VIP is a strange thing to shop for because the product and the protocol don't match. Research suppliers sell a small vial of lyophilized powder, the same format as everything else on this site. It's reconstituted with bacteriostatic water and injected under the skin. The VIP dosing in circulation was written for a compounded nasal spray, in a different setting and by a different route. The numbers travelled, the context didn't.
This page separates the two, then covers the injectable patterns people run, what a course costs, and where the human research does and doesn't reach. Vial size doesn't decide concentration. The volume of bacteriostatic water does, and our reconstitution calculator handles the math for whichever vial you're using.
What it is
Your body already makes VIP. It's a small protein found in the gut, lungs and nervous system. It relaxes blood vessels so they open wider and turns down an immune system running hotter than it needs to. That second action is why people buy it: they hope it will quiet inflammation nobody has managed to name.
The literal name is useful. Vasoactive intestinal peptide acts on blood vessels, was first found in the intestine, and is a short protein. Opening blood vessels is called vasodilation, and it's the compound's most reliable effect. You're also likely to feel it as warmth, flushing or a head-rush when you stand too quickly. That sensation is real, it doesn't mean the immune effect is working.
The same molecule has two names. Clinicians and researchers call it aviptadil, while vendors call it VIP. Searching for one won't necessarily find the other. Someone can read for an hour and conclude that there is almost no human research, even though VIP has more than nearly anything else on this site. Whether that research says what you'd want it to say is another matter, and the VIP research notes carry the full record.
What people use it for
The oldest and largest thread is chronic inflammatory response syndrome, usually shortened to CIRS and often described as mold illness. VIP is the final step in a multi-stage protocol developed by Ritchie Shoemaker. Nearly every VIP number in circulation comes from that protocol. This lineage matters even if CIRS isn't why you're here, because it explains the dosing you'll see quoted.
This audience tends to arrive with narrower, familiar complaints: inflammation without a tidy name, or the fatigue and fog that get waved off in a ten-minute appointment. Some describe immune signalling that feels stuck in the on position. Others come from the gut angle, since that is where the peptide was found and where it regulates secretion and blood flow.
Bluntly, the fit isn't great. VIP has more human trial data than most compounds on this site, but almost none of it covers these uses. The largest studies tested intravenous VIP in COVID-19 respiratory failure. Other trials used inhaled VIP in two lung diseases. On the outcomes those studies were designed to measure, it mostly didn't work. What remains is an immune-regulating mechanism observed in twenty people without a control group, along with tolerability data from hundreds of critically ill patients. That's enough to justify curiosity. It isn't enough to expect a result.
Formulations
VIP ships as lyophilized powder in 1 mg and 5 mg vials. The 5 mg vial is more common among the vendors we track. It's reconstituted with bacteriostatic water and injected subcutaneously, which is what the vial is made for. That's the product side of the split. The route people eventually use is a separate question.
The nasal spray is a different product. Compounding pharmacies make it by prescription at a fixed strength, typically 50 mcg per spray, in a bottle metered for that dose. People do convert research vials into nasal sprays. It's not equivalent to buying a compounded spray, because accurate metering, the preservative system and sterility assurance are much of what the prescription product pays for.
One quirk separates VIP from nearby compounds on this site. The peptide is short-lived in solution, so reconstituted material is kept cold and freeze-thaw cycles are avoided carefully. At common amounts, a 5 mg vial contains more material than can be used within the solution's usual life. Most compounds here don't have that problem.
Dosing protocols
Every figure below is convention. No human trial has established a subcutaneous VIP dose for any reason people buy it, so the source column is the useful part of this table.
| Pattern | Amount | How often | Where it comes from |
|---|---|---|---|
| Subcutaneous, most commonly referenced | 50 mcg | Twice daily, morning and evening | Vendor education and dosing guides repeat this pattern most often for the injectable vial. No named clinician stands behind it, and no trial has tested it. It appears to be the nasal spray's per-dose amount transferred to a syringe. |
| Subcutaneous, higher variant | 100–200 mcg | Once or twice daily | This less common variant appears in descriptions where the lower amount did nothing. Nothing establishes it as more effective. Vasodilation is dose-dependent, so blood pressure and flushing become the main concerns here. |
| Intranasal, the original protocol | 50 mcg (one spray) | Four times daily, alternating nostrils | The Shoemaker CIRS protocol uses a compounded nasal spray rather than a research vial. Some descriptions increase to two sprays four times daily after the first month. Almost every other number on this page descends from this source. |
| What the human research used | Not comparable | Three-day infusion, or four weeks nebulized | Trials used intravenous VIP in critical COVID-19 respiratory failure and inhaled VIP in sarcoidosis and pulmonary hypertension. Neither the route nor the condition resembles what's sold here, so the size of that literature tells us nothing about the rows above. |
The route changes by row. That's the point. The first two rows cover subcutaneous injection, the third a compounded nasal spray, and the fourth hospital delivery.
Why the numbers all look the same
Fifty micrograms appears throughout VIP dosing literature, but not because anyone found it to be the right amount. It's the strength a compounding pharmacy selected for a metered nasal spray. From there, it spread into injection protocols that have nothing to do with a spray bottle. Repetition makes a figure look established. This one is a manufacturing decision dressed as a finding.
The distinction has practical consequences. A nasal dose and an injected dose of the same peptide don't deliver the same exposure because they reach different tissue by different paths. Anyone reasoning from what the community runs is reasoning from a spray. The vial in front of them isn't one.
The cost, and the math that surprises people
At the commonly referenced 50 mcg twice daily, the daily amount is 100 mcg. Eight weeks is 56 days, requiring 5,600 mcg, or 5.6 mg. One 5 mg vial and one 1 mg vial cover the run with a little left. By this site's standards, that's a cheap course. Compounds dosed in milligrams routinely require ten times as much material.
The nasal pattern works differently. Four sprays at 50 mcg equal 200 mcg daily, making a 5 mg vial last 25 days and a 1 mg vial last five. That calculation excludes the spray bottle, sterile diluent and metering, which account for much of the cost of a compounded prescription.
Working the syringe math. Reconstituting 5 mg in 5 mL of bacteriostatic water gives 1,000 mcg per mL. For a 50 mcg dose, divide 50 by 1,000 and multiply by 100. The result is 5 units on a standard U-100 insulin syringe. A 100 mcg dose is 10 units. Reconstituting a 1 mg vial in 1 mL produces the same concentration and syringe marks, which is one reason the smaller vial is easier to manage.
How much to reconstitute at once. VIP differs from almost everything else on the site here. The usual refrigerated window for a reconstituted peptide is about 28 days, while a 5 mg vial used at 100 mcg a day contains 50 days of material. The vial outlasts its solution by three weeks. People respond by using smaller vials, freezing some of the reconstituted volume in single-use portions despite the freeze-thaw caution, or accepting that the final stretch falls beyond the conventional window. None is a clean answer, and knowing about it before mixing is better than finding out at week five. See how much to reconstitute at once for the general approach.
Cycling guidelines
The pattern discussed most often is eight weeks on, followed by a similar break before reassessment. In the CIRS protocol, VIP may be used for many months and tied to repeat lab markers instead of a calendar. Neither schedule comes from a trial.
There is one mechanistic reason people describe taking a break. VIP is a vasodilator, and its receptors can down-regulate under constant stimulation. Whether that happens at these amounts in people hasn't been established. The eight-week convention is a hedge against a plausible effect, not a documented one.
Signs a run is commonly stopped or reconsidered:
- Light-headedness or a drop in blood pressure on standing, a predictable effect of the molecule
- Flushing or warmth that persists beyond the first days
- Headache around dosing times
- Loose stools or cramping, given the peptide's role in the gut
- A completed eight weeks with nothing to show, usually treated as a reason to reassess rather than increase the amount
Stacking
Most commonly paired: VIP with thymosin alpha-1.
Rationale: both are used for immune dysregulation, but they act through unrelated routes. Thymosin alpha-1 affects T-cell maturation and signalling. VIP affects the surrounding inflammatory tone. The case for combining them is that they address different parts of the same complaint. No combination research has tested that argument.
Protocol as run: two separate schedules used during the same general period. Thymosin alpha-1 follows its own frequency, VIP follows the twice-daily pattern, and the compounds are injected separately.
Lighter pairings: KPV appears when the complaint is gut-led, based on its local anti-inflammatory action in the gut while VIP works systemically. BPC-157 comes up in the same conversations for the same reason.
Combinations to approach carefully: anything else that lowers blood pressure. VIP is a vasodilator, and this interaction isn't theoretical. Blood pressure medication and nitrates, plus other vasodilating compounds, deserve attention before use. Anyone whose blood pressure already runs low has a concrete reason to be cautious with the 100–200 mcg variant in the table.
Expected results timeline
First days: people usually notice vasodilation first, which is the molecule doing what it was named for. That may mean warmth, flushing or a head-rush on standing. It isn't an effect on the complaint you're trying to address, though it's easy to mistake it for one.
Two to four weeks: reports of energy or mental clarity tend to appear here. They are self-reported and uncontrolled. That's a serious limitation when the proposed mechanism involves inflammation, an area where expectation strongly affects how people describe feeling.
Across a full run: the CIRS setting uses a lab number rechecked over months instead of relying on how someone feels. That distinction matters because it's the only form of VIP use with a defined measure rather than an impression to interpret.
What to expect realistically: the strongest human finding is that four weeks of nebulized VIP shifted immune markers in twenty sarcoidosis patients. There was no comparison group, and everyone knew what treatment they were receiving. It shows a mechanism in people, which is more than most compounds here can claim. It does not show that an injection helps fatigue or fog. Larger, better-run trials in another condition mostly missed their intended outcomes.
Administration technique
- The lyophilized powder is reconstituted with bacteriostatic water, with the volume chosen for the target amount using the reconstitution calculator. A 1 mg vial into 1 mL, or 5 mg into 5 mL, both land at 1,000 mcg per mL and the tidy 5-unit draw that follows from it.
- The water is run down the inside wall of the vial rather than jetted onto the powder, and the vial is swirled gently rather than shaken, since agitation degrades peptides.
- The dose is drawn into an insulin syringe. The volumes here are small, which is why the concentration above should be set deliberately rather than by habit.
- A subcutaneous site is chosen, commonly the abdomen or the outer thigh, with sites rotated between doses.
- The skin is pinched and the injection given at roughly a 45-degree angle.
- Sitting for a few minutes afterward comes up consistently in community descriptions, on account of the vasodilation, particularly on the first few doses of a run and particularly for anyone whose blood pressure runs low.
- Doses are usually spaced morning and evening on the twice-daily pattern, and the run is dated, since eight weeks is a decision point rather than something to drift past.
Side effects and safety
Common: flushing, warmth and light-headedness on standing. These follow directly from vasodilation and vary by dose and route, so they appear more often at the higher end of the table.
Less common: headache, loose stools, abdominal cramping and injection-site reactions. Nasal irritation is the corresponding complaint with a spray.
What the trial record actually covers: the 196-patient intravenous trial reported no drug-related serious adverse events. The four-week nebulized sarcoidosis study described the compound as safe and well tolerated. That's a better tolerability record than most compounds on this site have. It deserves to stand on its own.
What we don't know: none of the safety data covers subcutaneous injection, ongoing daily use or healthy people. Tolerated in a hospital for three days isn't the same as tolerated at home for eight weeks. Nobody has answered the second question.
Contraindications: there are no data for pregnancy, breastfeeding or use in minors. Low blood pressure and a history of fainting are concerns, as is any condition in which vasodilation is the problem rather than the goal.
Drug interactions: blood pressure medication and nitrates, plus anything else vasodilating. This interaction follows from established pharmacology, not boilerplate caution.
VIP vs. thymosin alpha-1
These compounds are cross-shopped constantly because they're where a midlife researcher often lands after other explanations have been ruled out. They aren't alike. The differences go beyond mechanism.
| VIP | Thymosin Alpha-1 | |
|---|---|---|
| What it does | Dampens inflammatory signalling and dilates blood vessels | Supports T-cell maturation and immune signalling |
| Human evidence | Substantial, but mostly in conditions and routes nobody buys it for | Substantial, including approved clinical use for hepatitis B in several countries |
| Dose established for how people use it | No. The circulating figures descend from a nasal spray strength | No, though the clinical use gives the convention a firmer anchor |
| Route the market uses | Subcutaneous vial, or converted into a nasal spray | Subcutaneous, straightforwardly |
| Most noticeable early effect | Flushing and vasodilation, not the effect you're after | Generally nothing perceptible, which makes it harder to judge |
| Material a run takes | Micrograms. An eight-week run is under 6 mg | More, dosed over a longer stretch |
Choose VIP if: the complaint is inflammation-led and you want the shorter, cheaper run to assess first, or CIRS is the actual context and you want the compound that protocol was built around.
Choose thymosin alpha-1 if: the complaint is immune function specifically, particularly repeated infections, and you'd rather have the compound whose clinical use sits closer to what you're hoping for.
Running both: the pairing above is common, and it's two separate schedules rather than one protocol. See the thymosin alpha-1 guide and protocols for its own dosing.
Storage and handling
Lyophilized powder: refrigerated at 2 to 8°C and kept out of the light, or frozen for anything you won't reach for soon. Take lot-specific stability from the vendor's certificate of analysis rather than from a general rule.
Reconstituted solution: refrigerated, and treated as shorter-lived than most peptides on this site. VIP is unstable in solution, so repeated freeze-thaw cycles are avoided and the usual 28-day refrigerated window is a ceiling rather than a target. That window is why the size of the vial is a storage decision as much as a price one. A 5 mg vial at the commonly referenced 100 mcg a day is 50 days of material, so it outlasts its own solution by about three weeks.
The storage and stability parameters above follow the ones on the VIP research notes, which set them out alongside the vial sizes and the purity standard to look for.
Signs of degradation:
- Cloudiness or visible particles in solution that was clear when mixed
- Any discoloration of the powder or the liquid
- Powder that has clumped or gone tacky, which usually means moisture reached it
FAQ
Where does the 50 mcg figure come from? It is the strength used for a metered nasal spray in the CIRS protocol. The figure moved into injection protocols without anyone testing whether it transfers.
Injection or nasal spray? Vendors sell a vial made for injection. The nasal version is a compounded prescription product. Converting a research vial into a spray gives up the metering and sterility the compounded product is meant to provide.
Isn't there a lot of human research on VIP? Yes, and that's the trap. Research has tested intravenous VIP in COVID-19 respiratory failure and inhaled VIP in sarcoidosis and pulmonary hypertension. In the pulmonary hypertension study, 56 people showed no significant benefit. The largest trial was stopped early for futility. None of this addresses subcutaneous injection for fatigue or inflammation.
Why do I feel flushed and light-headed? Vasodilation is the compound's most reliable property and the reason for its name. The effect is expected and dose-dependent. It doesn't signal that anything else is working.
How long before I know? Convention calls for judging an eight-week run at its end. Reports from the first two weeks usually describe vasodilation.
What does an eight-week run take in material? At 50 mcg twice daily, it takes 5.6 mg: one 5 mg vial and one 1 mg vial. Check the current price per milligram in the comparison tool instead of relying on a figure from a vendor page.
Should I go higher if nothing happens? No evidence establishes higher amounts as more effective, while vasodilation rises with the dose. Escalation here is paid for in blood pressure, not money.
Is VIP approved anywhere? Aviptadil combined with phentolamine is licensed as Invicorp for erectile dysfunction in the United Kingdom and several Nordic countries. It is a different product, given at a different dose and injected into different tissue. It says nothing about another use.
Bottom line
Key dosing takeaways:
- The most commonly referenced injectable pattern is 50 mcg twice daily. It descends from a nasal spray strength, not a study.
- The 100 to 200 mcg variant isn't established as better. Vasodilation is where the extra dose appears first.
- Human trials used intravenous or nebulized VIP for different conditions, so the size of that record doesn't validate subcutaneous use.
Best practices:
- Choose the reconstitution volume according to how quickly you'll use it. At 100 mcg a day, a 5 mg vial outlasts the usual solution window by three weeks.
- Sit for a few minutes after the first several doses because vasodilation is a predictable effect.
- Treat blood pressure medication and other vasodilators as genuine interactions.
Works best for people who:
- Have an inflammation-led complaint and want a short, well-defined run to assess
- Are working within the CIRS framework, where this compound has an actual protocol and a marker to recheck
- Would rather run a compound with a low material cost and a clear stopping point than commit to something expensive on the same quality of evidence
VIP is sold for research, and no human trial has established a subcutaneous dose or a long-term profile in people. You already know that. You're an adult making an informed call about your own body, and that's yours to make.
Sources
- Said SI, Mutt V. Potent peripheral and splanchnic vasodilator peptide from normal gut. Nature. 1970;225(5235):863–864. The discovery paper, and the basis for describing vasodilation as the compound's defining property. PubMed ↗
- Youssef JG, Lavin P, Schoenfeld DA, 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. The trial included 196 patients; the primary endpoint was not significant, a secondary survival signal was positive, and no drug-related serious adverse events were reported. One author is affiliated with the sponsor. PubMed ↗
- Brown 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. The compound's largest trial; the aviptadil arm was stopped for futility. PubMed ↗
- Prasse A, Zissel G, Lützen N, et al. Inhaled vasoactive intestinal peptide exerts immunoregulatory effects in sarcoidosis. American Journal of Respiratory and Critical Care Medicine. 2010;182(4):540–548. Twenty patients received nebulized VIP for four weeks in an open-label study without a control arm. This is the source for the immune-regulating mechanism described above. PubMed ↗
- Cassady SJ, Soldin D, Ramani GV. Novel and emerging therapies in pulmonary arterial hypertension. Frontiers in Drug Discovery. 2022;2. The review covers the inhaled VIP programme, including a randomized controlled study of 56 pulmonary hypertension patients that found no significant benefit. It supplies the third strand of the human record described above. DOI ↗