Two Halves, Both Required

VIP / Aviptadil

Also known as Vasoactive intestinal peptide · Aviptadil

Prescription-class · no approved product existsSummary coverage

At a glance

What it is: The pharma programme failed its controlled trials while the community protocol grew.

Evidence: Practitioner experience onlyHow the tiers workThe pharmaceutical half: NCT04311697, intravenous aviptadil in critical COVID-19, completed; ACTIV-3b / TESICO (NCT04843761) had its aviptadil arm discontinued by the data safety monitoring board for futility in May 2022; FDA declined emergency use authorisation in July 2022 and denied breakthrough therapy designation in June 2022. Why this tier

Half-life: Not established in available literature
Routes: Intranasal, Subcutaneous, Intravenous
Category: Support, Immune
FDA: Investigational; As of 3 August 2026. What that means
WADA: We do not state a status
Amino acids: 28

Putting VIP / Aviptadil on a schedule, with the vial it comes from and a log of each dose, happens in the app: Claritide for iPhone.

Evidence

Why this tier

The pharmaceutical half: NCT04311697, intravenous aviptadil in critical COVID-19, completed; ACTIV-3b / TESICO (NCT04843761) had its aviptadil arm discontinued by the data safety monitoring board for futility in May 2022; FDA declined emergency use authorisation in July 2022 and denied breakthrough therapy designation in June 2022. It holds an orphan designation for sarcoidosis from 2021. The community half: the paper everyone cites is Shoemaker, House and Ryan (2013) on VIP correcting chronic inflammatory response syndrome: open-label, uncontrolled, 20 participants, published in a low-tier non-indexed venue. Both halves are the story, and neither supports the other.

Overview

What it is

Vasoactive intestinal peptide is both a failed pharmaceutical programme and a growing community protocol, and the record only makes sense with both halves. As aviptadil it was trialled intravenously in critical COVID-19: the trial arm was discontinued for futility, FDA declined emergency use authorisation and denied breakthrough therapy designation. Meanwhile the intranasal community protocol for chronic inflammatory response syndrome rests on one open-label uncontrolled study of 20 people.

Mechanism

How it works

VIP is a 28-amino-acid neuropeptide and a potent vasodilator, acting through VPAC1 and VPAC2 receptors. It relaxes smooth muscle, modulates immune and inflammatory signalling, and is present at high levels in the lung, which is why the pharmaceutical programme targeted acute respiratory failure. The vasodilatory action is also the source of its most consistent reported side effect, transient hypotension, and it is a property of the molecule rather than of any particular route.

Dosing

Commonly researched ranges

These are figures reported in published literature and practitioner protocols: a commonly researched range, not a recommendation. Claritide does not tell you what to take.

Community intranasal (CIRS protocol)200–400 mcg
Daily, as 50 mcg per spray, four sprays daily rising over weeks
Vendor-tier. Reported as 200 mcg/day for weeks 1–4 escalating to 300–400 mcg/day. Derived from an open-label uncontrolled study of 20 people published in a low-tier venue.

Phase	Amount	Frequency	Timing	Note
Community intranasal (CIRS protocol)	200–400 mcg	Daily, as 50 mcg per spray, four sprays daily rising over weeks	Not established in available literature	Vendor-tier. Reported as 200 mcg/day for weeks 1–4 escalating to 300–400 mcg/day. Derived from an open-label uncontrolled study of 20 people published in a low-tier venue.

Cycle guidance: Community protocols report 8 weeks on and 8 weeks off for the subcutaneous route, and a minimum of 18 months for the intranasal CIRS protocol. Neither comes from a controlled trial.
Goals: Immune, Energy

Legal standing

Where this sits with the FDA

Dated, sourced, and separate from whether it works. Removal from a warning list is not permission to compound.

Investigationalas of 3 August 2026 · US

Aviptadil holds an orphan designation for sarcoidosis granted in 2021, which is a development incentive and not an approval. The COVID-19 programme ended when the ACTIV-3b trial arm was discontinued for futility.

Last change · 1 July 2022 · FDA declined emergency use authorisation for intravenous aviptadil in July 2022, having denied breakthrough therapy designation in June 2022.

Primary source

How it got here

1 May 2022
The ACTIV-3b / TESICO data safety monitoring board discontinued the aviptadil arm for futility.
1 June 2022
FDA denied breakthrough therapy designation for aviptadil.
1 July 2022
FDA declined emergency use authorisation for intravenous aviptadil in critical COVID-19.

Sport

WADA status

The 2026 Prohibited List entered force on 1 January 2026.

We do not state a status

Not named on the 2026 Prohibited List. We could not determine a classification and do not state one.

We looked and could not resolve it. This is not the same as "not prohibited". Treat it as unresolved and check with your federation before competing.

Reconstitution

Mixing recipes our sources document

Concentration (mg/mL) = vial mg ÷ diluent mL. On a U-100 barrel, 1 unit = 0.01 mL.

5 mg vial+5 mL bacteriostatic water

= 1 mg/mL

5 units50 mcg

Beyond-use

No source we hold states a beyond-use window for this pairing, so we publish none. Go by what is printed on your own vial, and read the storage note below.

Open the calculator

Expectations

Week by week

What our material describes people reporting. Individual responses vary widely.

Not established in available literature.

Tolerability

Side effects

Grouped by how often our sources report them. Percentages appear only where a published trial figure exists.

Common

Transient hypotensionVIP is a potent vasodilator; low blood pressure is a direct consequence of the mechanism rather than an idiosyncratic reaction.
Mild headache
Loose stools

Uncommon

Elevated lipaseMonitored as a safety marker in community protocols. The 2013 study reported one transient elevation without abdominal pain.

Safety

Contraindications and interactions

Do not use if

Reported community exclusions: active MARCoNS colonisation, ongoing mould exposure, VIPoma or other pancreatic tumours, pregnancy
Blood-pressure medication: additive hypotension from a potent vasodilator
Pancreatitis history: lipase is monitored in these protocols for a reason

Interactions

Blood pressure medicationcaution
VIP is a potent vasodilator and the combination is additive.

Absence from this list does NOT mean safety. It means lack of research.

Handling

Storage and cost

Storage: The circulating community preset is a 5 mg vial with 5 mL of bacteriostatic water. No source we hold states a beyond-use window, so we publish none.
Cost: Not established in available literature

Deep dive

VIP / Aviptadil in full

Limited coverage, and two halves that must be read together

The pharmaceutical half. Vasoactive intestinal peptide, as aviptadil, was developed for acute respiratory failure. NCT04311697 studied intravenous aviptadil in critical COVID-19 and completed. Then ACTIV-3b / TESICO (NCT04843761) had its aviptadil arm discontinued by the data safety monitoring board for futility in May 2022. FDA denied breakthrough therapy designation in June 2022 and declined emergency use authorisation in July 2022. It holds an orphan designation for sarcoidosis from 2021, which is a development incentive, not an approval.

That is a programme that was given a fair test in controlled trials and did not pass.

The community half. Over the same period, an intranasal VIP protocol for chronic inflammatory response syndrome grew steadily. The paper everyone cites is Shoemaker, House and Ryan, "Vasoactive intestinal polypeptide (VIP) corrects chronic inflammatory response syndrome", published in Health, volume 5 issue 3, 2013. It is open-label, uncontrolled, with 20 participants, in a low-tier non-indexed venue.

Those two facts sit side by side and neither supports the other. A controlled trial in a different indication failing does not disprove the community protocol, and an uncontrolled study of 20 people does not establish it.

What circulates

Intranasal: 50 mcg per spray, four sprays daily, 200 mcg/day, for weeks 1 to 4, escalating to 300 to 400 mcg/day, with the CIRS protocol running a minimum of 18 months. Subcutaneous: 50 mcg morning and evening, 8 weeks on and 8 weeks off, from a 5 mg vial in 5 mL of bacteriostatic water at 1 mg/mL, so 50 mcg is 5 units on a U-100 syringe.

Reported effects: transient hypotension, which is not a side effect so much as the mechanism, since VIP is a potent vasodilator, plus mild headache, loose stools, and elevated lipase, which these protocols monitor deliberately. Reported exclusions: active MARCoNS colonisation, ongoing mould exposure, VIPoma or pancreatic tumours, and pregnancy.

If you are on blood-pressure medication, the vasodilation is the thing to think about first.

References

Sources

1
Shoemaker, House, Ryan, 2013 · VIP corrects chronic inflammatory response syndrome, Health 5(3). Open-label, uncontrolled, n=20
Source
2
The Peptide Catalog · VIP dosing guide (vendor tier)
Source
3
Prasse et al., 2010 · Inhaled vasoactive intestinal peptide in sarcoidosis, Am J Respir Crit Care Med. Nebulised 50 µg four times daily, corroborating the 50 mcg unit (dose review, 2026-08-17)
Source
4
SurvivingMold · the originating intranasal protocol: 50 mcg per spray, four to eight sprays daily, first dose in clinic with lipase checked before and after (dose review, 2026-08-17)
Source

Every record in this library is free to read, and it stays free. Your own schedule, vials and log live in the app: Claritide for iPhone.