Peptides · Neuro & cognitive (under FDA review)

Vasoactive Intestinal Peptide (VIP)

Vasoactive intestinal peptide with case-by-case pharmacy review.

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Vasoactive Intestinal Peptide (VIP) molecular structure (Endogenous neuropeptide)

Why this needs to be personal

Why Personalized Vasoactive Intestinal Peptide (VIP)

The evidence base for VIP includes endogenous physiology, aviptadil clinical studies, and foreign-product context, but no FDA-approved US VIP or aviptadil product. Some US development programs did not meet approval standards, so patient-specific review must be cautious.

Physicians may submit patient-specific prescription requests for VIP for pharmacy review. Certain preparations may be available now when clinically appropriate, lawfully prescribed, supported by patient-specific documentation, and approved by the dispensing pharmacy. Availability is determined case by case. This is not a consumer access promise; it is a clinical, sourcing, formulation, and regulatory review process. This ingredient is part of an evolving FDA review process for peptide-related bulk substances used in compounding.

The legitimate path for VIP is not a protocol bought from an unregulated channel. It is a prescriber-submitted request reviewed by a licensed pharmacy against evidence, sourcing, sterile formulation, and patient-specific risk.

In brief

Vasoactive Intestinal Peptide (VIP) Explained

Vasoactive intestinal peptide (VIP) is a small natural hormone, a chain of 28 amino acids, that the body makes in the nervous system, gut, lungs, and immune cells 212. It relaxes blood vessels and airway smooth muscle, helps regulate inflammation, and influences gut, lung, and brain function. It was discovered in 1970 by Said and Mutt, who isolated it from pig intestine, and was first synthesized in the laboratory in 1974 13.

Synthetic VIP and the closely related synthetic analogue aviptadil have been studied as drugs for several conditions. The most-discussed example is aviptadil for severe COVID-19 respiratory failure, the ZYESAMI program ran a randomized trial (TESICO) that did not meet its primary endpoint, and the drug was not approved 21. Inhaled VIP has been studied in small trials in pulmonary hypertension and sarcoidosis. In Europe a combination product (aviptadil plus phentolamine, brand name Invicorp) is authorized for erectile dysfunction by intracavernosal injection, but this product is not approved in the U.S 11. Some integrative practitioners have used intranasal VIP in chronic inflammatory response syndrome (the Shoemaker protocol), but the published evidence for that use is weak 13.

VIP has no FDA approval in the United States. This ingredient is part of an evolving FDA review process. Physicians may submit patient-specific prescription requests for pharmacy review. Availability is determined case by case, and availability may change after FDA review, PCAC discussion, final agency action, or state-board guidance.

At a glance

Quick Facts About Vasoactive Intestinal Peptide (VIP)

Category
Endogenous 28-amino-acid neuropeptide of the secretin/glucagon superfamily
Active ingredient
Vasoactive intestinal peptide (VIP), 28-amino-acid peptide isolated by Said and Mutt from porcine intestinal wall; synthetic VIP and the closely related synthetic analogue aviptadil are the forms studied clinically
FDA-approved branded forms
None in the United States. The combination intracavernosal product Invicorp (aviptadil + phentolamine) is approved in several European countries for erectile dysfunction but is not FDA-approved in the U.S. The aviptadil ARDS program (ZYESAMI/RLF-100) did not meet its primary endpoint and was not approved.
Evidence posture
Emerging clinical evidence in pulmonary hypertension, ARDS/COVID-19 respiratory failure, sarcoidosis, and intracavernosal erectile dysfunction; most U.S. clinical development discontinued. Preclinical literature broad and biologically plausible. No FDA-approved U.S. product.
FDA-approval status
Category 2, evolving FDA review process. Valid patient-specific prescription required; supporting clinical rationale may be requested.
Compounded under
Physicians may submit patient-specific prescription requests for pharmacy review. Availability is determined case by case.

Prescription review

Patient-Specific Prescription Only

Physicians may submit patient-specific prescription requests for Vasoactive Intestinal Peptide (VIP) for pharmacy review. Certain preparations may be available now when clinically appropriate, lawfully prescribed, and approved by the dispensing pharmacy. Availability is determined case by case.

  • Made to order, not off a shelf. No batch sits in a warehouse waiting for buyers. Your prescription is what triggers the prep.
  • Named-patient label. The bottle carries your name. The batch records carry your prescription.
  • Dose, strength, and route chosen for you. A prescriber who knows your chart decides what gets compounded, not a manufacturer who set the strength for a trial population.
  • Licensed pharmacist on the hook. A real person, with a license that can be pulled, signs off on every prep. State inspectors check the facility.
  • Compounded drugs are not FDA-approved. They should not be evaluated using branded-drug trial data. Availability varies by state and prescribed medication.
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Real medicine, not gray market

How This Differs from a Research-Use-Only Website

A research-use-only website ships a vial from a warehouse. There is no prescription, no pharmacist, no facility inspection, and no way to recall the product if something is wrong with it. If the vial is mislabeled, contaminated, or under-potent, there is nobody whose license is at stake.

A 503A compounding pharmacy is the other thing. Your doctor writes the prescription. A licensed pharmacist, whose name is on the label, prepares the medicine in a facility the state inspects. If something goes wrong, there is a person and a license on the hook, and a documented chain of custody on every lot. That accountability is what makes it safe.

What it is

What is Vasoactive Intestinal Peptide (VIP)?

Vasoactive intestinal peptide is a 28-amino-acid linear neuropeptide of the secretin/glucagon/PACAP family. The mature sequence (HSDAVFTDNYTRLRKQMAVKKYLNSILN-NH2) is produced from a larger precursor (prepro-VIP) that also yields the peptide histidine isoleucine (PHI, or its human homolog PHM) by tissue-specific post-translational processing. VIP is widely distributed across the central and peripheral nervous systems, enteric neurons, lung, pancreas, immune tissues, and reproductive tract, and acts as both a neurotransmitter and a paracrine/endocrine signal 1319.

VIP was discovered by Sami Said and Viktor Mutt in 1970 during a search for endogenous vasodilators released from the lung and was named for its vasodilator activity isolated from intestinal extracts. The full 28-residue structure was reported by Said and Mutt in 1972 1 and the first total chemical synthesis was completed by Bodanszky, Klausner, and Lin in 1974 2. The peptide's broad physiologic range, initially classified as a 'gut hormone,' later as a neurotransmitter, led Said to summarize the discovery history as a peptide 'initially looked for in the lung, isolated from intestine, and identified as a neuropeptide' 3.

VIP signals through two class B G-protein-coupled receptors, VPAC1 (VIPR1) and VPAC2 (VIPR2), which it shares with the closely related neuropeptide PACAP; PACAP additionally activates the PAC1 receptor selectively. The IUPHAR concise guide and Harmar review summarize the receptor pharmacology and tissue-expression patterns of the VIP/PACAP receptor family 14. Synthetic VIP and the synthetic analogue aviptadil (the same 28-residue sequence supplied as a pharmaceutical-grade synthetic peptide) are the forms used in clinical research.

How it works

How Vasoactive Intestinal Peptide (VIP) Works

Class
Endogenous neuropeptide
First studied
1970 discovery
Current status
Category 2, evolving FDA review process
Compounding category
Patient-specific 503A on physician request, pending broader FDA review

VIP exerts its effects through two related class B GPCRs, VPAC1 and VPAC2, both coupled primarily to Gαs with downstream adenylyl cyclase activation and intracellular cAMP elevation; secondary coupling to Gαq with phospholipase C and intracellular calcium mobilization has been characterized in several cell types 14. The cAMP/PKA pathway underlies VIP's smooth-muscle relaxant and vasodilator effects in vascular, airway, and gastrointestinal smooth muscle 48.

In the immune system, VIP signaling shifts macrophage polarization toward an anti-inflammatory phenotype, inhibits Th1-skewing cytokines, supports regulatory T cell function, and suppresses NF-κB-driven proinflammatory cytokine transcription in dendritic cells and lymphocytes. Delgado and Ganea reviewed the pleiotropic immune functions of VIP as an endogenous anti-inflammatory neuropeptide and a candidate immunomodulatory drug class 15.

In the pulmonary circulation, VIP and aviptadil produce dose-dependent reduction in pulmonary vascular resistance with relatively selective pulmonary vasodilation when delivered by inhalation. In the airway, VIP relaxes bronchial smooth muscle and inhibits airway inflammation, a rationale for asthma and COPD drug development that has been reviewed extensively 9. In the central nervous system, VIP is a key signaling peptide in the suprachiasmatic nucleus of the hypothalamus where it coordinates circadian rhythm entrainment and synchronization 17 16. In the gastrointestinal tract, VIP relaxes intestinal smooth muscle and regulates fluid and electrolyte secretion; pathologic over-secretion by VIP-producing neuroendocrine tumors produces the WDHA (watery diarrhea, hypokalemia, achlorhydria) syndrome characteristic of VIPoma 1819 5.

Research history

Vasoactive Intestinal Peptide (VIP) Research History

The story begins with Sami Said's search in the late 1960s for a vasodilator substance released from the lung. Collaborating with Viktor Mutt at the Karolinska Institute, who had isolated several gut peptides from porcine intestine, Said and Mutt extracted a vasodilator polypeptide from porcine duodenal wall and reported the 28-residue sequence in 1970 (Science) and in expanded form in 1972 (Eur J Biochem) 1. Bodanszky, Klausner, and Lin completed the first total chemical synthesis of VIP in 1974 2. Said's 2007 retrospective summarized the discovery and the evolution of VIP's classification from gut hormone to neuropeptide 3.

The 1980s and 1990s established VIP's broad signaling roles. Henning and Sawmiller (2001) reviewed cardiovascular effects, including systemic and pulmonary vasodilation, coronary vasodilation, and inotropic and chronotropic effects 4. Groneberg and colleagues (2001, 2006) reviewed the pulmonary biology and the asthma/COPD drug-development rationale 58; Onoue and colleagues (2007) summarized bioactive analogues and inhaled drug-delivery work 9. Delgado and Ganea (2013) consolidated the immunomodulatory literature 15. The Harmar IUPHAR review (2012) systematized the VPAC1/VPAC2/PAC1 receptor pharmacology shared with PACAP 14. Iwasaki and colleagues (2019) reviewed recent advances in VIP physiology and pathophysiology with a focus on the gastrointestinal system 19. Vosko and colleagues (2015) reviewed the role of VIP in the suprachiasmatic light-input circadian system 17.

Clinical drug development. The synthetic peptide (named aviptadil when supplied as a pharmaceutical-grade product) has been studied in: (1) primary/pulmonary arterial hypertension, Petkov and colleagues (2003) reported acute hemodynamic and chronic clinical improvement with inhaled aviptadil in a small uncontrolled trial in J Clin Invest 7; Leuchte and colleagues (2008) reported single-dose hemodynamic effects in pulmonary hypertension 10; (2) pulmonary sarcoidosis, Prasse and colleagues (2010) reported immunoregulatory effects of inhaled VIP in a Phase 1 study 12; (3) erectile dysfunction, intracavernosal aviptadil/phentolamine (brand Invicorp) was developed and is approved in several European countries 116; (4) acute respiratory distress syndrome and COVID-19, Youssef and colleagues (2022) reported on IV aviptadil in critically ill COVID-19 patients 20, and the U.S. ACTIV-3b/TESICO multicenter trial of IV aviptadil plus remdesivir vs remdesivir in COVID-19 hypoxemic respiratory failure (Brown and colleagues, Lancet Respir Med 2023) reported no benefit 21; Udupa and colleagues (2025) performed a systematic review and meta-analysis of aviptadil in ARDS and concluded the evidence does not support survival or oxygenation benefit 22. Mathioudakis and colleagues (2013) reviewed the inhaled-VIP literature across respiratory indications 16. Most U.S. clinical development for inhaled or IV VIP/aviptadil has been discontinued.

Timeline

Vasoactive Intestinal Peptide (VIP) Timeline

  1. 1970 Said and Mutt report isolation of a vasodilator polypeptide from porcine duodenal extracts in Science 3
  2. 1972 Said and Mutt publish the full 28-residue VIP sequence in Eur J Biochem 1
  3. 1974 Bodanszky, Klausner, and Lin (J Am Chem Soc) complete the first total chemical synthesis of VIP 2
  4. 2001 Henning and Sawmiller (Cardiovasc Res) review the cardiovascular effects of VIP, summarizing pulmonary and systemic vasodilation and inotropic and chronotropic effects 4
  5. 2001 Groneberg and colleagues (Pulm Pharmacol Ther) review VIP as a mediator of asthma, the rationale for inhaled VIP/aviptadil drug development 5
  6. 2001 Keijzers (Curr Opin Investig Drugs) reviews the aviptadil development program 6
  7. 2003 Petkov and colleagues (J Clin Invest) report acute pulmonary vasodilation and chronic clinical improvement with inhaled aviptadil in a small uncontrolled trial in primary pulmonary hypertension 7
  8. 2006 Groneberg and colleagues (Eur J Pharmacol) review neuropeptide-based drug therapy with VIP and its receptors 8
  9. 2007 Said (Peptides) publishes a retrospective on the discovery of VIP, 'initially looked for in the lung, isolated from intestine, identified as a neuropeptide' 3
  10. 2007 Onoue and colleagues (Peptides) review bioactive VIP analogues and drug-delivery systems for asthma/COPD 9
  11. 2008 Leuchte and colleagues (Eur Respir J) report single-dose hemodynamic effects of inhaled VIP in pulmonary hypertension 10
  12. 2008 Dinsmore and Wyllie (BJU Int) review intracavernosal VIP/phentolamine (Invicorp) for erectile dysfunction, approved in several European countries, not FDA-approved 11
  13. 2010 Prasse and colleagues (Am J Respir Crit Care Med) report immunoregulatory effects of inhaled VIP in a Phase 1 study in pulmonary sarcoidosis 12
  14. 2010 Shoemaker and colleagues (Neurotoxicol Teratol) describe biomarkers including VIP in chronic biotoxin/inflammatory response syndromes, foundation for the CIRS observational protocol; no randomized controlled trial 13
  15. 2012 Harmar and colleagues (Br J Pharmacol) publish the IUPHAR review of VPAC1/VPAC2/PAC1 receptor pharmacology and functions 14
  16. 2013 Delgado and Ganea (Amino Acids) review VIP as a neuropeptide with pleiotropic immune functions 15
  17. 2013 Mathioudakis and colleagues (Hippokratia) review inhaled VIP agonists across respiratory therapeutics 16
  18. 2015 Vosko and colleagues (Eur J Neurosci) review VIP in the suprachiasmatic nucleus light-input circadian system 17
  19. 2017 Belei and colleagues (Rom J Morphol Embryol) publish a literature review of Verner-Morrison syndrome, VIP-secreting tumors (VIPomas) and the WDHA syndrome 18
  20. 2019 Iwasaki and colleagues (F1000Res) review recent advances in VIP physiology and pathophysiology with focus on the gastrointestinal system 19
  21. 2022 Youssef and colleagues (Crit Care Med) report on IV aviptadil in critical COVID-19 respiratory failure, the early ZYESAMI/RLF-100 clinical experience 20
  22. 2023 Brown and colleagues (Lancet Respir Med) report TESICO, multicenter randomized trial of IV aviptadil plus remdesivir vs remdesivir alone in hospitalized COVID-19 hypoxemic respiratory failure: no benefit; aviptadil ARDS development effectively halted 21
  23. 2025 Udupa and colleagues (Indian J Crit Care Med) publish a systematic review and meta-analysis of aviptadil in ARDS, aggregate evidence does not support survival or oxygenation benefit 22

Natural role

Biological Role of Vasoactive Intestinal Peptide (VIP)

VIP is one of the most broadly distributed neuropeptides in mammalian physiology. It is co-stored and co-released with classical neurotransmitters from autonomic and enteric neurons, is expressed in CNS regions including the suprachiasmatic nucleus and cerebral cortex, and is produced by immune cells including T lymphocytes and macrophages. Physiologic roles include systemic and pulmonary vasodilation, airway and gut smooth-muscle relaxation, exocrine secretion (pancreatic, biliary, intestinal), endocrine modulation (prolactin release, insulin secretion), central nervous system functions including circadian rhythm coordination in the SCN, and immune modulation 41517.

The receptor system is shared with the closely related neuropeptide pituitary adenylate cyclase-activating polypeptide (PACAP): both peptides activate VPAC1 and VPAC2 with comparable affinity, while PACAP additionally activates the selective PAC1 receptor 14 19. This receptor sharing complicates the interpretation of physiologic roles assigned to VIP versus PACAP and is one reason that VIP-knockout mice display compensatory phenotypes.

Compounded use

Compounded Vasoactive Intestinal Peptide (VIP) (503A)

Physicians may submit patient-specific prescription requests for pharmacy review. For VIP, certain preparations may be available now when clinically appropriate, lawfully prescribed, and approved by the dispensing pharmacy. Availability is determined case by case and may depend on patient-specific documentation, ingredient status, source qualification, formulation feasibility, state requirements, and pharmacist judgment. The review starts with the evidence constraint: The evidence base for VIP includes endogenous physiology, aviptadil clinical studies, and foreign-product context, but no FDA-approved US VIP or aviptadil product. Some US development programs did not meet approval standards, so patient-specific review must be cautious.

This ingredient is part of an evolving FDA review process. RonanRx is monitoring FDA's PCAC process and any subsequent agency action. This ingredient is part of an evolving FDA review process for peptide-related bulk substances used in compounding. Availability may change after FDA review, PCAC discussion, final agency action, or state-board guidance. For VIP, RonanRx ties that monitoring to the evidence limits described above and to any patient-specific documentation submitted by the prescriber.

Valid patient-specific prescription required. Supporting clinical rationale may be requested. Compounded medications are not FDA-approved. No consumer self-ordering, no office stock, no bulk dispensing. Requests for VIP are reviewed before any preparation is made or released. The legitimate path for VIP is not a protocol bought from an unregulated channel. It is a prescriber-submitted request reviewed by a licensed pharmacy against evidence, sourcing, sterile formulation, and patient-specific risk.

Formulations and routes

Vasoactive Intestinal Peptide (VIP) Formulations and Routes

FormConcentrationDescription
Synthetic VIP / aviptadil (research and clinical-trial supply) — Pharmaceutical-grade synthetic 28-amino-acid VIP, designated aviptadil when supplied as a pharmaceutical product, has been used in published clinical trials by inhalation (pulmonary hypertension, sarcoidosis), intravenous infusion (COVID-19 ARDS), and intracavernosal injection (erectile dysfunction, combined with phentolamine as Invicorp).710122120116
Invicorp (aviptadil + phentolamine intracavernosal injection) — Combination product approved for erectile dysfunction in several European countries; not FDA-approved in the U.S. The product combines synthetic VIP/aviptadil with phentolamine for intracavernosal administration.116
Research peptide preparations (not commercial products) — Synthetic VIP is also available from peptide chemistry suppliers as a research-grade peptide. These preparations are not FDA-approved drug products and are not equivalent to pharmaceutical-grade clinical-trial supply.23

Dosing

Vasoactive Intestinal Peptide (VIP) Dosing

No FDA-labeled VIP product exists in the United States and no consensus human dosing regimen is available 23. Published clinical-trial regimens are indication-specific and include inhaled aviptadil at microgram-range nebulized doses in pulmonary hypertension and sarcoidosis 71012, IV aviptadil infusion protocols in COVID-19 hypoxemic respiratory failure 2021, and intracavernosal aviptadil/phentolamine doses for erectile dysfunction (the Invicorp regimen approved in Europe) 116. These regimens cannot be extrapolated outside their original indications and study populations without further trial evidence.

RonanRx does not publish a consumer dosing schedule for VIP. Any request requires a valid patient-specific prescription, supporting clinical rationale, and pharmacist review. Route, strength, dosing interval, monitoring expectations, and dispensing quantity would be determined case by case from the prescriber's documentation and pharmacy feasibility review.

Doses listed are literature context, not patient instructions. Dosing decisions are made by the prescribing doctor and tailored to the individual patient.

Safety

Vasoactive Intestinal Peptide (VIP) Safety

Safety overview

Reported clinical safety experience with synthetic VIP/aviptadil is limited to small trials and one large multicenter randomized study in COVID-19 hypoxemic respiratory failure. The most consistently reported acute adverse events are dose-dependent systemic vasodilation effects, facial flushing, hypotension, and reflex tachycardia, particularly with intravenous administration; these reflect the peptide's primary pharmacology 42120. The TESICO multicenter trial of IV aviptadil plus remdesivir vs remdesivir alone in hospitalized COVID-19 hypoxemic respiratory failure characterized adverse events in approximately 470 randomized participants and did not demonstrate clinical benefit on the primary respiratory recovery endpoint 21; the 2025 systematic review and meta-analysis confirmed absence of survival or oxygenation benefit across the aviptadil ARDS trial corpus 22.

Inhaled VIP/aviptadil has been generally well tolerated in small uncontrolled or Phase 1 trials in pulmonary hypertension 710 and pulmonary sarcoidosis 12 with localized airway tolerability and short-term hemodynamic safety reported, but trial sizes are small and long-term safety in chronic respiratory indications is not characterized. The intracavernosal aviptadil/phentolamine combination (Invicorp, European approval) has documented intracavernosal-injection-class adverse events (transient facial flushing, headache, injection-site pain) 11.

Because VIP is on FDA's Category 2 bulk-substance list for 503A compounding 23, FDA has identified either safety concerns or an information gap that must be evaluated. Clinicians considering VIP-containing preparations from non-503A sources, including intranasal preparations used in the Shoemaker CIRS protocol, should be aware that such products are not subject to FDA bulk-substance review, USP <797> sterility standards, or pharmacist verification of identity and potency, and that the published evidence base for the CIRS indication is observational and weak 13. Availability through RonanRx is determined case by case after pharmacy review.

Contraindications

Honest gap. No FDA-approved U.S. VIP product exists, so no FDA-defined contraindications. Published trial protocols typically excluded patients with severe hemodynamic instability, profound hypotension, or known hypersensitivity to the peptide or excipients. The European Invicorp label (intracavernosal aviptadil/phentolamine for erectile dysfunction) contraindicates use in patients with predisposition to priapism and certain hematologic conditions. FDA Category 2 bulk-substance status precludes 503A compounding pending reclassification.

Searched: PubMed, DailyMed, FDA bulk-substance review documents on 2026-05-11 · terms vasoactive intestinal peptide OR aviptadil AND (contraindication OR contraindicated OR hypersensitivity).

Drug interactions

Honest gap. No formal published drug-interaction studies for VIP/aviptadil are indexed at the time of review. Pharmacodynamic interaction with other vasodilators (nitrates, phosphodiesterase-5 inhibitors, prostacyclin analogues) is theoretical given the peptide's systemic vasodilator effects; no clinical interaction studies have been published.

Searched: PubMed, DailyMed on 2026-05-11 · terms vasoactive intestinal peptide OR aviptadil AND (drug interaction OR pharmacokinetic interaction).

Adverse events

Across published clinical trials, the most consistently reported VIP/aviptadil adverse events are acute systemic-vasodilation-class events: facial flushing, hypotension, and reflex tachycardia, predominantly with intravenous administration 21204. The TESICO multicenter trial in COVID-19 hypoxemic respiratory failure 21 characterized adverse events in approximately 470 randomized participants and did not demonstrate clinical benefit on the primary respiratory recovery endpoint 21; the 2025 systematic review and meta-analysis confirmed no survival or oxygenation benefit across the aviptadil ARDS corpus 22. Inhaled VIP/aviptadil has been generally well tolerated in small uncontrolled or Phase 1 trials in pulmonary hypertension 710 and pulmonary sarcoidosis 12, with short-term safety reported but trial sizes too small to characterize uncommon events.

Intracavernosal aviptadil/phentolamine (Invicorp, European approval) has documented class-typical adverse events for intracavernosal-injection ED therapy, transient facial flushing, headache, and injection-site pain, without the priapism rate associated with selective α-adrenergic intracavernosal therapies 11.

Monitoring

Monitoring Vasoactive Intestinal Peptide (VIP) Therapy

No RonanRx-specific monitoring protocol has been established for VIP. If a patient-specific prescription is submitted, supporting clinical rationale may be requested, and monitoring expectations would be reviewed case by case against the published evidence, route, sterile or nonsterile status, concomitant therapies, and patient risk factors.

Special populations

Vasoactive Intestinal Peptide (VIP) in Special Populations

Pregnancy

No FDA-recognized use guidance for VIP in this population is established. Any patient-specific request would require prescriber rationale, patient-specific risk review, and pharmacist approval before dispensing.

Lactation

No published human lactation data for synthetic VIP/aviptadil exposure are indexed 23.

Pediatric

No published pediatric clinical-trial data for synthetic VIP/aviptadil are indexed 23.

Geriatric

Published trials in pulmonary hypertension and COVID-19 hypoxemic respiratory failure included older adults but did not perform pre-specified geriatric subgroup analyses with adequate power to characterize age-specific safety or efficacy 21.

Renal impairment

No dedicated renal-impairment pharmacokinetic studies for synthetic VIP/aviptadil are indexed. The peptide is expected to be catabolized by serum and tissue peptidases with minimal renal clearance as a primary pathway 23.

Hepatic impairment

No dedicated hepatic-impairment pharmacokinetic studies for synthetic VIP/aviptadil are indexed 23.

Evidence quality

Vasoactive Intestinal Peptide (VIP) Evidence Quality

The VIP physiologic and preclinical evidence base is broad and biologically coherent. The peptide is established as an endogenous neuropeptide with vasodilator, smooth-muscle-relaxant, immunomodulatory, and neurotransmitter roles, signaling through the VPAC1/VPAC2 receptors shared with PACAP 2314. The clinical drug-development evidence base for synthetic VIP/aviptadil, however, is small in absolute terms and dominated by negative or inconclusive late-stage results.

Pulmonary arterial hypertension. Published inhaled aviptadil evidence consists of small open-label or uncontrolled trials 7 reporting acute pulmonary vasodilation and short-term clinical signal; no large randomized confirmatory trial has been published and most development was discontinued 71016. Pulmonary sarcoidosis. The Prasse 2010 Phase 1 inhaled-VIP trial reported immunoregulatory and symptomatic signal in a small sample without progression to a confirmatory program 12. COVID-19 hypoxemic respiratory failure. The TESICO multicenter randomized trial 21 of IV aviptadil plus remdesivir vs remdesivir alone reported no benefit on the primary respiratory recovery endpoint 21; the Youssef 2022 single-center report described the prior ZYESAMI/RLF-100 clinical experience 20; the Udupa 2025 systematic review and meta-analysis confirmed absence of survival or oxygenation benefit across the aviptadil ARDS corpus 22. Erectile dysfunction. Intracavernosal aviptadil/phentolamine (Invicorp) is approved in several European countries on the basis of multiple controlled trials 116; the product is not FDA-approved and intracavernosal ED compounding is outside RonanRx's scope. CIRS / Shoemaker protocol 151917. Use of intranasal VIP within the chronic-inflammatory-response-syndrome protocol described by Shoemaker and colleagues is supported by observational case-series and biomarker data without randomized controlled trials 13; the evidence is honestly characterized as weak 14.

Regulatory and compounding considerations dominate the access question for U.S. patients. VIP is on FDA's Category 2 bulk-substance list for 503A compounding 23. There is no FDA-approved U.S. product. The pharmacovigilance, sterility-assurance, and identity-verification framework that legitimate 503A compounding provides is therefore unavailable for VIP under current FDA designation, and Physicians may submit patient-specific prescription requests for pharmacy review. Availability is determined case by case. Any clinical use in U.S. adults at the time of this review (2026-05-11) is outside the FDA bulk-substance review and outside RonanRx's quality and traceability standards.

Major studies

Major Vasoactive Intestinal Peptide (VIP) Clinical Studies

StudyDesignParticipantsDurationFinding
Said and Mutt (1972, Eur J Biochem), VIP isolation and sequence Biochemical isolation from porcine intestinal wall; structural determination — — Isolation of a vasoactive 28-residue octacosapeptide related to secretin and glucagon, the canonical VIP isolation paper 1
Bodanszky, Klausner, and Lin (1974, J Am Chem Soc), Total synthesis Solid-phase chemical synthesis — — First total chemical synthesis of the 28-residue VIP molecule, enabling pharmacologic and clinical investigation 2
Said (2007, Peptides), Discovery retrospective Historical narrative review by the discoverer — — Summarizes the discovery sequence, VIP was 'initially looked for in the lung, isolated from intestine, and identified as a neuropeptide' 3
Henning and Sawmiller (2001, Cardiovasc Res), Cardiovascular effects Comprehensive narrative review — — Summarizes systemic and pulmonary vasodilation, coronary vasodilation, and inotropic/chronotropic effects of VIP across animal models and human physiology 4
Groneberg et al. (2001, Pulm Pharmacol Ther), VIP in asthma Narrative review — — Articulates the rationale for VIP and inhaled VIP analogue development in asthma, bronchial smooth-muscle relaxation, airway anti-inflammatory effects 5
Petkov et al. (2003, J Clin Invest), Inhaled aviptadil in PAH Small uncontrolled trial of single-dose and short-term repeated inhaled aviptadil in adults with primary pulmonary hypertension 8 — Acute reduction in pulmonary vascular resistance and improvement in 6-minute walk distance over 3 months in a small uncontrolled cohort, the foundational positive PAH signal that motivated subsequent inhaled-VIP development 7
Groneberg et al. (2006, Eur J Pharmacol), VIP neuropeptide drug therapy Narrative review — — Reviews novel neuropeptide-based drug therapy concepts with VIP and its receptors across respiratory, gastrointestinal, and inflammatory indications 8
Onoue et al. (2007, Peptides), Bioactive analogues and drug delivery Narrative review — — Summarizes VIP analogue medicinal chemistry and inhaled and parenteral drug-delivery systems developed for asthma and COPD 9
Dinsmore and Wyllie (2008, BJU Int), Intracavernosal VIP/phentolamine for ED Narrative review of the aviptadil/phentolamine intracavernosal program (Invicorp) — — Synthesizes the controlled-trial evidence base supporting European approval of intracavernosal aviptadil/phentolamine for erectile dysfunction; product is not FDA-approved in the U.S 11.
Leuchte et al. (2008, Eur Respir J), Inhaled VIP in pulmonary hypertension Single-dose hemodynamic study of inhaled VIP in adults with pulmonary hypertension — — Acute reduction in pulmonary vascular resistance with inhaled VIP; small sample, no long-term efficacy claim 10
Prasse et al. (2010, Am J Respir Crit Care Med), Inhaled VIP in pulmonary sarcoidosis Phase 1 study of inhaled VIP in adults with pulmonary sarcoidosis — — Inhaled VIP exerted immunoregulatory effects (reduced TNF-α from alveolar macrophages; increased regulatory T cell signal) with short-term tolerability; small sample without progression to a confirmatory program 12
Harmar et al. (2012, Br J Pharmacol), VPAC/PAC1 receptor pharmacology IUPHAR receptor-nomenclature review — — Systematizes the pharmacology and functions of VPAC1, VPAC2, and PAC1 receptors shared by VIP and PACAP, the canonical reference for VIP receptor signaling 14
Delgado and Ganea (2013, Amino Acids), Pleiotropic immune functions Comprehensive narrative review — — Summarizes VIP as an endogenous anti-inflammatory neuropeptide with effects on macrophage polarization, Th cell balance, regulatory T cells, and NF-κB-driven cytokine transcription 15
Mathioudakis et al. (2013, Hippokratia), Inhaled VIP agonists Narrative review of inhaled VIP across respiratory indications — — Synthesizes the inhaled-VIP literature in asthma, COPD, pulmonary hypertension, and sarcoidosis; signals are positive in small trials with no large confirmatory program 16
Vosko et al. (2015, Eur J Neurosci), VIP in circadian system Narrative review — — Characterizes VIP's role in the suprachiasmatic nucleus light-input pathway and circadian rhythm coordination 17
Belei et al. (2017, Rom J Morphol Embryol), Verner-Morrison syndrome Literature review of VIPoma and the WDHA syndrome — — Summarizes clinical, biochemical, and pathologic features of VIP-secreting neuroendocrine tumors, the pathologic counterpart that established VIP's physiologic GI secretory role 18
Iwasaki et al. (2019, F1000Res), Recent advances in VIP physiology Narrative review with focus on the GI system — — Updates VIP physiology and pathophysiology with emphasis on gastrointestinal motility, secretion, and inflammatory regulation 19
Youssef et al. (2022, Crit Care Med), IV aviptadil in critical COVID-19 Single-center clinical report of IV aviptadil in critically ill COVID-19 respiratory failure patients (ZYESAMI/RLF-100 clinical experience) — — Described early experience with IV aviptadil in critical COVID-19; foundational clinical-experience report leading into the multicenter randomized program 20
Brown et al. (2023, Lancet Respir Med), TESICO trial Multicenter randomized double-blind placebo-controlled trial of IV aviptadil plus remdesivir vs remdesivir alone in hospitalized COVID-19 hypoxemic respiratory failure (ACTIV-3b) 471 — IV aviptadil plus remdesivir did not improve the primary respiratory recovery endpoint compared with remdesivir alone, the largest randomized VIP/aviptadil trial reported to date; effectively halted U.S 21. ARDS development
Udupa et al. (2025, Indian J Crit Care Med), Aviptadil in ARDS meta-analysis Systematic review and meta-analysis of aviptadil clinical trials in ARDS — — Aggregate evidence across the aviptadil ARDS trial corpus does not support survival or oxygenation benefit 22
Shoemaker et al. (2010, Neurotoxicol Teratol), Biotoxin biomarker work Observational case-series characterizing biomarkers including VIP in chronic biotoxin-associated inflammatory illness — — Established VIP as one biomarker in the chronic-inflammatory-response-syndrome framework; foundation for the observational Shoemaker protocol, no randomized controlled trial of intranasal VIP exists 13

Pharmacology

Vasoactive Intestinal Peptide (VIP) Pharmacokinetics & Pharmacodynamics

Pharmacokinetics

VIP is a 28-amino-acid peptide rapidly catabolized in plasma and tissue by peptidases, with reported plasma half-lives in the order of 1, 2 minutes after intravenous administration. Synthetic-peptide pharmacokinetic characterization for aviptadil has been performed in the context of clinical-trial development for pulmonary hypertension, ARDS, and intracavernosal ED therapy; published comprehensive PK profiles for VIP/aviptadil are limited and indication-specific, and there is no FDA-approved label that consolidates a U.S. PK section.

Inhaled aviptadil delivers peptide directly to the pulmonary vasculature with relatively selective pulmonary vasodilation reported in pulmonary hypertension trials 710. Intravenous aviptadil produces systemic vasodilation with the corresponding hemodynamic adverse-event profile (flushing, hypotension, reflex tachycardia) 2120. Intracavernosal aviptadil/phentolamine acts locally on cavernosal smooth muscle with limited systemic exposure 11.

Pharmacodynamics

Reported pharmacodynamic effects of synthetic VIP/aviptadil include: dose-dependent reduction in pulmonary vascular resistance and modest systemic vasodilation (cardiovascular endpoints); bronchial smooth-muscle relaxation and airway anti-inflammatory effects (respiratory endpoints); immunomodulation of macrophage polarization and Th cell balance (immune endpoints) 1512; gastrointestinal smooth-muscle relaxation and secretory effects (the WDHA syndrome physiology of VIPoma confirms the GI secretory role) 1819; and corpus cavernosum smooth-muscle relaxation supporting erectile response (intracavernosal therapy) 11 58916.

RonanRx operations

Vasoactive Intestinal Peptide (VIP) Compounding & Operations

503A compounding

Physicians may submit patient-specific prescription requests for pharmacy review. For VIP, certain preparations may be available now when clinically appropriate, lawfully prescribed, and approved by the dispensing pharmacy. Availability is determined case by case and may depend on patient-specific documentation, ingredient status, source qualification, formulation feasibility, state requirements, and pharmacist judgment. The review starts with the evidence constraint: The evidence base for VIP includes endogenous physiology, aviptadil clinical studies, and foreign-product context, but no FDA-approved US VIP or aviptadil product. Some US development programs did not meet approval standards, so patient-specific review must be cautious.

This ingredient is part of an evolving FDA review process. RonanRx is monitoring FDA's PCAC process and any subsequent agency action. This ingredient is part of an evolving FDA review process for peptide-related bulk substances used in compounding. Availability may change after FDA review, PCAC discussion, final agency action, or state-board guidance. For VIP, RonanRx ties that monitoring to the evidence limits described above and to any patient-specific documentation submitted by the prescriber.

Valid patient-specific prescription required. Supporting clinical rationale may be requested. Compounded medications are not FDA-approved. No consumer self-ordering, no office stock, no bulk dispensing. Requests for VIP are reviewed before any preparation is made or released. The legitimate path for VIP is not a protocol bought from an unregulated channel. It is a prescriber-submitted request reviewed by a licensed pharmacy against evidence, sourcing, sterile formulation, and patient-specific risk.

Pharmacist review

For VIP, the pharmacist review starts before any preparation is made. Valid patient-specific prescription required. Supporting clinical rationale may be requested. The pharmacist reviews ingredient status, sourcing, formulation feasibility, state requirements, patient-specific documentation, and whether dispensing is appropriate case by case.

Quality and traceability

If a VIP preparation is approved after pharmacy review, RonanRx applies source documentation, formulation records, lot traceability, release checks, and storage controls appropriate to the actual dosage form. Research-use vial storage practices do not substitute for pharmacy-assigned storage, beyond-use dating, sterility controls when applicable, or recallable batch records. The patient-specific framework and quality controls are documented in the cited compounding references 242625.

Cold chain

If a VIP preparation is approved after pharmacy review, RonanRx applies source documentation, formulation records, lot traceability, release checks, and storage controls appropriate to the actual dosage form. Research-use vial storage practices do not substitute for pharmacy-assigned storage, beyond-use dating, sterility controls when applicable, or recallable batch records.

FAQ

Frequently Asked Questions About Vasoactive Intestinal Peptide (VIP)

Can physicians request VIP through RonanRx?

Physicians may submit patient-specific prescription requests for pharmacy review. Certain preparations may be available now when clinically appropriate, lawfully prescribed, and approved by the dispensing pharmacy. Availability is determined case by case. Compounded medications are not FDA-approved, and no consumer self-ordering, office stock, or bulk dispensing is offered.2324

What is VIP?

Vasoactive intestinal peptide is a 28-amino-acid endogenous neuropeptide of the secretin/glucagon/PACAP superfamily, discovered by Sami Said and Viktor Mutt in 1970 in porcine intestinal extracts 1314. It signals through the VPAC1 and VPAC2 receptors with downstream cAMP elevation and produces vasodilation, smooth-muscle relaxation, immune modulation, and neurotransmission in autonomic, enteric, and central pathways 4.

Is aviptadil the same as VIP?

Aviptadil is the pharmaceutical-grade synthetic 28-residue VIP peptide supplied as a drug product 2. The amino-acid sequence is identical to endogenous human VIP. The name aviptadil is used in regulatory and clinical-trial contexts; 'VIP' is used in biology and pharmacology more broadly 6.

Is there an FDA-approved VIP product in the U.S.?

No. There is no FDA-approved VIP or aviptadil product in the United States. In several European countries the intracavernosal combination product Invicorp (aviptadil + phentolamine) is authorized for erectile dysfunction 11. The U.S. aviptadil ARDS/COVID-19 program (ZYESAMI/RLF-100) did not meet its primary endpoint in the TESICO multicenter trial and was not approved 62122.

What about VIP for chronic inflammatory response syndrome (CIRS / Shoemaker protocol)?

For VIP, physicians may submit patient-specific prescription requests for pharmacy review. Availability is determined case by case, and supporting clinical rationale may be requested.1323

Did inhaled VIP work for pulmonary hypertension or sarcoidosis?

Small uncontrolled or Phase 1 trials reported short-term hemodynamic and immunoregulatory signal with inhaled VIP/aviptadil in primary pulmonary hypertension (Petkov 2003; Leuchte 2008) and in pulmonary sarcoidosis (Prasse 2010) 71012. No large randomized confirmatory trial has been published in either indication and most U.S. development was discontinued 16.

What is a VIPoma?

A VIPoma is a rare VIP-secreting neuroendocrine tumor, most often pancreatic, that produces the Verner-Morrison syndrome (also called WDHA syndrome: watery diarrhea, hypokalemia, achlorhydria) by sustained pathologic VIP secretion 18. The syndrome is the pathologic counterpart that established VIP's normal physiologic role in gastrointestinal motility and secretion 19.

Could VIP move from FDA Category 2 to Category 1?

Possibly, if the agency receives sufficient evidence to evaluate safety and clinical utility. The Category 2 designation reflects FDA's current assessment of the evidence base; it is not a permanent finding. RonanRx will track future bulk-substance review revisions and will reconsider compounding only if and when VIP is moved to Category 1 23.

Clinician resource

Download the Vasoactive Intestinal Peptide (VIP) Clinical Monograph (PDF)

The full white paper covers every section on this page plus chemical identity, evidence grading, indication-by-indication summaries, research gaps, and reference appendix. Suitable for sharing with prescribing doctors and pharmacist reviewers.

Download information packet ↓

References

References

  1. [saidmutt1972] Said SI, Mutt V. Isolation from porcine-intestinal wall of a vasoactive octacosapeptide related to secretin and to glucagon. European Journal of Biochemistry. 1972. PMID 5069712. (accessed 2026-05-11)
  2. [bodanszky1974] Bodanszky M, Klausner YS, Lin CY. Synthesis of the vasoactive intestinal peptide (VIP). Journal of the American Chemical Society. 1974. PMID 4854585. (accessed 2026-05-11)
  3. [said2007] Said SI. The discovery of VIP: initially looked for in the lung, isolated from intestine, and identified as a neuropeptide. Peptides. 2007. PMID 17719695. (accessed 2026-05-11)
  4. [henning2001] Henning RJ, Sawmiller DR. Vasoactive intestinal peptide: cardiovascular effects. Cardiovascular Research. 2001. PMID 11121793. (accessed 2026-05-11)
  5. [groneberg2001] Groneberg DA, Springer J, Fischer A. Vasoactive intestinal polypeptide as mediator of asthma. Pulmonary Pharmacology and Therapeutics. 2001. PMID 11603952. (accessed 2026-05-11)
  6. [keijzers2001] Keijzers GB. Aviptadil (Senatek). Current Opinion in Investigational Drugs. 2001. PMID 11566015. (accessed 2026-05-11)
  7. [petkov2003] Petkov V, Mosgoeller W, Ziesche R, Raderer M, Stiebellehner L, Vonbank K, Funk GC, Hamilton G, Novotny C, Burian B, Block LH. Vasoactive intestinal peptide as a new drug for treatment of primary pulmonary hypertension. Journal of Clinical Investigation. 2003. PMID 12727925. (accessed 2026-05-11)
  8. [groneberg2006] Groneberg DA, Rabe KF, Fischer A. Novel concepts of neuropeptide-based drug therapy: vasoactive intestinal polypeptide and its receptors. European Journal of Pharmacology. 2006. PMID 16473346. (accessed 2026-05-11)
  9. [onoue2007] Onoue S, Yamada S, Yajima T. Bioactive analogues and drug delivery systems of vasoactive intestinal peptide (VIP) for the treatment of asthma/COPD. Peptides. 2007. PMID 17537541. (accessed 2026-05-11)
  10. [leuchte2008] Leuchte HH, Baezner C, Baumgartner RA, Bevec D, Bacher G, Neurohr C, Behr J. Inhalation of vasoactive intestinal peptide in pulmonary hypertension. European Respiratory Journal. 2008. PMID 18978135. (accessed 2026-05-11)
  11. [dinsmore2008] Dinsmore WW, Wyllie MG. Vasoactive intestinal polypeptide/phentolamine for intracavernosal injection in erectile dysfunction. BJU International. 2008. PMID 18485029. (accessed 2026-05-11)
  12. [prasse2010] Prasse A, Zissel G, Lützen N, Schupp J, Schmiedlin R, Gonzalez-Rey E, Rensing-Ehl A, Bacher G, Cavalli V, Bevec D, Delgado M, Müller-Quernheim J. Inhaled vasoactive intestinal peptide exerts immunoregulatory effects in sarcoidosis. American Journal of Respiratory and Critical Care Medicine. 2010. PMID 20442436. (accessed 2026-05-11)
  13. [shoemaker2010] Shoemaker RC, House D, Ryan JC. Defining the neurotoxin derived illness chronic ciguatera using markers of chronic systemic inflammatory disturbances: a case/control study. Neurotoxicology and Teratology. 2010. PMID 20685390. (accessed 2026-05-11)
  14. [harmar2012] Harmar AJ, Fahrenkrug J, Gozes I, Laburthe M, May V, Pisegna JR, Vaudry D, Vaudry H, Waschek JA, Said SI. Pharmacology and functions of receptors for vasoactive intestinal peptide and pituitary adenylate cyclase-activating polypeptide: IUPHAR Review 1. British Journal of Pharmacology. 2012. PMID 22289055. (accessed 2026-05-11)
  15. [delgado2013] Delgado M, Ganea D. Vasoactive intestinal peptide: a neuropeptide with pleiotropic immune functions. Amino Acids. 2013. PMID 22139413. (accessed 2026-05-11)
  16. [mathioudakis2013] Mathioudakis A, Chatzimavridou-Grigoriadou V, Evangelopoulou E, Mathioudakis G. Vasoactive intestinal Peptide inhaled agonists: potential role in respiratory therapeutics. Hippokratia. 2013. PMID 23935337. (accessed 2026-05-11)
  17. [vosko2015] Vosko A, van Diepen HC, Kuljis D, Chiu AM, Heyer D, Terra H, Carpenter E, Michel S, Meijer JH, Colwell CS. Role of vasoactive intestinal peptide in the light input to the circadian system. European Journal of Neuroscience. 2015. PMID 25885685. (accessed 2026-05-11)
  18. [belei2017] Belei OA, Heredea ER, Boeriu E, Marcovici TM, Cerbu S, Mărginean O, Iacob ER, Iacob D, Motoc AGM, Boia ES. Verner-Morrison syndrome. Literature review. Romanian Journal of Morphology and Embryology. 2017. PMID 28730220. (accessed 2026-05-11)
  19. [iwasaki2019] Iwasaki M, Akiba Y, Kaunitz JD. Recent advances in vasoactive intestinal peptide physiology and pathophysiology: focus on the gastrointestinal system. F1000Research. 2019. PMID 31559013. (accessed 2026-05-11)
  20. [youssef2022] Youssef JG, Lavin P, Schoenfeld DA, Lee RA, Lenhardt R, Park DJ, Fernandez JP, Robertson MJ, Atkinson SJ, Bain W, Sells DR, Aziz S, Choe Y, Galyean P, Brown SM, Javaheri A, Kim KS, Wunderink RG, Schiopu E, Jonigk DD, Kalil AC, Hummel M, Khan A, McSpadden EE, Hyzy RC, Sciurba J, Lavin PT, Hadya A, Yamamoto BJ, Stoll LL, Ben-Gary H, Levitt JE. 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. PMID 36044317. (accessed 2026-05-11)
  21. [brown2023] Brown SM, Barkauskas CE, Grund B, Sharma S, Phillips AN, Leither L, Peltan ID, Lanspa M, Gilstrap DL, Mourad A, Lane K, Beitler JR, Serra AL, Garcia I, Almasri E, Fayed M, Hubel K, Harris ES, Middleton EA, Barrios MAG, Mathews KS, Goel NN, Acquah S, Mosier J, Hypes C, Salvagio Campbell E, Khan A, Hough CL, Wilson JG, Levitt JE, Duggal A, Dugar S, Goodwin AJ, Terry C, Chen P, Rock P, Mehkri O, Sevransky JE, Olson D, Ringwood N, Wentowski C, Slack A, Schoenfeld D, Lavin PT, Sturek J, Saggar R, Brouwer R, Bhakta NR, Trahanovsky E, Higgins T, Aboodi MS, Cibinel GA, Brueckmann M, Roldan J, Gao Y, Liu M, Reilly C, Aviptadil and Remdesivir Trial Group; ACTIV-3b/TESICO Study Group. Intravenous aviptadil and remdesivir for treatment of COVID-19-associated hypoxaemic respiratory failure in the USA (TESICO): a randomised, placebo-controlled trial. Lancet Respiratory Medicine. 2023. PMID 37348524. (accessed 2026-05-11)
  22. [udupa2025] Udupa AA, Todur P, Chaudhuri S. Aviptadil Therapy in Acute Respiratory Distress Syndrome Patients: A Systematic Review and Meta-analysis. Indian Journal of Critical Care Medicine. 2025. PMID 41368449. (accessed 2026-05-11)
  23. [fda_cat2_peptides] U.S. Food and Drug Administration. Bulk Drug Substances Used in Compounding Under Section 503A of the FD&C Act. FDA Drug Compounding. 2024. https://www.fda.gov/drugs/human-drug-compounding/bulk-drug-substances-used-compounding-under-section-503a-fdc-act (accessed 2026-05-11)
  24. [fda503a] U.S. Food and Drug Administration. Compounding Laws and Policies — Section 503A of the Federal Food, Drug, and Cosmetic Act. FDA Drug Compounding. 2024. https://www.fda.gov/drugs/human-drug-compounding/compounding-laws-and-policies (accessed 2026-05-11)
  25. [usp_797] United States Pharmacopeia. USP General Chapter <797> Pharmaceutical Compounding — Sterile Preparations. USP Compounding Compendium. 2023. https://www.usp.org/compounding/general-chapter-797 (accessed 2026-05-11)
  26. [usp_795] United States Pharmacopeia. USP General Chapter <795> Pharmaceutical Compounding — Nonsterile Preparations. USP Compounding Compendium. 2023. https://www.usp.org/compounding/general-chapter-795 (accessed 2026-05-11)

How to access

How to Access Vasoactive Intestinal Peptide (VIP)

Physicians may submit patient-specific prescription requests for Vasoactive Intestinal Peptide (VIP) for pharmacy review. Availability is determined case by case, and RonanRx is monitoring FDA's PCAC process and any subsequent agency action.

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