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Sermorelin

Also called Sermorelin acetate, GHRH(1-29)-NH2, GRF(1-29)-NH2, hGRF(1-29)-NH2, Geref (former US brand, withdrawn).

Sermorelin is a lab-made copy of the first 29 building blocks of a natural brain hormone that tells the pituitary gland to release growth hormone. The US once approved it as a test and for children with low growth hormone. The maker stopped selling it, and both US approvals were withdrawn in 2009. FDA said this was not for safety reasons.

Sermorelin is not an approved medicine for these uses in most countries. This page explains the science and the law; it does not give dosing, sourcing or usage advice.

How strong is the evidence?

AnecdoteAnimalsHuman trialsApproved
Small human. Small or uncontrolled studies in people.Sermorelin has real human clinical data, but no current marketing authorisation. The best data are one open-label, uncontrolled 12-month study of 110 previously untreated children with growth hormone deficiency (Geref International Study Group, 1996), earlier small paediatric studies (for example, eight children in a 1990 continuous-infusion study), and a 1999 review that supported the former US approvals. In adults there are only small, short studies, such as a two-week crossover in old men that raised GH and IGF-I. No large randomised trial shows benefit for healthy adults, and none of the studies we reviewed reports final adult height; the 1999 review notes only a few children followed for up to 36 months. Its FDA approvals (1990 and 1997) were withdrawn in 2009 after the company stopped selling it.

Last verified 2026-09-29 · how we verify

Rendering of PDB 7CZ5: GHRH(1-44) (native hormone) bound to the Growth hormone-releasing hormone receptor. Experimental structure · cryo-EM 2.6 Å · PDB 7CZ5 (2020).
Related structure

Experimental structure · cryo-EM 2.6 Å · PDB 7CZ5 (2020)RCSB entry ↗

Not Sermorelin itself. No structure of Sermorelin bound to its receptor has been published, so a related structure is shown for context.

The body's own growth hormone-releasing hormone (GHRH, 44 residues) at its receptor. No tesamorelin- or sermorelin-bound structure was found in the PDB (RCSB search, 2026-09-29); shown for context only. Palmitic acid, cholesterol and nanobody Nb35 (chain N) omitted. Structure from Zhou et al., Nat Commun 2020. Colours are ours, not the molecule's.

Acts on
Growth hormone-releasing hormone (GHRH) receptor on pituitary somatotroph cells
Taken as
When it was FDA-approved (Geref), it was given by injection: as a single intravenous test to check pituitary growth hormone reserve, and as a daily subcutaneous injection for children with idiopathic growth hormone deficiency under specialist care. It has also been studied in small trials by subcutaneous and intravenous routes and by continuous subcutaneous infusion; a nasal route was tested in healthy men and absorbed poorly (about 3 to 5% bioavailability). It is not approved for any other use.
Half-life
Short: about 10 to 20 minutes in humans, according to a 2003 review by Serono scientists, mostly because the kidneys filter it out and enzymes cut its front end.[src]
FDA approvals (both withdrawn)
NDA 19-863 (diagnostic ampules) approved 1990-12-28 and NDA 20-443 (children with idiopathic growth hormone deficiency) approved 1997-09-26; holder EMD Serono; brand Geref.[src]
Approval withdrawn
Approval of both NDAs was withdrawn effective 2009-06-18 after the company reported discontinuation in 2008. In 2013 FDA determined the products were not withdrawn from sale for reasons of safety or effectiveness.[src]
Paediatric trial result
In 110 previously untreated GH-deficient children (86 evaluable), height velocity rose from 4.1 to 8.0 cm/yr at 6 months and 7.2 cm/yr at 12 months; 74% were good responders at 6 months (open-label, no control group).[src]

Inside the body

What Sermorelin does, step by step

Watch the 3D journey →
  1. 01Skin

    Given by injection

    When doctors used sermorelin, it was injected: into a vein for a one-off test, or just under the skin for children's treatment.

    For experts

    The approved presentations were an intravenous diagnostic dose and a subcutaneous daily regimen in children. Nasal absorption is poor (bioavailability about 3 to 5% in healthy men). Human subcutaneous bioavailability is not given in the sources we reviewed; in anaesthetised rats, plasma exposure after subcutaneous injection was about 4% of that after an intravenous injection, which suggests substantial degradation at the site or during absorption (animal-only finding).[src][src][src]

  2. 02Bloodstream

    Broken down within minutes

    In studies of the body's own full-length hormone, enzymes in the blood snip the first two building blocks off the front of the chain, and that makes it almost inactive. Sermorelin has the same front end. Together with removal by the kidneys, this is why sermorelin is gone from the blood within minutes.

    For experts

    For human GHRH(1-44), plasma dipeptidyl-peptidase cleavage of the N-terminal Tyr-Ala gives GHRH(3-44)-NH2, which has less than 1/1000 of the activity; the in vivo half-life of GHRH(1-44) by HPLC was 6.8 min in normal subjects. Sermorelin shares the same N-terminus. A 2003 review reports its plasma half-life as roughly 10 to 20 minutes in humans, caused mostly by renal ultrafiltration and N-terminal enzymatic degradation, and an infusion study in men measured a disappearance half-time of 4.3 +/- 1.4 min (versus 6.7 +/- 0.5 min for a D-Ala2 analogue with reduced clearance).[src][src][src]

  3. 03Brain

    Signals the pituitary gland

    The pituitary is a pea-sized gland at the base of the brain. Sermorelin fits a lock (a receptor) on the pituitary cells that make growth hormone. It is the same lock the body's own hormone uses.

    For experts

    Sermorelin acts on the GHRH receptor, a class B GPCR that couples to Gs, on pituitary somatotrophs. The cryo-EM structure of the human receptor with Gs and full-length GHRH(1-44) (PDB 7CZ5) shows the natural ligand that sermorelin copies; sermorelin corresponds to residues 1 to 29 of that peptide. The structure is of the natural hormone, not of sermorelin.[src][src]

  4. 04Brain

    A pulse of growth hormone is released

    The pituitary answers with a burst of growth hormone. The burst lasts a few hours, even though sermorelin itself is gone in minutes.

    For experts

    In a study of 30 healthy men aged 19 to 43 given GHRH(1-29)-NH2 intravenously or intranasally, intravenous doses gave dose-related GH release; despite rapid elimination of the peptide, GH remained elevated for about 3 hours. In eight slowly growing children, continuous subcutaneous infusion gave sustained pulsatile GH secretion without desensitisation for up to a year; the authors took the persisting pulses as evidence that somatostatin still sets the rhythm, so the body's own brake stays active.[src][src]

  5. 05Liver

    The body makes IGF-I

    Growth hormone tells the liver and other tissues to make a helper hormone called IGF-I. IGF-I carries out much of the growth message around the body.

    For experts

    GH raises circulating IGF-I. In a small crossover study in 10 healthy old men, twice-daily subcutaneous GHRH(1-29) for 14 days raised mean 24-hour GH and IGF-I in a dose-related way (statistically significant only at the higher dose), and after the higher dose the values did not differ significantly from those of young men. In children treated for a year, IGF-I did not rise excessively. These are hormone markers, not proof of clinical benefit in adults.[src][src]

  6. 06Bone

    Growth speeds up in some children

    In children whose bodies make too little growth hormone, this can make them grow faster. Most children in the main study had a good response. It was not tested head-to-head against standard growth hormone.

    For experts

    In the open-label study of 110 previously untreated prepubertal GH-deficient children (86 evaluable), mean height velocity rose from 4.1 +/- 0.9 cm/yr to 8.0 +/- 1.5 at 6 months and 7.2 +/- 1.3 at 12 months; 74% were classed as good responders at 6 months, and bone age advanced in proportion to height age. The 1999 review notes that effects on final adult height were not established and that increases in height velocity appeared smaller than with somatropin (indirect comparison). There is no equivalent proof of effect on body composition or ageing outcomes in adults.[src][src]

For experts

The detail

Sermorelin is GHRH(1-29)-NH2, a 29-residue C-terminally amidated peptide (C149H246N44O42S, about 3358 Da) whose sequence is identical to the N-terminal 29 residues of human growth hormone-releasing hormone (GHRH 1-44); it is the shortest fragment that keeps the full biological activity of the parent hormone. It activates the GHRH receptor (a class B G protein-coupled receptor coupled to Gs) on pituitary somatotrophs, stimulating pulsatile GH release and, downstream, IGF-I, with the physiological feedback system (somatostatin) remaining in place. It has no engineered half-life extension: a Serono review attributes its short half-life mostly to renal ultrafiltration and N-terminal enzymatic degradation (plasma dipeptidyl-peptidase removal of Tyr-Ala was shown for GHRH 1-44), and its plasma half-life in humans is short, reported as about 10 to 20 minutes in a review, with a disappearance half-time of 4.3 min in an infusion study in ten men, yet GH stays raised for about 3 hours after an intravenous dose. Subcutaneous exposure was about 4% of intravenous in an anaesthetised-rat study (animal-only). Regulatory history (FDA): NDA 19-863 (diagnostic ampules, evaluation of pituitary GH secretory ability) was approved 1990-12-28 and NDA 20-443 (idiopathic GH deficiency in children with growth failure) on 1997-09-26, both held by EMD Serono. The company reported discontinuation in 2008 and requested withdrawal; approval of both NDAs was withdrawn effective 2009-06-18, and in 2013 FDA determined the products were not withdrawn for reasons of safety or effectiveness. Key evidence is an open-label, 110-child, one-year study (Geref International Study Group, 1996) and a 1999 review; mean height velocity rose from 4.1 to 8.0 cm/yr at 6 months and 7.2 cm/yr at 12 months in GH-deficient children. A 1999 review notes there was no direct comparison with somatropin, and that height-velocity gains with sermorelin given by continuous infusion or in three divided doses were smaller than with daily somatropin in other children; effect on final adult height was not established. Use in healthy adults, or for anti-ageing or body-composition aims, is unapproved and rests on small, short human studies. Compounding and country-by-country legal status are covered in the status records, not here.

Evidence: Sermorelin has real human clinical data, but no current marketing authorisation. The best data are one open-label, uncontrolled 12-month study of 110 previously untreated children with growth hormone deficiency (Geref International Study Group, 1996), earlier small paediatric studies (for example, eight children in a 1990 continuous-infusion study), and a 1999 review that supported the former US approvals. In adults there are only small, short studies, such as a two-week crossover in old men that raised GH and IGF-I. No large randomised trial shows benefit for healthy adults, and none of the studies we reviewed reports final adult height; the 1999 review notes only a few children followed for up to 36 months. Its FDA approvals (1990 and 1997) were withdrawn in 2009 after the company stopped selling it.[src][src][src][src][src]

Known safety signals

  • In clinical use in children and as a diagnostic test, sermorelin was reported to be well tolerated; transient facial flushing and pain at the injection site were the most commonly reported adverse events.[src]
  • In the 110-child one-year study, no adverse changes in general biochemical or hormonal tests were noted, there was no change in fasting glucose, and IGF-I did not rise excessively.[src]
  • Evidence in adults is small and short: in a 14-day crossover in old men, GHRH(1-29) did not change fasting glucose, urinary C-peptide, blood pressure, or chemistry and haematology profiles. Longer-term safety in healthy adults has not been established by the studies we reviewed.[src]
  • FDA determined in 2013 that Geref was not withdrawn from sale for reasons of safety or effectiveness; the withdrawal followed the manufacturer's decision to discontinue the product.[src]
  • Sermorelin is not named on FDA's page of bulk substances that may present significant safety risks. For other peptides on that page, FDA cites immunogenicity from aggregation and peptide-related impurities as concerns, so the quality of unregulated or compounded peptide products is a general open question rather than a sermorelin-specific finding.[src]

Around the world

Is Sermorelin legal where you live?

CountryStatusWhat it meansVerified
AustraliaNot approvedNot on the ARTG. Sermorelin is prescription-only (Schedule 4), and as a GHRH analogue it may also fall under the Appendix D possession control.Details →source2026-09-29
BrazilNot approvedNo Brazilian registration for sermorelin; the unregistered-peptide rules applyDetails →source2026-09-29
CanadaProhibitedNot authorised; named in Health Canada's 2025 Canada Peptide seizure notice and banned in sportDetails →source2026-09-29
ChinaNot approvedNo NMPA approval found for sermorelin; it cannot lawfully be sold as a medicine in China and is banned in sport.Details →source2026-09-29
European UnionNot approvedNo EU marketing authorisation; banned in sport (WADA S2.2.4)Details →source2026-09-29
IndiaNot approvedNot approved in India: no CDSCO marketing permission found for Sermorelin; making or selling it as a medicine would be unapprovedDetails →source2026-09-29
JapanNot approvedNot an approved medicine in Japan; sermorelin is absent from PMDA's lists, and WADA bans it in sportDetails →source2026-09-29
MexicoNot approvedNo current registration for sermorelin found in COFEPRIS listsDetails →source2026-09-29
New ZealandNot approvedNo Medsafe-approved medicine contains sermorelin; it is classed as a prescription medicineDetails →source2026-09-29
United Arab EmiratesUnverifiedCould not determine sermorelin's UAE status; no registration or enforcement record was foundsource2026-09-29
United KingdomNot approvedSermorelin is not licensed in the UKDetails →source2026-09-29
United StatesCompounding restrictedPreviously FDA-approved as Geref (now discontinued, not for safety reasons); sermorelin acetate can be compounded only under 503A/503B conditionsDetails →source2026-09-29

Related molecules

TesamorelinCJC-1295Ipamorelin

Sources (57)

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