.fda.gov/scripts/cder/daf/index.cfm?event=overview.process&ApplNo=217806 | https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/fdas-concerns-unapproved-glp-1-drugs-used-weight-loss | https://doi.org/10.1056/NEJMoa2404881 | https://doi.org/10.1056/NEJMoa2410819 | https://doi.org/10.7759/cureus.86080 | https://pubmed.ncbi.nlm.nih.gov/42803597/", "page": "https://peptidegraded.com/p/tirzepatide/" }, { "slug": "tripeptide-10-citrulline", "name": "Tripeptide-10 citrulline", "aliases": "Decorinyl; Tripeptide-10 citrullin; Tripeptide 10 citrulline; Decorin mimetic peptide; cosmetic peptide; skincare peptide; Matrixyl; Argireline", "class": "Signal peptide", "body_system": "Skin", "families": "Cosmetic skin peptides", "uses": "skin and hair", "route": "Topical", "evidence_grade": "D", "grade_meaning": "No meaningful data", "human_studies_cited": 0, "animal_or_cell_studies_cited": 1, "fda_status": "Cosmetic ingredient", "fda_as_of": "2026-10-26", "fda_statement": "Tripeptide-10 citrulline is a cosmetic ingredient and falls outside FDA drug approval. Cosmetics do not need pre-market approval; the ingredient has not been reviewed as a drug for any claim.", "sold_for": "Tripeptide-10 citrulline is sold in anti-aging creams as a decorin mimic that organizes collagen fibers for firmer, more elastic skin.", "studies_say": "A single manufacturer paper shows the peptide alters collagen fiber assembly in a test tube and asserts a suppleness benefit without a described human trial, which does not establish a clinical effect, hence D.", "grade_reasoning": "The entire published record is one 2008 paper by scientists at the ingredient's manufacturer, Lipotec, describing an in vitro collagen-assembly assay and stating that the peptide increases skin suppleness, without a reported human sample size or control group. There is no independent replication and no controlled trial with clinical endpoints, so the firming and anti-wrinkle claims grade D.", "citations": "https://doi.org/10.1111/j.1468-2494.2008.00429.x", "page": "https://peptidegraded.com/p/tripeptide-10-citrulline/" }, { "slug": "triptorelin", "name": "Triptorelin", "aliases": "Trelstar; Triptodur; Decapeptyl; Diphereline; Gonapeptyl; Triptorelin pamoate; Triptorelin acetate; Trelstar Depot", "class": "GnRH agonist", "body_system": "Reproduction", "families": "", "uses": "cancer; other", "route": "Injection", "evidence_grade": "A", "grade_meaning": "Strong human evidence", "human_studies_cited": 1, "animal_or_cell_studies_cited": 0, "fda_status": "FDA approved", "fda_as_of": "2026-10-26", "fda_statement": "Triptorelin is approved by the FDA as Trelstar (since 2000) for treatment of advanced prostate cancer, in 1-, 3- and 6-month depot injections, and as Triptodur (2017) for central precocious puberty in children 2 years and older.", "sold_for": "Triptorelin is a long-acting hormone-suppressing injection used for prostate cancer and to pause puberty, and is discussed online as a tool for hormone manipulation.", "studies_say": "Randomized trials show it drives testosterone to castrate levels as reliably as leuprolide, which supports an A for its approved indications.", "grade_reasoning": "Triptorelin's prostate cancer use rests on randomized comparisons with leuprolide, the reference GnRH agonist, including a 2003 BJU International trial of 284 men showing equivalent maintenance of castrate testosterone over nine months. Hormonal suppression is a surrogate endpoint, but it is the accepted basis for approval of this drug class, so it grades A for its approved use.", "citations": "https://doi.org/10.1046/j.1464-410x.2003.04308.x | https://www.accessdata.fda.gov/drugsatfda_docs/label/2026/020715s052lbl.pdf | https://www.accessdata.fda.gov/drugsatfda_docs/nda/2017/208956Orig1s000Lbl.pdf", "page": "https://peptidegraded.com/p/triptorelin/" }, { "slug": "trofinetide", "name": "Trofinetide", "aliases": "DAYBUE and DAYBUE STIX; Daybue; Daybue Stix; NNZ-2566; NNZ2566; Trofinetide oral solution; Glycyl-L-2-methylprolyl-L-glutamic acid; cGPE analog", "class": "IGF-1-derived tripeptide analog", "body_system": "Nervous system", "families": "", "uses": "rare disease; cognition", "route": "Oral", "evidence_grade": "A", "grade_meaning": "Strong human evidence", "human_studies_cited": 4, "animal_or_cell_studies_cited": 0, "fda_status": "FDA approved", "fda_as_of": "2026-10-26", "fda_statement": "Trofinetide is approved by the FDA as Daybue (March 2023) for the treatment of Rett syndrome in adults and children 2 years and older, the first drug approved for the condition. The current label on DailyMed (updated September 2026) also covers Daybue Stix, a powder for oral solution.", "sold_for": "Trofinetide is the first drug ever approved for Rett syndrome, a severe genetic neurological disorder affecting mostly girls.", "studies_say": "A single well-run phase 3 trial showed statistically significant improvement on caregiver and clinician rating scales, with diarrhea in four out of five patients, which earns an A for the approved indication.", "grade_reasoning": "Approval rests on LAVENDER, a 187-patient randomized placebo-controlled phase 3 trial that met both co-primary endpoints, preceded by two randomized phase 2 trials in 56 adolescents and adults and 82 children. The approved use matches the studied use, so it grades A, with the caveat that the endpoints are rating scales and the effect size is modest.", "citations": "https://doi.org/10.1016/j.pediatrneurol.2020.04.019 | https://doi.org/10.1038/s41591-023-02398-1 | https://www.accessdata.fda.gov/drugsatfda_docs/nda/2023/217026Orig1s000lbl.pdf | https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=67e6f2d9-21f6-466f-9def-826c6a4b8257 | https://pubmed.ncbi.nlm.nih.gov/28964591/ | https://pubmed.ncbi.nlm.nih.gov/30918097/", "page": "https://peptidegraded.com/p/trofinetide/" }, { "slug": "trofinetide-predecessor-programs", "name": "Trofinetide (predecessor programs)", "aliases": "NNZ-2566; NNZ2566; Daybue; Glycyl-L-2-methylprolyl-L-glutamate", "class": "IGF-1-derived peptide", "body_system": "Nervous system", "families": "", "uses": "rare disease; cognition", "route": "Oral", "evidence_grade": "B", "grade_meaning": "Some human evidence", "human_studies_cited": 2, "animal_or_cell_studies_cited": 1, "fda_status": "FDA approved", "fda_as_of": "2026-10-26", "fda_statement": "Trofinetide is approved by the FDA as Daybue (March 2023) for Rett syndrome in adults and children 2 years and older. The earlier programs covered here, in fragile X syndrome and traumatic brain injury, were investigational and did not lead to approval.", "sold_for": "Before Rett syndrome, trofinetide was pitched as a brain-repair drug for concussion, fragile X and other neurodevelopmental conditions.", "studies_say": "The fragile X program produced one small 28-day randomized trial with a positive signal at the higher dose and the brain injury work is in rats, so the predecessor programs grade B; only the Rett indication reached phase 3.", "grade_reasoning": "This page covers trofinetide's development outside Rett syndrome. The fragile X program produced one randomized placebo-controlled phase 2 trial in 72 adolescent and adult males, which reported an efficacy signal at the higher trial dose over 28 days on a novel composite analysis; the published brain injury work is in rats. A single small, short randomized trial makes the fragile X use B; the Rett syndrome use, graded on its own page, has a 187-patient phase 3 trial.", "citations": "https://doi.org/10.1016/j.pediatrneurol.2020.04.019 | https://doi.org/10.1038/s41591-023-02398-1 | https://www.accessdata.fda.gov/drugsatfda_docs/nda/2023/217026Orig1s000lbl.pdf | https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=67e6f2d9-21f6-466f-9def-826c6a4b8257 | https://pubmed.ncbi.nlm.nih.gov/19656406/", "page": "https://peptidegraded.com/p/trofinetide-predecessor-programs/" }, { "slug": "vancomycin", "name": "Vancomycin", "aliases": "Vancocin; Vancomycin hydrochloride; Firvanq; Vancomycin HCl; Vanco; Vancomycin oral; Vancomycin IV", "class": "Glycopeptide antibiotic", "body_system": "Circulation", "families": "", "uses": "infection", "route": "Several routes", "evidence_grade": "A", "grade_meaning": "Strong human evidence", "human_studies_cited": 1, "animal_or_cell_studies_cited": 0, "fda_status": "FDA approved", "fda_as_of": "2026-10-26", "fda_statement": "Vancomycin has been FDA-approved since 1958. Intravenous vancomycin is approved for serious infections caused by Gram-positive bacteria including MRSA; oral vancomycin (Vancocin capsules, first approved in 1986, and generics) is approved for Clostridioides difficile-associated diarrhea and staphylococcal enterocolitis.", "sold_for": "Vancomycin is the hospital's last-line antibiotic for MRSA and the standard pill for C. difficile gut infection.", "studies_say": "Randomized trials and more than 65 years of use support both the intravenous and oral indications, with kidney toxicity and rising resistance as the known costs, hence A.", "grade_reasoning": "Vancomycin's use is backed by decades of clinical practice and by randomized trials in which it served as the standard-therapy comparator, including a 246-patient trial in Staphylococcus aureus bloodstream infection and endocarditis where daptomycin was tested against vancomycin or an antistaphylococcal penicillin. Grade A for the approved intravenous and oral uses.", "citations": "https://pubmed.ncbi.nlm.nih.gov/16914701/ | https://www.accessdata.fda.gov/drugsatfda_docs/label/2026/050671s043lbl.pdf | https://www.accessdata.fda.gov/drugsatfda_docs/label/2021/050606s039lbl.pdf", "page": "https://peptidegraded.com/p/vancomycin/" }, { "slug": "vasopressin", "name": "Vasopressin", "aliases": "Vasostrict; Pitressin; Antidiuretic hormone; ADH; Arginine vasopressin; AVP; Argipressin; 8-arginine vasopressin; Vasopressin injection", "class": "V1/V2 receptor agonist", "body_system": "Circulation", "families": "", "uses": "other", "route": "Intravenous", "evidence_grade": "A", "grade_meaning": "Strong human evidence", "human_studies_cited": 1, "animal_or_cell_studies_cited": 0, "fda_status": "FDA approved", "fda_as_of": "2026-10-26", "fda_statement": "Vasopressin injection is approved by the FDA as Vasostrict (2014) and generics to raise blood pressure in adults with vasodilatory shock who remain hypotensive despite fluids and catecholamines. It is given as a continuous intravenous infusion in intensive care.", "sold_for": "Vasopressin is the second-line pressor in septic shock, used to spare high doses of adrenaline-type drugs.", "studies_say": "A 778-patient randomized trial showed vasopressin raises blood pressure as well as norepinephrine without improving survival, which supports A for its approved hemodynamic indication.", "grade_reasoning": "The VASST trial randomized 778 patients with septic shock to vasopressin or norepinephrine added to open-label vasopressors and found no difference in 28-day mortality. The drug reliably raises blood pressure and reduces catecholamine requirements, which is the approved use and is supported by randomized data, so A, with the understanding that no survival benefit has been shown.", "citations": "https://doi.org/10.1056/NEJMoa067373 | https://www.drugs.com/pro/vasostrict.html", "page": "https://peptidegraded.com/p/vasopressin/" }, { "slug": "vosoritide", "name": "Vosoritide", "aliases": "Voxzogo; BMN 111; BMN111; BMN-111; Vosoritide injection", "class": "CNP analog", "body_system": "Muscle and bone", "families": "", "uses": "rare disease", "route": "Injection", "evidence_grade": "A", "grade_meaning": "Strong human evidence", "human_studies_cited": 1, "animal_or_cell_studies_cited": 0, "fda_status": "FDA approved", "fda_as_of": "2026-10-26", "fda_statement": "Vosoritide is approved by the FDA as Voxzogo (November 2021, accelerated approval) to increase linear growth in children with achondroplasia and open growth plates. Initially for ages 5 and up, the indication was extended in October 2023 to children of all ages with open epiphyses. Continued approval may depend on confirmatory evidence of final adult height.", "sold_for": "Vosoritide is the first drug that makes children with achondroplasia grow taller, an injection that reactivates stunted bone growth.", "studies_say": "One randomized trial showed about 1.6 centimeters per year of extra growth, with final adult height and effects on complications still unproven, which is why it holds an A under accelerated approval.", "grade_reasoning": "A 121-child randomized placebo-controlled phase 3 trial showed a 1.57 centimeter per year increase in growth velocity over 52 weeks, the basis for approval. The endpoint is a surrogate (growth rate, not final height or function), which the FDA addressed by granting accelerated approval. Grade A for the approved use given the randomized design and matching indication.", "citations": "https://doi.org/10.1016/S0140-6736(20)31541-5 | https://www.accessdata.fda.gov/drugsatfda_docs/label/2024/214938s004lbl.pdf", "page": "https://peptidegraded.com/p/vosoritide/" }, { "slug": "ziconotide", "name": "Ziconotide", "aliases": "Prialt; SNX-111; SNX111; Omega-conotoxin MVIIA; ω-conotoxin MVIIA; Ziconotide intrathecal; Ziconotide acetate", "class": "N-type Ca-channel blocker (conotoxin)", "body_system": "Nervous system", "families": "", "uses": "pain", "route": "Implant", "evidence_grade": "A", "grade_meaning": "Strong human evidence", "human_studies_cited": 1, "animal_or_cell_studies_cited": 0, "fda_status": "FDA approved", "fda_as_of": "2026-10-26", "fda_statement": "Ziconotide is approved by the FDA as Prialt (December 2004) for the management of severe chronic pain in patients for whom intrathecal therapy is warranted and who are intolerant of or refractory to other treatments. It is delivered by an implanted pump into the fluid around the spinal cord and carries a boxed warning for severe psychiatric symptoms and neurological impairment.", "sold_for": "Ziconotide is the cone-snail venom painkiller, a non-opioid delivered straight to the spinal cord for pain nothing else touches.", "studies_say": "Randomized trials show substantial pain relief over placebo in refractory patients, bought at the price of frequent neurological and psychiatric side effects, which keeps it an A for its narrow approved use.", "grade_reasoning": "Approval rested on randomized placebo-controlled trials of intrathecal ziconotide, including a 111-patient trial in cancer and AIDS pain published in JAMA in 2004 that showed a 53 percent improvement in pain scores versus 18 percent on placebo. The approved use matches the trial populations, so A, with the note that the early trials used faster titration than is now recommended and had high adverse-event rates.", "citations": "https://doi.org/10.1001/jama.291.1.63 | https://www.drugs.com/pro/prialt.html", "page": "https://peptidegraded.com/p/ziconotide/" }, { "slug": "zilucoplan", "name": "Zilucoplan", "aliases": "Zilbrysq; RA101495; RA-101495; Zilucoplan injection", "class": "Complement C5 inhibitor peptide", "body_system": "Muscle and bone", "families": "", "uses": "rare disease; other", "route": "Injection", "evidence_grade": "A", "grade_meaning": "Strong human evidence", "human_studies_cited": 1, "animal_or_cell_studies_cited": 0, "fda_status": "FDA approved", "fda_as_of": "2026-10-26", "fda_statement": "Zilucoplan is approved by the FDA as Zilbrysq (October 2023) for generalized myasthenia gravis in adults who are anti-acetylcholine receptor antibody positive. It carries a boxed warning for serious meningococcal infections, requires meningococcal vaccination, and is available only through a restricted REMS program.", "sold_for": "Zilucoplan is the first self-injected complement inhibitor for myasthenia gravis, a self-injected shot that replaces hospital infusions.", "studies_say": "A 174-patient randomized trial showed clinically meaningful improvement in daily-living symptoms over placebo at 12 weeks, with the class risk of meningococcal infection, which supports an A.", "grade_reasoning": "Approval rests on RAISE, a 174-patient randomized placebo-controlled phase 3 trial that met its primary endpoint on the patient-reported MG-ADL scale at 12 weeks, plus a phase 2 trial. The approved use matches the trial population, so A; durability beyond 12 weeks comes from open-label extension data.", "citations": "https://doi.org/10.1016/S1474-4422(23)00080-7 | https://www.accessdata.fda.gov/drugsatfda_docs/label/2024/216834s001lbl.pdf", "page": "https://peptidegraded.com/p/zilucoplan/" } ]