Peptide

GHRP-2

pralmorelin hydrochloride

Evidence TierCWADA PROHIBITED

tuneTypical Dose

30-300 ug/kg oral acute. 0.3-3 ug/kg/day SC in published pediatric protocols.

watchEffect Window

Hours for endocrine biomarkers. Weeks to months for growth-velocity signals in pediatric cohorts.

lockCompliance

WADA PROHIBITED

Overview

Clinical Summary

GHRP-2 is a growth hormone releasing peptide that acts via ghrelin receptors. It is used to increase pulsatile growth hormone secretion and IGF-1 levels, mainly in research contexts.

Human studies show increased growth hormone pulses and elevated IGF-1, supporting endocrine research applications. Controlled evidence for improved body composition, strength, or recovery in healthy users is limited. Minority effects include appetite changes and sleep-related subjective reports, consistent with ghrelin signaling. Long-term safety and metabolic effects, including glucose changes, are not well defined outside clinical research.

GH secretagogue pathway via ghrelin receptor signaling, with short-duration GH pulse effects and variable downstream translation to IGF or growth endpoints.

Outcomes

What This Is Expected To Influence

Primary Outcomes

  • Acute GH pulse elevation
  • Growth velocity signal in selected pediatric GH-deficiency cohorts
  • Acute appetite increase

Secondary Outcomes

  • Pulsatile endocrine effects are short-lived in some protocols
  • Potential endocrine axis interactions in critical illness

Safety

Contraindications and Interactions

Contraindications

  • Uncontrolled endocrine instability
  • Active endocrine neoplasia under evaluation
  • Severe hepatic or renal risk without specialist oversight
  • Pregnancy
  • Breastfeeding

Side effects

  • Increased appetite
  • Water retention
  • Tingling
  • Cortisol increase

Interactions

  • Pituitary stimulatory hormones
  • Overlapping GH axis products

Avoid if

  • Critical illness without specialist protocol
  • Active malignancy risk without oversight
  • Unstable psychiatric or cardiovascular disease

Evidence

Study-level References

ghrp-2-SRC-001Single-blind randomized crossover, dose-response acute human trial.
Sourceopen_in_new

Hartman ML et al. Oral administration of growth hormone (GH)-releasing peptide stimulates GH secretion in normal men. J Clin Endocrinol Metab. 1992;74(6):1378-84. doi:10.1210/jcem.74.6.1592884. PMID:1592884.

Population: Healthy adult males (n=10 in abstract).

Dose protocol: Oral placebo, 30, 100, 300 ug/kg GHRP. IV comparator 1 ug/kg.

Key findings: Dose-dependent GH rise with oral response approaching IV comparator. Onset and duration characterized.

Paper content

Dose-dependent GH rise with oral response approaching IV comparator; onset and duration characterized.

ghrp-2-SRC-002Review; developmental and mechanism synthesis with regulatory context.
Sourceopen_in_new

Bowers CY, et al. Pralmorelin: GHRP 2, GPA 748, growth hormone-releasing peptide 2... Drugs R D. 2004;5(4):236-9. doi:10.2165/00126839-200405040-00011. PMID:15230633.

Population: Multi-population synthesis; human/animal.

Dose protocol: Discusses multiple investigational formats and oral/buccal/subcutaneous options.

Key findings: Confirms ghrelin-mimetic mechanism, diagnostic positioning, and limitations of GH-deficient response.

Paper content

Confirms ghrelin-mimetic mechanism, diagnostic positioning, and limitations of GH-deficient response.

ghrp-2-SRC-003Clinical Trial (pediatric, stepwise dosing).
Sourceopen_in_new

Mericq V et al. Effects of eight months treatment with graded doses of a growth hormone (GH)-releasing peptide in GH-deficient children. J Clin Endocrinol Metab. 1998;83(7):2355-60. doi:10.1210/jcem.83.7.4969. PMID:9661608.

Population: Prepubertal children with GH deficiency/growth failure.

Dose protocol: 0.3->1->3 ug/kg/day SC step-up. 2-month blocks. Last block combined with GHRH.

Key findings: Dosewise GH increase, improved growth velocity vs baseline/post, no major toxicities, no IGF-I rise.

Paper content

Dosewise GH increase, improved growth velocity vs baseline/post, no major toxicities, no IGF-I rise.

ghrp-2-SRC-004Controlled human crossover infusion study.
Sourceopen_in_new

Laferrère BL et al. Growth hormone releasing peptide-2 (GHRP-2), like ghrelin, increases food intake in healthy men. J Clin Endocrinol Metab. 2005;90(2):611-614. doi:10.1210/jc.2004-1719. PMID:15699539.

Population: Lean healthy males.

Dose protocol: 1 ug/kg/h SC infusion for 270 minutes.

Key findings: ~35.9% increase in ad libitum energy intake. Concurrent GH AUC increase.

Paper content

~35.9% increase in ad libitum energy intake; concurrent GH AUC increase.

ghrp-2-SRC-005Randomized, clinical trial in critical illness.
Sourceopen_in_new

Van den Berghe G et al. The combined administration of GH-releasing peptide-2 (GHRP-2), TRH and GnRH ... Clin Endocrinol (Oxf). 2002;56(5):655-69. doi:10.1046/j.1365-2265.2002.01255.x. PMID:12030918.

Population: Men with prolonged critical illness.

Dose protocol: 5-day randomized regimens: GHRP-2 alone, +TRH, +TRH+GnRH.

Key findings: Combo strategy improved endocrine axes more than GHRP-2 alone. Lactate and WBC rose with some single-combination conditions.

Notes: WADA prohibited classes list reference (S2.2.4) includes GH-releasing peptides with explicit example list containing GHRP-2 (pralmorelin).

Paper content

Combo strategy improved endocrine axes more than GHRP-2 alone; lactate and WBC rose with some single-combination conditions.

ghrp-2-SRC-007Observational comparative study.
Sourceopen_in_new

Teramoto S, Tahara S, Hattori Y, Kondo A, Morita A. Assessment of anterior pituitary reserve capacity based on growth hormone response to growth hormone-releasing peptide-2 test in the elderly. Growth Horm IGF Res. 2023;71-72:101545. doi:10.1016/j.ghir.2023.101545. PMID:37295337.

Population: Elderly patients with non-functioning pituitary neuroendocrine tumors who underwent surgery and preoperative testing.

Dose protocol: GHRP-2 stimulation test (standard diagnostic IV protocol) in elderly patients

Key findings: Optimal peak GH cut-off of 8.08 ng/mL (specificity 0.868, sensitivity 0.852). GH response correlated with cortisol and ACTH responses, suggesting GHRP-2 reflects broader pituitary reserve.

Notes: Diagnostic utility study. Supports GHRP-2 as a well-characterized provocative agent in elderly populations.

Paper content

This observational study assessed GHRP-2 stimulation test performance for identifying GH deficiency in 65 elderly patients with non-functioning pituitary tumors. The study established an optimal peak GH cut-off of 8.08 ng/mL (specificity 0.868, sensitivity 0.852) and found that GH response to GHRP-2 correlated with cortisol and ACTH responses, suggesting that GHRP-2 testing may reflect broader anterior pituitary reserve. The study supports the clinical utility of GHRP-2 as a diagnostic provocative agent in elderly populations and provides age-specific reference data for GH deficiency assessment. It does not address therapeutic use of GHRP-2 for supplementation purposes.

ghrp-2-SRC-006
Sourceopen_in_new

WADA prohibited list reference snippet, categories for GH secretagogues and GH-releasing peptides; GHRP-2 explicitly listed.

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