What is the typical dosing regimen for sermorelin (growth hormone-releasing hormone (GHRH) analogue) in a male patient?

Sermorelin Dosing in Males

For adult males seeking growth hormone augmentation, sermorelin is typically dosed at 0.2-0.3 mg (200-300 mcg) administered subcutaneously once daily at bedtime, though higher doses up to 10 mcg/kg (approximately 700-1000 mcg for a 70-100 kg male) have been studied in clinical trials. 1, 2

Standard Dosing Regimens

Diagnostic Testing

• Single-dose IV administration: 1 mcg/kg bodyweight is used as a provocative test for growth hormone deficiency diagnosis 1
• This represents a rapid and relatively specific test, with fewer false positives compared to other provocative tests 1

Therapeutic Use in Adults

Daily subcutaneous dosing:

• 10 mcg/kg bodyweight administered nightly at bedtime (approximately 700-1000 mcg for a 70-100 kg male) has been studied in age-advanced men with demonstrated efficacy 2
• In clinical practice, 200-300 mcg daily is commonly used, though this represents a lower dose than studied protocols 3

Combination therapy approach:

• When combined with growth hormone-releasing peptides (GHRP-2 or GHRP-6), 100 mcg three times daily (total 300 mcg/day) has been used in hypogonadal men on testosterone therapy 3
• This thrice-daily regimen requires strict compliance for efficacy 3

Administration Guidelines

Timing and route:

• Subcutaneous injection at bedtime (approximately 9-10 PM) optimizes physiologic growth hormone pulsatility 2
• The GH-releasing effect occurs within 10 minutes and lasts approximately 2 hours 2
• Self-injection technique is well-tolerated with minimal adverse effects 1

Expected Outcomes and Monitoring

Hormonal response:

• Significant increases in nocturnal integrated GH levels occur in men within the first treatment period 2
• IGF-1 levels increase within 2 weeks, with peak elevations at 2-12 weeks of continuous therapy 2, 3
• Mean IGF-1 increases from baseline of approximately 160 ng/mL to 240 ng/mL have been documented 3

Body composition effects in men:

• Increased lean body mass occurs specifically in men (not consistently in women) 2
• Skin thickness increases significantly in both genders 2
• Positive nitrogen balance trends toward significance 2

Metabolic benefits:

• Insulin sensitivity improves significantly in men but not women 2
• General well-being and libido improve in men 2

Duration of Therapy

• 4-5 months of continuous therapy has been studied in adults with sustained benefits 2
• 12-36 months of therapy in children shows maintained growth effects 1
• The GH-releasing effect remains sustained without tachyphylaxis during continued treatment 2

Adverse Effects and Safety

Common side effects:

• Transient facial flushing (most common) 1
• Pain at injection site 1
• Transient hyperlipidemia that resolves by end of treatment 2

Monitoring parameters:

• IGF-1 levels at baseline, 2 weeks, and periodically thereafter 2, 3
• Fasting glucose and insulin (remain stable in most patients) 2
• Lipid profile (transient elevations may occur) 2
• Blood pressure and body weight (typically unchanged) 2

Clinical Considerations

Factors affecting response:

• Co-administration of aromatase inhibitors or tamoxifen may blunt IGF-1 increases 3
• Compliance with thrice-daily dosing is critical when using combination GHRP/sermorelin protocols 3
• Gender differences exist, with men showing more robust anabolic responses than women 2

Contraindications and cautions:

• Normal growth hormone responses to sermorelin cannot exclude hypothalamic growth hormone deficiency 1
• Sermorelin is not FDA-approved for adult use; prescribing is off-label 1