Alexamorelin
Ala-hexarelin, Ala-His-D-2-methyl-Trp-Ala-Trp-D-Phe-Lys-NH2
1What it is
Alexamorelin was developed in the 1990s by the Italian company Mediolanum Farmaceutici as a close relative of hexarelin, which the same company had taken into clinical studies. Structurally it is hexarelin with an extra alanine on the front, and it shares hexarelin's 2-methyl-tryptophan modification, which gives these compounds chemical stability. It was studied by the Turin group of Ezio Ghigo and Emanuela Arvat, who ran much of the European human research on GH in that decade, and in receptor-binding work by Giampiero Muccioli and colleagues.
Development did not go beyond early clinical pharmacology. Today alexamorelin is mostly notable as a name on the WADA list and as a reminder that the GHRP family was larger than the handful of compounds that circulate online. The literature is thin and this profile reflects that.
2How it's thought to work
Alexamorelin binds the ghrelin receptor () in the pituitary and hypothalamus, triggering GH release through the phospholipase C pathway and amplifying the effect of endogenous GHRH. Like hexarelin, it also binds a second class of sites in human heart tissue that are not the GHS-R1a and are now thought to include CD36. Hexarelin's reported cardiac effects in animals (protection from ischaemia, improved contractility) have been attributed to these sites; alexamorelin was used in some of the binding studies that mapped them, but its own cardiac effects were not characterised in humans.
3What the research shows
GH release in humans
Receptor binding in human tissue
Body composition, cardioprotection, recovery
4Reported side effects and interactions
Literature-reported
transient flushing and mild sweating after IV dosing; small rises in cortisol and prolactin. No repeated-dose or long-term human data.Community-reported
very little; the compound is rarely used. Where discussed, hexarelin-type effects are described — flushing, hunger, water retention.Theoretical. class concerns — IGF-1 rise with repeated use, reduced insulin sensitivity, fluid retention, caution in active malignancy. Hexarelin showed desensitisation (declining GH response) with repeated dosing over weeks in humans; alexamorelin would be expected to behave similarly.
Interactions. additive or synergistic with GHRH analogues; glucose-lowering medicines may need monitoring if IGF-1 rises.
Markers researchers commonly monitor
Based on GHRP class physiology; nothing alexamorelin-specific is established:
| Marker | Why it's watched |
|---|---|
| IGF-1 | the marker of cumulative GH exposure. |
| Fasting glucose, insulin, HbA1c | GH reduces insulin sensitivity. |
| Morning cortisol and prolactin | the hexarelin family raises both slightly; a baseline is informative. |
| Blood pressure and weight | fluid retention is a class effect. |
| CBC and CMP | general baseline given the lack of long-term data. |
Free for everyone. Safety information is never behind a paywall.
5Reconstitution and handling
Seldom offered; vial sizes vary. with , swirl gently.
Open in calculator, pre-loaded →6Commonly studied alongside
Hexarelin (its parent), GHRP-2, GHRP-6, GHRH analogues (sermorelin, mod GRF 1-29) for synergy.
Informational cross-links. Not stack recommendations.
7Regulatory status by region
| Region | Status (checked —) |
|---|---|
| United States | Not FDA-approved; not named explicitly in the FDA's 2023 Category 2 compounding list † |
| European Union | Not authorised |
| United Kingdom | Not licensed |
| Australia | Not approved |
| South Africa | Not registered |
| Sport | Prohibited by WADA (S2 — alexamorelin is named as an example of a GH-releasing peptide) |
8Open questions
- Whether the cardiac binding sites shared with hexarelin translate to any functional effect in humans.
- Repeated-dose pharmacology, desensitisation and safety — never published.
9References
- 1Ghigo E, Arvat E, Muccioli G, Camanni F (1997). Growth hormone-releasing peptides. Eur J Endocrinol. PubMed · DOI
- 2Camanni F, Ghigo E, Arvat E (1998). Growth hormone-releasing peptides and their analogs. Front Neuroendocrinol. PubMed · DOI
- 3Muccioli G et al. (1998). Specific receptors for synthetic GH secretagogues in the human brain and pituitary gland. J Endocrinol. PubMed · DOI
- 4Papotti M et al. (2000). Growth hormone secretagogue binding sites in peripheral human tissues. J Clin Endocrinol Metab. PubMed · DOI
- 5Bodart V et al. (2002). CD36 mediates the cardiovascular action of growth hormone-releasing peptides in the heart. Circ Res. PubMed · DOI
† Being confirmed by our reviewers against current sources.
10Community
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Self-reported side effects Phase 2
11Page history
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