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VIP (Vasoactive Intestinal Peptide)

A 28-amino-acid peptide originally isolated from porcine intestine by Said and Mutt in 1970. We read all 60 studies. The protocol is below.

Updated 03 May 2026Read 12 minEvidence ●●●●○Citations 60
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The VIP (Vasoactive Intestinal Peptide) Report · $19

Everything you need to start: dose, sourcing, safety, our verdict.

One purchase · yours forever

Built from 60 cited studies.

Status
FDA
Class
Pulmonary
Evidence
4/ 5●●●●○
FDA status (US, full approval)
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Evidence score (4/5) covers
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Evidence for off-label CIRS nasal use
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Read this if
  • you're a CIRS / mold-illness patient working with a Shoemaker-trained clinician
  • you're a long-COVID patient tracking the lung-protective mechanism
  • you're researching aviptadil because someone in your family was in ICU during COVID
Skip this if
  • you want US-approved general use — full approval is narrow
  • you have hypotension or are on vasodilators — VIP is vasoactive by name and design
  • you're shopping nasal compounded VIP for "general inflammation" without a CIRS workup
The 4 ways you can buy VIP (Vasoactive Intestinal Peptide)
Brand
✗
No FDA approval
Compounded 503A
✓
Off-label compounded
$200–$500/mo
'CIRS' indication is not validated by controlled trials; small specialty network.
RUO (research-only)
✓
Sold for research only
$80–$200/mo
VIP degrades quickly; identity and stability unverified.
Gray market
✓
Illegal to import for huma…
$5–$8/mo at 100mcg/d
Small gray market; VIP stability is a real concern for any non-cold-chain shipment.
Click any lane for the full Sourcing breakdown.
First 90 days · VIP (Vasoactive Intestinal Peptide)
Weeks 1–2
Sleep depth shifts within days for the GH-secretagogue class (CJC, ipamorelin, sermorelin, hexarelin). If sleep hasn't deepened by week 2, the rest of the protocol probably won't move either.
Weeks 4–8
Subjective recovery and energy improvements. Body composition shifts modestly — slight muscle gain, slight fat loss if diet allows.
Week 12 — decide
Bloodwork: IGF-1 is the objective check. If IGF-1 hasn't moved, the protocol isn't working at this dose. Side effect bookkeeping: water retention, joint stiffness, any glucose changes.
Quit if
  • IGF-1 climbs above ~300 ng/mL (cancer-risk territory at the upper end).
  • Significant water retention or new carpal-tunnel-style symptoms.
  • New or worsening insulin resistance (fasting glucose creep).
  • 12 weeks with no IGF-1 movement and no subjective change.
Identity

What it is.

VIP is vasoactive intestinal peptide — a 28-amino-acid neuropeptide first isolated from the gut by Sami Said and Viktor Mutt in 1970. Despite the name, VIP is found throughout the body: brain, lungs, gut, heart, immune cells. It's involved in vasodilation, smooth-muscle relaxation, immune modulation, and circadian signaling.

It's a real signaling molecule in human physiology, not a designer . Synthetic VIP exists as an investigational drug — there are inhaled and intravenous formulations that have been studied for pulmonary arterial hypertension, sarcoidosis, and chronic inflammatory conditions, with mixed results.

It has no FDA approval. The off-label use most often referenced — intranasal VIP for chronic inflammatory response syndrome (CIRS) popularized by Dr. Ritchie Shoemaker in the mold-illness community — is a specific protocol that exists outside any approved indication. Sold as and through some compounding pharmacies for that specific protocol.

TL;DR

TL;DR. 30-second version.

The compressed verdict — what VIP (Vasoactive Intestinal Peptide) actually is, what the human evidence shows, and the watch-for in three bullets. Locked.

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Mechanism

Mechanism.

Mechanism · in the VIP (Vasoactive Intestinal Peptide) report

How the molecule actually works — receptor profile, downstream signaling, what to expect mechanistically.

Get the report · $19 ↓
Evidence

Evidence. What we actually know in humans.

Evidence · in the VIP (Vasoactive Intestinal Peptide) report

The trial breakdown — phase, n, primary endpoint, who funded, what hit, what didn't.

Get the report · $19 ↓
Human-Evidence Factbox
FDA status (US, full approval)
$19 ↓
Evidence score (4/5) covers
$19 ↓
Evidence for off-label CIRS nasal use
$19 ↓
COVID-19 ARDS trial program
$19 ↓
TESICO (JAMA 2023, n=461)
$19 ↓
Year discovered
$19 ↓
Mechanism
$19 ↓
Specialist-administered
$19 ↓
Trial regimen — sarcoidosis (inhaled)
$19 ↓
Trial regimen — ARDS (IV)
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Trial regimen — COPD / pulmonary HTN
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Community CIRS protocol (intranasal)
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Dose

Dose. The actual protocol.

Dose · in the VIP (Vasoactive Intestinal Peptide) report

The specific protocol — dose, titration schedule, cycle pattern, frequency, route.

We read 60 studies to write this report.
Get the report · $19 ↓
Sourcing

Sourcing. Where the cohort actually buys.

Sourcing · in the VIP (Vasoactive Intestinal Peptide) report

Sourcing breakdown — vendor methodology, red flags, our published test results, COA checklist.

We read 60 studies to write this report.
Get the report · $19 ↓
Safety

Safety. Side effects.

Safety · in the VIP (Vasoactive Intestinal Peptide) report

The watch-for list — contraindications, drug interactions, monitoring labs, when to stop.

Get the report · $19 ↓
Editorial Position

Editorial position.

Editorial Position · in the VIP (Vasoactive Intestinal Peptide) report

Our editorial position — explicit yes / no / depends, with the reasoning behind it.

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Citations

Citations.

  1. 01Said SI. Vasoactive intestinal peptide. Journal of endocrinological investigation. 1986;9(2):191-200. PMID: 2872248.
  2. 02Youssef JG, et al. The Use of IV Vasoactive Intestinal Peptide (Aviptadil) in Patients With Critical COVID-19 Respiratory Failure: Results of a 60-Day Randomized Controlled Trial. Critical care medicine. 2022;50(11):1545-1554. PMID: 36044317.
  3. 03Hou X, et al. Therapeutic potential of vasoactive intestinal peptide and its receptor VPAC2 in type 2 diabetes. Frontiers in endocrinology. 2022;13:984198. PMID: 36204104.
  4. 04Foster N. Editorial: vasoactive intestinal peptide (vip): historic perspective and future potential. Endocrine, metabolic & immune disorders drug targets. 2012;12(4):303-7. PMID: 23094826.
  5. 05Iwasaki M, et al. Recent advances in vasoactive intestinal peptide physiology and pathophysiology: focus on the gastrointestinal system. F1000Research. 2019;8. PMID: 31559013.
+Show all 60 citations
  1. 06Leuchte HH, et al. Inhalation of vasoactive intestinal peptide in pulmonary hypertension. The European respiratory journal. 2008;32(5):1289-94. PMID: 18978135.
  2. 07Chanchalani G. Aviptadil in Acute Respiratory Distress Syndrome-Promise or Mirage?. Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine. 2025;29(11):895-896. PMID: 41368453.
  3. 08Forssmann WG, et al. Vasoactive intestinal peptide in the heart. Annals of the New York Academy of Sciences. 1988;527:405-20. PMID: 3291696.
  4. 09Chen J, et al. Investigation of vasoactive intestinal peptide expression and significance in a congenital diaphragmatic hernia animal model. Pediatric surgery international. 2025;42(1):31. PMID: 41342973.
  5. 10Klippstein R, et al. Vasoactive Intestinal Peptide (VIP) Nanoparticles for Diagnostics and for Controlled and Targeted Drug Delivery. Advances in protein chemistry and structural biology. 2015;98:145-68. PMID: 25819279.
  6. 11Zverev AА, et al. Vasoactive Intestinal Peptide Changes the Frequency and Force of Myocardial Contraction in Rats. Bulletin of experimental biology and medicine. 2020;169(6):787-790. PMID: 33098516.
  7. 12Mukherjee T, et al. Anticipated pharmacological role of Aviptadil on COVID-19. Environmental science and pollution research international. 2022;29(6):8109-8125. PMID: 34846667.
  8. 13Youssef JG, et al. Brief Report: Rapid Clinical Recovery From Critical Coronavirus Disease 2019 With Respiratory Failure in a Pregnant Patient Treated With IV Vasoactive Intestinal Peptide. Critical care explorations. 2022;4(1):e0607. PMID: 35018346.
  9. 14Bryant MG. Vasoactive intestinal peptide (VIP). Journal of clinical pathology. Supplement (Association of Clinical Pathologists). 1978;8:63-7. PMID: 298740.
  10. 15Smitherman TC, et al. Vasoactive intestinal peptide as a coronary vasodilator. Annals of the New York Academy of Sciences. 1988;527:421-30. PMID: 3291697.
  11. 16Ganea D, et al. The neuropeptide vasoactive intestinal peptide: direct effects on immune cells and involvement in inflammatory and autoimmune diseases. Acta physiologica (Oxford, England). 2015;213(2):442-52. PMID: 25422088.
  12. 17Wenger GD, et al. Vasoactive intestinal peptide. Messenger in a neuroimmune axis. Annals of the New York Academy of Sciences. 1990;594:104-19. PMID: 2165755.
  13. 18Grubsic C, et al. Myopia pathogenesis and vasoactive intestinal peptide: Molecular mechanisms, experimental models, and clinical implications. Experimental eye research. 2026;263:110810. PMID: 41421442.
  14. 19Delgado M, et al. The significance of vasoactive intestinal peptide in immunomodulation. Pharmacological reviews. 2004;56(2):249-90. PMID: 15169929.
  15. 20Atala A. Re: antitumoral effects of vasoactive intestinal peptide in human renal cell carcinoma xenografts in athymic nude mice. The Journal of urology. 2014;191(3):866-8. PMID: 24522075.
  16. 21Delgado M, et al. Vasoactive intestinal peptide in the immune system: potential therapeutic role in inflammatory and autoimmune diseases. Journal of molecular medicine (Berlin, Germany). 2002;80(1):16-24. PMID: 11862320.
  17. 22Said SI. Vasoactive intestinal peptide in the lung. Annals of the New York Academy of Sciences. 1988;527:450-64. PMID: 2898912.
  18. 23Prysor-Jones RA, et al. Vasoactive intestinal peptide and anterior pituitary function. Clinical endocrinology. 1988;29(6):677-88. PMID: 3076850.
  19. 24Couvineau A, et al. Editorial: GPCR in Inflammatory and Cancer Diseases. Frontiers in endocrinology. 2020;11:588157. PMID: 33101216.
  20. 25Keijzers GB. Aviptadil (Senatek). Current opinion in investigational drugs (London, England : 2000). 2001;2(4):545-9. PMID: 11566015.
  21. 26White CM, et al. Therapeutic potential of vasoactive intestinal peptide and its receptors in neurological disorders. CNS & neurological disorders drug targets. 2010;9(5):661-6. PMID: 20632962.
  22. 27Pozo D, et al. Immunobiology of vasoactive intestinal peptide (VIP). Immunology today. 2000;21(1):7-11. PMID: 10637552.
  23. 28Brenneman DE, et al. Vasoactive intestinal peptide. Link between electrical activity and glia-mediated neurotrophism. Annals of the New York Academy of Sciences. 1999;897:17-26. PMID: 10676432.
  24. 29Voice JK, et al. Immunoeffector and immunoregulatory activities of vasoactive intestinal peptide. Regulatory peptides. 2002;109(1-3):199-208. PMID: 12409234.
  25. 30Fahrenkrug J. Vasoactive intestinal polypeptide. Clinics in gastroenterology. 1980;9(3):633-43. PMID: 6107190.
  26. 31Brown SM, et al. Intravenous aviptadil and remdesivir for treatment of COVID-19-associated hypoxaemic respiratory failure in the USA (TESICO): a randomised, placebo-controlled trial. The Lancet. Respiratory medicine. 2023;11(9):791-803. PMID: 37348524.
  27. 32Onoue S, et al. Structure-activity relationship of vasoactive intestinal peptide (VIP): potent agonists and potential clinical applications. Naunyn-Schmiedeberg's archives of pharmacology. 2008;377(4-6):579-90. PMID: 18172612.
  28. 33Bloom SR, et al. Vasoactive intestinal peptide secreting tumors. Pathophysiological and clinical correlations. Annals of the New York Academy of Sciences. 1988;527:518-27. PMID: 2839088.
  29. 34Delgado M, et al. Vasoactive intestinal peptide in thymus: synthesis, receptors and biological actions. Neuroimmunomodulation. 1999;6(1-2):97-107. PMID: 9876240.
  30. 35Stanisz AM, et al. The role of vasoactive intestinal peptide and other neuropeptides in the regulation of the immune response in vitro and in vivo. Annals of the New York Academy of Sciences. 1988;527:478-85. PMID: 3291699.
  31. 36Bevan JA, et al. In vitro evidence that vasoactive intestinal peptide is a transmitter of neuro-vasodilation in the head of the cat. Neuroscience. 1986;19(2):597-604. PMID: 2430233.
  32. 37Frye BC, et al. Vasoactive Intestinal Peptide in Checkpoint Inhibitor-Induced Pneumonitis. The New England journal of medicine. 2020;382(26):2573-2574. PMID: 32579820.
  33. 38Barrowcliffe MP, et al. Pulmonary clearance of vasoactive intestinal peptide. Thorax. 1986;41(2):88-93. PMID: 3010486.
  34. 39Said SI. Vasoactive peptides in the lung, with special reference to vasoactive intestinal peptide. Experimental lung research. 1982;3(3-4):343-8. PMID: 6762962.
  35. 40Venugopalan CS. Vasoactive intestinal peptide (VIP), a putative neurotransmitter of nonadrenergic, noncholinergic (NANC) inhibitory innervation and its relevance to therapy. Journal of veterinary pharmacology and therapeutics. 1989;12(2):113-23. PMID: 2568497.
  36. 41Freund H, et al. An increase in vasoactive intestinal peptide levels in canine endotoxin shock. Surgery, gynecology & obstetrics. 1981;152(5):604-6. PMID: 7221842.
  37. 42Ago Y, et al. [Development of the vasoactive intestinal peptide receptor 2 (VIPR2) antagonist peptide for the treatment of schizophrenia]. Nihon yakurigaku zasshi. Folia pharmacologica Japonica. 2023;158(3):242-245. PMID: 36990792.
  38. 43Bodanszky M. Synthesis of vasoactive intestinal peptide and related peptides. Annals of the New York Academy of Sciences. 1988;527:20-8. PMID: 3291693.
  39. 44Bolin DR, et al. Design and development of a vasoactive intestinal peptide analog as a novel therapeutic for bronchial asthma. Biopolymers. 1995;37(2):57-66. PMID: 7893947.
  40. 45Lundberg P, et al. Expression and regulatory role of receptors for vasoactive intestinal peptide in bone cells. Microscopy research and technique. 2002;58(2):98-103. PMID: 12203709.
  41. 46Gross PC, et al. Analytics of the therapeutic peptide aviptadil by sheathless CE-MS and comparison with nanoRP-HPLC-MS. Journal of pharmaceutical and biomedical analysis. 2014;88:477-82. PMID: 24176753.
  42. 47Udupa AA, et al. Aviptadil Therapy in Acute Respiratory Distress Syndrome Patients: A Systematic Review and Meta-analysis. Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine. 2025;29(11):942-953. PMID: 41368449.
  43. 48Ulrich CD 2nd, et al. Secretin and vasoactive intestinal peptide receptors: members of a unique family of G protein-coupled receptors. Gastroenterology. 1998;114(2):382-97. PMID: 9453500.
  44. 49Flood JF, et al. Vasoactive intestinal peptide (VIP): an amnestic neuropeptide. Peptides. 1990;11(5):933-8. PMID: 2178250.
  45. 50Said SI. Vasoactive intestinal peptide in pulmonary arterial hypertension. American journal of respiratory and critical care medicine. 2012;185(7):786; author reply 786. PMID: 22467806.
  46. 51Besson J. Distribution and pharmacology of vasoactive intestinal peptide receptors in the brain and pituitary. Annals of the New York Academy of Sciences. 1988;527:204-19. PMID: 2839077.
  47. 52El-Gehani F, et al. Vasoactive intestinal peptide stimulates testosterone production by cultured fetal rat testicular cells. Molecular and cellular endocrinology. 1998;140(1-2):175-8. PMID: 9722187.
  48. 53Sutliff VE, et al. Actions of vasoactive intestinal peptide and secretin on chief cells prepared from guinea pig stomach. The American journal of physiology. 1986;251(1 Pt 1):G96-102. PMID: 3014896.
  49. 54Petkov V, et al. Vasoactive intestinal peptide as a new drug for treatment of primary pulmonary hypertension. The Journal of clinical investigation. 2003;111(9):1339-46. PMID: 12727925.
  50. 55— VIP and diarrhoea. Lancet (London, England). 1984;1(8370):202. PMID: 6141341.
  51. 56Lee SS, et al. Vasoactive intestinal peptide in cirrhotic rats: hemodynamic effects and mesenteric arterial receptor characteristics. Hepatology (Baltimore, Md.). 1996;23(5):1174-80. PMID: 8621151.
  52. 57Hill JM, et al. VIP regulation of embryonic growth. Annals of the New York Academy of Sciences. 1996;805:259-68; discussion 268-9. PMID: 8993408.
  53. 58Gozes I, et al. Clinical endocrinology and metabolism. Potential clinical applications of vasoactive intestinal peptide: a selected update. Best practice & research. Clinical endocrinology & metabolism. 2004;18(4):623-40. PMID: 15533779.
  54. 59Gressens P. [Vasoactive intestinal peptide: a novel neurotrophic factor]. Archives de pediatrie : organe officiel de la Societe francaise de pediatrie. 1998;5(6):654-60. PMID: 9759212.
  55. 60Biancani P, et al. Dysfunction of the gastrointestinal tract. Vasoactive intestinal peptide in peristalsis and sphincter function. Annals of the New York Academy of Sciences. 1988;527:546-67. PMID: 2898914.
The VIP (Vasoactive Intestinal Peptide) Report · $19

Everything you need to start.

Dose, sourcing, safety, our verdict. One purchase. Yours forever.

Built from 60 cited studies.

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